Frankly Speaking About Family Medicine

Latest Episodes:

Primary HPV Testing Alone for Cervical Cancer Screening: a Review of Recent Guideline Updates - Frankly Speaking Ep 251 Nov 22, 2021

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-251

Overview: Primary care providers should be up to date on the changes to the guidelines for cervical cancer screening to be able to guide patients in shared decision-making about health maintenance. Join us to review the recent changes to cervical cancer screening guidelines as recommended by the American Cancer Society.

Episode resource links:

Cervical Cancer Screening: Updated Guidelines from the American Cancer Society. Am Fam Physician. 2021 Sep; 104(2):314-315.
American College of Obstetricians and Gynecologists. Updated cervical cancer screening guidelines. Practice advisory. April 2021. Accessed September 30, 2021. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines
Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin. 2020. https://doi.org/10.3322/caac.21628.

Guest: Jillian Joseph, MPAS, PA-C

Music Credit: Richard Onorato

Time to Recommend the Use of Salt Substitutes for CVD Prevention? - Frankly Speaking Ep 250 Nov 15, 2021

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-250

Overview: While the data conflict on how much sodium intake is optimal for preventing cardiovascular disease, it is clear that daily salt intake for most Americans exceeds what is recommended. However, restricting salt intake on an individual or on a public health level has been controversial. An interesting alternative is the use of salt substitutes, which can help to decrease sodium intake while increasing potassium intake, and both have been associated with lowering blood pressure. Join us to hear a discussion on the results of the recently published studies on salt and cardiovascular disease, along with an overview of the Salt Substitute and Stroke Study (SSaSS).

Episode resource links:

Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med. DOI: 10.1056/NEJMoa2105675
O’Donnell M, Mente A, Alderman MH, et al. Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake, European Heart Journal, Volume 41, Issue 35, 14 September 2020, Pages 3363–3373, https://doi.org/10.1093/eurheartj/ehaa586
Circulation. 2021;143:1542–1567. DOI: 10.1161/CIRCULATIONAHA.120.050371

Guest: Robert A. Baldor MD, FAAFP

Music Credit: Richard Onorato

Using DOACs for Valvular Atrial Fibrillation - Frankly Speaking Ep 249 Nov 08, 2021

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-249

Overview: For non-valvular atrial fibrillation, physicians, patients, and guideline organizations all prefer direct oral anticoagulants (DOACs) over vitamin K antagonists, such as warfarin, for thromboembolic prophylaxis. For those with valvular atrial fibrillation, the data for safety and efficacy have been limited because randomized trials comparing DOACs to warfarin often exclude patients with valvular atrial fibrillation. Join us to explore new data that shed light on the use of DOACs in valvular atrial fibrillation.

Episode resource links:

Dawwas GK, Dietrich E, Cuker A, Barnes GD, Leonard CE, Lewis JD. Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study. Ann Intern Med. 2021;174(7):910-919.

Guest: Alan Ehrlich MD, FAAFP

Music Credit: Richard Onorato

Aspirin—Not Really for Primary Prevention - Frankly Speaking Ep 248 Nov 01, 2021

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-248

Overview: Join us to hear a discussion on the important changes the AHA/ACC and USPSTF have made to their positions on the use of aspirin for primary prevention of cardiovascular disease. The organizations note that while aspirin for primary prevention lowers the risk of a myocardial infarction, its harmful effects may outweigh its benefits. Learn the aspirin recommendations for your patients in their 40s, 50s, and 60s who are at higher risk for a cardiovascular event.

Episode resource links:

Guest: Jill M. Terrien PhD, ANP-BC

Music Credit: Richard Onorato

A Fishy Method to Prevent Migraines - Frankly Speaking Ep 247 Oct 26, 2021

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-247

Overview: When it comes to chronic migraines, your first-line prevention is probably medication, but according to a new study, it may not have to be. Certain foods may play a role in increasing and decreasing migraine recurrence. Join us to review a recent randomized controlled trial aimed at preventing migraines in those with chronic migraines.

Episode resource links:

BMJ 2021; 374 :n1448 doi:10.1136/bmj.n1448; doi: https://doi.org/10.1136/bmj.n1448
The association of dietary patterns with migraine attack frequency in migrainous women. Nutritional Neuroscience 23:9, pages 724-730

Guest: Alan Ehrlich MD, FAAFP

Music Credit: Richard Onorato

Muscle Relaxants for Low Back Pain: Are They Worth the Risk? - Frankly Speaking Ep 246 Oct 18, 2021

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-246

Overview: Low back pain often leads to disability and loss of income and is a significant burden on patients and the healthcare system. While muscle relaxants are the third most common prescribed drugs in the treatment of low back pain, recent data demonstrating its use and efficacy are limited. This session discusses a recent systematic review of the safety, efficacy, and accepted use of muscle relaxants in the treatment of low back pain. Don’t miss this opportunity to learn how to provide low back pain treatments that have clear benefits for your patients.

Episode resource links:

Cashin A G, Folly T, Bagg M K, Wewege M A, Jones M D, Ferraro M C et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis BMJ 2021; 374 :n1446 doi:10.1136/bmj.n1446 https://pubmed.ncbi.nlm.nih.gov/34233900/

Guest: Jill M. Terrien PhD, ANP-BC

Music Credit: Richard Onorato

MRI for Elevated PSA - Frankly Speaking Ep 245 Oct 11, 2021

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-245

Overview: When your patient has an elevated screening PSA level, your first inclination may be to refer for a biopsy, but have you considered obtaining a pre-biopsy MRI? In this podcast, we will review the appropriate management for an elevated screening PSA. You’ll want to hear about the new benefit of obtaining a pre-biopsy MRI to guide diagnostic procedures.

Episode resource links:

NEJM July 9, 2021; DOI: 10.1056/NEJMoa2100852\
Urology 2016 Apr;90:32-7. doi: 10.1016/j.urology.2015.11.046

Guest: Frank J. Domino, MD

Music Credit: Richard Onorato

Can Artificial Intelligence Predict and Prevent Suicide? - Frankly Speaking Ep 244 Oct 04, 2021

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-244

Overview: Suicide and attempted suicide are significant health issues affecting the United States and the world. Are you aware of the tools available to you that can support suicide prevention strategies and save lives? Don’t miss this session to learn about how the use of an electronic health record in a large health system may help predict suicide attempts.

Episode resource links:

Walsh CG, Johnson KB, Ripperger M, Sperry S, Harris J, Clark N, Fielstein E, Novak L, Robinson K, Stead WW. Prospective Validation of an Electronic Health Record-Based, Real-Time Suicide Risk Model. JAMA Netw Open. 2021 Mar 1;4(3):e211428. doi: 10.1001/jamanetworkopen.2021.1428. PMID: 33710291; PMCID: PMC7955273 doi: 10.1001/jamanetworkopen.2021.1428
Liang, Angela, and Paul Nestadt S . "Suicide Risk in the COVID-19 Pandemic." Johns Hopkins Psychiatry Guide, 2021. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787393/all/Suicide_Risk_in_the_COVID_19_Pandemic.

Guest: Jill M. Terrien PhD, ANP-BC

Music Credit: Richard Onorato

“Can You Hear Me Now?”— Aging, Hearing Impairment, and Physical Function - Frankly Speaking Ep 243 Sep 27, 2021

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-243

Overview: Evidence strongly supports a correlation between hearing impairment in older adults and decline in physical functioning. A recent population cohort study of older adults revealed that hearing impairment was associated with poorer physical function, reduced walking endurance, and accelerated decline. Join us while we discuss this evidence and how to apply it to your practice. You’ll walk away with strategies to promote hearing assessment and to help optimize physical functioning in your older adult patients.

Episode resource links:

Brenowitz WD, Wallhagen MI. Does Hearing Impairment Affect Physical Function?: Current Evidence, Potential Mechanisms, and Future Research Directions for Healthy Aging. JAMA Netw Open. 2021 Jun 1;4(6):e2114782. doi: 10.1001/jamanetworkopen.2021.14782. PMID: 34170308.
Martinez-Amezcua P, Powell D, Kuo PL, Reed NS, Sullivan KJ, Palta P, Szklo M, Sharrett R, Schrack JA, Lin FR, Deal JA. Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US. JAMA Netw Open. 2021 Jun 1;4(6):e2113742. doi: 10.1001/jamanetworkopen.2021.13742. PMID: 34170305; PMCID: PMC8233700.
Martinez-Amezcua P, Kuo PL, Reed NS, Simonsick EM, Agrawal Y, Lin FR, Deal JA, Ferrucci L, Schrack JA. Association of hearing impairment with higher level physical functioning and walking endurance: Results from the Baltimore Longitudinal Study of Aging (BLSA). J Gerontol A Biol Sci Med Sci. 2021 May 18:glab144. doi: 10.1093/gerona/glab144. Epub ahead of print. PMID: 34003883.
Croll, P.H., Vinke, E.J., Armstrong, N.M. et al. Hearing loss and cognitive decline in the general population: a prospective cohort study. J Neurol 268, 860–871 (2021). https://doi.org/10.1007/s00415-020-10208-8

Guest: Susan Feeney, DNP, FNP-BC, NP-C

Music Credit: Richard Onorato

Cutting Through the Fog: Recognizing Gluten-Induced Neurocognitive Impairment - Frankly Speaking Ep 242 Sep 20, 2021

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-242

Overview: Gluten exposure is known to cause a number of problems in both those with celiac disease and those with non-celiac gluten sensitivity. One aspect that has not received much attention from the research community is the neurocognitive impairment that can occur following gluten exposure in these individuals. Join us for this podcast to dive into a recent article that describes these effects.

Episode resource links:

Edwards George JB, Aideyan B, Yates K, et al. Gluten-induced Neurocognitive Impairment: Results of a Nationwide Study [published online ahead of print, 2021 May 28]. J Clin Gastroenterol. 2021

Guest: Alan Ehrlich MD, FAAFP

Music Credit: Richard Onorato

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