Frankly Speaking About Family Medicine

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-234   Overview: Many providers overtreat outpatient infections for fear of not treating until resolution or causing a complication, but this can lead to antibiotic resistance and adverse events. Join us to discuss the new ACP guidelines on antibiotic use in the outpatient setting and the pediatric treatment recommendations. Walk away with a clear understanding of the guidelines for optimal duration of antibiotic treatment for individuals with an outpatient infection.   Episode resource links: ACP: Ann Intern Med. doi:10.7326/M20-7355; https://www.acpjournals.org/doi/pdf/10.7326/M20-7355 Low risk for PCN allergy: Am J Respir Crit Care Med 2020 Feb 21; [e-pub]. (https://doi.org/10.1164/rccm.202001-0089LE); Mayo Clinic Proceedings 2018, 93 (1): 101-107 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-233   Overview: T2DM is an epidemic, and its impact on quantity of life is well documented. In most cases, treatment involves significant lifestyle changes in combination with medication. Distress about the T2DM diagnosis and necessary behavioral changes occurs in about one-third of people, and this distress is associated with poor glycemic management. Join us as we discuss a recent meta-analysis on mindfulness and learn how cognitive therapies may be effective in reducing distress and HbA1c.   Episode resource links: Ngan, H.Y., Chong, Y.Y. and Chien, W.T. (2021), Effects of mindfulness‐ and acceptance‐based interventions on diabetes distress and glycaemic level in people with type 2 diabetes: Systematic review and meta‐analysis. Diabet Med, 38: e14525. https://doi.org/10.1111/dme.14525; https://onlinelibrary-wiley-com.umassmed.idm.oclc.org/doi/ep

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-232   Overview: For patients with community-acquired pneumonia (CAP), wide variation in the duration of treatment exists. Longer duration of treatment may increase the risk of adverse effects and lead to antibiotic resistance. However, shorter duration of treatment may result in treatment failure. See what new evidence shows may be the best antibiotics treatment duration in most patients with CAP.   Episode resource links: Dinh A et al. Pneumonia Short Treatment (PTC) Study Group. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet. 2021 Mar 27;397(10280):1195-1203 Metlay JP et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the A

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-231   Overview: Who couldn’t use a refresher on how to diagnose and treat neck pain in the primary care setting? Review the techniques for assessing neck pain, determining its cause, and providing relief. Immediately apply what you learn to start helping patients with neck pain feel better.   Episode resource links: Am Fam Physician 2016 May 1;93(9):746-54. Sub occipital Release: J Electromyogr Kinesiol 2016 Oct;30:31-7. doi: 10.1016/j.jelekin.2016.05.007 Self Myofascial Release: Spine 2020 Nov 1;45(21):E1367-E1375 Guest: Robert A. Baldor MD, FAAFP/Frank   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-230   Overview: Join us to discuss the results of the Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE) cohort study, aimed at understanding the safety of using a simplified perioperative management approach for patients with atrial fibrillation taking DOACs. After this episode, you’ll be able to make sense of the controversy over current guidelines around surgical care in this patient population. More importantly, you’ll walk away with practical knowledge to help these patients minimize their risk of adverse events.   Episode resource links: Perioperative Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant. JAMA Intern Med.2019; 179(11 ): 1469-14 78. doi: 10.1001 /jamainternmed.2019.2431   Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-229   Overview: Ample evidence shows that adverse childhood experiences (ACEs) and trauma in adulthood may lead to poor health outcomes, such as cardiovascular disease and other chronic diseases. These traumas may also affect a person’s inclination to seek care and participate in plans of care. As a provider, it is important to consider this history and ensure the psychological and physical safety of these affected individuals. Join us to learn proven strategies to help you practice trauma-informed care, including how to recognize trauma and offer effective interventions to help patients dealing with these issues.   Episode resource links: ACOG Committee Decision: Caring for Patients who have Experienced Trauma. Obstetrics and Gynecology. VOL. 37, NO. 4. April 2021. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/04/

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-228   Overview: Join us for this episode as we discuss the results of a systematic review examining the benefits and risks from delaying the use of antibiotics to treat patients in the community for a respiratory infection.   Episode resource links: Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis. BMJ 2021;372:n808 http://dx.doi.org/10.1136/bmj.n808 Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-227   Overview: Join us as we discuss a recent review article on the evidence behind monofilament testing for peripheral neuropathy in people with diabetes.   Episode resource links: J Diabetes Res. 2017; 2017: 8787261. Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis Diabetes Care 2017 Jan;40(1):136-154   Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-226   Overview: Patients with a history of transient ischemic attack (TIA) are at increased risk of stroke in the future. The ABCD2 score is the most used risk assessment tool for people with acute TIA, but it is not recommended for this purpose by the National Institute for Heath and Care Excellence (NICE). Join us for today’s episode as we describe a new validated risk assessment tool developed in Canada you can use to classify patients as low, medium, or high-risk for stroke over the 7 days following a TIA.   Episode References and Resource Links: Perry JJ et al. Prospective validation of Canadian TIA Score and comparison with ABCD2 and ABCD2i for subsequent stroke risk after transient ischaemic attack: multicentre prospective cohort study. BMJ. 2021 Feb 4;372:n49   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-225   Overview: Join us for this episode as we review the recently published (Dec. 2020) cohort study in JAMA on using bisphosphonates to prevent hip fractures. We will review the utility of bisphosphonates after 5 years and how to discuss their risks and benefits with patients.   Episode resource links: JAMA.2020;3(12):e2025190.doi:10.1001/jamanetworkopen.2020.25190 JAMA. 2018;319(24):2521-2531. doi:10.1001/jama.2018.7498 https://www.sheffield.ac.uk/FRAX/tool.aspx?country=9 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-224   Overview: More than 250 million individuals worldwide have osteoarthritis (OA) of the knee and the burden on individuals and healthcare systems is enormous. There is no cure for OA, with treatments such as NSAIDs and acetaminophen aimed towards symptom reduction and improved functioning. Most evidence-based guidelines include the use of supportive shoes, however little evidence exists on effectiveness of these types of shoes. It is also unclear what the characteristics of a supportive shoe are and what type of shoe is best for OA. Join us as we discuss a recent randomized controlled trial that compared 2 types of shoes, and their benefits in symptom reduction and functional improvement of knee OA   Episode resource links: AAOS EBG: Lateral Wedge Insole. https://www.orthoguidelines.org/guideline-detail?id=1209&tab=all_guidelines AAOS EBG

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-223   Overview: Clinical psychologist Dr. Christine Runyan joins host, Dr. Frank Domino, in today’s episode to discuss the various self-care methods to help healthcare workers overcome stressors related to the COVID-19 pandemic, and to describe the potential future impact of the COVID-19 crisis on this population.   Episode resource links: https://tend.health/ https://www.pri-med.com/online-education/webcast/west-2019-well-being https://www.pri-med.com/online-education/podcast/pri-med-podcasts-well-being   Guest: Christine Runyan, PhD, ABPP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-222   Overview: Join us for this episode as we discuss a recent Cochrane review of the safety and effectiveness of topical treatments for toenail onychomycosis, and review when and how to prescribe these agents for patients.   Episode resource links: Topical and device-based treatments for fungal infections of the toenails. Cochrane Database Syst Rev. 2020; (1): CD012093 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-221   Overview: Join us as we discuss another finding of the Nurses Health Study II—this podcast focuses on the findings of a prospective look at GERD, and the effect of diet and lifestyle on the prevention of GERD.   Episode resource links: Mehta RS, Nguyen LH, Ma W, Staller K, Song M, Chan AT. Association of Diet and Lifestyle With the Risk of Gastroesophageal Reflux Disease Symptoms in US Women. JAMA Intern Med. Published online January 04, 2021. doi:10.1001/jamainternmed.2020.7238 For Patients: Eating, Diet, & Nutrition for GER & GERD https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/eating-diet-nutrition Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-220   Overview: Join us for this episode as we review a recent meta-analysis that addresses best treatment modalities for adhesive capsulitis.   Episode resource links: JAMA Netw Open. 2020 Dec 1;3(12):e2029581. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-219   Overview: The COVID pandemic and the precautionary changes in behavior put into practice are creating an immeasurable cost in ways that are still being identified – social isolation, stresses on mental health, as well as neglect of chronic disease management – to name a few. In a recent study out of China, it was found that 6, 7 and 8-year-olds had a significant increase in myopia associated with the lockdown and school closures. This level of myopia places these children at much greater risk of poor vision in adulthood. Join us as we discuss these findings and how they may impact prevention strategies and assessment parameters in children during and after the pandemic.   Episode References: Klaver CCW, Polling JR, Enthoven CA. 2020 as the Year of Quarantine Myopia. JAMA Ophthalmol. Published online January 14, 2021. doi:10.1001/jamaophthalmo

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-218   Overview: Join us for this session where we will discuss the data behind the recent USPSTF recommendations on the use of ASA as a colorectal cancer (CRC) preventive agent, and when to incorporate this recommendation into practice.   Episode resource links: www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-and-cancer doi:10.1001/jamaoncol.2020.7338 N Engl J Med 2018; 379:1519-1528 DOI: 10.1056/NEJMoa1803955 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-217   Overview: Join us as we review communication styles that influence vaccination uptake by the adolescent population. We will discuss a recent article examining the effects of provider’s recommendation styles with adolescent patients regarding HPV and meningococcal vaccines.   Episode resource links: Anny T.H.R. Fenton, Chelsea Orefice, Terresa J. Eun, Dea Biancarelli, Amresh Hanchate, Mari-Lynn Drainoni, Rebecca B. Perkins, Effect of provider recommendation style on the length of adolescent vaccine discussions, Vaccine, Volume 39, Issue 6, 2021, Pages 1018-1023, ISSN 0264-410X,https://doi.org/10.1016/j.vaccine.2020.11.015. (https://www.sciencedirect.com/science/article/pii/S0264410X20314419) HPV Vaccine recommendations CDC: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html 5 Ways to boost your HPV Vaccination Rates CDC: https://w

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-216   Overview: Osteoarthritis (OA) is a very common problem seen in the primary care setting, but pharmacologic treatments do not alter the course of the disease and they are often associated with side effects or contraindicated in many older patients. Curcumin is an herbal treatment that has been shown to be effective for treating symptoms of OA. Join us for this episode as we discuss the evidence for curcumin in treating OA, and how to counsel patients on its use.   Episode resource links: Wang Z. et al. Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion-Synovitis of Knee Osteoarthritis : A Randomized Trial. Ann Intern Med. 2020 Dec 1;173(11):861-869. Daily JW, Yang M, Park S. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Random

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-215    Overview: Times are stressful. Recent evidence has shown that stress, anxiety, and depression experienced by pregnant women may have a negative impact on the wellness of the newborn. Stress management is constrained during pregnancy due to concerns that pharmaceutical approaches may be harmful to the baby. Non-pharmaceutical approaches are accessible and safe. Join us as we review recent evidence on the effectiveness of mind-body interventions (MBI) in reducing stress and decreasing depression and anxiety in pregnant women, and discuss how MBI can be incorporated into patient care.   Episode resource links: Re-Engineering Your Clinical Practice for Patient and Clinician Well-Being Guo P, Zhang X, Liu N, Wang J, Chen D, Sun W, Li P, Zhang W. Mind-body interventions on stress management in pregnant women: A systematic review and meta-analys