CFPCLearn

Older adults can often present with moderate-severe intensity general symptoms and a broad workup may need to be supplemented with a detailed history. In this case, we explore one such case of an older adult with cryptic abdominal pain. 

1.       Understand the importance of a detailed and organized history in accurately diagnosing acute medical issues.  

2.       Acknowledging age-related biases and their role in medical care.  

3.       Highlight the central role of family discussions with geriatric patients.   

In episode 560, Mike and James finish their discussion around the use of hallucinogens/psychedelics by going over the psilocybin evidence. As with ketamine we cover the many limitations of the evidence around psilocybin and also talk about the side effects, costs and inconvenience. So now you know all we know for what that is worth.

Show notes

HANDOUT From Hallucinations to Healing: The Rise of Novel Mental Health Therapies

In episode 559, Mike and James continue to discuss the best available evidence around ketamine and severe depression. We go over the many limitations of the evidence and at the end we wrap it all up by going over the side effects, costs and inconvenience.

Show notes

HANDOUT Psychodelics Podcast From Hallucinations to Healing?

In episode 558, Mike and James decide to start to tackle the ketamine for depression story. Mike talks about what the media says about ketamine and then he delves into what the guidelines say. Then as always, we discuss the best available evidence. Have a listen so that you can be in the know about ketamine.

Show notes

HANDOUT Psychodelics Podcast From Hallucinations to Healing?

Episode 557: Fancy Creams for Scaly Skin: Topical calcineurin inhibitors for atopic dermatitis

In episode 557, Mike and James invite Emelie Braschi back to the podcast to talk about how effective topical calcineurin inhibitors are for atopic dermatitis. We’ll give you all the numbers so have a listen and learn what they are.

Show notes

Tools for Practice Fancy Creams for Scaly Skin: Topical calcineurin inhibitors for atopic dermatitis

In episode 556, Mike and James have Betsy Thomas back to podcast to talk about how effective are artificial tears for people with dry eyes. Both of us cry halfway through the podcast because of the craziness and inconsistency of the evidence. Have a listen and see what we found.

Show notes

Tools for Practice Not a Dry Eye in the House – Looking into Artificial Tears

In episode 555, James and Mike invite Jamie Falk back to the podcast to talk about the best available evidence for acetylsalicylic acid and its potential impact on reducing the risk of complications in women at risk of preeclampsia. The evidence is pretty clear and we are able to give decent estimates of the benefits and harms. Have a listen – it may change your practice.

Show notes

Tools for Practice An ASA a day when a baby’s on the way?

In episode 554, James and Mike go over a topic we have never covered in 553 previous podcasts. We invited Samantha Moe back to the podcast to talk about how effective are pelvic floor exercises or pessaries for stress urinary incontinence. We find that the magnitude of the benefits from pelvic floor exercises is fairly impressive. Tune in to find out what numbers we thought justified the phrase “fairly impressive” and see if you agree.

Show notes

Tools for Practice Stress Urinary Incontinence: Pelvic floor exercises or pessary?

In episode 553, James and Mike get Jen Potter back to talk about the last option we have for heavy menstrual bleeding – tranexamic acid. We talk about how it compares to placebo, NSAIDs, progestins and levonorgestrel intrauterine devices and go over all the numbers for benefits and harms. And then as always, we put everything into clinical context.

Show notes

1) How to Slow the Flow III: Tranexamic acid for heavy menstrual bleeding

Tools for Practice

2) Updated Simplified Lipid Guideline 2023

Canadian Family Physician October 2023, 69 (10) 675-686; DOI: https://doi.org/10.46747/cfp.6910675

3) CFPC Learn

In episode 552, James and Mike go over a couple of new trials. We talk about a blood pressure trial that examined taking the pills in the morning vs the evening and a heart failure trial that looked at getting patients on “high intensity” treatment. Find out the results here.

Show notes

Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial Lancet 2022 Oct 22;400(10361):1417-1425

Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial

Lancet 2022 Dec 3;400(10367):1938-1952