In this very special no-Mike episode, James gets together with our good friend and colleague Bruce Arroll from New Zealand who capably sits in to fill Mike’s shoes which Mike actually left in New Zealand last year. We discuss impetigo, otitis externa, chronic supporative otitis media and eczema and decide that the old drugs are still very useful.

Show notes

1) Impetigo

Cochrane Library

2) Otitis externa

Cochrane Library

3) Beta-lactam versus beta-lactam-aminoglycoside combination therapy in immunocompetent patients with sepsis

BMJ 2004;328:668–72

4) Beta-lactam versus beta-lactam-aminoglycoside combination therapy in cancer patients with neutropenia

Cochrane Library

 5) Chronic supporative otitis media

Cochrane Library

In episode 158, Mike and James work under very distressing conditions (no microphones, colds, Bubonic plague) and discuss the issue of which thiazide should you choose. Evidence, personal experience and values swirl continually through the diatribe. At the end the stress becomes so significant that they both develop high blood pressure and decide to take high dose reserpine.

Show notes
1) Is hydrochlorothiazide the best thiazide diuretic for hypertension?

Tools for Practice

2) COLD-FX

CBC marketplace expose

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In episode 157, James and Mike discuss the latest study of H pylori eradication in patients with functional dyspepsia. We discuss what to do in patients who come in with dyspeptic symptoms and when to scope, when to test, when to treat, when to say you aren’t taking any new patients. At the end we decide, to bring in another Mike (Kolber) for a future podcast to help put the whole issue into its proper perspective.

Show notes

1) Helicobacter pylori eradication in functional dyspepsia

Arch Intern Med 2011;171:1929-36

In episode 156, Mike and James inject a large dose of therapeutics into yet another PREMIUM podcast. We discuss steroid injections for trochanteric pain and which pain medication is safer for long-term use in osteoarthritis. At the end James and Mike offer to send the listeners lidocaine to dull the pain associated with listening to their latest offerings.

Show notes

1) Corticosteroid injections for trochanteric bursitis 

Ann Fam Med 2011;9:226-34

2) Fluoroscopy bursa injection vs injection by landmark

BMJ 2009;338:b1088 doi:10.1136/bmj.b1088

3) Steroid vs shock wave vs exercise

Am J Sports Med 2009;37:1981-90

4) Are corticosteroid injections effective in the management of lateral epicondylitis (tennis elbow)?

Tools For Practice

5) Osteoathritis pain – NSAIDs or narcotics – which is safer?

Arch Intern Med 2010;170:1968-78

In episode 155 Mike and James delve into the tricky area of the evidence around using antipsychotics as either monotherapy or augmentation for depression. We discuss that while there is evidence of benefit, the effect is not dissimilar to that seen with antidepressants. 

Show notes

1) Second-generation antipsychotics for major depressive disorder and dysthymia

Cochrane Library

2) Antipsychotics for depression: An acceptable risk/benefit profile?

Tools for Practice

3) Why Olanzapine Beats Risperidone, Risperidone Beats Quetiapine, and Quetiapine Beats Olanzapine

Am J Psychiatry 2006;163:185–94

In episode 154, Mike and James discuss the whole issue of why we use antibiotics. We discuss patient preferences, the use of delayed antibiotics, diagnostic uncertainty and at the end of the podcast we realise that the whole thing is tricky and so we give tips and tricks for how to deal with all the confusion.
Show notes

In episode 153, James and Mike attempt to breath life into a new agent for COPD called roflumilast. Unfortunately, by the end of the podcast we find out that the effect of this agent doesn’t leave Mike and James breathless but unfortunately it will leave our COPD patients that way. 

Show notes

1)Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease

Cochrane Library CD002309

2) Is roflumilast (Daxas®) beneficial as an add-on therapy in the management of COPD?

Tools for Practice

3) Tiotropium or salmeterol for COPD?

N Engl J Med 2011;364:1093-1103

In episode 152, Mike and James stream to the listeners a synopsis of the literature associated with treatments for overactive bladder and urge incontinence. Despite constant interruptions by James, Mike is able to provide a torrent of useful tips and suggestions for this common problem.

Show notes

1) Diagnosing Incontinence

Ann Intern Med 2006;144:715-723

2) Anticholinergics and pelvic floor exercises

Ann Intern Med 2008; 148; 459-73

3) Overactive bladder, urge incontinence and anticholinergic drugs

Tools for practice

4) Overactive bladder drugs

Cochrane 2006;4:CD00378

Cochrane 2007;4:CD003190

Cochrane 2005;3:CD005429

In episode 151, James and Mike start of the new year with premium information so, by law we had to put it in a PREMIUM podcast. The first study we looked at was AIM-HIGH which showed us that we might need to re-assess how we use niacin and we finally have some reasonable data that helps us figure out how long to stay on a bisphosphonate.

Show notes

1) AIM-HIGH – Niacin added to statins in patients with cardiovascular disease

N Engl J Med 2011; 365:2255-67

2) The idolatry of the surrogate 

BMJ 2011;343:d7995

3) HORIZON-Pivotal Fracture Trial – using zoledronic acid for 3 years or 6 years

J Bone Min Res 2011 DOI:10.1002/jbmr.1494