Frankly Speaking About Family Medicine

Alternate-day Fasting for Weight Loss - Frankly Speaking EP 19

Is Alternate day fasting the future of weight loss?  Maybe not... Learning Objectives Understand how Alternate day fasting is practiced Appreciate why Alternate day fasting might make physiologic sense Review the recent literature on its strengths and weaknesses

Do Corticosteroids Decrease the Pain of Acute Pharyngitis? - Frankly Speaking EP 18

When patients present with symptoms of a sore throat, an option for managing the pain  that is sometimes used is corticosteroids. A randomized trial of a 1-time dose of 10 mg in patients with moderate to severe pharyngitis who were deemed to not need antibiotics found higher rates of symptom resolution at 48 hours. Learning Objectives: Understand potential benefits of corticosteroids for treatment of pain of acute pharyngitis Understand limitations of evidence for benefit Understand other options for symptom relief

Contraception: The Pill Needs to Share - Frankly Speaking EP17

Sensitive and important conversations with your adolescent population include contraceptive options.  How do long acting reversible contraceptive methods (LARC’s) fit into your conversation?  Let’s discuss a recent review and update your talk! Learning Objectives: Discuss the use of long acting reversible contraceptive methods (LARC’s). Describe the efficacy or LARC’s compared to other birth control methods. Describe communication strategies useful in discussing contraception with adolescents. 

Safe and Effective Narcotic Use in Chronic Pain - Frankly Speaking EP 16

Based upon CDC data of death, narcotic prescription length of less than 5 days provided the best outcomes and the lowest risk of continued narcotic use. Learning Objectives: Understand the scope of the death attributable to narcotics Learn how to prevent a patient from becoming dependent upon opioids Consider methods to wean off opioids and use other proven agents for chronic non-cancerous pain

Oxygen for patients with STEMI: Who benefits? - Frankly Speaking EP 15

Oxygen is frequently  given to patients routinely during the initial treatment of a myocardial infarction, but there is a lack of data to support or refute this. A recent systematic review found no benefit in patients who did not have baseline hypoxia. Oxygen therapy continues to be indicated for those with hypoxia and needs to be used with caution in COPD patients with carbon dioxide retention. Learning Objectives Understand the role of oxygen in the management of acute myocardial infarction Understand the potential for harm of unnecessary oxygen therapy

Back Pain is Here to Stay! - Frankly Speaking EP 14

What are your evidence-based strategies for managing acute, subacute and chronic low back pain?  A review of the current American College of Physicians Clinical Practice Guideline can renew your toolkit as you help your patients with back pain maintain a healthy and active lifestyle. Learning Objectives Review the latest guidelines on acute, subacute and chronic low back pain (ACP 2/2017) Discuss non-pharmacologic and pharmacologic therapies available to the primary care provider

When Can We Start Preventing Recurrence of Acute Gout? - Frankly Speaking EP13

Most patients who suffer an acute gout attack should be started on urate lowering therapy. It is known that starting urate lowering therapy can itself precipitate a gout attack and concern for not worsening the acute symptoms has been the reason some guidelines recommend waiting until after the acute episode has subsided to start urate lowering therapy. A look at recent data indicates waiting for the acute attack to subside may not be necessary Learning Objectives: Understand the principles of urate lowering therapy for preventing gout attacks Be familiar with the risks and benefits or starting urate lowering therapy during an acute gout attack

Constipation: Going With the Flow - Frankly Speaking EP12

In this week's podcast episode, we will review recent literature on ineffectiveness of laxatives and learn about indications for newer agents. 

Physical Activity Following a Concussion - Frankly Speaking EP11

In this podcast episode, we will discuss current guidelines for a concussion evaluation or work-up as well as return to activity following a concussion. We will also put into context this paper and consider what impact this should have on your practice.

Treating Systolic Hypertension in the Elderly - Frankly Speaking EP10

In this podcast episode, we will talk about how systolic hypertension effects outcomes, put into context a recent JACC systematic review paper on the topic and JNC 8 and discuss NNT and NNH.