Four healthily skeptical primary care physicians discuss the latest in primary care medicine. Join Essential Evidence Editor Mark Ebell MD, Rush University's Kate Rowland MD, MSU Professor of Medicine Gary Ferenchick MD, and POEMs co-founder Henry Barry MD, MS for this fast-paced weekly update on evidence-based primary care.
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Jennifer Ebeling from 6ftmama.com created Still Growing...with Jennifer Ebeling. Still Growing is a weekly gardening podcast dedicated to helping you and your garden grow. Jennifer hosts this hour-long show interviewing experts from around the country. The podcast also features a bi-monthly Master Gardener roundtable with Master Gardeners who share their gardening tips and horticulture techniques for gardeners of all skill levels. Still Growing is a terrific resource for gardeners looking to ...
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Episode 166: vaping cessation, BP meds and dementia, SGLT-2's, and AI for melanoma
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Join Gary, Kate, Mark and Henry as they discuss text messages for adolescent vaping cessation, stopping BP meds in nursing home residents with dementia, the benefits of SGLT-2 inhibitors, and mobile phone app–based artificial intelligence for diagnosing melanoma. Click here for transcript, notes and links for this episode.…
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Episode 165: psychedelics for depression, preventing and treating influenza, and GLP-2 for...sleep apnea?
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It's biscuit week, oops, I mean flu week here on the Great Primary Care Update. Join our bakers, I mean POETs, as they discuss preventing influenza, treating severe influenza, psychedelics for depression, and GLP-1 agonists to treat sleep apnea of all things.
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Episode 164: HTN in kids, steroids for hip OA, drugs for T2DM, and AI to develop guidelines
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32:38
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This week, Gary, Henry, Kate and Mark discuss CV events in children with hypertension, intra-articular steroid injections in adults with hip DJD, the best drug classes for treating adults with T2DM, and AI supported development of practice guideline questions. And a quiz, and two sports stories from Henry!…
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Episode 163: salt substitutes, VR apps for pain, multivitamins, and vitamin D
29:24
29:24
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This week join Kate, Mark, Henry and Gary for a discussion of the cardiovascular benefits of salt substitutes, using virtual reality for cancer-related pain, whether multivitamins reduce mortality, and if and when to recommend vitamin D supplements.
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Episode 162: PREVENT risk score, UTI prognosis, sinusitis treatment, and biomarkers for SDAT
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33:53
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This week, Kate, Mark, Gary and Henry tackle 4 new studies: the updated PREVENT cardiovascular disease risk calculators from the AHA, long-term consequences of UTIs in children, antibiotics for sinusitis in kids, and biomarkers to diagnose Alzheimer’s disease
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Episode 161: Antibiotics for CAP, melatonin for delirium, screening for lung disease, and seizures after COVID vaccine
30:53
30:53
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This week, join Kate, Gary, Mark and Henry as they discuss screening asymptomatic people for COPD and asthma, the rate of new onset seizures after COVID vaccination, choosing the best oral antibiotic for mild to moderate CAP, and a trail of melatonin for delirium in older, hospitalized adults
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Episode 160: prostate meds and dementia, umbilical hernias, mortality for infections, and AF detection
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This week, Kate, Mark, Henry and Gary tackle the association between prostate medications and lower dementia risk, the natural history of umbilical hernias in children, differential mortality for flu, RSV and COVID, and what to do about device-detected atrial fibrillation.
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Episode 159: DAPT duration, starting contraception, krill oil for OA, and misdiagnosis of CAP
29:58
29:58
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This week, join Kate, Henry, Gary and Mark as they discuss same-day start contraception, krill oil for adults with knee DJD, misdiagnosis of community-acquired pneumonia, and ticagrelor + placebo VS ticagrelor + ASA after PCI. Plus some book recommendations: Whalefall, The Demon of Unrest, and the Commissario Brunetti novels by Donna Leon…
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Episode 158: dequalinium for BV, mammography, weight loss drugs, and tirzepatide for OSA
28:39
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Happy 4th of July! This week Kate, Gary, Henry and Mark celebrate by talking about dequalinium for bacterial vaginosis, the comparative effectiveness of weight loss drugs, the new USPSTF mammography recommendation, and tirzepatide for adults with sleep apnea.
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Episode 157: Bleeding risk with AF, treating minor ischemic stroke, and beta-blockers after AMI
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It's cardiovascular day at Primary Care Update as Kate, Mark and Henry discuss bleeding risk with diltiazem in treatment for atrial fibrillation, whether alteplase improves outcomes in patients with minor ischemic stroke, and whether to continue beta-blockers long-term after acute MI with preserved ejection fraction.…
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Episode 156: APAP in pregnancy, AI for AOM, current use of Paxlovid, and CGM for T2DM
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This week, Kate, Gary, Mark and Henry discuss 4 new studies that answer some important questions: Does acetaminophen in pregnancy and neurodevelopmental outcomes in offspring? Can AI accurately diagnose otitis media in children? Is nirmatrelvir-ritonavir (Paxlovid) still an effective treatment for outpatients with mild to moderate COVID? And finall…
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Episode 155: wrist imaging, opioids post-op, rate vs rhythm control, and updated Cologuard,
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This week, Kate, Gary, Henry and Mark discuss 4 new studies: a decision support tool for imaging wrist injuries, how many opioids should be dispensed after ACL reconstruction, an updated fecal DNA + FIT test for colon cancer screening, and rate vs. rhythm control and the risk of dementia/cognitive decline. And a quiz about...cicadas! Bzzzz.…
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Episode 154: triptans and CV risk, urate levels and flares, tests for acute diverticulitis, and APOE4
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Quite a diversity of topics this week, as Gary, Henry, Kate and Mark talk about: CV risk with triptans, baseline urate levels and risk of acute flairs in adults with gout, primary care feasible tests for acute diverticulitis, and how APOE4 homozygosity represents a distinct genetic form of Alzheimer’s disease.…
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Episode 153: gabapentinoids and COPD, shoulder dislocations, and older Alzheimer's drugs
30:08
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This week, Mark is taking a break so Kate, Henry and Gary will discuss gabapentinoids and the risk of severe COPD, rehab after an initial anterior shoulder dislocation, and cognitive enhancers for patients with Alzheimer’s dementia
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Episode 152: SGLT2's for heart failure, bariatric surgery outcomes, UTI in kids, and lung screening outcomes.
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Join Kate, Gary, Mark and Henry (who went to the eclipse!) as they discuss SGLT2 inhibitors for older adults and frail adults with heart failure, the long term outcomes of bariatric surgery in adults with T2DM, the best duration of antibiotics for febrile UTI in kids, and real world outcomes of lung cancer screening.…
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Episode 151: SSRIs and mania, oseltamivir, exercise and BP, and HPV vaccine preventing cancer.
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Join us today as Gary, Kate, Mark and Henry discuss risks of SSRIs provoking mania in adolescents, real world effectiveness of HPV vaccination for preventing cervical cancer, whether tamiflu reduces hospitalization in adults with flu, and the effects of exercise on BP.
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Episode 150: EXXUA for depression, ubrogepant for migraine, PCI for stable angina, and a simple way to communications
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This week, Gary, Kate, Henry and Mark discuss a newly approved medication for major depression in adults, initiation of abortive therapy using ubrogepant during migraine prodrome, the value of PCI for patients with stable angina, and a simple intervention to improve communication with hospitalized patients. And a quiz!…
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Episode 149: afib risk scores, tai chi and cognition, flu vax, and managing gallstones
32:58
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This week join us as Kate, Mark, Henry and Gary discuss clinical prediction tool for patients using DOACs for atrial fibrillation, the benefits of cognitively enhanced tai chi, whether high dose recombinant flu vaccine is useful in adults 50-64, and watching patients with symptomatic gallstone disease.…
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Episode 148: meds for alcohol withdrawal, opioids and stimulants, and treating agitation in AD
23:19
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This week, Kate, Henry and Mark discuss pharmacotherapy for alcohol use disorder, using opioids in adults with cancer pain who also use non-medical stimulants, and brexpiprazole for agitation in patients with Alzheimer's dementia.
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Episode 147: TENS for post-op pain, Alzheimer's meds, and delivering bad news
32:37
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Join Kate, Mark, Henry and Gary as they talk about: TENS for pain after cesarean delivery, cholinesterase inhibitors and risk of falls, a meta-analysis of the new Alzheimer’s drugs, and telephone delivery of bad news
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Episode 146: nasal suction for infants, amitriptyline for IBS, aspirin to prevent CRC, and talking about hard things
31:58
31:58
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This week, join Henry, Kate, Gary and Mark as they discuss 4 great studies: home suction devices for infants with bronchiolitis, amitriptyline for adults with irritable bowel, high-dose aspirin for preventing colorectal cancer, and communicating about serious illness and end of life.
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Episode 145: DAPT for dementia, BP control post-stroke, managing CHD, and probiotics for IBS
36:07
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This week, Kate, Henry, Mark and Gary discuss antiplatelet medications to prevent dementia, post-stroke blood pressure control, the latest guideline for managing patients with chronic cardiac disease, and probiotics for patients with irritable bowel syndrome.
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Episode 144: cellulitis prognosis, chronic migraine tx, long COVID tx, and drugs for lipids
30:23
30:23
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This week Kate, Mark, Henry and Gary talk about how long it takes for lower extremity cellulitis to improve, how long it takes for CGRP monoclonal antibodies to take effect in adults with chronic migraine, whether CBT is effective for fatigue in patients with long COVID, and outcome data for various lipid lowering therapies. Plus a painful quiz, an…
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Episode 143: sponges for acne, renal colic, breast CA overdiagnosis, BP cuff size
26:36
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This week, Kate, Mark, Gary and Henry will discuss a possible new agent for acne, analgesia in adults with renal colic, breast cancer overdiagnosis in older women, and the importance of BP cuff size. Plus a Dickensian quiz.
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Episode 142: Tdap in pregnancy, atogepant for migraine, POCUS for SBO and gastroparesis
30:11
30:11
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This week, join Kate, Mark, Henry and Gary (from his carport) as they discuss third trimester Tdap for prevention of infant pertussis, atogepant for preventing migraines, POCUS for diagnosing small bowel obstruction, and whether any medications work for treating gastroparesis
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Episode 141: an app to reduce drinking, e-cigs to quit smoking, and does ADHD lead to substance use
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This week, we give Henry the day off, leaving Kate, Mark and Gary to discuss a new app to reduce unhealthy alcohol use, whether e-cigarettes can help you quit smoking, and whether taking stimulant meds for ADHD increases the risk of substance use down the road. And the quiz, and a book recommendation ("A Voyage for Madmen").…
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Episode 140: Mg+ for CP, amox challenge, ACP guidelines, and carotid surgery
30:41
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This week Kate, Mark, Gary and Henry discuss magnesium to prevent cerebral palsy, amoxicillin challenge in the primary care clinic for suspectec PCN non-allergy, new ACP guidance on colorectal cancer screening, and surgery for carotid disease.
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Episode 139: U=U, tetracyclines and teeth staining, metformin to prevent long COVID and the best med for onychomycosis
27:05
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This week, Kate, Mark, Gary and Henry discuss viral loads and risk of HIV transmission, tetracyclines and dental staining in kids, metformin to prevent long COVID in obese and overweight adults, and the effectiveness of terbinafine pulse therapy for ugly toenails
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Episode 138: Deprescribing, meds for neuropsych symptoms in dementia, and lowering BP too much
30:37
30:37
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While Mark is biking, Kate, Henry and Gary talk about a deprescribing intervention for older adults in the hospital, medications for managing neuropsychiatric symptoms in adults with dementia, and harms associated with aggressive BP lowering in hospitalized older adults.
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Episode 137: amox/mono, hearing aids, stem cells for knee OA, and preventing T2DM
29:56
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This week, Kate, Mark, Henry and Gary talk about whether amoxicillin really causes a rash in kids with mono, whether hearing aids improve cognition in the elderly, stem cell injections and knee OA, and nonpharmacologic approaches to preventing type 2 DM.
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Episode 136: Beers, testosterone harms, opioids for back and neck pain, and SDOH
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This week, join Mark, Kate, Henry and Gary as they discuss screening for social determinants of health, the updated Beers List of naughty medications, the value of opioids for acute back and neck pain, and testosterone and adverse events.
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Episode 135: osteoporosis treatment, evolocumab, mifepristone for adenomyosis, and ambulatory BP
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This week, Kate, Gary, Mark and Henry discuss treatments for osteoporosis in post-menopausal women, the effect of adding evolocumab to a statin - a reanalysis of the FOURIER trial, using mifepristone for painful adenomyosis, and real world data comparing 24-hour ambulatory BP with clinic readings.
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This week, Kate, Gary, Henry and Mark discuss some fun throwbacks to 2003, the new first line medications for treating T2DM, whether you can take a diuretic at bedtime, and how to manage perioperative antihypertensive medications. And a quiz. Get CME credit at iafp.com just for listening, go to their education Web page.…
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Episode 133: bilirubin in infants, rest after concussion, child abuse, and why words matter
25:29
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This week, join Kate, Henry, Gary and Mark as they discuss point of care bilirubin tests for neonatal jaundice, guideline for evaluating children in close contact with abused children, early return to activity after concussion, and terminology preferences by patients being treated for substance use disorder.…
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Episode 132: new drug for hot flushes, screening for autism, and steroids for pneumonia
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28:59
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This week, Kate, Henry and Mark discuss a new drug therapy for vasomotor symptoms of menopause, the accuracy of the M-CHAT tool for autism, and the value of steroids for severe community-acquired pneumonia. And Henry tells a joke about hot air balloons. And the quiz.
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Episode 131: non-STEMI management in frail elderly, diagnosing secondary HTN in kids, and RSV vaccine for pregnant women
25:03
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This week, while Gary tries to learn French in of all places France, Kate, Mark and Henry discuss management of non-STEMI in frail older adults, identifying children with secondary hypertension, and RSV vaccination in pregnant women
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Episode 130: bempedoic acid, polypills and dementia, prophylaxis for STIs, and interpreting asymptomatic CAD
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This week Kate, Gary, Henry and Mark talk about bempedoic acid for the prevention of ASCVD, the polypill and cognitive decline in the elderly, post-exposure prophylaxis in persons at high risk of STIs, asymptomatic CAD and subsequent AMI risk. And do you know how long ankle arthroplasties last?
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Episode 129: estimating mortality in acute HF, a new migraine drug, and 15 year f/u of the largest RCT of prostate CA treatment
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Kate, Gary and Henry discuss 3 new studies: a clinical decision support tool to assess mortality risk in patients presenting with acute heart failure, a new intranasal medication for treating acute migraine attacks, and the pros and cons of different approaches to treatment of low grade prostate cancer.…
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Episode 128: BP targets, treatment resistant depression, angry and disruptive patients, and putting infants to bed
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This week our intrepid team of primary care physicians (Kate Rowland, Henry Barry, Gary Ferenchick and Mark Ebell) discuss treatment of resistant depression in older adults, recognizing and managing angry and disruptive patients, the best way to settle a cranky infant, and the AAFP 2022 Guideline on BP targets in adults with hypertension.…
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Episode 127: LDL targets, genicular nerve blocks, adding cytology to HPV, and HCTZ to prevent stones
26:43
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This week, Henry, Kate, Gary and Mark discuss: treating to LDL target or intensity-based statin therapy for adults with CAD, genicular nerve blocks for pain relief in adults with DJD, the value of adding cytology to HPV for cervical cancer screening, and HCTZ for preventing kidney stone recurrence
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Episode 126: screening for genital herpes, semaglutide for obesity, ACG guideline on lower GI bleed, and whether invasive management is helpful for stable CAD
29:37
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This week, Gary, Kate, Henry and Mark discuss 2 new studies and 2 new guidelines: screening for genital herpes infections from the USPSTF, semaglutide injections in obese adolescents, ACG guidelines for acute lower GI bleeding, and invasive vs. noninvasive management of patients with stable CAD. And Henry manages to not talk about baseball!…
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Episode 125: reducing seizure frequency, antidepressants for pain, and periop anticoagulation
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Kate is at the Cubs opener today, so you'll have to settle for Mark, Gary and Henry as they discuss reducing seizures in young kids, the best antidepressants for managing pain, and new ACCP guidelines for peri-operative management of anticoagulation and antiplatelet agents.
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Episode 124: etonogestrel and lactogensis, celiac guidelines, FODMAPS for IBS, and a new CV drug
33:47
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This week, join Kate, Henry, Gary and Mark as they discuss: immediate insertion of etonogestrel contraception and lactogenesis, ACG Guideline for managing patients with celiac disease, FODMAPS diet for irritable bowel, and a new way to lower cholesterol and reduce CV events.
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Episode 123: mindfulness, PRP for Achilles rupture, lecanab for Alzheimer's, and VTE prophylaxis post-fracture
25:01
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This week, Kate, Gary, Henry and Mark discuss mindfulness based stress reduction for anxiety, platelet rich plasma for Achilles tendon ruptures, lecanamab for Alzheimer’s, and VTE prevention after fracture. Is aspirin sufficient?
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Episode 122: predicing dementia, incentives to quit smoking, HP eradication for dyspepsia, and comparison of diabetes meds
32:56
32:56
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Join Kate, Mark, Gary and Henry as they discuss whether we should (or can) use biomarkers to predict mild cognitive impairment or dementia, financial incentives to promote smoking cessation, the efficacy of HP eradication for functional dyspepsia, and results of the glycemic control arm of the GRADE Trial.…
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Episode 121: vitamin C for sepsis, probiotics for halitosis, and dyspepsia evaluation
24:19
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This week, Kate, Henry and Mark discuss vitamin C for sepsis, probiotics for treating halitosis, and new UK guidelines for evaluation of dyspepsia. Plus a quiz: how much time do we primary care docs spend every day delivering preventive services?
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Episode 120: sleepy time for kids, crenezumab for Alzheimers, prognosis after TKA, and intermittent fasting
32:23
32:23
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Join us this week as Kate, Henry, Gary and Mark discuss: nonpharmacologic sleep interventions in children, crenezumab for treating patients with early Alzheimers, prognosis after knee replacement, and time restricted eating (“intermittent fasting”) for weight loss. Henry and Gary are oxygen deprived and recording in Big Sky, teaching a CME course. …
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Episode 119: insomnia treatment, when to take HTN meds, colonoscopy effectiveness, and chlorthalidone vs HCTZ
32:55
32:55
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An action packed episode with some truly landmark studies to discuss. Join Kate, Henry, Gary and Mark as they discuss drug treatment of insomnia, when to take your anti-hypertensive meds, whether colonoscopy is effectiveness, and chlorthalidone vs HCTZ.
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Episode 118: hyperbilirubinemia, diabetic neuropathy, acute heart failure, and screening for CVD
27:55
27:55
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This week, Kate, Gary, Henry and Mark discuss a new guideline for managing jaundice in babies, treating painful diabetic peripheral neuropathy, acetazolamide for patients hospitalized with CHF, and screening for CVD in older men.
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Episode 117: the plague, treatment of prediabetes, asymptomatic bacteriuria, and the value of pyuria
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This week, Mark, Kate, Henry and Gary discuss black Friday, black Death; long term outcomes of managing patients with impaired glucose tolerance or "pre-diabetes" (Henry hates that term); treating asymptomatic bacteriuria in nursing home residents; and the significance of microscopic pyuria in asymptomatic patients.…
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