Advertise on podcast: Primary Care Update

Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs (Patient Oriented Evidence that Matters, studies with the potential to change practice): a summary of the evidence on tirzepatide (Zepbound) for weight loss, using the Beers list with your patients, high vs standard dose flu vaccine and the risk of hospitalization, and whether stent or endarterectomy are better than maximal medical therapy for patients with asymptomatic carotid stensosis. Here are the links: Essential Evidence Plus: www.essentialevidenceplus.com Tirzepatide systematic review: https://pubmed.ncbi.nlm.nih.gov/41015578/ Tirzepatide vs dulaglutide: https://pubmed.ncbi.nlm.nih.gov/41406444/ Applying the Beers list: https://pubmed.ncbi.nlm.nih.gov/40697073/ High vs standard dose flu vaccine: https://pubmed.ncbi.nlm.nih.gov/41115437/ Another high dose flu trial: https://pubmed.ncbi.nlm.nih.gov/39230284/ Asymptomatic carotid stenosis treatment: https://pubmed.ncbi.nlm.nih.gov/41269206/

This week, primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry tackle 4 new practice changing studies (POEMs): bathing frequency for people with eczema, tirzepatide in obese children and adolescents with T2DM, a new flu vaccine, and whether beta-blockers still matter after MI.

Join primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new POEM (Patient Oriented Evidence that Matters), chosen for their potential to change practice and improve patient outcomes: Mediterranean diet to prevent diabetes, an update to the community-acquired pneumonia guideline, coffee or decaf for afib, and safety of meds for acute agitation in the elderly. North Dakota Academy of Family Physicians Conference in Big Sky: https://www.ndafp.org/cme/big-sky-conference/ Essential Evidence Plus and all the POEMs: www.essentialevidenceplus.com Med diet to prevent diabetes: https://pubmed.ncbi.nlm.nih.gov/40854218/ Safety of meds for agitation in elderly: https://pubmed.ncbi.nlm.nih.gov/40275439/ Updated pneumonia guidelines from ATS/IDSA: https://pubmed.ncbi.nlm.nih.gov/40679934/ Coffee or decaf with afib:  https://pubmed.ncbi.nlm.nih.gov/41206802/

Join Kate, Gary and Mark (Henry has the day off) as we discuss 3 useful new studies: colorectal cancer screening reminders, aspirin or clopidogrel for secondary prevention of CV events, and lipid lowering drugs and dementia risk

This week primary care physicians Gary, Henry, Kate and Mark discuss the safety of CBD, a new guideline for managing adults with hypertension, whether COVID-19 vaccines are still effective, and a living guideline from the BMJ to help us choose the best diabetes drugs. Links to stuff Essential Evidence Plus Illinois Academy of Family Physicians meeting Dec 6 in Naperville, IL (Kate, Gary and Mark)   North Dakota Academy of Family Physicians Big Sky Conference Jan 19 in Big Sky, Montana (Gary and Kate) Safety of CBD ACC/AHA Hypertension guideline PREVENT-CVD risk calculator Efficacy of COVID-19 vaccines BMJ living guideline for diabetes BMJ MATCH-IT interactive tool for selecting drugs

Primary care physicians Gary Ferenchick, Kate Rowland, Henry Barry and Mark Ebell want you to know about 4 new studies: the best choice of pharmacotherapy in hypertensive disorders of pregnancy, benefits and harms of intensive BP lowering, elinzanetant for therapy-induced vasomotor symptoms in women with breast cancer, and 23 year follow up of the European Prostate Cancer Screening Trial. Plus a confusing quiz question (thanks Gary!). Links Essential Evidence Plus: www.essentialevidenceplus.com HTN in pregnancy: https://pubmed.ncbi.nlm.nih.gov/40216176/ Intensive BP lowering: https://pubmed.ncbi.nlm.nih.gov/40902616/ Elinzanetant for vasomotor symptoms in patients taking tamoxifen or anastrozole: https://pubmed.ncbi.nlm.nih.gov/40454634/ 23 year follow-up of large European prostate cancer study: https://pubmed.ncbi.nlm.nih.gov/41160819/

This week, Gary, Kate, Mark and Henry discuss the optimal duration of anticoagulation after a provoked DVT, using low doses of mirtazapine or amitriptyline in adults with insomnia, whether a lower dose of semaglutide is still effective for weight loss, and adding aspirin for patients with coronary heart disease, a stent and who are also on a DOAC for another indication. Links: NICE Barrett Esophagus guideline: https://pubmed.ncbi.nlm.nih.gov/38553042/ Essential Evidence Plus: www.essentialevidenceplus.com Duration of anticoagulation: https://pubmed.ncbi.nlm.nih.gov/40888734/ Mirtazapine or amitriptyline for insomnia: ttps://pubmed.ncbi.nlm.nih.gov/39814428/ Lower dose semaglutide for obesity: https://pubmed.ncbi.nlm.nih.gov/40934115/ Adding aspirin: N Engl J Med . 2025 Oct 23;393(16):1578-1588https://pubmed.ncbi.nlm.nih.gov/40888725/

This week, primary care physicians Kate Rowland, Mark Ebell, and Henry Barry want to arm our primary care colleagues with the best evidence on whether acetaminophen causes autism, whether MMR causes autism, and whether leucovorin can treat autism. Gary then turns to a study of the value of continuity in primary care, and its association with better health outcomes. Links: Henry's essay on Ignaz Semelweis, handwashing, and postage stamps: https://thestampforum.boards.net/thread/13044/current-issue-volume-jul-2025 Essential Evidence Plus and POEMs: www.essentialevidenceplus.com Acetaminophen in pregnancy and autism: https://www.ncbi.nlm.nih.gov/pubmed/38592388 Leucovorin to treat autism: https://www.ncbi.nlm.nih.gov/pubmed/15781839, https://www.ncbi.nlm.nih.gov/pubmed/34834493 MMR and autism, Wakefield investigation: https://www.bmj.com/content/342/bmj.c5347 MMR and autism, Madsen's Danish study: https://pubmed.ncbi.nlm.nih.gov/12421889/ Value of primary care continuity: https://www.ncbi.nlm.nih.gov/pubmed/40355250 And do NOT eat roadkill. Definitely.

Today Kate, Gary, Mark and Henry discuss influenza vaccines and dementia incidence, therapies for endometriosis-related pain, colchicine for secondary prevention of heart disease, and green tea and drug absorption. Links: IgNobel prizes: IgNobel Prizes were recently awarded: https://improbable.com/ig/winners/  www.ncbi.nlm.nih.gov/pubmed/40601364  https://pubmed.ncbi.nlm.nih.gov/40373315/ Colchicine for secondary prevention of CHD: https://pubmed.ncbi.nlm.nih.gov/40314334/ Green tea and drug absorption: https://pubmed.ncbi.nlm.nih.gov/39748104/ https://www.sciencealert.com/a-distinct-new-form-of-diabetes-is-officially-recognized https://www.medscape.com/viewarticle/malnutrition-related-diabetes-officially-named-type-5-2025a10008pd

This week Gary, Kate, Henry and Mark discuss 4 important new studies that are potential POEMs: A new(ish) rescue therapy for asthma, IV thrombolytics for adults with acute minor stroke, whether exercise reduces cancer mortality, and digitoxin (with a t!) as add-on therapy for adults with heart failure.

Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine’s effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading. Links: Essential Evidence Plus: www.essentialevidenceplus.com Digital mental health app for depression: https://pubmed.ncbi.nlm.nih.gov/40227715/ RIsk of DKA with SGLT2s: pubmed.ncbi.nlm.nih.gov/40070044/ Esketamine and resistant depression or suicidality: pubmed.ncbi.nlm.nih.gov/39790081/ What is a normal TSH: https://pubmed.ncbi.nlm.nih.gov/40324200/ Joseph O'Connor and the Escape Line Trilogy (2 great novels): https://www.amazon.com/The-Rome-Escape-Line-Trilogy-2-book-series/dp/B0BSNX3C89 

This week, we found 4 great new studies for primary care physicians (and their patients): the health benefits of “incidental” activity, real world data and the amyloid cascade theory for Alzheimer’s disease, a new blood test for colorectal cancer screening, and DORAs for sleep. Check out Essential Evidence Plus: www.essentialevidenceplus.com Incidental activity: https://pubmed.ncbi.nlm.nih.gov/40228066/ New Alzheimer's definition in the real world: https://pubmed.ncbi.nlm.nih.gov/40359457/ Blood test for colorectal cancer screening:  https://pubmed.ncbi.nlm.nih.gov/40455622/ "DORAs" for insomnia: https://pubmed.ncbi.nlm.nih.gov/40555730/

Kate, Mark, Gary and Henry discuss 4 important new studies relevant to primary care clinicians: negative pressure wound therapy for wounds healing by secondary intention, comparative effectiveness of acute migraine treatments, contrast enhanced mammography, US, or MRI for women with dense breasts, and metformin for knee pain in patients without diabetes. Negative pressure wound therapy: https://pubmed.ncbi.nlm.nih.gov/40250455/ Acute migraine treatments: https://pubmed.ncbi.nlm.nih.gov/40096693/ Best enhanced screening for women with dense breasts:  https://pubmed.ncbi.nlm.nih.gov/40412427/ Metformin for knee pain in patients without DM: https://pubmed.ncbi.nlm.nih.gov/40274279/

This week our intrepid primary care docs discuss 4 new POEMs: spironolactone vs amiloride for resistant hypertension, mirtazapine for insomnia in older adults, baloxivir for influenza post exposure prophylaxis, and platelet-rich plasma injections for knee osteoarthritis. We've got opinions! Show notes: Spironolactone vs amiloride for resistant hypertension: pubmed.ncbi.nlm.nih.gov/40366680/ Mirtazapine for chronic insomnia: https://pubmed.ncbi.nlm.nih.gov/40135470/ Baloxavir to prevent flu in household contacts: https://pubmed.ncbi.nlm.nih.gov/40267424/ Platelet-rich plasma for knee OA: https://pubmed.ncbi.nlm.nih.gov/39751394/

Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs: a new and very hard to pronounce antibiotic for uncomplicated UTI, the best drugs for relieving pain in adults with fibromyalgia, a clinical trial of a multicancer detection test in asymptomatic persons, and bedtime vs morning administration of antihypertensives. Gepotidacin for uncomplicated UTI: https://pubmed.ncbi.nlm.nih.gov/38342126/ Drugs for fibromyalgia: https://www.ncbi.nlm.nih.gov/pubmed/39705187 Multicancer detection test trial: https://pubmed.ncbi.nlm.nih.gov/39948555/ TIming of antihypertensives: https://pubmed.ncbi.nlm.nih.gov/40354045/