In episode 224, James and Mike talk generically about generic medications and come up with some generic recommendations for how to generically use generic medications. At the end of the podcast they brand their podcast as being excellent.
Show notes
1) Backlash against bioequivalence
2) Bioequivalence
Ann Pharmacotherapy 2009;43:1583-97
3) Clinical comparisons
4) Generic deception trial
In episode 223, Mike and James get back to being PREMIUM and briefly discuss 4 new studies that we think you might find interesting. These studies primarily back up a lot of what we have said in the past so we present this evidence with vigour and ignore the rest of the contradictory data – JUST kidding.
Show notes
1) Pioglitazone
2) Treatment of fever
3) Bone density measurements
4) Steroids for tennis elbow
In episode 222, James, Mike and Tina discuss why calcitonin was taken off the market and then what is still available to reduce the pain associated with osteoporotic vertebral compression fractures. At the end we realize we really don’t have a lot and there is no evidence to really guide us so basically all we can do is use analgesics. So, Mike and Tina give James some morphine and they notice absolutely no change at all in his demeanour.
Show notes
1) Calcitonin withdrawal: Now what for acute vertebral fractures?
In episode 221, James, Mike and Tina delve into the newly released 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. We discuss the highlights of the guidelines and how it appears the guidelines are, low and behold, actually following the evidence. The only caveat is we felt they should have had a stronger focus on patient preferences rather than the somewhat black and white approach they took to who should get a statin. Nonetheless, we discuss how this can be done yet still be true to the guideline. At the end we all decide we are basically happy – at least on the inside.
Show notes
In episode 220, James and Mike delve into the scary evidence zone of statistical significance. We discuss p-values, confidence intervals and in a confusing manner explain why many authors are confused about what is actually quite a simple concept. We also show how misinterpretation leads to inappropriate author conclusions. At the end we decide the podcast overall trended towards marginal significance.
Show notes
1) How confidence intervals become confusion intervals
BMC Medical Research Methodology 2013, 13:134 doi:10.1186/1471-2288-13-134
In episode 219, Mike and James final get to the end of the Vitamin D trilogy by reviewing the data for fractures and falls, mortality and cancer. At the end they identify that the best thing one can do when it comes to Vitamin D is to stand in the sun in a speedo bathing suit and eat mackerel – however the authorities intervene before that actually happened.
Show
notes
1) Vitamin D and fractures
Cochrane 2009;2:CD000227
Ann Intern Med 2011;155:827-38
Arch Intern Med 2009;169:551-61
N Engl J Med 2012;367:40-9
2) Vitamin D and falls
Cochrane 2009;2:CD007146
Cochrane 2010;1:CD005465
J Am Geriatr Soc 2010;58:1299-1310
BMJ 2009;339:b3692
Can Geriatric J 2011;14:93-9
Ann Intern Med 2010;153:815-25
J Clin Endocrinol Metab 2011;96:2997-3006
3) Vitamin D and mortality
Cochrane 2011;7:CD007470
Arch Intern Med 2007;167:1730-7
J Clin Endocrinol Metab 2012;97:2670–81
J Clin Endocrinol Metab 2011;96:1931–42
4) Vitamin D and Cancer
Ann Intern Med. 2011;155:827-38
Am J Clin Nut 2007;85:1586-91
5) Diabetes
Age Ageing 2009;38:606-9
Eur J Nutr 2009;48:349–54
Diabet Med 2008;25:320-5
6) Vitamin D and sun
J Clin Endo Metab 2009;94:1092–3
N Engl J Med 2007;357:266-81
7) Harm
Am J Clin Nutr 2007;85:6-18
In episode 218, Mike and James give you more and more Vitamin D love. We look at Vitamin D for MS, depression and upper respiratory tract infections and basically Vitamin D does nothing for these conditions – so go forth and share the love – which means not recommending Vitamin D for these conditions.
Show notes
1) The Calcium and Vitamin “Bible”
Dietary Reference Intakes for Calcium and Vitamin D. Institute of Medicine 2011.
http://www.ncbi.nlm.nih.gov/books/NBK56070
2) Vitamin D and MS
Neurology 2004;62:60-5
J Neurol Neurosurg Psychiatry 2012;83:565e571
Neurology 2011;77:1611-8
Neurology 2010;74:1852-9
kampmanMult Scler 2012;18:1144-51
Immunol Invest 2011;40:627-39
3) Vitamin D and depression
Brit J Psych 2013; 202:100–7
Nutrition Journal 2004;3:8
J Int Med 2008 264:599–609
PLoS ONE 2011;6: e25966
Brit J Psych 2011;198:357–64
Brit J Psych 2012;201:360–8
Am J Epidemiol 2012;176:1–13
Menopause 2012;19:697–703
J Clin Psychopharmacol 2013;33:378-85
4)Vitamin D and URTI
Epidemiol Infect;2009:137:1396–1404
The Journal of Infectious Diseases 2010; 202:809–14
Rees JR, et al. Clin Infect Dis. 2013 Sep 6. Pub online
JAMA 2012;308:1333-9
Am J Clin Nutr 2010;91:1255–60
BMJ Open 2012;2:e001663
Age and Ageing 2007;36: 574–92
Trop Med Int Health 2010;15:1148-55
Lancet 2012;379:1419–27
In episode 217, Mike and James level the playing field by talking about the evidence behind recommended Vitamin D levels. We then start to look at the evidence for the use of Vitamin D in a variety of conditions, starting off with rheumatoid arthritis. At the end we realize the recommendations are far stronger than the evidence – surprise, surprise.
Show notes
1) The Calcium and Vitamin “Bible”
Dietary Reference Intakes for Calcium and Vitamin D. Institute of Medicine 2011.
2) Variability in measurements
J Clin Endocrin Metab 2004;89:3152-7
3) Vitamin D levels and outcomes
Arch Intern Med 2009;169:551-61
4) Change in level with 800 IU
Scand J Clin Lab Invest 2006;66:227–38
5) Vitamin D and rheumatoid arthritis
Arthritis Rheum 2004;50:72-7
Ann Rheum Dis 2008;67:530–5
Autoimmun Rev 2012; 12:127–36
Semin Arthritis Rheum2011;40:512-31
Rheumatol Int 2012;32:3823–30
Rheumatol Int 2012;32:2129–33
Int J Rheum Dis 2011; 14:332–9
Scand J Rheumatology 1973;2:173-176
In episode 216, Mike and James finally get to the last of the listener questions. We discuss the numbers around the pneumococcal and influenza vaccines, metformin and contraindications, the timing of antihypertensives, and stuff for osteoporosis. Ironically we end with the question “does any of this mean anything in the grand scheme of things?” and we design a metaphorical RCT to answer that question.
Show notes
1) Metformin and harm
Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review
2) Metformin’s contraindications should be contraindicated
2) MAPEC study
Chronobiol Int 2010;27:1629-51
3) Tools for Practice
4) CVD risk calculator
In episode 213, Mike and James get back to listener questions and we talk about hormones and VTE, gliptins, sulfonlyureas. statins, risk calculators, the elderly and statins and targets. At the end we answer the question “what is the meaning of life” but unfortunately we ran out of tape and this answer wasn’t recorded.
Show notes
1) The ESTHER study
2) Gliptins/DPP4s, sulfonlyureas
SAVOR-TIMI 53 – saxagliptin and cardiovascular outcomes
September 2, 2013DOI: 10.1056/NEJMoa1307684
EXAMINE – alogliptin and cardiovascular outcomes
September 2, 2013DOI: 10.1056/NEJMoa1305889
Sulphonylureas and risk of cardiovascular disease:systematic review and meta-analysis
3) Statin intolerance
RxFiles – Statin intolerance – management considerations
4) The greatest CVD risk calculator ever
5) Statins and the elderly
THE NUTRITION PROPOSITION BOOK
Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.
This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)
