In the Clinic Episode #24: Insomnia, Part I

In this episode of In the Clinic, Mike and Jess are joined by Mike Kolber, family physician from Peace River, Alberta. The team discusses Michelle Reblok - a 25 year old patient who presents with stomach problems - and works through the differential diagnosis.  To claim Mainpro+ credits, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-29-stomach-problems/ 

Mike, Jess and Jennifer follow up with Farrah Lo, a 27 year old patient, who was diagnosed with iron deficiency anemia in an earlier podcast. Today, the team discusses the management of heavy menstrual bleeding.  Did you miss Farrah's original visit? Tune into episode #13: https://open.spotify.com/episode/366me3xA7wkZYEWS9ANynE?si=5a2b105167214a29 To claim your Mainpro+ credit, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-28-heavy-menstrual-bleeding/ 

In episode 587, Mike and James invite Adrienne Lindblad back to the podcast to go over all the evidence we have for the oral GLP-1 weight loss medications. You know you are going to get lots of questions about these medications so tune in to find out all the numbers around the benefit and potential harms – and cost. Show notes 1) Tools for Practice Mission Slimpossible Part 2: Oral GLP-1 agonists for weight loss

In episode 585, Mike and James invite Émélie Braschi back to the podcast to talk about the tricky issue of how to deal with a potential penicillin allergy. Believe it or not there are a couple of RCTs looking at this issue. These two trials compared oral challenge alone to skin testing followed (if negative) by oral challenge. The results may allow you to change your practice in a good way. Tune in and find out why. Show notes Tools for Practice It’s time to challenge penicillin allergy labels!

In episode 585, Mike and James finally get back to being PREMIUM. We review the REDUCE-AMI trial which tried to answer the question – do you need to use a beta-blocker after an MI if there is preserved ejection fraction? We also review a COPD trial that shows integrating respiratory specialists in primary care improves guideline adherence. However, the interesting finding is what happens to the quality-of-life change and hospitalizations. The results of both of these trials may surprise you. Show notes 1) REDUCE-AMI- Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction N Engl J Med 2024;390:1372-1381 2) Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD) Thorax 2024;79:209–218

In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer’s dementia. Unfortunately, the evidence shows these medications don’t seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients. Show notes Tools for Practice Remind me, do medications that target brain amyloid improve my dementia?

Mike, Jess and Émélie follow up with Charlotte McLeod, a 50 year old patient, who originally presented to the clinic with diabetes. Today, the team discusses the management of Charlotte's blood pressure in the context of diabetes. Did you miss Charlotte's original visit? Tune into episode #12: https://open.spotify.com/episode/1F1eZobKKIKTswqYGy9C2c?si=22fa6e6f8a9041e1. To claim your Mainpro+ credit, please click on this link: https://cfpclearn.ca/podcast/in-the-clinic-episode-27-managing-hypertension-in-diabetes/   

Mike, Jess and Émélie discuss Ms. Ottie Stone, a 35 year old patient who presents with dizziness. Today's podcast will discuss the diagnosis and management of benign paroxysmal positional vertigo. To claim your Mainpro+ credit on CFPCLearn, click here: https://cfpclearn.ca/?post_type=podcast&p=13750&preview=true

In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.   Show notes PEER Simplified Cardiovascular Decision Aid Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022 JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793 Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines Am Heart J 2009;157:111-7.e2 Agreement among cardiovascular disease risk calculators Circulation. 2013;127:1948–1956

In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.   Show notes 1) PEER Simplified Cardiovascular Decision Aid https://decisionaid.ca/cvd/ 2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022 JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793 3) Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines Am Heart J 2009;157:111-7.e2 4) Agreement among cardiovascular disease risk calculators Circulation. 2013;127:1948–1956