Frankly Speaking About Family Medicine

Your Gut Doesn’t Have to Be Irritated: Treatment Options for IBS - Frankly Speaking Ep 365

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-365
Overview: The chronic nature of irritable bowel syndrome (IBS) necessitates persistence when trialing treatment options. After reviewing key identifiers of IBS, we discuss a second-line treatment’s efficacy in reducing symptoms and improving quality of life for patients with continued IBS symptoms. Tune in for valuable insights to make informed recommendations for your patients.
Episode resource links:
Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial - PubMed (nih.gov)
https://www.aafp.org/pubs/afp/issues/2005/1215/p2501.html
Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Richard Onorato

Can Saline Rinsing and Gargling Clear the Path to COVID-19 Relief? - Frankly Speaking Ep 364

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-364
Overview: In this episode, we explore a nonpharmacologic approach to easing symptoms of COVID-19 in patients who are at lower risk of progression. Supported by a small study, a nasal saline rinse and gargle regimen was associated with more rapid symptom resolution and lower hospitalization rates. Learn how a simple salt solution can be an effective step in preventing adverse outcomes of COVID-19 for patients who are at low risk.
Episode resource links:
Am Col Allergy Asthma and Immunology: https://acaai.org/news/new-study-gargling-with-salt-water-may-help-prevent-covid-hospitalization/
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato

Vitamins and Supplements for T2DM: What’s the Best Approach? - Frankly Speaking Ep 363

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-363
Overview: Patients often reach for vitamins and supplements in type 2 diabetes mellitus (T2DM) management, but what does the research show? In this episode, you’ll hear expert faculty discuss the efficacy of vitamins and supplements, debunk common myths, and explore the power of dietary changes and exercise. Deepen your knowledge to guide your patients toward taking evidence-based steps in their T2DM management.
Episode resource links:
CinnamonJ Pharmacy Practice. 2017;30(6):631-638.J Med Food . 2011 Sep;14(9):884-9. doi: 10.1089/jmf.2010.0180J Endocr Soc. 2020 Nov 1; 4(11): bvaa094
ChromiumBiol Trace Elem Res. 2022 Feb;200(2):516-525. 
Vitamin CDiabetes Metab Syndr. 2023 Jul 7;17(8):102824.
Vitamin DAnn Intern Med. 2023 Mar;176(3):355-363. doi: 10.7326/M22-301
Soluble Fiber:   Diabetes Care. 2019 Jan 7. pii: dc181126. doi: 10.2337/dc18-1126
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Richard Onorato

”I Am Tired!” How Common is Iron Deficiency in Women? - Frankly Speaking Ep 362

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-362
Overview: Recorded live at Pri-Med East! Iron deficiency and IDA are common, especially in women of childbearing age, and often under diagnosed. These conditions carry with them risk for increased morbidity and mortality. Screening is focused on high-risk groups, specifically toddlers and pregnant women, however these conditions in women of childbearing age are also common. Please join us to discuss the recent data on the prevalence of ID/IDA, how to appropriately screen and treat this common condition. 
Episode resource links:
Weyand AC, Chaitoff A, Freed GL, Sholzberg M, Choi SW, McGann PT. Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020. JAMA. 2023;329(24):2191-2193. doi:10.1001/jama.2023.8020
Dyna-Med: https://www-dynamed-com.umassmed.idm.oclc.org/management/treatment-of-iron-deficiency-anemia-in-adults#IRON_DEFICIENCY_WITHOUT_ANEMIA
 
NIH Iron Fact Sheet for Health Professionals: https://ods-od-nih-gov.umassmed.idm.oclc.org/factsheets/Iron-HealthProfessional/
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Psilocybin for Depression: Are Magic Mushrooms Doing the Trick? - Frankly Speaking Ep 361

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-361
Overview: In this episode, we delve into a topic of growing interest in medicine—the use of psilocybin to treat depression. Join us as we discuss the pharmacotherapeutic action of psilocybin and the results of a recent study that has suggested that a one-time dose of psilocybin can be an effective treatment for depression. Hear valuable insights into the potential benefits and limitations and feel prepared to respond to patient questions about this treatment.
Episode resource links:
JAMA. 2023;330(9):843-853. doi:10.1001/jama.2023.14530
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato

Medical Myths: Grapefruit Juice, Broccoli, and Biotin - Frankly Speaking Ep 360

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-360
Overview: Join us as we examine common medical myths encountered in primary care. Hear what the evidence has to say about grapefruit and statins, vitamin K-rich vegetables and warfarin, and biotin for treating hair loss. Stay informed, challenge assumptions, and enhance your practice with insights on these long-held beliefs.
Episode resource links:
Grapefruit: Am J Med 2016; Vol 129 (1): 26-29, Br J Clin Pharmacol. 2011 Sep;72(3):434-41.
 
Warfarin: Medicine (Baltimore). 2016 Mar;95(10):e2895
 
Biotin: The Journal of Clinical and Aesthetic Dermatology. 2020;13(3):37-40
Guest: Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Walking, Riding, Lifting—Is One Exercise Better than Another? - Frankly Speaking Ep 359

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-359
Overview: There is plenty of evidence linking exercise to improved overall health. It is associated with weight loss, improved biomarkers, improved sleep, and mood. The few studies comparing types and intensity of exercise have resulted in varied and inconsistent findings. Listen in as we discuss a recent prospective cohort study examining associations between combinations of exercise and reduction in all-cause, cardiovascular, and cancer mortality and how the evidence can inform your practice to improve patients’ health.
Episode resource links:
López-Bueno, R., Ahmadi, M., Stamatakis, E., Yang, L., & Del Pozo Cruz, B. (2023). Prospective Associations of Different Combinations of Aerobic and Muscle-Strengthening Activity With All-Cause, Cardiovascular, and Cancer Mortality. JAMA internal medicine, 183(9), 982–990. https://doi.org/10.1001/jamainternmed.2023.3093
 
Standards of Care, 2023 American Diabetic Association. https://diabetesjournals.org/care/issue/46/Supplement_1
 
https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
 
https://diabetes.org/health-wellness/fitness
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Prophylactic Power: Doxycycline’s Role in STI Prevention - Frankly Speaking Ep 358

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-358
Overview: In this episode, we explore new data that could reshape how we approach sexually transmitted infection (STI) prevention in clinical practice. Discover how doxycycline can serve as prophylaxis for bacterial STIs in populations who are at high risk and come away with practical strategies for counseling patients on STI prevention. Tune in to enhance your clinical expertise and provide superior care to your patients.
Episode resource links:
Luetkemeyer AF, Donnell D, Dombrowski JC, et al. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. N Engl J Med. 2023;388(14):1296-1306. 
Guest: Alan M. Ehrlich MD, FAAFP Music Credit: Richard Onorato

Emergency Contraception—Can It Be More Effective? - Frankly Speaking Ep 357

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-357
Overview: Progesterone-based emergency contraception (EC) is established as a method to reduce the risk of pregnancy after unprotected intercourse. This EC works by blocking or delaying ovulation. However, if taken after ovulation, there is a higher failure rate. A recent study showed increased efficacy of levonorgestrel when given with a COX-2 inhibitor (NSAID). Please join us as we discuss the results of the randomized controlled trial, including the efficacy of levonorgestrel when taken with piroxicam and their potential to reduce EC failure.
Episode resource links:
Li, R. H. W., Lo, S. S. T., Gemzell-Danielsson, K., Fong, C. H. Y., Ho, P. C., & Ng, E. H. Y. (2023). Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet (London, England), 402(10405), 851–858. https://doi.org/10.1016/S0140-6736(23)01240-0
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato

Addressing Penicillin Allergies in Primary Care - Frankly Speaking Ep 356

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-356
Overview: Patient-reported penicillin allergies are common; however, more than 95% of such patients have negative penicillin allergy testing and will tolerate subsequent antibiotic use. Currently, disproving a penicillin allergy includes negative skin testing followed by an oral challenge, which is considered the gold standard to remove the penicillin allergy label, as skin testing alone lacks 100% negative predictive value. Recent reports have suggested that low-risk individuals can be assessed with a direct oral challenge, but the safety and efficacy of such an approach has not been rigorously studied. Listen in as expert faculty discuss a recent randomized controlled trial that validates such an approach.
Episode resource links:
Trubiano JA, Vogrin S, Chua KYL et al. Development and Validation of a Penicillin Allergy Clinical Decision Rule. JAMA Internal Med. Published March 16, 2020. doi:10.1001/jamainternmed.2020.0403
JAMA Intern Med. doi:10.1001/jamainternmed.2023.2986
Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato