In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Mr. Ramakanta, a 75-year-old man who is having trouble sleeping at night and difficulty breathing in the day time.

In episode 597, James and Mike invite David Gardner to talk in depth about the issue of insomnia. We talk about triggers, precipitating factors, acute and chronic insomnia, and chronic use of sleeping pills. We discuss Cognitive Behavioral Therapy for Insomnia (CBT-I) and how his team has developed a comprehensive website, Sleepwell, that provides patients and clinicians with great tools and recommendations for the self-care of chronic insomnia. Mike stays awake for the whole podcast and James only has a brief nap.

Show Notes

Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals.

Visit https://mysleepwell.ca/

Some features and resources to explore are: Sleepwell stories (patient and health care professional video and written accounts) Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)

In episode 596, Mike and James talk in a PREMIUM way about three trials that used methotrexate for osteoarthritis and walking for back pain. Nothing miraculous but there seems to be an effect – so have a listen.

In episode 595, Mike and James invite Jennifer Young back to talk about the use of combined oral contraceptives for heavy menstrual bleeding (benign etiology) and see if they improve patient outcomes. They do! Have a listen to get all the numbers and see how they compare to using levonorgestrel-containing intrauterine devices or NSAIDs.

Show notes

Tools for Practice 1) How to Slow the Flow: Combined oral contraceptives 2) How to Slow the Flow: Tranexamic acid for heavy menstrual bleeding 3) How to Slow the Flow: Levonorgestrel intrauterine systems for heavy menstrual bleeding 4) How to Slow the Flow: NSAIDs for Heavy Menstrual Bleeding

In episode 594, Mike and James invite Samantha Moe back to talk about the use of the RSV vaccine in pregnancy. The only way to have an informed conversation around this vaccine is to know the numbers. If you listen to the whole podcast, you’ll get all the numbers available to date.

Show notes Tools for Practice 1)Bumpin’ Up the Protection? RSV Vaccine in Pregnancy

2) Preventing RSV Infections in Infants

3) Preventing RSV in the elderly

In episode 593, Mike and James invite Samantha Moe back to talk about a newer agent for osteoporosis. So, if you want to know all the evidence for romosozumab, tune in and all will be revealed about the benefits and harms.

Show notes 1) Tools for Practice Tony Romo-sozumab: Winning touchdown in osteoporosis or interception for the loss?

2) FRAX site for Canada

In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Jay Mal, a 9 year old boy presenting with fatigue and fever.

In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Brea Salter, a 4-year old girl presenting with wheezing.