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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
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)?
5) Osteoathritis pain – NSAIDs or narcotics – which is safer?
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
2) Antipsychotics for depression: An acceptable risk/benefit profile?
3) Why Olanzapine Beats Risperidone, Risperidone Beats Quetiapine, and Quetiapine Beats Olanzapine
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
2) Is roflumilast (Daxas®) beneficial as an add-on therapy in the management of COPD?
3) Tiotropium or salmeterol for COPD?
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
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
3) HORIZON-Pivotal Fracture Trial – using zoledronic acid for 3 years or 6 years
In episode 150, the last for 2011, Mike and James elicit the help of Laurie Mallery and Paige Moorhouse from Halifax. Laurie and Paige guide us through a step-by step approach to deal with frailty and end of life care. We also discuss their PATH (Palliative and Therapeutic Harmonization) clinic developed for older people in Nova Scotia with chronic health conditions.
Show notes
1) Respecting frailty
J Med Ethics 2010. doi:10.1136/jme.2010.040147
2) PATH – Palliative and Therapeutic Harmonization Clinic
In episode 149, Mike and James finally get to the last of the questions and discuss the use of vinegar for weight loss, surrogate markers and what to do about them, steroids for migraine, niacinamide for acne, statins for women, and what is the meaning of life. We discuss, all of these issues in depth and believe it or not at the end of the podcast we actually figure out the meaning of life but accidentally erase that part. We’ll bring that issue up at a later date in a PREMIUM podcast.
Show notes
1) Vinegar for weight loss
Bioscience, Biotechnology, and Biochemistry 2010:73:1837–43
2) Steroids for acute migraines
Academic Emergency Medicine 2008;15:1223–33
BMJ 2008;336:1359–61
3) Statins in women
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)
