In episode 533, Mike and James go PREMIUM yet again with new information on not so new primary care questions. We talk about FODMAP diets, intra-articular steroids, cannabis and time taken in family practice to do everything.

Show Notes
1) Diet or medication in primary care patients with IBS: the DOMINO study – a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute
Gut. 2022 Nov;71(11):2226-2232
2) Clinical effectiveness of one ultrasound guided intra-articular corticosteroid and local anaesthetic injection in addition to advice and education for hip osteoarthritis (HIT trial): single blind, parallel group, three arm, randomised controlled trial
BMJ. 2022 Apr 6;377:e068446
3) Revisiting the Time Needed to Provide Adult Primary Care
J Gen Intern Med. 2022 Jul 1 . DOI: 10.1007/s11606-022-07707-x

In episode 532, Mike and James bring Mike Kolber in to chat about potential treatments for anal fissures. We discuss the evidence for topical nitroglycerin, topical calcium channel blockers and topical Vitamin E. At the end we provide guidance that will blow your head off – or maybe we were all using too high a dose of topical nitroglycerin.

Show Notes
Tools for Practice
Topical Anal Fissure Treatments – getting to the bottom of it

In episode 531, Mike and James chat with Samantha Moe yet again. In this podcast we go over all the best evidence for whether or not inhalers help with post-infectious cough in adults without asthma. The evidence is miles/kilometres from being overwhelming but we do our best give you numbers you can use in your practice.

Show Notes
Tools for Practice
Coughing up the evidence: Bronchodilators or inhaled steroids for post-infectious cough

In episode 530, Mike and James welcome Samantha Moe back to the podcast to do an end of the year podcast. In this podcast we discuss the evidence around New Year’s resolutions. We discuss what are the most popular types of resolutions and which are more likely to be kept. At the end we resolve to “improve” future podcasts – so please continue to listen to see if that happens and give us feedback – although we also resolved to ignore all feedback so who knows what will happen. Happy Holidays Everyone!!

Show Notes
Tools for Practice
Resolving New Year’s Resolutions

In episode 529, Mike and James welcome Mike Kolber back to the podcast and we discuss all the best available around the use of tranexamic acid for acute adult trauma and acute GI bleed. It seems to have an effect in one of these. Tune in to find out the numbers. Show Notes 1) Tools…

In episode 528, James and Mike go through the logic and math around CVD risk estimates with regard to repeat cholesterol measurements. We discuss the impact remeasuring cholesterol has on CVD risk estimates and show that re-measuring every 5-10 years provides minimal if any value when it comes to making treatment decisions. All you need to do is look at a person’s drivers license.

Show Notes

The Absolute CVD Risk/Benefit Calculator

Don’t Be Unheard – an educational medical musical parody of the iconic song We Are The World by USA for Africa.

YouTube Link

In episode 527, Mike and James continue their urinary tract infections “trilogy and more” discussions. In this podcast, we look at the evidence around whether or not we need to use antibiotics to treat uncomplicated symptomatic urinary tract infections. We talk about the evidence for NSAIDs and antibiotics and we also delve a little bit into testing. Have a listen so you can get all the numbers and use them tomorrow in your practice.

Show Notes

Tools for Practice
To Treat or Not Treat Uncomplicated UTIs

In episode 526, Mike and James go PREMIUM yet again, although it takes a while – so stay till the end. We go over the latest research on low sodium in heart failure, Vitamin D for preventing COVID, and multivitamins for doing anything. Show Notes 1) Reduction of dietary sodium to less than 100 mmol…

In episode 525 – part two of our series on weight – James and Mike talk about how best to measure “weight” – and waste circumference, and hip -to-weight ratio and so on. We show that there is very little reason to measure much else other than actual weight. We also look at the evidence around whether intentional weight loss improves outcomes. Bariatric surgery evidence is also reviewed. And also a few other gems of knowledge.

Show Notes
1) The Nutrition Proposition
Book website
nutritionproposition.com

 Amazon Link

2) Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies
Lancet. 2011;377(9784):1085-1095. doi:10.1016/s0140-6736(11)60105-0
3) Central fatness and risk of all-cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies
Bmj. 2020;370:m3324. doi:10.1136/bmj.m3324
4) Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis
Prev Chronic Dis. 2020;17:E131. doi:10.5888/pcd17.200112

5) A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life
Clinical Obesity 7, 273–289, October 2017

6) Effectiveness of Weight-Loss Interventions for Reducing Pain and Disability in People With Common Musculoskeletal Disorders: A Systematic Review With Meta-Analysis
J Orthop Sports Phys Ther 2020;50(6):319–333. Epub 9 Apr 2020. doi:10.2519/jospt.2020.9041

In episode 524 – the first of a 2-part series about weight – James and Mike talk about why people wish to lose weight, the words we use to describe weight, the obesity paradox, all the cohort evidence around weight and mortality/cardiovascular disease/depression/osteoarthritis/fractures, and in a nice juxtaposition do it while eating rum and raisin ice cream – yes it is a thing.

Show Notes
1) The Nutrition Proposition
Book website

Amazon Link

2) In their own words: Topic analysis of the motivations and strategies of over 6,000 long‐term weight‐loss maintainers
Obesity (Silver Spring). 2022;30:751–7614)

3) Patients’ preferred terms for describing their excess weight: discussing obesity in clinical practice
Obesity (Silver Spring). 2012;20(1):147–50