Frankly Speaking About Family Medicine

The American Academy of Neurology recently published the first updated practice guideline on mild cognitive impairment since 2001. Listen to this week’s episode for an overview of the updated practice guideline, which includes a systematic review of prevalence, prognosis, screening, and treatment research with clear recommendations for practicing clinicians. Guest: Robert A. Baldor, MD, FAAFP

This observational study found adding very little activity, akin to going for a 30-minute walk or converting to a standing desk for half your workday, lowered all-cause and cardiovascular mortality. Guest: Alan Ehrlich, MD

Direct acting oral anticoagulants are increasingly used for stroke prevention for individuals with atrial fibrillation. Whether these agents are as safe and effective as warfarin has been a concern for many clinicians, but recent comparative effectiveness analyses are providing answers. In this week’s podcast episode, we will review these recent studies and draw some conclusions about which agents are best. Guest: Robert A. Baldor, MD, FAAFP

Listen to this week’s episode to learn about the basic concepts of behavioral activation (BA), what research has demonstrated about its use in depression, and how to apply BA in everyday care.  Guest: Susan Feeney, DNP, FNP-BC

Patients with chronic diseases, including coronary artery disease, are advised to get yearly flu shots because they are at higher risk for having a more severe illness. Canadian researchers have found that in the week following being diagnosed with the flu, adults over 65 years old have a significantly increased risk of myocardial infection.

In this session we discuss the impact of length of sleep on obesity and DM II.

This session will review the existing evidence between coffee consumption and multiple health outcomes. 

Treating recurrent C. difficile colitis can be difficult, but recent trials have demonstrated the benefit of treating with fecal transplantation. Questions exist, however, about around the best mode of administration. Listen to this week’s episode to learn about a recent RCT that compares oral and colonoscopic delivery methods and provides an answer.   Learning Objectives:  Appreciate the current guidelines for treating recurrent difficile colitis Understand the pharmacology of fecal transplantation Learn about the latest research on how best to administer such treatment

New hypertension guidelines from the American College of Cardiology have introduced a new blood pressure classification system and lowered the threshold for initiating pharmacotherapy in certain patient populations. Learning Objectives: Understand the new classification categories of hypertension Understand the new thresholds for starting treatment Understand the limitations of the new recommendations to specific patient populations

For severe, acute pain, 1000 mg of acetaminophen PLUS 400 mg of ibuprofen is as effective as acetaminophen/oxycodone, acetaminophen/hydrocodone, or acetaminophen/codeine. Listen to this week’s episode to learn more about treating acute pain safely.    Learning Objectives:  Review the current trial comparing Acetaminophen plus Ibuprofen to other acetaminophen/opioid combinations on pain outcomes Summarize the other data supporting this combination in children and adults Understand the path that can lead from acute pain to dependence.

This session will review the recommendations put forth by the CDC’s Advisory Committee on Immunization Practices for the use of a new shingles vaccine. Dosing, use, and efficacy will be discussed.   Learning Objectives: Review the new vaccine recommendations for the prevention of shingles. Discuss the use of the current vaccine and new vaccine with dosage and schedule. Provide a resource for the treatment of post herpetic neuralgia.

Diabetes remission is defined as a return to normal blood sugar control without the use of medications. Listen to this episode to learn about a trial in which the use of a very low calorie diet in a primary care setting resulted in significant weight loss and remission of diabetes.   Learning Objectives: Understand what is meant by diabetes remission Understand what treatments can lead to diabetes remission  

Listen to this episode to learn about the evidence-based guidelines for the diagnosis and management of acute sinusitis. Learning Objectives: Discuss the most recent EBP Guidelines on diagnosis and management of acute sinusitis Discuss application of best practices for appropriate management of acute sinusitis and strategies for good antibiotic stewardship. Guest: Susan Feeney, DNP, FNP-BC

Medication-based maintenance therapy is recommended for patients with opioid dependence. Listen to this week’s episode to learn how once monthly naltrexone injections are as effective as daily treatment with buprenorphine/naloxone.   Learning Objectives:  Understand data comparing long-acting naltrexone to daily buprenorphine/naloxone Understand importance of medication-based maintenance therapy

We will discuss the use of azithromycin as a therapeutic option for patients with persistent symptomatic asthma despite controller maintenance therapy with inhaled corticosteroids and a long-acting bronchodilator. Learning Objectives: Understand the effect of chronic azithromycin for reducing asthma exacerbation Understand the role azithromycin can play in asthma step-wise therapy

What do you say when your 50-year-old patient that has been relatively sedentary in the last 3 decades wants to do a triathlon? In this episode, we will review a U.S. case series of participants in triathlon races from 1985-2016, and discuss risk, reward, and reality. Learning Objectives:  Review data collected over 30 years on triathlon events and the risks to participants. Discuss recommendations for patients embarking on extreme physical activity. Review strategies to promote well-being and lower risk when considering endurance sports.

If you become frustrated trying to get a thigh cuff onto the arm of an obese patient, we may have the answer. Learning Objectives:  Review the comparison of standard BP determination with using the forearm and radial pulse with a large cuff Appreciate the benefits of systolic hypertension control Review the causes of secondary hypertension in obese patients 

In this episode, we discuss the first evidence-based guidelines by the American Academy of Pediatrics on body modification, piercing, and scarification, including complications and assessment of risk.  Learning Objectives:  Discuss the AAP’s EBP Guidelines on body modification, piercing and scarification in children, adolescents and young adults Discuss best practices for counseling adolescents and strategies for reducing associated risks regarding these practices.    

How much exercise makes a difference in the primary prevention of depression and anxiety? Find out in this podcast which will provide insights from Norway’s HUNT cohort study that followed a healthy cohort of 33,908 individuals for 11 years. Learning Objectives:  Review the relation of exercise and the development of depression and anxiety in a healthy population. Discuss strategies and options to alleviate stress and promote wellness.  

Learning Objectives:  Understand the results of the Stroke Oxygen Study Understand which patients will benefit from supplemental oxygen