Frankly Speaking About Family Medicine

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.

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: 1. Understand the new classification categories of hypertension 2. Understand the new thresholds for starting treatment 3. 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. Learning Objectives:  1. Review the current trial comparing Acetaminophen plus Ibuprofen to other acetaminophen/opioid combinations on pain outcomes 2. Summarize the other data supporting this combination in children and adults 3. 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: 1. Review the new vaccine recommendations for the prevention of shingles. 2. Discuss the use of the current vaccine and new vaccine with dosage and schedule. 3. 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: 1. Understand what is meant by diabetes remission 2. 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: 1. Discuss the most recent EBP Guidelines on diagnosis and management of acute sinusitis 2. 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:  1. Understand data comparing long-acting naltrexone to daily buprenorphine/naloxone 2. 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: 1. Understand the effect of chronic azithromycin for reducing asthma exacerbation 2. 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:  1.Review data collected over 30 years on triathlon events and the risks to participants. 2. Discuss recommendations for patients embarking on extreme physical activity. 3. Review strategies to promote well-being