Frankly Speaking About Family Medicine

Latest Episodes:

Statins for Cardiovascular Disease—It’s All Relative - Frankly Speaking Ep 280 Jun 13, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-280

Overview: Statins are widely used for lowering cholesterol in patients at risk for cardiovascular disease. While the benefit is more established with secondary prevention compared with primary prevention, most of the benefits are reported in relative risk reduction, which can exaggerate the benefit to an individual person. In this podcast, you’ll hear a discussion of a recent systematic review that looked at the absolute risk reduction and relative risk reduction with statins for preventing death, myocardial infarctions, and stroke.

Episode resource links:

Byrne, P. , Demasi, M. , Jones, M. , et al. Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment. JAMA Internal Medicine

Guest: Alan Ehrlich MD, FAAFP
Music Credit: Richard Onorato

Step It Up! But by How Much? - Frankly Speaking Ep 279 Jun 06, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-279

Overview: Clinicians (and patients) know that walking is beneficial for overall health, but what are the specifics? How many steps per day lower health risks? What impact does walking have on mortality? What’s the best way to count steps? Join us to hear answers to these questions and more as we discuss evidence-based recommendations for steps/day.

Episode resource links:

Paluch, A. E., Bajpai, S., Bassett, D. R., Carnethon, M. R., Ekelund, U., Evenson, K. R., Galuska, D. A., Jefferis, B. J., Kraus, W. E., Lee, I. M., Matthews, C. E., Omura, J. D., Patel, A. V., Pieper, C. F., Rees-Punia, E., Dallmeier, D., Klenk, J., Whincup, P. H., Dooley, E. E., Pettee Gabriel, K., … Steps for Health Collaborative (2022). Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. The Lancet. Public health, 7(3), e219–e228. https://doi.org/10.1016/S2468-2667(21)00302-9
https://www.cdc.gov/physicalactivity/index.html This website includes data, resources and information for patients and providers for physical activity.

Guest: Jill M. Terrien PhD, ANP-BC
Music Credit: Richard Onorato

Forget About Weed - Frankly Speaking Ep 278 May 30, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-278

Overview: Misconceptions abound on the long-term effects of chronic use of marijuana. This episode tackles these misconceptions head-on, highlighting new data on marijuana’s adverse effects on central nervous system function, including loss of memory, IQ points, and executive functioning. It’s a must-listen for clinicians caring for patients engaging in regular marijuana use.

Episode resource links:

Am J Psych 8 Mar 2022 https://doi.org/10.1176/appi.ajp.2021.21060664

Guest: Jillian Joseph, MSPAS, PA-C
Music Credit: Richard Onorato

Pneumococcal Vaccines Simplified! - Frankly Speaking Ep 277 May 23, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-277

Overview: Join us to discuss a summary of the newly published guidelines for pneumococcal vaccines and to review the most recently approved vaccines. We’ll begin by describing the challenges from the previous guidelines and how these new guidelines address these challenges. Given the burden of pneumococcal disease and that vaccination is our best weapon to combat the disease, you won’t want to miss this episode.

Episode resource links:

Morga, A., Kimura, T., Feng, Q., Rozario, N., & Schwartz, J. (2022). Compliance to Advisory Committee on Immunization Practices recommendations for pneumococcal vaccination. Vaccine.
https://www.medscape.com/viewarticle/967675#vp_1
Schulz, P. S., Moore, S. E., Smith, D., Javed, J., & Wilde, A. M. (2022, April). Missed Pneumococcal Vaccination Opportunities in Adults With Invasive Pneumococcal Disease in a Community Health System. In Open Forum Infectious Diseases (Vol. 9, No. 4, p. ofac075). US: Oxford University Press.
Center for disease Control and Prevention Resources: App for iphone and android PneumoRecs

Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Richard Onorato

Does Acetaminophen Increase Stroke Risk? - Frankly Speaking Ep 276 May 16, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-276

Overview: The concerns over the use of NSAIDs have been well documented. The medications can raise blood pressure and have been linked to an increased risk of heart disease and stroke when used long term. These known risks, supported by the FDA’s warning in 2005, has prompted many clinicians to prescribe acetaminophen instead. But do acetaminophen products confer a lower risk of cardiovascular effects? Join us for this episode to review the results from recent trials assessing similar blood pressure effects from regular use of acetaminophen.

Episode resource links:

https://doi.org/10.1161/CIRCULATIONAHA.121.056015 Circulation. 2022;145:416–423
https://doi.org/10.1093/eurheartj/ehac059; European Heart Journal. 2,24,2022

Guest: Robert A. Baldor MD, FAAFP
Music Credit: Richard Onorato

Breastfeeding Really Is Best—New Evidence for Improved Health in Infants - Frankly Speaking Ep 275 May 09, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-275

Overview: The multitude of benefits of breastfeeding for both mother and baby are well documented. However, we’ve seen mixed evidence for the relationship between breastfeeding and certain childhood lung conditions, with some studies suggesting an increase in risk. A recent study found that exclusive breastfeeding was associated with decreased lower respiratory tract infection (LRTI), asthma, and allergic rhinitis. A potential connection between these conditions, breastfeeding, and the infant’s gut microbiome was also found. Join us as we discuss these findings and how to incorporate them into your practice to improve the health of women and infants.

Episode resource links:

Rosas-Salazar C, Shilts MH, Tang ZZ, Hong Q, Turi KN, Snyder BM, Wiggins DA, Lynch CE, Gebretsadik T, Peebles RS Jr, Anderson LJ, Das SR, Hartert TV. Exclusive Breastfeeding, the Early-life Microbiome and Immune Response, and Common Childhood Respiratory Illnesses. J Allergy Clin Immunol. 2022 Mar 10:S0091-6749(22)00292-5. doi: 10.1016/j.jaci.2022.02.023. Epub ahead of print. PMID: 35283139.
Rosas-Salazar C, Forno E, Brehm JM, Han YY, Acosta-Pérez E, Cloutier MM, Wakefield DB, Alvarez M, Colón-Semidey A, Canino G, Celedón JC. Breastfeeding duration and asthma in Puerto Rican children. Pediatr Pulmonol. 2015 Jun;50(6):527-34. doi: 10.1002/ppul.23061. Epub 2014 Aug 6. PMID: 25100626; PMCID: PMC4320027.
AAP Breastfeeding Guidelines. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Where-We-Stand-Breastfeeding.aspx
ACOG. https://www.acog.org/womens-health/infographics/breastfeeding-benefits
CDC Recommendations and Benefits of Breastfeeding. https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/recommendations-benefits.html
CDC Breastfeeding Report Card. https://www.cdc.gov/breastfeeding/data/reportcard.htm
US Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf#page=65

Guest: Susan Feeney, DNP, FNP-BC, NP-C
Music Credit: Richard Onorato

Recurrent UTIs—Prevention Without Antibiotics - Frankly Speaking Ep 274 May 02, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-274

Overview: Recurrent urinary tract infections (UTIs) can be a frustrating problem for both patients and clinicians. Antibiotics are often used, but a prevailing concern is that the overuse of antibiotics may lead to more resistant bacteria. This podcast discusses methenamine hippurate as an important nonantibiotic alternative for UTI prophylaxis.

Episode resource links:

Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ. 2022 Mar 9;376:e068229.
Lee BS, Bhuta T, Simpson JM, Craig JC. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;10(10):CD003265. Published 2012 Oct 17.

Guest: Alan Ehrlich MD, FAAFP
Music Credit: Richard Onorato

A Smoke Screen? Is Secondhand Aerosol Exposure From E-Cigarettes harmful? - Frankly Speaking Ep 273 Apr 25, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-273

Overview: The evidence continues to grow and evolve on the potential harms of e-cigarette use and on their efficacy and safety as a harm reduction strategy. One aspect of e-cigarette use that has not received much attention is the effect of secondhand exposure to the exhaled aerosol from e-cigarettes. Previous small studies have suggested some exposure risk, but a recent study of >2,000 participants found that secondhand exposure to e-cigarette aerosol increased the risk of bronchitic symptoms and shortness of breath in young adults. Join us as we discuss these findings and their implications to practice.

Episode resource links:

Islam T, Braymiller J, Eckel SP, et al
Secondhand nicotine vaping at home and respiratory symptoms in young adults
Thorax Published Online First: 10 January 2022. doi: 10.1136/thoraxjnl-2021-217041
Caponnetto P, Caruso M, Maglia M, et al. Non-inferiority trial comparing cigarette consumption, adoption rates, acceptability, tolerability, and tobacco harm reduction potential in smokers switching to Heated Tobacco Products or electronic cigarettes: Study protocol for a randomized controlled trial. Article. Contemporary Clinical Trials Communications. 2020;17100518. doi:10.1016/j.conctc.2020.100518
Gaiha SM, et al. J Adolesc Health. Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19. J Adolesc Health. Vol 67, issue 4, pp 519-523; DOI: https://doi.org/10.1015/j.jadolhealth.2020.07.002
Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5
Mayo Clinic. (2022, January 13). E-cigarette users who test positive for COVID-19 are more likely to experience COVID-19 symptoms. ScienceDaily. Retrieved January 17, 2022 from www.sciencedaily.com/releases/2022/01/220113151402.htm
McAlinden KD, Eapen MS, Lu W, Chia C, Haug G, Sohal SS. COVID-19 and vaping: risk for increased susceptibility to SARS-CoV-2 infection? Eur Respir J. 2020. vol. 1.
McFadden, DD, Bornstein, SL, Vassallo, R, Salonen, BR, Nadir Bhuiyan, M, Schroeder, DR, Croghan, IK. Symptoms COVID 19 Positive Vapers Compared to COVID 19 Positive Non-vapers. Journal of Primary Care & Community Health, 2022; 13: 215013192110626 DOI: 10.1177/21501319211062672

Guest: Susan Feeney, DNP, FNP-BC, NP-C
Music Credit: Richard Onorato

Estimating Jugular Venous Pressure: Point-of-Care Ultrasound Can Help - Frankly Speaking Ep 272 Apr 18, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-272

Overview: Clinicians need to accurately assess the degree of heart failure at the bedside to make appropriate management decisions. However, the common bedside practice of estimating right atrial pressure by measuring jugular venous pressure (JVP) has several accuracy limitations. This session focuses on the use of point-of-care ultrasound (POC-US) to improve the accuracy of JVP measurements. Join us to hear the salient findings from a recent study comparing POC-US measurements to right heart catheterization measurements, and walk away with a clear understanding of how POC-US can quickly and easily improve accuracy.

Episode resource links:

Wang L, Harrison J, Dranow E, Aliyev N, Khor L. Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion. Ann Intern Med. 2021 Dec 28. doi: 10.7326/M21-2781. Epub ahead of print.

Guest: Alan Ehrlich MD, FAAFP

Music Credit: Richard Onorato

Cardiovascular Disease and Exercise - Frankly Speaking Ep 271 Apr 11, 2022

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-271

Overview: Given the prevalence of cardiovascular disease (CVD) in the United States, it is key for primary care providers to counsel patients on the importance of exercise for CVD prevention. This brief podcast explores data that will help clinicians understand the need to prescribe exercise and rehabilitation in the primary care setting. You’ll walk away with clear guidance to offer patients and ultimately improve outcomes in CVD as well as multiple chronic diseases.

Episode resource links:

Naci, H., & Ioannidis, J. P. (2015). Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. British journal of sports medicine, 49(21), 1414–1422. https://doi.org/10.1136/bjsports-2015-f5577rep
Sanchis-Gomar, F., Lavie, C. J., Marín, J., Perez-Quilis, C., Eijsvogels, T. M., O’Keefe, J. H., ... & Blair, S. N. (2021). Exercise effects on cardiovascular disease: from basic aspects to clinical evidence. Cardiovascular Research.

Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Richard Onorato

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