Episode 182: atrial appendage occlusion for AF, oral semaglutide, and epidural steroidsand

This week, join Kate, Mark and Henry as they discuss all in one triple inhalers for COPD, the best medication for pain management in children and suzetrigine, a new medicine for acute pain in adults. Gary is off this week, working on his French lessons. And we add intro music! Yay!

Join Mark, Henry, and Gary (we are Kate-less unfortunately this week) for discussion of epidural steroid injections for adults with radicular back pain, post a fib ablation management, and oral semaglutide for high-risk patients with Type 2 DM

This week, Kate, Mark, Gary and Henry discuss 4 great new POEMs: foot care wipes for patients at risk of diabetic foot infection, resuming DOACS following intracerebral hemorrhage in adults with a fib, treating prediabetes with tirzepatide, and more on intermittent fasting.Show linksBMJ Magic Evidence interactive review of diabetes medications. A great practice and teaching tool: https://matchit.magicevidence.org/230125dist-diabetes/#!/https://www.ncbi.nlm.nih.gov/pubmed/31574019https://pubmed.ncbi.nlm.nih.gov/39964684/ https://pubmed.ncbi.nlm.nih.gov/40023176/ttps://pubmed.ncbi.nlm.nih.gov/39536238/https://pubmed.ncbi.nlm.nih.gov/40163873/

This week, Kate, Gary, Mark and Henry chat about the health effects of dance for older adults, POCUS for diagnosing clavicular fractures, treating male partners of women with BV, and prehabilitation  before elective surgery .Links:Dance for older adults: https://pubmed.ncbi.nlm.nih.gov/39480190/POCUS for clavicle fractures: https://pubmed.ncbi.nlm.nih.gov/39626455/ Oral + topical treatment of male partners for BV: https://pubmed.ncbi.nlm.nih.gov/40043236/ Prehabilitation before elective surgery: https://pubmed.ncbi.nlm.nih.gov/39843215/Case series of avian flu patients: https://www.nejm.org/doi/full/10.1056/NEJMoa2414610

This week join our intrepid primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new studies: an experimental treatment for chronic migraines, safety of albuterol in wheezy kids under 2, oral gepotidacin for uncomplicated UTI, and vitamin K2 and Leg Cramps.Here are the links:Lukas' Fund supporting the Piedmont Athens and Grady Atlanta NICUs: https://www.lukasfund.org Essential Evidence Plus: http://www.essentialevidenceplus.comVibrating intranasal balloons for migraine: https://pubmed.ncbi.nlm.nih.gov/39787477/ and OziliaSafety of albuterol in infants: https://www.ncbi.nlm.nih.gov/pubmed/39266286Oral gepotidacin for uncomplicated UTI: https://www.ncbi.nlm.nih.gov/pubmed/38342126 Vitamin K2 for nocturnal leg cramps: https://pmc.ncbi.nlm.nih.gov/articles/PMC11581596/

This week Kate, Gary, Mark and Henry discuss discontinuation of benzodiazepines and treatment of insomnia, the value of baseline cognitive testing of college athletes, vonoprazan vs PPI for preventing and treating ulcers, and whether herpes zoster vaccine reduces dementia risk.Show links:Essential Evidence Plus: www.essentialevidenceplus.comTapering benzos: https://pubmed.ncbi.nlm.nih.gov/39374004/ Baseline neuro eval for athletes: pubmed.ncbi.nlm.nih.gov/39741470/ David Kaufman, “We Need You in the Locker Room” https://thesagergroup.net/books/in-the-locker-room Vonoprazan vs PPIs for ulcers: https://pubmed.ncbi.nlm.nih.gov/39294424/ Zoster and dementia: https://pubmed.ncbi.nlm.nih.gov/40175543/ 

This week Gary, Mark, Kate and Henry discuss: adverse effects from inhaled steroids in asthma, Italian dementia guideline, fezolinetant for treatment of vasomotor symptoms, and updated USPSTF recommendations for osteoporosis screening.Show notes and links:Asthma and risk of CV events: https://pubmed.ncbi.nlm.nih.gov/39088770/ GINA 2024 guidelines: https://ginasthma.org/2024-report/ Italian dementia guidelines: https://www.ncbi.nlm.nih.gov/pubmed/39544104 with link to full report in Inglese: https://www.iss.it/documents/d/guest/the-full-guideline-english-version Fezolinetant for vasomotor symptoms: https://pubmed.ncbi.nlm.nih.gov/39557487/USPSTF osteoporosis screening guideline: https://pubmed.ncbi.nlm.nih.gov/39808425/ Dietary assessment tool: https://epi.grants.cancer.gov/asa24/ Article on interval for next BMD screening based on initial result: https://pubmed.ncbi.nlm.nih.gov/22256806/

Join Kate, Gary, Mark and Henry as they discuss 4 new POEMs relevant to primary care: bright light therapy for non-seasonal depression, fever control in children, abelacimab for atrial fibrillation, antibiotics vs surgery in children with nonperforated appendicitis. Get all of the POEMs (a new one every day) by going to Essential Evidence Plus and subscribing.Links from today's podcast:Bright lights for non-seasonal depression: https://pubmed.ncbi.nlm.nih.gov/39356500/ Controlling fever in children: https://pubmed.ncbi.nlm.nih.gov/39318339/ Abelacimab for anticoagulation in atrial fib: https://pubmed.ncbi.nlm.nih.gov/39842011/ Antibiotics vs surgery for appendicitis in kids: https://www.ncbi.nlm.nih.gov/pubmed/39826968Independent predictors of suicidal ideation: https://pubmed.ncbi.nlm.nih.gov/7966924/ Here is the probability of suicidal ideation by # of risk factors: 0: 0.5% 1: 3.0% 2: 7.4% 3: 23% 4: 46%

This week, Gary, Kate, Henry and Mark discuss 4 new studies relevant to primary care practice: the effectiveness of RSV monoclonals in infants, acupuncture for sciatica associated with disk herniation, zoledronate every 5 years for low risk women, and the effect of arm position on blood pressure readings. Plus a quiz! Please see below for show notes and links:Learn more about Essential Evidence Plus: www.essentialevidenceplus.comReal world study of nirsevemab for average risk infants: https://pubmed.ncbi.nlm.nih.gov/39257372/Acupuncture effective for sciatica: https://pubmed.ncbi.nlm.nih.gov/39401008/Zoledronate every 5 years for average risk women: https://pubmed.ncbi.nlm.nih.gov/39813642/Importance of correct arm position for BP: https://pubmed.ncbi.nlm.nih.gov/39373998/A nice infographic for measuring BP correctly from the AMA and Johns Hopkins: https://targetbp.org/wp-content/uploads/2016/10/MAPHypertension_7StepsInOfficeInfographic_Landscape_English_NoCropsNoBleeds-12.pdf

Join Kate, Mark, Gary and Henry as they discuss 4 new POEMs on treatment of sexual dysfunction, the benefits and harms of GLP-1 agonists, active surveillance vs usual care for ductal carcinoma in situ, and medications to prevent episodic migraine headache.Henry mentioned AAFP's uncensored resources:www.aafp.org/family-physician/patient-care/clinical-recommendations.html www.aafp.org/family-physician/patient-care/care-resources.htmlwww.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines.htmlwww.aafp.org/family-physician/patient-care/care-resources/sexually-transmitted-infections.htmlwww.aafp.org/family-physician/patient-care/care-resources/womens-health.html www.aafp.org/family-physician/patient-care/care-resources/reproductive-health.html  Kate's links on sexual dysfunction:NEJM review:  https://pubmed.ncbi.nlm.nih.gov/39167808/ED prevalence:  https://pubmed.ncbi.nlm.nih.gov/38410029/GLP-1s do everything: www.ncbi.nlm.nih.gov/pubmed/39833406Active monitoring of DCIS:  https://pubmed.ncbi.nlm.nih.gov/39665585/Episodic migraines: https://pubmed.ncbi.nlm.nih.gov/39899861/ https://www.ncbi.nlm.nih.gov/pubmed/39631943