Frankly Speaking About Family Medicine

Caffeine Contrasts: Coffee, Energy Drinks, and Suicide Risk Screening - Frankly Speaking Ep 458

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-458
Overview: In this episode, we explore the relationship between caffeine consumption and suicide risk. Hear how coffee may offer protective effects—while energy drinks raise concern—and gain practical tips for screening patients for caffeine and substance use as part of suicide risk assessment in primary care.
Episode resource links:
Low, C.E.; Chew, N.S.M.; Loke, S.; Tan, J.Y.; Phee, S.; Lee, A.R.Y.B.; Ho, C.S.H. Association of Coffee and Energy Drink Intake with Suicide Attempts and Suicide Ideation: A Systematic Review and Meta-Analysis. Nutrients 2025, 17, 1911. https://doi.org/10.3390/ nu17111911
 
Costantino, A., Maiese, A., Lazzari, J., Casula, C., Turillazzi, E., Frati, P., & Fineschi, V. (2023). The Dark Side of Energy Drinks: A Comprehensive Review of Their Impact on the Human Body. Nutrients, 15(18), 3922. https://doi.org/10.3390/nu15183922
Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

When Sweet Turns Sour: The Risks of Artificial Sugars - Frankly Speaking Ep 457

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-457
Overview: Many patients turn to low- and no-calorie sweeteners to help with weight loss and lower diabetes risk, but do these alternatives actually deliver? In this episode, we review common artificial sweeteners and explore evidence on hunger, cardiovascular, diabetes, and dementia risks to understand how sugar substitutes can impact long-term health outcomes in your patients.
Episode resource links:
fMRI Data: Nat Metab 7, 574–585 (2025). https://doi.org/10.1038/s42255-025-01227-8
Adverse effects: Adv Nutr. 2023 Jul;14(4):710-717. doi: 10.1016/j.advnut.2023.05.010
Dementia Data: Neurology® 2025;105:e214023. doi:10.1212/WNL.0000000000214023
Stevia: Obes Rev. 2025 Jun;26(6):e13902. doi: 10.1111/obr.13902
High Fructose Corn Syrup:  Nutrition Reviews. 2021;79(2):209-226. doi:10.1093/nutrit/nuaa077
Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

It Doesn’t Have to Be That Way: Managing IUD Placement Pain and Anxiety - Frankly Speaking Ep 456

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-456
Overview: Experiences of significant pain and anxiety during intrauterine device (IUD) insertion may lead patients to forgo this effective contraceptive option. Listen in as we discuss how to reduce procedural pain, address anxiety, and foster trust using updated guidelines and shared decision-making to improve patient satisfaction and support informed contraceptive choices.
Episode resource links:
Charles, D. N., Nagarsheth, M., & Oshman, L. (2025). Pain Management for IUD Insertion in Primary Care. American Family Physician, 111(4), 299-301.
Dempsey, A., Aucoin, C., Stallings, W., Kulangara, A., & Sundstrom, B. (2025). Beyond pain medication: striving toward more patient-centered placement of intrauterine devices. Contraception, 110944.
Estevez, E., Hem-Lee-Forsyth, S., Viechweg, N. D., John, S., & Menor, S. P. (2024). Advancing pain management protocols for intrauterine device insertion: integrating evidence-based strategies into clinical practice. Cureus, 16(6).
Hoover, K., & Riley, K. (2025). Pain Management for In-Office Uterine and Cervical Procedures.
Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Microhematuria and the Right Time to Refer: Guideline Updates - Frankly Speaking Ep 455

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-455
Overview: Microscopic hematuria is common in primary care, but not every patient needs an urgent urology referral. Tune in to learn how to apply the latest evidence-based guidelines to risk-stratify patients and confidently manage workup and follow-up from your clinic, improving care while reducing unnecessary testing.
Episode resource links:
Barocas DA, Lotan Y, Matulewicz RS, Raman JD, Westerman ME, Kirkby E, Pak L, Souter L. Updates to Microhematuria: AUA/SUFU Guideline (2025). J Urol. 0(0). doi: 10.1097/JU.0000000000004490.
Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Don’t Wait to Medicate—Evidence for Early Intervention in Hypertension - Frankly Speaking Ep 454

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-454
Overview: Treating hypertension within the first month can significantly improve long-term blood pressure control. This episode reviews new evidence and practical strategies to help you initiate timely therapy, optimize follow-up, and improve outcomes for patients with newly diagnosed, uncontrolled hypertension. Gain actionable insights to close a critical care gap.
Episode resource links:
Barrett, R. B., Riesser, B., Martin, B., Sachdev, N., Rakotz, M. K., Sutherland, S. E., & Egan, B. M. (2025). Treatment in the First Month After Hypertension Diagnosis Improves Blood Pressure Control. Hypertension (Dallas, Tex. : 1979), 82(6), 1129–1136. https://doi.org/10.1161/HYPERTENSIONAHA.124.23508
For your patients: 10 Ways to Control High Blood Pressure Without Medication 
For your patients: Natural Ways to Lower Blood Pressure 
Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Don’t Forget the Shingles Vaccine - Frankly Speaking Ep 453

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-453
Overview: Many patients are still hesitant about the shingles vaccine, but the benefits go far beyond preventing a painful rash. Hear how varicella zoster vaccination can also reduce the risks of postherpetic neuralgia, dementia, and cardiovascular events, giving you powerful tools to guide more informed patient decisions.
Episode resource links:
Dementia: Neurol Sci. 2024 Jan;45(1):27-36.  doi: 10.1007/s10072-023-07038-7CV: J Infect Dis. 2025 Feb 28:jiaf105. doi: 10.1093/infdis/jiaf105 
Guest: Robert A. Baldor MD, FAAFPMusic Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Autism and Acetaminophen—Separating Fact from Misinformation - Frankly Speaking Ep 452

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-452
Overview: The healthcare landscape is evolving rapidly, and clinicians are navigating conflicting guidance on established, evidence-based recommendations. Recent news suggest acetaminophen use during pregnancy causes autism spectrum disorder (ASD), which is not the consensus of medical experts based on available data. When guidance from various sources conflicts with established research, clinicians face challenges in providing evidence-based care. Join us to review the current evidence on acetaminophen and ASD risk. 
Episode resource links:
Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172
 
Damkier, P., Gram, E. B., Ceulemans, M., Panchaud, A., Cleary, B., Chambers, C., Weber-Schoendorfer, C., Kennedy, D., Hodson, K., Grant, K. S., Diav-Citrin, O., Običan, S. G., Shechtman, S., & Alwan, S. (2025). Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstetrics and gynecology, 145(2), 168–176. https://doi.org/10.1097/AOG.0000000000005802
 
Ji Y, Azuine RE, Zhang Y, et al. Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. 2020;77(2):180–189. doi:10.1001/jamapsychiatry.2019.3259
 
Hirota T, King BH.  Autism Spectrum Disorder: A Review. JAMA. 2023;329(2):157–168. doi:10.1001/jama.2022.23661
 
Liu, X., Zou, M., Sun, C., Wu, L., & Chen, W. X. (2022). Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression. Journal of autism and developmental disorders, 52(2), 522–539. https://doi.org/10.1007/s10803-021-04951-8
 
DSM-5-TR: Neurocognitive Disorders Supplement; October 2022. https://psychiatryonline.org/pb-assets/dsm/update/DSM-5-TR_Neurocognitive-Disorders-Supplement_2022_APA_Publishing.pdf
https://www.npr.org/sections/shots-health-news/2025/09/06/nx-s1-5532143/hhs-responds-to-report-about-autism-and-acetaminophen
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

A Side-by-Side Look at GLP-1 RAs for Weight Loss - Frankly Speaking Ep 451

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-451
Overview: The obesity epidemic has fueled a demand for weight loss medications. Trials have directly compared medications—specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—with a recent study doing just that. Tune in as we explore the evidence comparing semaglutide and tirzepatide for weight loss outcomes up to 1 year.
Episode resource links:
Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity. JAMA Intern Med. 2024;184(9):1056-1064. 
Moiz A, Filion KB, Toutounchi H, et al. Efficacy and Safety of Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss Among Adults Without Diabetes : A Systematic Review of Randomized Controlled Trials. Ann Intern Med. 2025;178(2):199-217. 
Wen J, Syed B, Nadora D, et al. Tirzepatide Versus Semaglutide on Weight Loss in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis of Direct Comparative Studies. Endocrinol Diabetes Metab. 2025;8(3):e70045. 
Guest: Alan M. Ehrlich, MD, FAAFPMusic Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Trying to Quit—Effective Cessation Strategies for Teens Who Vape - Frankly Speaking Ep 450

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-450
Overview: Use of e-cigarettes has increased significantly over the last several years and their popularity continues to grow, notably among adolescents and young adults. Recent evidence indicates that the majority of teens and young adults who vape consider quitting; however, nicotine addiction has historically been difficult to treat in this population. Join us as we discuss the prevalence of vaping, associated harms, and new evidence on the effectiveness of varenicline on cessation. 
Episode resource links:
CDC https://www.cdc.gov/tobacco/e-cigarettes/youth.html
Evins, A. E., Cather, C., Reeder, H. T., Evohr, B., Potter, K., Pachas, G. N., Gray, K. M., Levy, S., Rigotti, N. A., Iroegbulem, V., Dufour, J., Casottana, K., Costello, M. A., Gilman, J. M., & Schuster, R. M. (2025). Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, e253810. Advance online publication. https://doi.org/10.1001/jama.2025.3810
Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;1(1):CD010216. Published 2024 Jan 8. doi:10.1002/14651858.CD010216.pub8
Park-Lee E, Ren C, Sawdey MD, et al. Notes from the Field: E-Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1387–1389. DOI: http://dx.doi.org/10.15585/mmwr.mm7039a4external icon; 
Tuisku A, Rahkola M, Nieminen P, Toljamo T. Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults: A Randomized Clinical Trial. JAMA Intern Med. 2024;184(8):915–921. doi:10.1001/jamainternmed.2024.1822
Zhang, L., Gentzke, A., Trivers, K. F., & VanFrank, B. (2022). Tobacco Cessation Behaviors Among U.S. Middle and High School Students, 2020. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 70(1), 147–154. https://doi.org/10.1016/j.jadohealth.2021.07.011
Guest: Susan Feeney, DNP, FNP-BC, NP-CMusic Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

DASHing Away Colon Cancer - Frankly Speaking Ep 449

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-449
Overview: In this episode, we discuss new evidence linking high compliance with the Dietary Approaches to Stop Hypertension (DASH) diet to lower risks of colorectal cancer, reinforcing the DASH diet’s well-established role in managing hypertension while also highlighting its potential to reduce cancer risk. Gain practical insights into translating these findings into actionable nutrition guidance to support your patients’ overall health.
Episode resource links:
Explain the risk factors for development of colorectal cancers
Review the Dietary Approaches to Stop Hypertension (DASH) and discuss the proposed mechanisms for colorectal cancer reduction by following this approach
Apply evidence from a meta-analysis to support dietary counseling strategies aimed at cancer prevention in clinical settings
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com