In episode 170, James and Mike continue their quest to answer the questions of the universe but fail and barely give answers to the podcast listener enquiries. We talk about thiazides and potassium, constipation, hazard a definition of hazard ratios and as always rant and rave about the lipid hypothesis or lack thereof.
Show notes
NONE
In episode 169, Mike and James get back to listener questions. Our listeners lead us down the garden path and we end up talking about bladder irritants, riboflavin for migraine prophylaxis, placebo, and as always low doses. Mike rebels by taking a high dose of obecalp which leads to some very strange side effects.
Show notes
1) Is caffeine a bladder irritant?
Urol Ann 2011:3:14-8
JAMA 2004;291:986
2) Riboflavin in migraine prophylaxis
Neurology 1998;50:466-70
Headache 2004;44:885-90
Cephalgia 2010;30:1426-34
J Child Neurol 2008;23:1300-4
3) Tools for practice
Are antihypertensive medications effective for migraine prophylaxis?
Antidepressants for preventing headaches: Which work and how well?
4) Placebo effect
Cochrane library CD003974
5) Low dose
CMAJ 2011;183:65–9
In episode 168, Mike and James welcome back the returning Bruce Arroll who helps us out with the painful issue of how to diagnosis, treat and prevent gout. We crystallize the evidence and stick a needle into the beliefs about diet and colchicine dose. At the end we all go out to celebrate and drink milk and wine because neither are associated with developing gout.
Show notes
1) A Diagnostic Rule for Acute Gouty Arthritis in Primary Care Without Joint Fluid Analysis
2) Tools For Practice
Is colchicine an effective alternative to NSAIDs for the treatment of acute gout?
3) Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout
N Engl J Med 2004;350:1093-103
4) Febuxostat vs allopurinol
In episode 167, we welcome back Bruce Arroll who, as he commonly does, helps us talk about common conditions and in this case it is the common cold. We discuss common diagnoses, common treatments and uncommonly, we pretty much agree with everything he has to say about this common ailment.
Show notes
1) Intranasal zinc for the common cold
J Prim Health Care 2009;1:134-9
2) Phenylpropanolamine and stroke
3) Rapid response – letter BMJ on rebound from nasal decongestants
In episode 166, James and Mike battle the issue of low dose statins, high dose statins and also traffic noise to try to figure if we should consider high doses of statins. We discover that bigger is better but that a lot bigger ends up being just a little bit better.
Show notes
1) Tools For Practice
How does high dose statin compare to low dose in people with heart disease?
In episode 165, Mike and James talk about how should we diagnose type 2 diabetes and should we use A1c, FPG or OGTT or a magic crystal ball. At the end we come to the conclusion that you need to realize the vagueness of the diagnosis so you can be specific in your recommendations.
Show notes
1) Tools For Practice
Hemoglobin A1c for the diagnosis of Type II Diabetes
2) ESRD and Blindness risk
In episode 164, Mike and James finally get to another PREMIUM episode and boy is it ever premium. We discuss the latest HDL raising drugs, ASA after a DVT, and a new meta-analysis of metformin. With our usual skill, alacrity and boyish charm we give all our premium listeners their monies worth with practice changing evidence.
Show notes
1) Dalcetrapib (HDL raising) study stopped due to no benefit
2) Genetic HDL – no reduction in heart disease
Lancet doi:10.1016/S0140-6736(12)60312-2
3) WARFASA – Aspirin for Preventing the Recurrence of Venous Thromboembolism
4) A new metformin meta-analysis – is it good or bad?
PLoS Med 9(4): e1001204. doi:10.1371/journal.pmed.1001204
In episode 163, Mike and James race to the end of their in-depth look at critical appraisal and as they get to the end their final kick is at some of the problems seen with meta-analyses. We discuss examples of how meta-analyses sometime go wrong and we do our best to make them right – with varying degrees of success.
Show notes
1) Glucose lowering meta-analysis
Ann Intern Med 2009;151:394-403
2) Beta-blocker meta-analysis
3) PSA screening
BMJ 2010;341:c4543 doi:10.1136/bmj.c4543
3) Statin meta-analyses on mortality effect in primary prevention
RR 0.88 (0.81-0.96)
Arch Intern Med 2010;170:1024-31
RR 0.91 (0.83-1.01)
Arch Intern Med 2005;165:725-30
RR 0.86 (0.76 -0.99)
Arch Intern Med 2006;166:2307-13
RR 0.92 (0.84-1.01)
J Am Coll Cardiol 2008;52:1769-81
RR 0.93 (0.87-0.99)
4) Back pain meta-analysis
In episode 162, Mike and James decide to tackle the whole concept of meta-analyses and try their very best to shine a clear light on this important concept. By the end they have brought up so many different valuable points that they decide to add them all together to make their own misleading and deceptive meta-analysis.
I just realised (thanks listeners) that the last podcast posted (Episode 161) was missing Mike’s vocal track. AHHGG. I’ve reposted the podcast and I think the problem is fixed. The irony is at the beginning of the podcast I mention that because of Skype the quaity of Mike’s audio is a little bit off in a few spots. In a case of double irony, many people felt the podcast without Mike’s track was the best one we have done so far. Just kidding Mike 🙂
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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.
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