Frankly Speaking About Family Medicine

A Primer on Monkeypox - Frankly Speaking Ep 282

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-282
Overview: Monkeypox is endemic in certain parts of Africa, but outbreaks in Europe and North America have recently occurred. While still uncommon, clinicians need to be alert to the possibility of this diagnosis. This podcast gives you the tools you need to identify risk factors and distinguish the disease from other infections.
Episode resource links:
World Health Organization Health Topics/Monkeypox https://www.who.int/health-topics/monkeypox#tab=tab_1
Disease outbreak New/Item/Multi-country monkeypox outbreak: situation update 6-10-2022 https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON392
Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato

Access to Care: Safety of Medication Abortion - Frankly Speaking Ep 281

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-281
Overview: Clinicians may hesitate to provide medication abortion without first performing a pelvic ultrasound or pelvic examination, but recent data may give clinicians more confidence in their decision to do so. This episode explores the evidence for the safety of telehealth-based, or no-test screening, approaches to providing medication abortion for pregnant women at less than 10 weeks’ gestation. 
Episode resource links:
Upadhyay UD, Raymond EG, Koenig LR, et al. Outcomes and Safety of History-Based Screening for Medication Abortion: A Retrospective Multicenter Cohort Study. JAMA Intern Med. Published online March 21, 2022. doi:10.1001/jamainternmed.2022.0217
Upadhyay UD, Koenig LR, Meckstroth KR. Safety and Efficacy of Telehealth Medication Abortions in the US During the COVID-19 Pandemic. JAMA Network Open. 2021;4(8):e2122320. doi:10.1001/jamanetworkopen.2021.22320
Endler M, Lavelanet A, Cleeve A, Ganatra B, Gomperts R, Gemzell-Danielsson K. Telemedicine for medical abortion: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2019;126(9):1094-1102. doi:10.1111/1471-0528.15684
Guest: Jillian Joseph, MSPAS, PA-C Music Credit: Richard Onorato

Statins for Cardiovascular Disease—It’s All Relative - Frankly Speaking Ep 280

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

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

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

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

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

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

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

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 alSecondhand nicotine vaping at home and respiratory symptoms in young adultsThorax 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