Frankly Speaking About Family Medicine

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-318 Overview: Have you ever experienced impostor syndrome? Or do you mentor someone struggling with this sense of inadequacy? If so, you won’t want to miss this podcast episode. You will formulate a clear definition of impostor syndrome, understand its components, and walk away with practical tips to help overcome it... Episode resource links: J Am Coll Surg  2021 Nov;233(5):633-638. Curr Pharm Teach Learn 2022 Feb;14(2):130-132. doi: 10.1016/j.cptl.2021.11.019. Epub 2021 Dec 27 Guest: Mariyan L. Montaque, DNP, FNP-BC & Susan Feeney, DNP, FNP-BC, NP-C & Jill M. Terrien, PhD, ANP-BC   Music Credit: Richard Onorato To learn more about Primary Care Bootcamp for NPs and PAs: https://bootcamp.pri-med.com/app 

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-317 Overview: Exercise has been shown to be an effective way of decreasing migraine frequency, but the best type of exercise for this has not been established. A systematic review compared strength training to both high-intensity aerobic exercise and low-intensity aerobic exercise. Episode resource links: Woldeamanuel YW, Oliveira ABD. What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials. J Headache Pain. 2022;23(1):134. Published 2022 Oct 13. Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato

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-316 Overview: While the benefits of proton pump inhibitors (PPIs) are widely known, the same cannot be said of the risks. These common medications are generally considered “safe,” but new data suggest the potential for long-term risks. Join us to discuss these long-term risks of PPI use and whether some of your patients should step down from PPIs to H2RAs.  Episode resource links: Gut : 28 September 2020. doi: 10.1136/gutjnl-2020-322557 Gut 2022 Jan; 71:16. (https://doi.org/10.1136/gutjnl-2021-325097) Front Pharmacol. 2022 Sep 14;13:979215. doi: 10.3389/fphar.2022.979215. eCollection 2022 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato

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-315 Overview: A recent publication shows that being a “weekend warrior” exerciser provides the same benefit to mortality risk as spreading the physical activity out across the week. Listen to this podcast to hear the data from this study and to optimally counsel your patients on how to lower their mortality risk through physical activity. Episode resource links: Physical Activity Guidelines for Americans, 2nd Edition.; 2018. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf. dos Santos M, Ferrari G, Lee DH, et al. Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns With All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study. JAMA Intern Med.2022;182(8):840–848. doi:10.1001/jamainternmed.2022.2488 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

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-314 Overview: The herpes zoster virus, or shingles, is more than just a rash. Oftentimes we don’t consider the long-term risk of viruses, but we should. This episode focuses on the association between the herpes zoster virus and an increased risk of stroke. Join us to discuss data that show a reduction in stroke risk in individuals who receive the herpes zoster vaccine.  Episode resource links: Andrew N Bubak, Christina Coughlan, Janelle Posey, Anthony J Saviola, Christy S Niemeyer, Serena W R Lewis, Sara Bustos Lopez, Adriana Solano, Stephen K Tyring, Cassidy Delaney, Keith B Neeves, Ravi Mahalingam, Kirk C Hansen, Maria A Nagel, Zoster-Associated Prothrombotic Plasma Exosomes and Increased Stroke Risk, The Journal of Infectious Diseases, 2022;, jiac405, https://doi.org/10.1093/infdis/jiac405 https://www.idse.net/Review-Articles/Article/10-22/Immunization-Vacci

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-313 Overview: The prevalence of anxiety and depression has been increasing in US youth over the past decade with noted increases during the pandemic. The USPSTF recently released its recommendations supporting general screening for depression in 12- to 18-year-olds. Join us while we discuss the recommendations, the basis for these recommendations, how to integrate them into practice, and some strategies on how to support adolescents and families with a positive screen. Episode resource links: CDC Children’s Mental Health: https://www.cdc.gov/childrensmentalhealth/depression.html i. Data and Statistics on Children’s Mental Health https://www.cdc.gov/childrensmentalhealth/data.html Screening for Depression and Suicide Risk in Children and Adolescents - US Preventive Services Task Force Recommendations Statement; JAMA. doi:10.1001/jama.2022.16946. Published online

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-312 Overview: Brain training activities have been advocated to slow or prevent cognitive decline. Crossword puzzles can be cognitively demanding and have recently been shown to be superior to some of the brain training activities that have been promoted on apps and websites. Join us for discussion on how to counsel patients looking to improve their cognitive function. Episode resource links: Pillai JA, Hall CB, Dickson DW, Buschke H, Lipton RB, Verghese J. Association of crossword puzzle participation with memory decline in persons who develop dementia. J Int Neuropsychol Soc. 2011;17(6):1006-1013. Devanand DP et al. Computerized Games versus Crosswords Training in Mild Cognitive Impairment. NEJM Evidence October 27,2022 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato

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-311 Overview: Join us to discuss the results of a randomized controlled trial that evaluated the influence of increased dairy intake on fractures in older adults. Learn how this simple intervention can significantly mitigate the risk of falls and fractures in this vulnerable population. Episode resource links: BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2364 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato

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-310 Overview: Join us as we discuss the importance of assessing for sexual dysfunction in young women with a cancer diagnosis.  Episode resource links: Lena Wettergren, Lars E. Eriksson, Charlotta Bergström, Christel Hedman, Johan Ahlgren, Karin E. Smedby, Kristina Hellman, Roger Henriksson & Claudia Lampic (2022): Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis – a population-based study, Acta Oncologica, DOI: 10.1080/0284186X.2022.2112283 https://doi.org/10.1080/0284186X.2022.2112283 Guest: Jill Terrien PhD, ANP-BC   Music Credit: Richard Onorato

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-309 Overview: Listen to this podcast to get answers to important questions about vitamin D supplementation in the first year of life. We will review a recent systematic review and meta-analysis on the relationship between vitamin D supplementation in the first year of life and outcomes, and we will discuss how these findings can be applied to your practice. Episode resource links: Nutrients; 2021 Feb 5;13(2):524. doi: 10.3390/nu13020524 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

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-308 Overview: In this episode, each podcaster will discuss the most impactful paper and podcast of the year. Episode resource links: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-302 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-299 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-281 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-275 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-268 Guest: Alan Ehrlich MD, FAAFP, Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C, Mariyan L. Montaque, DNP, FNP-BC, Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato

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-307 Overview: The COVID-19 epidemic resulted in overflowing ICUs and significant numbers of deaths among older adults. A recent study looked at the differences in outcomes between patients admitted with “No-code” vs “CPR” status and found no difference for high-risk individuals. Listen to this brief podcast to explore the data from this study and, in turn, give patients the information they need to make informed decisions regarding their desired code status on their advanced directives. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

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-306 Overview: In 2015, a landmark study, LEAP (Learning Early About Peanut Allergy), found that early introduction to peanuts, at 4 to 6 months, significantly reduced the incidence of peanut allergies in all children but especially in those at high risk for allergies. A recent survey of pediatric residents and attendings in a large academic center regarding knowledge and implementation of the guidelines uncovered a significant knowledge gap impacting the health of children. Join us as we discuss this gap and review the guidelines for preventing peanut allergies in infants and children.   Episode resource links: Sandhu S, Hanono M, Nagarajan S, Vastardi MA. Knowledge assessment of early peanut introduction in a New York City population [published online ahead of print, 2022 Jun 18]. Ann Allergy Asthma Immunol. 2022;S1081-1206(22)00534-8. doi:10.1016/j.anai.2022.0

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-305 Overview: We will review the general treatment approach to gastroesophageal reflux disease (GERD) and the risks of using proton pump inhibitors (PPI) for long durations. In particular, we will examine a new study that links PPI use, in comparison with H2 receptor antagonist (H2RA) use, with a significant increase in the risk of gastric cancer. This episode will highlight the importance of looking at PPIs on a medication review and evaluating whether patients are taking them for longer than needed.   Episode resource links: Abrahami D, McDonald EG, Schnitzer ME, et al. Proton pump inhibitors and risk of gastric cancer: population-based cohort study. Gut. 2022;71(1):16-24. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

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-304 Overview: Pharmacogenomic testing has been suggested as a way to personalize medicine, particularly where the metabolism of medications can vary significantly. Unfortunately, despite increasing use of this testing, there has been little evidence showing a benefit in clinical outcomes. Listen to this podcast to explore the data on clinical outcomes for pharmacogenetic testing and how to best select medication for patients with depression. Episode resource links: Oslin DW, Lynch KG, Shih MC, et al. Effect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial. JAMA. 2022;328(2):151-161. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato

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-303 Overview: Millions of Americans take Vitamin D supplementation to prevent a variety of illnesses, from COVID-19 and osteoporosis to heart disease and cancer. While most studies have failed to show a benefit in preventing COVID-19, heart disease, and cancer, the evidence has been mixed, at best, in showing benefits for preventing bone fractures. Despite this, vitamin D supplementation remains popular for fracture prevention. Join us to review a study published in the New England Journal of Medicine that failed to find any benefits for preventing fractures. Episode resource links: N Engl J Med 2022;387:299-309. DOI: 10.1056/NEJMoa2202106 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

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-302   Overview: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, with a prevalence rate of more than 30% of US adults. Most have not been diagnosed or treated. Join us to discuss the new AACE guidance on the diagnosis and treatment of NAFLD to reduce the burden of this common disease.   Episode resource links: AACE Guideline:  Endocrine Pract: May 2022, 28(5): 528-562 Coffee: Front Pharmacol. 2021 Dec 13;12:786596. doi: 10.3389/fphar.2021.786596   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato  

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-301   Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population.   Episode resource links: Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601 Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B.,

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-300   Overview: Most primary care clinicians are unaware of a possible association between childhood cat ownership and adult psychosis. Join us to hear the results of a recent retrospective study that suggests this link. Hear practical tips to share with patients who own an outdoor cat to help them avoid the toxoplasmosis that may be a potential etiologic agent for psychiatric illness.   Episode resource links: Journal of Psychiatric Research. Volume 148, April 2022, Pages 197-203 doi.org/10.1016/j.jpsychires.2022.01.058   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato  

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-299 Overview: Polypharmacy is a burden on patients with dementia. Adverse drug reactions, side effects, the cost, and inappropriate medications that may lead to falls and morbidity/mortality may be conferring more harm than benefit. Unfortunately, 44% of men and 57% of women >65 years take five or more nonprescription and/or prescription medications per day. Join us as we discuss methods for deprescribing polypharmacy in this patient population.  Episode resource links: Growdon, M. E., Gan, S., Yaffe, K., & Steinman, M. A. (2021). Polypharmacy among older adults with dementia compared with those without dementia in the United States. Journal of the American Geriatrics Society, 69(9), 2464–2475. PMID: 34101822 https://doi.org/10.1111/jgs.17291 Narayan, S. W., & Nishtala, P. S. (2017). Discontinuation of Preventive Medicines in Older People with Limited Li