Frankly Speaking About Family Medicine

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

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

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

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

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.

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.

In this week's podcast episode, we will identify the known health risks of OSA and outcomes of OSA treatment, discuss the new USPSTF screening recommendations on OSA and consider application of the new recommendations, known risks and outcomes of practice.

In this podcast episode, we will consider the rationale for using non-fasting labs to screen for ASCVD as well as review the controversies around their use and talk about the differential diagnosis of hypertriglyceridemia.

In this podcast episode, we will talk about the benefits of alpha antagonists on passing larger kidney stones as well as discuss the need for stone collection and analysis to prevent future stones. We will also learn how to effectively counsel patients about alpha antagonist use including risks and benefits.

In this podcast episode, we consider the premise of overdiagnosis and how it applies to women being screened for breast cancer and highlight ways to mitigate the risks of overdiagnosis of breast cancer.