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-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

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 Com

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

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-li

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

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 al Secondhand nicotine vaping at home and respiratory symptoms in young adults Thorax Published Online First: 10 January 2022. doi: 10.1136/thoraxjnl-2021-217041 Caponnetto P, Caruso M, Maglia M

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-272 Overview: Clinicians need to accurately assess the degree of heart failure at the bedside to make appropriate management decisions. However, the common bedside practice of estimating right atrial pressure by measuring jugular venous pressure (JVP) has several accuracy limitations. This session focuses on the use of point-of-care ultrasound (POC-US) to improve the accuracy of JVP measurements. Join us to hear the salient findings from a recent study comparing POC-US measurements to right heart catheterization measurements, and walk away with a clear understanding of how POC-US can quickly and easily improve accuracy. Episode resource links: Wang L, Harrison J, Dranow E, Aliyev N, Khor L. Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion. Ann Intern Med. 2021 Dec 28. doi: 10.7326/M21-2781. Epub ahead of print. Guest

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-271 Overview: Given the prevalence of cardiovascular disease (CVD) in the United States, it is key for primary care providers to counsel patients on the importance of exercise for CVD prevention. This brief podcast explores data that will help clinicians understand the need to prescribe exercise and rehabilitation in the primary care setting. You’ll walk away with clear guidance to offer patients and ultimately improve outcomes in CVD as well as multiple chronic diseases. Episode resource links: Naci, H., & Ioannidis, J. P. (2015). Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. British journal of sports medicine, 49(21), 1414–1422. https://doi.org/10.1136/bjsports-2015-f5577rep   Sanchis-Gomar, F., Lavie, C. J., Marín, J., Perez-Quilis, C., Eijsvogels, T. M., O’Keefe, J. H., ... & Blair,

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-270 Overview: You know GLP-1 RAs are an important class of agents for weight loss, but do you know which drug within this class is right for your patient? This brief podcast walks you through the recent evidence from the STEP 8 randomized clinical trial, comparing the efficacy and adverse reaction profiles for 2 GLP-1 RAs: semaglutide (Wegovy) and liraglutide (Saxenda). This is a must-listen for anyone looking to optimally individualize care for patients with obesity. Episode resource links: Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. doi:10.1001/jama.2021.23619 Guest: Jillian Joseph, MSPAS, 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-269 Overview: Join us as we discuss the trajectories of prescription drug misuse from adolescence through adulthood. This session explores the findings from a longitudinal cohort study demonstrating the need for screening patients from adolescence through adulthood for substance use disorder. You’ll walk away with the tools and resources you need to accurately screen patients and determine next best steps for each individual. Episode resource links: McCabe, S. E., Schulenberg, J. E., Schepis, T. S., Evans-Polce, R. J., Wilens, T. E., McCabe, V. V., & Veliz, P. T. (2022). Trajectories of Prescription Drug Misuse Among US Adults From Ages 18 to 50 Years. JAMA network open, 5(1), e2141995. https://doi.org/10.1001/jamanetworkopen.2021.41995 PMID: 34982159 National Institute on Drug Abuse (NIDA) Drug Screening Tool for use in general medical settings:  https://ar

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-268 Overview: This episode will help bring awareness to the importance of educating patients about post-exposure prophylaxis (PrEP) in the primary care setting. This talk will also discuss how to reduce the stigma surrounding this prevention method. Finally, you will hear about the newly FDA approved PrEP treatment option that could potentially improve outcomes for patients.    Episode resource links: https://www.healio.com/news/infectious-disease/20211220/fda-approves-first-longacting-injectable-for-hiv-prevention Philbin, M. M., Parish, C., Kinnard, E. N., Reed, S. E., Kerrigan, D., Alcaide, M. L., ... & Metsch, L. R. (2021). Interest in long-acting injectable pre-exposure prophylaxis (LAI PrEP) among women in the women’s interagency HIV study (WIHS): a qualitative study across six cities in the United States. AIDS and Behavior, 25(3), 667-678.   Kim Y.

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-267 Overview: The clinical literature is filled with new and evolving evidence on the use of e-cigarettes and potential harms. The question of their use as a harm reduction strategy is a hotly debated topic—pitting traditional combustible tobacco with its well-known effect on morbidity and mortality against electronic nicotine delivery systems (ENDS), which although not harmless, are considered less harmful than smoked cigarettes. Recent evidence is emerging on the potential cardiovascular risks posed by newer generations of ENDS with far greater delivery of nicotine. Join us while we discuss the findings from a recent study that examines ENDS use and associated increase rates of erectile dysfunction (ED) and how this information may impact your practice. Episode resource links: El-Shahawy O, Shah T, Obisesan OH, Durr M, Stokes AC, Uddin I, Pinjani R, Benjamin

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-266 Overview: ‘Tis the season for pediatric fevers! Join us to review a recent meta-analysis looking at 18 studies with patients younger than 2 years old who received acetaminophen or ibuprofen for fever or pain to determine if one medication should be recommended first, before the other. After this session, you’ll be able to confidently advise parents of young children on how best to manage fever and/or pain at home with over-the-counter medications.   Episode resource links: Long B, Gottlieb M. Ibuprofen vs. Acetaminophen for Fever or Pain in Children Younger Than Two Years. Am Fam Physician. 2022 Jan ;105(1):19. Wong T, Stang AS, Ganshorn H, Hartling L, Maconochie IK, Thomsen AM, Johnson DW. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Evid Based Child Health. 2014 Sep;9(3):675-729. doi: 10.1002/ebch.1978. PMID: 25236309. S

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-241   Overview: Seven percent of the US population has an active levothyroxine prescription, which is significantly greater than the number of people diagnosed with overt hypothyroidism. Many of these prescriptions appear to be for the treatment of subclinical hypothyroidism and other conditions in euthyroid individuals. Join us to uncover the latest findings on the use of levothyroxine and what the evidence tells us about appropriate use and misuse of this drug.   Episode resource links: Brito, J., Ross, J., El Kawkgi, O., Maraka, S., Deng, Y., Shah, N., Lipska, K. & (9000). Levothyroxine Use in the United States, 2008-2018. JAMA Internal Medicine, Publish Ahead of Print, doi: 10.1001/jamainternmed.2021.2686. Johansen, M., Marcinek, J., Yun, J. & (2020). Thyroid Hormone Use in the United States, 1997–2016. Journal of the American Board of Family Medicin

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-265 Overview: Most cases of COVID-19 will resolve without interventions, but some patients are at high risk for complications. Several treatment options for high-risk patients are now available to help prevent the need for hospitalization. Join us to review a recent large, randomized trial evaluating fluvoxamine as a treatment for high-risk patients who were diagnosed with COVID-19.   Episode resource links: Reis G, et al. TOGETHER investigators. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health. 2022 Jan;10(1):e42-e51 Berwanger O. Fluvoxamine for outpatients with COVID-19: where do we stand? Lancet Glob Health. 2022 Jan;10(1):e2-e3. doi: 10.1016/S2214-109X(21)00501-5 https://activ6study.org/ Guest: Alan M. Ehrlich, MD, FAAFP

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-264 Overview: Get answers to your questions on COVID-19 infection in children. Listen to this podcast to review outcomes and potential risk factors associated with acute COVID-19 infection in this population. Finally, learn the status of immunizations for children younger than 5 years of age.   Episode resource links: JAMA Netw Open. 2022;5(1):e2142322. doi:10.1001/jamanetworkopen.2021.42322 Guest: Jillian Joseph, MSPAS, 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-263   Overview: The FDA’s recent emergency use authorization (EUA) for oral agents to treat COVID-19 means that primary care providers (PCPs) will be on the frontline of treating patients with COVID-19. Therefore, PCPs must understand who is eligible for such treatments and how to prescribe them. We will discuss the results of the recent FDA EUA for Pfizer’s Paxlovid and Merck’s molnupiravir antiviral agents and give you the information you need to confidently prescribe them.   Episode resource links: FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR MOLNUPIRAVIR (fda.gov) FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR PAXLOVID (fda.gov) 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-262   Overview: Join us as we discuss menopausal transition and the unique qualities and symptoms that are bothersome to women at an early age.   Episode resource links: Coslov, N., Richardson, M. K., & Woods, N. F. (2021). Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey. Menopause (New York, N.Y.), 28(9), 1012–1025. https://doi.org/10.1097/GME.0000000000001805 https://pubmed.ncbi.nlm.nih.gov/34313615/   ACOG Practice Guidelines: Clinical Guidelines on the Management of Menopausal Symptoms: https://www.aafp.org/afp/2014/0901/p338.html Women Living Better Website:  https://womenlivingbetter.org/ Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., Bobo, W. V., Rubin, L. H., Koleva, H. K., Cohen, L. S., Soares,

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-261   Overview: Stroke is a major health problem, and the risk of stroke is five-times higher in individuals with atrial fibrillation (AF) than those without. AF can be asymptomatic or subclinical. In 18% of AF patients, the condition is only detected at the time of stroke. It is not known whether individuals whose AF is deterred via screening carry a similar risk to individuals with known AF. A recent randomized trial evaluated a screening program for AF in individuals at high risk of stroke; for individuals identified with AF, anticoagulation was given for stroke prevention.   Episode resource links: Svendsen JH, Diederichsen SZ, Højberg S et al. Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial. Lancet. 2021 Oct 23;398(10310):1507-1516 Guest: Alan Ehrlich MD, FAAFP  

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-260   Overview: We will review the current USPSTF recommendations regarding aspirin use to reduce the risk of CVD and colorectal cancer. Additionally, we will discuss as well as the findings of the ASPREE (ASPirin in reducing events in the elderly) randomized clinical trial.   Episode resource links: POEMs: In Older Adults, Aspirin Increases the Risk of Metastatic of Stage 4 Cancers and Cancer Mortality. Barry, Henry C. Am Fam Physician. 2021 Sep; 104(2):online Effect of Aspirin on Cancer Incidence and Mortality in Older Adults. McNeil, John. JNCI: Journal of the National Cancer Institute Volume: 113 Issue 3 (2021) ISSN: 0027-8874 Online ISSN: 1460-2105 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato