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-376 Overview: While GLP-1 agents are center stage in the medical and lay press, drugs in the class of sodium-glucose cotransporter 2 inhibitors (SGLT2is) are also quite remarkable at improving a variety of health endpoints. This episode provides an overview of studies supporting the use of SGLT2is to improve patient outcomes. Episode resource links: DM/HF:  Age Ageing 2024 Jan 2;53(1):afad254. doi: 10.1093/ageing/afad254 Kidney stones: JAMA Intern Med. 2024 Jan 29:e237660. doi: 10.1001/jamainternmed.2023.7660 Guest: Susan Feeney, DNP, FNP-BC, NP-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-375 Overview: Listen in as we discuss trends seen in breast cancer incidence over recent decades. Despite a notable rise in its prevalence, we’ve witnessed a decline in mortality rates. This positive shift owes itself to improvements in medication and screening efforts. Explore with us the multifaceted factors shaping this evolving landscape of breast cancer diagnosis and treatment. Episode resource links: https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html https://www.uspreventiveservicestaskforce.org/uspstf/ Caswell-Jin, J. L., Sun, L. P., Munoz, D., Lu, Y., Li, Y., Huang, H., ... & Plevritis, S. K. (2024). Analysis of Breast Cancer Mortality in the US—1975 to 2019. JAMA, 331(3), 233-241. Xu, S., Murtagh, S., Han, Y., Wan, F., & Toriola, A. T. (2024). Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Rac

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-374 Overview: This episode explores the use of data from smartphone recordings as a diagnostic tool for obstructive sleep apnea (OSA), highlighting at-home testing as a more accessible, convenient, and appropriate option for some patients. Hear how the evidence can inform your practice and improve the diagnosis and treatment of patients with OSA. Episode resource links: Han SC, Kim D, Rhee CS, Cho SW, Le VL, Cho ES, Kim H, Yoon IY, Jang H, Hong J, Lee D, Kim JW. In-Home Smartphone-Based Prediction of Obstructive Sleep Apnea in Conjunction With Level 2 Home Polysomnography. JAMA Otolaryngol Head Neck Surg. 2024 Jan 1;150(1):22-29. doi: 10.1001/jamaoto.2023.3490. PMID: 37971771; PMCID: PMC10654929. OSA and CV disease in adults, UpToDate Home sleep apnea testing for adults, UpToDate 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-373 Overview: In this episode, we review the effectiveness of intensive lifestyle intervention for type 2 diabetes mellitus (T2DM) remission. We unpack study findings on total diet replacement and consider its potential for improving weight loss and maintenance in patients. Tune in to enrich your clinical toolkit, empowering you to optimize patient outcomes and enhance quality of life. Episode resource links: Hocking, S. L., Markovic, T. P., Lee, C. M. Y., Picone, T. J., Gudorf, K. E., & Colagiuri, S. (2024). Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus. Diabetes care, 47(1), 66–70. https://doi.org/10.2337/dc23-0781   Centers for Disease Control:  Diabetes Care for Providers: https://www.cdc.gov/diabetes/professional-info/index.html   Optifast USA: https://www.optifast.com/   Pattinso

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-372 Overview: Listen in as we unwrap Consumer Reports’ findings on heavy metals found in commonly consumed chocolate products. Our discussion looks into concerns about high levels of metals like lead and cadmium in these treats and offers advice on how to counsel your patients for worry-free chocolate enjoyment.  Episode resource links: A Third of Chocolate Products Are High in Heavy Metals, CR T - Consumer Reports 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-371 Overview: Beta-blockers have traditionally been used indefinitely after a myocardial infarction (MI), but this is now only recommended for a subset of patients. Listen in as faculty review new recommendations for managing patients with chronic cardiac disease, including how to determine which patients are good candidates for beta-blocker therapy and for how long. Episode resource links: Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2023 Sep 26;148(13):e148] [published correction appears in Circulation. 2023 Dec 5;148(23):e186]. Circulation. 2023;148(9):e9-e119.  Joo SJ. Beta-blocker therapy in pati

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-370 Overview: Low back pain is one of the most common symptoms presenting in primary care. Listen in as we analyze the results of a recent systematic review supporting the use of a variety of effective nonnarcotic treatments for this condition. Gain evidence-based insights to help you choose the most informed option for managing low back pain. Episode resource links: Gianola S, Bargeri S, Del Castillo G, et al. Br J Sports Med 2022;56:41–50. doi.org/ 10. 1136/ bjsports- 2020- 103596). 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-369 Overview: Uncover a simple, 10-second intervention—the 1-legged stance test—for predicting the risk of falling in adults. Join us as we discuss how this swift assessment can help identify patients who are prone to falls, fractures, and increased mortality. This episode brings you a practical tool to enhance patient assessments and tailor interventions, contributing to a more proactive and personalized approach to care. Episode resource links: JAMA. 2023;329(18):1605-1607. doi:10.1001/jama.2023.3054 Br J Sports Med. 2022;56:975–980. Pharmacoepidemiol Drug Saf. 2021 Aug;30(8):1049-1056. doi: 10.1002/pds.5201 PLoS Med 18(11): e1003821. https://doi.org/10.1371/journal.pmed.1003821 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-368 Overview: In this insightful episode, we explore compelling data comparing inappropriate prescribing practices among physicians and nonphysician prescribers. This discussion covers the nuances and restrictive scope of prescribing authority and aims to take an evidence-based approach to encouraging collaboration between clinicians and expanding patients’ access to care. Episode resource links: Huynh, J., Alim, S. A., Chan, D. C., & Studdert, D. M. (2023). Inappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians. Annals of internal medicine, 176(11), 1448–1455. https://doi.org/10.7326/M23-0827 American Association of Nurse Practitioners https://www.aanp.org/ American Academy of Physician Associates https://www.aapa.org/ Jiao, S., Murimi, I. B., Stafford, R. S., Mojtabai, R., & Alexander, G. C. (2018). Quality of Pr

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-367 Overview: Join us for a look at the Portfolio Diet, a plant-based approach with potential to improve cardiovascular outcomes. We’ll take you through the details of this regimen and what the evidence says about its effect on the risks of cardiovascular diseases. Stay informed on the latest research and feel prepared to answer your patients’ questions about the Portfolio Diet. Episode resource links: Circulation. 2023;148:00–00. DOI: 10.1161/CIRCULATIONAHA.123.065551 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-366 Overview: Join us as we explore the nuances of healthy eating patterns, distinguishing between time-restricted and calorie-restricted approaches. We also review a randomized controlled trial that found time-restricted eating for people with type 2 diabetes mellitus (T2DM) can benefit HbA1c levels and weight reduction. Gain insights to elevate patient care in understanding and implementing these impactful dietary strategies. Episode resource links: Pavlou V, Cienfuegos S, Lin S, et al. Effect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2339337. doi:10.1001/jamanetworkopen.2023.39337 Jefcoate PW, Robertson MD, Ogden J, Johnston JD. Exploring Rates of Adherence and Barriers to Time-Restricted Eating. Nutrients. 2023 May 16;15(10):2336. doi: 10.3390/nu15102336. PMID: 37242218;

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

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

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: Cinnamon J Pharmacy Practice. 2017;30(6):631-638. J Med Food . 2011 Sep;14(9):884-9. doi: 10.1089/jmf.2010.0180 J Endocr Soc. 2020 Nov 1; 4(11): bvaa094 Chromium Biol Trace Elem Res. 2022 Feb;200(2):516-525.  Vitamin C Diabetes Metab Syndr. 2023 Jul 7;17(8):102824. Vitamin D Ann 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: Ji

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-adul

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

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

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.2

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

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/