NB Hot Topics Podcast

Welcome to the latest Hot Topics podcast from NB Medical with Dr Neal Tucker. Three great pieces of research, all from the New England Journal of Medicine, to discuss today. 

First up. Retatrutide - how effective is this injectable weight-loss medication? Can it help other problems like knee OA and OSA? Is there a downside?

Second, starting statins in the elderly. Is there any benefit in over-70-year-olds?

Third, can the Galleri multi-cancer early detection blood test improve the stage of cancer at diagnosis? We now have strong NHS data, but what does it show? 

References

Retatrutide and weight loss

Retatrutide editorial

STAREE trial

STAREE editorial

NHS Galleri trial

Galleri editorial

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Welcome to Season 8 of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Lots of research, as usual, and some future medicine too.

Do NHS health checks actually make a difference, or is it a waste of everybody's time? This month's BJGP has the answer.

From the BMJ this week, which exercises should we recommend to patients (and ourselves...) to maintain bone mineral density and prevent fractures, and how long do we need to exercise for it to make a difference?

And in JAMA, does texting or emailing patients boost statin use in patients who don't really want to take statins, or can we save ourselves some typing?

Finally, in Future Medicine, lipoprotein(a). What is it, why should we care, and what can you do about it?

References

BJGP NHS Health checks and mortality

BMJ Best exercises for BMD

JAMA Statins vs text messages

Lancet Kylo 11 and lipoprotein(a)

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this summer sizzler, we have three new pieces of research for clinicians in general practice. 

First, do antihistamines help with managing atopic eczema, or do they do more harm than good? Does which one we use matter? 

Second, exploring the pain relief achieved by opioids in the short and long term. Are there new lessons to be learned? 

Third, for an alternative way of managing chronic MSK pain, could self-directed CBT be the solution?

References

BMJ Antihistamines and eczema

UK data on use of antihistamines for eczema

Eczema Care Online

BJGP Opioid effects on pain over time

JAMA Self-directed CBT for chronic MSK pain

Podcast on chronic pain with Rangan Chatterjee and Howard Schubiner

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new pieces of research and a special interview later on discussing the recommendations of the National Screening Committee on prostate cancer screening in the UK.

First up for research: nasal sprays versus the common cold. The BJGP reports on longer-term findings through this simple intervention. Can it help this age-old problem?

Second, new kid on the block, orforglipron - could it replace SGLT2 inhibitors for management of type 2 diabetes?

Third, home-based hypnotherapy. Can it help children struggling with functional abdominal pain or IBS? We have a RCT to tell us. 

Finally, our interview with Dr Liz Bancroft, consultant nurse in oncogentics research, and Natalia Norori, interim Head of Data and Evidence at Prostate Cancer UK join us to discuss the new recommendations from the National Screening Programme with targeted screening of men with BRCA2, why they made this recommendation and how this affects us in general practice, plus what we need to know for our patients about the government-backed trial, TRANSFORM.

References

Prostate Cancer UK Information on NSC decision

Prostate Cancer UK Health Professional NSC FAQs

National Screening Committee report on prostate cancer screening

BJGP Nasal sprays for the common cold

Lancet Nasal Sprays original paper

Lancet Orforglipron vs dapagliflozin and T2DM

BJGP Hypnotherapy in children for abdo pain

National Screening Committee report on prostate cancer screening

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Lots going on in this new episode! 

Three new pieces of research and an interview with Dr Anna Martinez, consultant paediatric dermatologist at GOSH, talking about a skin fragility condition many of us may not have heard of before - epidermolysis bullosa - in conjunction with DEBRA, the leading charity for EB awareness and research. 

In research, we look at two papers published this week in finerenone. Does it have a role in CKD management in patients without diabetes, and if so, how good is it?

Second, retatruide - the latest injectable weight loss medication making a splash across the headlines - could it be used as monotherapy for recent onset type 2 diabetes?

Resources

NB Medical Epidermolysis bullosa free online educational module

DEBRA

NEJM Finerenone for CKD

Lancet Finerenone MA

Lancet Retatrutide for early T2DM

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. More new research to discuss for the world of general practice.

First, which antibiotic is actually best for managing uncomplicated UTI - is UK guidance offering the best choice to women?

Second, are you using the Kidney Failure Risk Equation in your patients with CKD? New research on how your risk of death may be much more important than your risk of end-stage renal disease.

Finally, does empathy work in telephone consultations, and can it improve important hard outcomes such as symptom control?

References

Lancet Abx for UTI

BJGP Kidney Failure Risk Equation, Death and ESRD

Kidneyfailurerisk.co.uk

BJGP Empathy and the telephone

CARE measure

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new pieces of research that affect us in general practice. 

First: What interim anti-coagulation would you give your patient with suspected VTE? One common option has 5 times the rate of major bleeding.

Second: How much muscle mass do people lose with weight loss on GLP1s? Is this different from lifestyle-based interventions, and is there anything patients can do about it?

Third: Why don't we use clinical decision support tools for cancer? This research looks at the barriers and then I over-share my own thoughts on the subject...

References

NEJM Apixaban or rivaroxaban bleeding risk with acute VTE

Diabetes, Obesity & Metabolism Lean mass loss with incretin therapies vs lifestyle interventions

BJGP: Why don't we use clinical decision tools

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Three new research papers to help us along our way in general practice this month.

First, how long do modern hip replacements last? How does this new data change our conversation with patients?

Second, it's thought GLP1 agonists could have a role in addiction management, but so far, research has failed to show a definitive benefit. Could new data from the US on veterans with type 2 diabetes show a different picture? 

Finally, what analgesia would you recommend for a child in pain? This new paper compared ibuprofen with or without paracetamol or hydromorphone - yes, an extremely potent long-acting opioid for kids. Good idea? We find out.

References

Lancet Hip replacement longevity

Lancet THR Editorial

BMJ GLP1ra and addiction

BJP editorial

JAMA Analgesia and Child  

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.Three new pieces of research to talk about in today's podcast. 

First, in the NEJM - could patients stop anti-coagulation after ablation for AF? Conventional practice says no. Does this paper change that?

Second, in JAMA - can spinal manipulation, or clinician-guided self-management, or both help with low back pain? This paper is a good crack.

Finally, in the BJGP - what do our patients think about advance care planning? Should we be talking about this more, and, if so, in whom and how?

References

NEJM Anti-coags after ablation in AF

NEJM Editorial

JAMA Low back pain

BJGP Advance care planning

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new and interesting research papers to look at. 

First, hitting the headlines this week, weight regain after cessation of GLP1 receptor agonists. Not a surprise, perhaps, but how fast does the weight come back, can anything be done to prevent it, and what are the implications for patients and the NHS?

Second, orforglipron - the new GLP1ra on the block and an oral treatment. Can it help weight loss and improvement in cardiometabolic markers in patients with obesity and type 2 diabetes? 

Finally, which is better for treating scabies - permethrin or oral ivermectin? Would a tablet be an easier option, or is it just not as good? 

References

BMJ Weight regain after cessation of weight loss medications

BMJ Editorial

BMJ Opinion 

BMJ Side Effects of GLP1ras

NEJM Orforglipron RCT in obesity

Lancet Orforglipron RCT in obesity and T2DM

BMJ Scabies treatment - ivermectin or permethrin?

PCDS Scabies guideline

BAD Scabies guideline

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