In episode 348, Mike and James invite Mike Kolber yet again and he urgently works us through the evidence for treating hypertensive urgency. At the end we realize that asymptomatic patients with BPs >180/110 mmHg can be dealt with addition or initiation of oral agents at presentation with close outpatient follow-up. Even though it is “urgent” we don’t need to panic.

In episode 347, Mike and James get Mike Kolber to work us through all the evidence around chewing gum after bowel surgery. Believe it or not there are lots of studies and believe it or not there is reasonable benefit. The only tricky part would be to try to get hospitals to implement this protocol. 

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Tools For Practice

In episode 346, Mike and James have Adrienne work us through the rest of the evidence for medications used to treat nausea and vomiting around pregnancy. We specifically look at the evidence for diclectin, B6 alone, ginger and ondansetron and then try to figure out what we would use.

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In episode 345, Mike and James enlist Adrienne Lindblad to help us go through the tricky topic of taking medications in pregnancy. Adrienne covers the topic in general and then discusses some of the evidence around medications for nausea and vomiting around pregnancy.

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In episode 344, Mike and James discuss the impact of giving fish oil supplementation to reduce the chance of allergic disease in children. The results are consistently inconsistent which leaves us both kind of itching for the truth.

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Tools for Practice

In episode 343, Mike and James talk about a paper they recently published about how we need to think about confidence intervals and how one can think overall about the results of clinical trials. The bottom line is to be more pragmatic and less dogmatic and remember the answers are rarely yes and no.

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In episode 342, James and Mike talk about yet another Vitamin D meta-analysis and explain why it really changes nothing when it comes to Vitamin D. But then we talk about a novel RCT on ultrasound treatment for serious hand tremor and it makes us shake all over.

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In episode 340, Mike and James get all bent out of shape when they discuss the evidence around spinal manipulative therapy and low back pain. The evidence suggests no reliable effect for acute pain but the possibility of an effect for chronic pain. But any recommendations are a stretch because of the poor quality of the evidence.

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In episode 339, Mike and James talk about the evidence that has do with do with whether you need to use sterile gloves and saline for excisions and lacerations. The answer is that you should insert a suppository with the non-tapered end first.  Listen to the podcast and see how we come to that conclusion.

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1) Tools for practice

In episode 338, Tina, Mike and James go over the best available evidence around the treatment for recurrent vulvovaginal candidiasis and we find that we can reduce relapse with regular use of azole antifungals or we could just treat when symptoms occur – guess what, it’s all up to patient preference. Oh, and treating the partner makes no difference.

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