In episode 541, James and Mike get into a powerful discussion of placebo. We talk about the evidence around placebo, the placebo effect, the placebo group effect/response and we try to put it all into the context of clinical practice. The bottom line is the placebo effect is likely not what you think it is, however, it is very important you know what it is and what it is not.
Show Notes
Placebo handout
In episode 540, James and Mike invite Jennifer Young to go over all the evidence we have for what antibiotics to choose for bladder infections. The evidence clearly shows that the antibiotics we have been using for decades are still the drugs of choice. Tune in and find out which one you should choose and also what dose and duration.
Show Notes
1) Tools For Practice
Clear, not cloudy: Antibiotic options for uncomplicated urinary tract infections
MEME medical conference
hectalks.com
In episode 539, James and Mike focus in a PREMIUM way on the latest prostate cancer intervention trial. Patients with prostate cancer were randomized to active monitoring, surgery, or radiotherapy and followed for 15 years to see which was the best option. Have a listen and hear what was found.
Show Notes
1) Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer
N Engl J Med. 2023:10.1056/NEJMoa2214122
2) Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment
NEJM Evid 2023;2 DOI: 10.1056/EVIDoa2300018
In episode 538, James and Mike discuss the great (but pretty much silly) egg controversy. We go over the best available evidence for eggs which is at best not great. We talk about the cohorts, the effect of eggs on cholesterol and much more. At the end we conclude definitively that, and you heard it here first, eggs are not as bad for you as smoking. Tune in to find out why.
Show Notes
The Nutrition Proposition
Book website
In episode 537, Mike and James invite Ricky Turgeon back to the podcast to talk about the impact of the influenza vaccination on cardiovascular events in both primary and secondary prevention. The best evidence is in secondary prevention. Tune-in to hear the numbers.
Show Notes
1) Tools for Practice
A Jab for Your CAD: Influenza vaccination for the prevention of cardiovascular events
2) Annual MEME conference – Vancouver May 12/13, 2023
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3) CFPC Learn
In episode 536, Mike and James talk about 4 questions – Is any bacteriuria associated with altered mental state? – Does treating ASB improve/prevent clinical outcomes? – Does treating ASB improve altered mental state? – Do antibiotic reduction interventions for ASB affect patient outcomes? Tune in to find out the answers.
Show Notes
1) Tools for Practice
Asymptomatic bacteriuria in the elderly: Don’t drug the bugs?
2) Annual MEME talk Vancouver May 12/13, 2023
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3) CFPC Learn
In episode 535, Mike and James work through all the evidence and come up with the definitive (in our minds) answer as to whether or not statins cause muscle symptoms. They likely do in 1% of people, but if you have muscle symptoms when you are on a statin it is very unlikely it is because of the statin.
Show Notes
Tools for Practice
Wouldn’t Bet On it: What is the risk of muscle symptoms on statins?
https://gomainpro.ca/wp-content/uploads/tools-for-practice/1676944827_tfp334_statinmsk.pdf
Annual MEME talk Vancouver May 12/13, 2023
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In episode 534, Mike and James bring Jamie Falk to go through all the evidence for continuous glucose monitors that use subcutaneous sensors. There certainly seems to be evidence of benefit for T1DM but when it comes to T2DM the evidence for a benefit is not clear at all. Have a listen to get all the details.
Show Notes
Tools for Practice
Come Spy with Me: Continuous glucose monitoring in diabetes
Annual MEME talk Vancouver May 12/13, 2023
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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
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)
