Primary Care Update

Latest Episodes:

Episode 188: digital therapy, DKA with SGLT2s, esketamine for resistant depression, and what is a normal TSH Aug 29, 2025

Show notes

Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine’s effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading.

Links:

Essential Evidence Plus: www.essentialevidenceplus.com

Digital mental health app for depression: https://pubmed.ncbi.nlm.nih.gov/40227715/

RIsk of DKA with SGLT2s: pubmed.ncbi.nlm.nih.gov/40070044/

Esketamine and resistant depression or suicidality: pubmed.ncbi.nlm.nih.gov/39790081/

What is a normal TSH: https://pubmed.ncbi.nlm.nih.gov/40324200/

Joseph O'Connor and the Escape Line Trilogy (2 great novels): https://www.amazon.com/The-Rome-Escape-Line-Trilogy-2-book-series/dp/B0BSNX3C89

Episode 187: incidental activity, a new definition of Alzheimers, blood test for CRC screening, and DORAs for sleep Aug 12, 2025

Show notes

This week, we found 4 great new studies for primary care physicians (and their patients): the health benefits of “incidental” activity, real world data and the amyloid cascade theory for Alzheimer’s disease, a new blood test for colorectal cancer screening, and DORAs for sleep.

Check out Essential Evidence Plus: www.essentialevidenceplus.com

Incidental activity: https://pubmed.ncbi.nlm.nih.gov/40228066/

New Alzheimer's definition in the real world: https://pubmed.ncbi.nlm.nih.gov/40359457/

Blood test for colorectal cancer screening: https://pubmed.ncbi.nlm.nih.gov/40455622/

"DORAs" for insomnia: https://pubmed.ncbi.nlm.nih.gov/40555730/

Episode 186: wound care, migraine tx, breast CA screening, and metformin for OA Jul 31, 2025

Show notes

Kate, Mark, Gary and Henry discuss 4 important new studies relevant to primary care clinicians: negative pressure wound therapy for wounds healing by secondary intention, comparative effectiveness of acute migraine treatments, contrast enhanced mammography, US, or MRI for women with dense breasts, and metformin for knee pain in patients without diabetes.

Negative pressure wound therapy: https://pubmed.ncbi.nlm.nih.gov/40250455/

Acute migraine treatments: https://pubmed.ncbi.nlm.nih.gov/40096693/

Best enhanced screening for women with dense breasts: https://pubmed.ncbi.nlm.nih.gov/40412427/

Metformin for knee pain in patients without DM: https://pubmed.ncbi.nlm.nih.gov/40274279/

Episode 185: resistant HTN tx, mirtazepine for sleep, baloxav for prevention, PRP for OA Jul 16, 2025

Show notes

This week our intrepid primary care docs discuss 4 new POEMs: spironolactone vs amiloride for resistant hypertension, mirtazapine for insomnia in older adults, baloxivir for influenza post exposure prophylaxis, and platelet-rich plasma injections for knee osteoarthritis. We've got opinions!

Show notes:

Spironolactone vs amiloride for resistant hypertension: pubmed.ncbi.nlm.nih.gov/40366680/

Mirtazapine for chronic insomnia: https://pubmed.ncbi.nlm.nih.gov/40135470/

Baloxavir to prevent flu in household contacts: https://pubmed.ncbi.nlm.nih.gov/40267424/

Platelet-rich plasma for knee OA: https://pubmed.ncbi.nlm.nih.gov/39751394/

Episode 184: new UTI antibiotic, fibromyalgia tx, trial of an MCED, and the best time for HTN meds Jul 02, 2025

Show notes

Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs: a new and very hard to pronounce antibiotic for uncomplicated UTI, the best drugs for relieving pain in adults with fibromyalgia, a clinical trial of a multicancer detection test in asymptomatic persons, and bedtime vs morning administration of antihypertensives.

Gepotidacin for uncomplicated UTI: https://pubmed.ncbi.nlm.nih.gov/38342126/

Drugs for fibromyalgia: https://www.ncbi.nlm.nih.gov/pubmed/39705187

Multicancer detection test trial: https://pubmed.ncbi.nlm.nih.gov/39948555/

TIming of antihypertensives: https://pubmed.ncbi.nlm.nih.gov/40354045/

Episode 183: triple inhaler for COPD, managing pain in kids, and suzetrigine for pain Jun 18, 2025

Show notes

This week, join Kate, Mark and Henry as they discuss all in one triple inhalers for COPD, the best medication for pain management in children and suzetrigine, a new medicine for acute pain in adults. Gary is off this week, working on his French lessons. And we add intro music! Yay!

Episode 182: atrial appendage occlusion for AF, oral semaglutide, and epidural steroidsand Jun 04, 2025

Show notes

Join Mark, Henry, and Gary (we are Kate-less unfortunately this week) for discussion of epidural steroid injections for adults with radicular back pain, post a fib ablation management, and oral semaglutide for high-risk patients with Type 2 DM

Episode 181: wipes to prevent foot ulcer, tirzepatide efficacy, May 21, 2025

Show notes

This week, Kate, Mark, Gary and Henry discuss 4 great new POEMs: foot care wipes for patients at risk of diabetic foot infection, resuming DOACS following intracerebral hemorrhage in adults with a fib, treating prediabetes with tirzepatide, and more on intermittent fasting.

Show links

BMJ Magic Evidence interactive review of diabetes medications. A great practice and teaching tool: https://matchit.magicevidence.org/230125dist-diabetes/#!/

https://www.ncbi.nlm.nih.gov/pubmed/31574019

https://pubmed.ncbi.nlm.nih.gov/39964684/

https://pubmed.ncbi.nlm.nih.gov/40023176/

ttps://pubmed.ncbi.nlm.nih.gov/39536238/

https://pubmed.ncbi.nlm.nih.gov/40163873/

Episode 180: dance benefits, POCUS for clavicles, treating BV, and prehab May 13, 2025

Show notes

This week, Kate, Gary, Mark and Henry chat about the health effects of dance for older adults, POCUS for diagnosing clavicular fractures, treating male partners of women with BV, and prehabilitation before elective surgery .

Links:

Dance for older adults: https://pubmed.ncbi.nlm.nih.gov/39480190/

POCUS for clavicle fractures: https://pubmed.ncbi.nlm.nih.gov/39626455/

Oral + topical treatment of male partners for BV: https://pubmed.ncbi.nlm.nih.gov/40043236/

Prehabilitation before elective surgery: https://pubmed.ncbi.nlm.nih.gov/39843215/

Case series of avian flu patients: https://www.nejm.org/doi/full/10.1056/NEJMoa2414610

Episode 179: novel migraine tx, safety of albuterol in infants, new UTI antibiotic, and vitamin K2 for leg cramps Apr 22, 2025

Show notes

This week join our intrepid primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new studies: an experimental treatment for chronic migraines, safety of albuterol in wheezy kids under 2, oral gepotidacin for uncomplicated UTI, and vitamin K2 and Leg Cramps.

Here are the links:

Lukas' Fund supporting the Piedmont Athens and Grady Atlanta NICUs: https://www.lukasfund.org

Essential Evidence Plus: http://www.essentialevidenceplus.com

Vibrating intranasal balloons for migraine: https://pubmed.ncbi.nlm.nih.gov/39787477/ and Ozilia

Safety of albuterol in infants: https://www.ncbi.nlm.nih.gov/pubmed/39266286

Oral gepotidacin for uncomplicated UTI: https://www.ncbi.nlm.nih.gov/pubmed/38342126

Vitamin K2 for nocturnal leg cramps: https://pmc.ncbi.nlm.nih.gov/articles/PMC11581596/

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