NB Hot Topics Podcast

In this latest Hot Topics Podcast, Dr Neal Tucker reflects on the NHSE Rescue Package and asks if we are going to strike are we clear what we want general practice to be? Time for us to make up our minds.In research we look at multimorbidity clusters and consultation rates - how should this influence funding? Also a ray of hope for patients with heart failure and preserved ejection fraction with empagliflozin - but is it as good as it appears to be? And two papers on AF screening including implanting a mini-ECG machine in your chest wall. Sounds like a lot of effort, but does it help???ReferencesBJGP MM & Consultation RatesNEJM Empagliflozin & HFpEFLancet STROKESTOP study & ILR studywww.nbmedical.com/podcast

In this latest episode of the Hot Topics podcast, Neal Tucker considers why the press have been attacking general practice and who stands to gain. We also look at new research in to giving anti-emetics for children with gastroenteritis, the accuracy of PHQ9 in the assessment of depression and what are safe levels of air pollution.ReferencesBMJ Air pollutionBJGP Ondansetron in children with gastroBMJ PHQ 9 accuracywww.nbmedical.com/podcast

Welcome, to Season 3 of the Hot Topics podcast with Dr Neal Tucker.In this episode, we lament why Health Secretaries appear to hate healthcare. We also look at the rationale for covid boosters with new research on the vaccine response in the immunosuppressed and waning efficacy in the general population.In other research, can a 4-in-1 pill be a helpful 1st line treatment for hypertension?  And should we all be prescribing medical cannabis? The BMJ says yes, but not how.A technical issue today means the SQ is not my best (or muppet-itis), but I've figured it out for next time!ReferencesBMJ Report Covid Vax & ImmunosuppressedNEJM Vaccine Efficacy 6 months onNEJM Israel & 3rd Dose ResultsLancet Quadpill & BPBMJ Medical Cannabiswww.nbmedical.com/podcast

In this summer holidays episode of the Hot Topics Podcast, Neal Tucker looks at the latest research for the primary care community.Firstly, three treatments for covid-19 in community-managed patients - do they work?Next rotator cuff injury - can progressive exercise beat usual care and is there ANY role for steroid injections?Finally, FIT testing for suspected colorectal cancer - do we now have the data to replace colonoscopy?And as you’re here you probably like podcasts, so have a listen to Tamsin Ellis on the BBC talking about general practice and the environment. Link below. ReferencesTamsin Ellis BBC PodcastNHS England Blood Bottle GuidanceCommunity Covid and Azithromycin, Doxycycline and ColchicineLancet Rotator Cuff Injury BJGP letterBJGP editorials - infection and CVD, expanding the role of GPBJGP FIT testingwww.nbmedical.com/podcast

In this episode, Neal Tucker squeezes in a podcast between childcare during self-isolation. When he's let out there will be a new sort of Freedom in England, should the rest of the UK be jealous? We think about rising covid numbers, how this impacts general practice (and the rest of the health service), and what role vaccination for children should play in this complex situation.Also, we look at new research on evidence-based drug optimisation strategies in multimorbid and question why they don't work and whether this matters, and antispasmodics for low back pain. Most of us prescribe them, are they really helpful?ReferencesNew Scientist Is it time for the UK to vaccination children against covid 19?JAMA Long term Symptoms After COVID infection in children and adolescentsBMJ OPERAM studyBMJ Antispasmodics in LBPwww.nbmedical.com/podcast

In this episode of the Hot Topics Podcast, Neal Tucker considers if there is a crisis of identity in GP and how the ever-increasing workload has changed the traditional role of a GP. Is there a solution? Possibly, but not everyone will agree.In new research, we focus on new technology. Are implantable rhythm monitors helpful after stroke? Do wearable glucose monitors improve diabetes care? Is more data always better?References:BJGP Editorial from Euan LawsonBJGP Editorial from Clare GeradaBJGP Editorial on crisis of identity in GPNICE Diagnostic Guideline Implantable Arrythmia MonitorsJAMA Implantable arrythmia monitors after strokeJAMA continuous glucose monitoring in T2DMLancet continuous glucose monitoring in T1DMwww.nbmedical.com/podcast

Approach a wounded animal with caution. Someone should have told this to NHS England before they wrote THAT letter. In this podcast, in classic GP style, we reflect on how this makes us feel and come to the only obvious conclusion. (We've kept it family friendly...)Meanwhile, Neal Tucker has a look at new research on COVID vaccinations and their efficacy against variants from around the world. New data on long covid which begs the question where is the tsunami we were expecting? Also getting to the heart of general practice, is there a role for grommets in recurrent acute otitis media? And finally what intervention has an NNT of 8 to prevent death in diabetics? Here's a clue: it isn't a medication.ReferencesLancet Efficacy of Pfizer vaccine against UK variantBMJ Efficacy of AZ/Pfizer against Indian variantNEJM Efficacy of AZ against South African variantBMJ Re-infections from Brazilian variantBMJ Clinical sequalae after acute covidNEJM Grommets or medicine for recurrent acute otitis mediaLancet Bariatric surgery long term follow upwww.nbmedical.com/podcast

Welcome back! Neal Tucker takes you through the latest Hot Topics podcast from NB Medical.In this edition after a "cry for help" from a UK practice written in a 16-page letter to patients we look at new research in the BJGP on remoting consulting and ask for your thoughts on the state of general practice.Are we complicit in pathologising normal life? 8% of the population are on anti-depressants - what does new research tell us about how to withdraw them?We also explore new research on the benefits of lowering blood pressure even when it's not low, and how to improve motor recovery after stroke.ReferencesRob Walker's Blog on NB MedicalIvy Grove Practice letter to patientsBJGP paper on remote consultingCochrane review on antidepressant withdrawal and blogLancet Paper on Blood Pressure LoweringLancet Paper on Vagus Nerve Stimulation after strokewww.nbmedical.com/podcast

The big news this week has been the risk of cerebral venous sinus thrombosis post-AZ vaccine and it's been giving us all a headache, but this has overshadowed further new data confirming benefit of inhaled corticosteroids for acute mild covid and guidance that we can offer this to older patients on a case-by-case basis.In the latest Hot Topics podcast Neal Tucker discusses the facts, figures, management and ethics of post-AZ vaccine thrombosis, reviews the Principle trial showing we now have a viable treatment for mild covid; and data on the rate of multi-organ dysfunction and death at 4 months post-hospital discharge for covid.ReferencesMHRA data on AZ vaccine and thrombosis riskCDC Data on Johnson&Johnson vaccine and thrombosis riskCDC Data on Transmission ReductionSTOIC trial Lancet RespPrinciple trialNHS recommendations from the Principle trial dataBMJ post-covid syndrome dataUnHerd Did I Give My Patients COVID?www.nbmedical.com/podcast

Big news in this new Hot Topics podcast as we discuss very positive data on the role of inhaled budesonide for early mild COVID in community-based patients - the STOIC trial may radically change our management of COVID but why hasn't this been a huge story and should we wait to change our practice?Also, we look at a BMJ paper examining the risk of catching and dying from COVID if you are an adult with children at home, a Lancet paper looking at only 3 days of antibiotics for pneumonia and more data on semaglutide and it's role in weight loss and improvement in non-alcoholic steatohepatitis.References:STOIC website and pre-printBMJ COVID and kids cohort studyLancet Pneumonia trialLancet Semaglutide and weight loss in T2DMNEJM Semaglutide and NASHwww.nbmedical.com/podcast