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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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, 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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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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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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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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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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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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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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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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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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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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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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Gary, Kate, Henry and Mark discuss 4 POEMs: polypills for secondary prevention of cardiovascular disease, yoga for migraines, the best 2nd drug for type 2 DM, and clinical outcomes with Paxlovid in the omicron wave. Do check out Essential Evidence Plus if you want all of the POEMs each month and a great primary care reference.…
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This week, Henry, Gary and Mark discuss: managing children with torus (buckle) fractures of the distal radius, tirzepatide for treating obesity in adults without T2DM, and stroke risk in patients with asymptomatic severe carotid artery stenosis. Kate couldn't join us this week, but check out her thoughtful essay in the journal Family Medicine…
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This episode, Henry, Kate, Mark and their colleague Gary Ferenchick from MSU discuss: pharmacogenomic-guided antidepressant therapy, non-drug interventions for children with functional abdominal pain, Vitamin D and fracture risk in the elderly, and NICE guideline for persons with T2DM.
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