NB Hot Topics Podcast

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
www.nbmedical.com/podcast

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
www.nbmedical.com/podcast

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  
www.nbmedical.com/podcast

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
www.nbmedical.com/podcast

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
www.nbmedical.com/podcast