Primary Care Update

This week: is it safe to skip breakfast (https://www.ncbi.nlm.nih.gov/pubmed/30700403), reducing fracture risk in women with osteopenia (https://www.ncbi.nlm.nih.gov/pubmed/30575489), drug therapy for anxiety disorder (https://www.ncbi.nlm.nih.gov/pubmed/30712879 ), and antibiotics for serious asthma exacerbations (https://www.ncbi.nlm.nih.gov/pubmed/30688986). 

Today we talk about stem cell injections for osteoarthritis (https://www.ncbi.nlm.nih.gov/pubmed/29099618), a rant about mortality outcomes in cancer screening from Mark, omega-3 oils for primary prevention (https://www.ncbi.nlm.nih.gov/pubmed/30415637), and testosterone for depression in men (https://www.ncbi.nlm.nih.gov/pubmed/30427999).

Today we talk about the impact of more primary care physicians in a population on health outcomes; whether or not probiotics, prebiotics, and antibiotics are helpful for irritable bowel; and the impact of SGLT-2 inhibitors like empagliflozin on cardiovascular outcomes in diabetics with heart disease or at very high risk.

Today's topics: what is the safest oral anticoagulant (https://www.ncbi.nlm.nih.gov/pubmed/30512099), new diabetes guidelines (https://www.ncbi.nlm.nih.gov/pubmed/30291106), and the good and the ouch of the new zoster vaccines (https://www.ncbi.nlm.nih.gov/pubmed/30361202).

Today we discuss: vitamin D for pain and headache (https://www.ncbi.nlm.nih.gov/pubmed/25261164); chronic diarrhea guidelines (https://www.ncbi.nlm.nih.gov/pubmed/29653941); lorcaserin and T2DM (https://www.ncbi.nlm.nih.gov/pubmed/30293771); and the results of "screening" MRI (https://www.bmj.com/content/363/bmj.k4577).

Does linagliptin prevent CV events: ttps://www.ncbi.nlm.nih.gov/pubmed/30418475; does Tai Chi prevent falls and fractures: https://www.ncbi.nlm.nih.gov/pubmed/30208396; treatment of endometriosis pain: https://www.ncbi.nlm.nih.gov/pubmed/30396557; and the benefits of sauna: https://www.ncbi.nlm.nih.gov/pubmed/30486813. 

This week: how does the yield for FIT testing compare with colonoscopy (https://www.ncbi.nlm.nih.gov/pubmed/29101260); our take on the new ACC/AHA lipid guidelines (https://www.ncbi.nlm.nih.gov/pubmed/30423391); and what works (or doesn't) for subacute cough (https://www.ncbi.nlm.nih.gov/pubmed/30201828).  

This week we talk about the results of the 3 ASPREE aspirin trials, whether omega-3 oil prevents CV events, and a new biologic agent for migraine. Pubmed abstract links: ASPREE: https://www.ncbi.nlm.nih.gov/pubmed/30221596 ; omega-3: https://www.ncbi.nlm.nih.gov/pubmed/30146932 ; and migraine: https://www.ncbi.nlm.nih.gov/pubmed/30360965

Topics: fluids to prevent UTI, deprescribing study, antipsychotics for delitium, and the value of ECG and echo for preparticipation physicals.

This week's topics: whether surgery works for shoulder impingement, framing test results positively for patients, vagus nerve stimulation for frequent migraines, and a commentary on shared decision-making. Study links: Impingement: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734212/ ; Vagus nerve stimulation: https://www.ncbi.nlm.nih.gov/pubmed/29907608 ; and Positive messaging: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495144/

We discuss recent studies on: antibiotics to treat appys, whether gabapentin is any good for back pain, the accuracy of a single BP measurement, and the best approach to smoking cessation.

Mark, John and Henry talk about tamsulosin for helping stones pass (but not all of them), how aspirin and esomoprazole (at the right dose) can reduce mortality in Barrett's esophagus, whether to do HPV only or co-testing in women 30-65 years, and the safety (and effectiveness) of lorcaserin for weight loss.

Mark, John and Henry discuss the new aspiring studies (does it really prevent heart disease), a positive (!) vitamin D trial, and whether procalcitonin can help us avoid antibiotics for patients with lower respiratory infection. Plus, the quiz, and John nerds out about vitamin D. In a good way.

Today's topics include anticoagulation in patients already taking aspirin, asthma treatment, and getting patients on board with advanced directives. Plus the quiz, and Nerd Alert with Henry.

Today's topics: are new basal insulins really any better, the impact of stigmatizing language, the value of adding cytology to HPV testing alone, and the best evidence to date on just how common incidentalomas are with MRI and CT. Plus, the pop quiz, and a segment we call "Preventing Bad Stuff" (today's topic is prostate CA screening).