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Frankly Speaking About Family Medicine

English, Sciences, 1 season, 391 episodes, 3 days, 37 minutes
About
A weekly Podcast series covering newsworthy topics in primary care medicine.
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Fact-Checking Social Media: Pregnancy, Acetaminophen, and Autism - Frankly Speaking Ep 384

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-384 Overview: This episode investigates the inaccurate correlation made between acetaminophen use during pregnancy and an increased risk of developmental disorders, including autism spectrum disorder, in children. Expert faculty discuss the history of these claims, followed by a study evaluating outcomes in children, and emphasize the importance of evidence-based decision-making for patients and clinicians. Episode resource links: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 Nat Rev Endocrinol. 2021 Dec;17(12):757-766. doi: 10.1038/s41574-021-00553-7 Guest: Aylin Madore, MD, MEd   Music Credit: Richard Onorato
6/10/20247 minutes, 10 seconds
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Beyond Reaction: Strategies for Mitigating the Food Allergy Surge - Frankly Speaking Ep 383

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-383 Overview: This episode highlights a growing concern—the prevalence of food allergies is on the rise. We underscore the importance for clinicians to help keep vulnerable populations safe through risk reduction strategies as well as the use of medication therapy. Feel empowered to prepare and safeguard patients from adverse reactions to food allergies. Episode resource links: Abrams, E. M., & Becker, A. B. (2015). Food introduction and allergy prevention in infants. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 187(17), 1297–1301. https://doi.org/10.1503/cmaj.150364 Elghoudi, A., & Narchi, H. (2022). Food allergy in children-the current status and the way forward. World journal of clinical pediatrics, 11(3), 253–269. https://doi.org/10.5409/wjcp.v11.i3.253 Wood, R. A., Togias, A., Sicherer, S. H., Shreffler, W. G., Kim, E. H., Jones, S. M., ... & Chinthrajah, R. S. (2024). Omalizumab for the Treatment of Multiple Food Allergies. New England Journal of Medicine. https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan CDC.gov https://acaai.org/ Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
6/3/202410 minutes, 23 seconds
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Time to Update Your CVD Risk Calculator? - Frankly Speaking Ep 382

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-382 Overview: Tune in as we discuss the AHA’s newly validated risk calculator designed to assess the risk of developing cardiovascular disease and heart failure in certain patients. We review which risk factor variables were included in the development of this new tool and whether to consider incorporating it in your practice. Episode resource links: https://doi.org/10.1161/CIRCULATIONAHA.123.067626 The calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/27/202412 minutes
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Do E-Cigarettes Help with Smoking Cessation? - Frankly Speaking Ep 381

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-381 Overview: While the aerosol in e-cigarettes does contain toxicants and carcinogens, since it is not burned like combustible tobacco cigarettes, vaping exposes the user to fewer toxicants and chemicals. Many consider using e-cigarettes for smoking cessation, but evidence has been conflicting. Tune in as we discuss a recent review examining the efficacy of e-cigarettes in aiding smoking cessation and explore potential adverse effects associated with their usage. Episode resource links: Lin, H. X., Liu, Z., Hajek, P., Zhang, W. T., Wu, Y., Zhu, B. C., Liu, H. H., Xiang, Q., Zhang, Y., Li, S. B., Pesola, F., & Wang, Y. Y. (2024). Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking: A Randomized Clinical Trial. JAMA internal medicine, 10.1001/jamainternmed.2023.7846. Advance online publication. https://doi.org/10.1001/jamainternmed.2023.7846 Lindson, N., Butler, A. R., McRobbie, H., Bullen, C., Hajek, P., Begh, R., Theodoulou, A., Notley, C., Rigotti, N. A., Turner, T., Livingstone-Banks, J., Morris, T., & Hartmann-Boyce, J. (2024). Electronic cigarettes for smoking cessation. The Cochrane database of systematic reviews, 1(1), CD010216. https://doi.org/10.1002/14651858.CD010216.pub8 Sanford BT, Brownstein NC, Baker NL, et al. Shift From Smoking Cigarettes to Vaping Nicotine in Young Adults. JAMA Intern Med. Published online November 13, 2023. doi:10.1001/jamainternmed.2023.5239 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
5/20/202413 minutes, 56 seconds
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ACE Inhibitors: Maybe Not for Hypertension Alone - Frankly Speaking Ep 380

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-380 Overview: This episode brings you a comparison of thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers on cardiovascular outcomes, stroke, and all-cause mortality. Gain evidence-based insights to help you make informed choices for your patients’ care. Episode resource links: Circulation . 2024 Jan 23;149(4):279-289. doi: 10.1161/CIRCULATIONAHA.123.066485. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
5/13/20249 minutes, 1 second
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Colchicine: It’s Not Just for Gout Anymore - Frankly Speaking Ep 379

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-379 Overview: Recent data has shown that colchicine can improve outcomes in patients with known coronary artery disease (CAD), with consideration of colchicine now recommended by the American Heart Association (AHA). Hear valuable insights into the potential benefits and limitations to refine your clinical approach to managing CAD. Episode resource links: Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-1847.  Mohammadnia N, Los J, Opstal TSJ, et al. Colchicine and diabetes in patients with chronic coronary artery disease: insights from the LoDoCo2 randomized controlled trial. Front Cardiovasc Med. 2023;10:1244529. Published 2023 Oct 6.  Roubille F, Bouabdallaoui N, Kouz S, et al. Low-Dose Colchicine in Patients With Type 2 Diabetes and Recent Myocardial Infarction in the COLchicine Cardiovascular Outcomes Trial (COLCOT). Diabetes Care. Published online January 5, 2024.  Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
5/6/20249 minutes, 45 seconds
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Dementia News Roundup - Frankly Speaking Ep 378

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-378 Overview: Effective treatments for dementia remain elusive. In this episode, we’re discussing dementia treatment developments gathered from recent publications, covering topics of drugs, exercise, and liver disease. Stay informed and equipped to offer the latest guidance to patients with dementia and their families. Episode resource links: Ann Fam Med 2024;22:50-58. https://doi.org/10.1370/afm.3050 JAMA Netw Open. 2024;7(1):e2353965. doi:10.1001/jamanetworkopen.2023.53965 Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
4/29/202410 minutes, 37 seconds
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To Treat or Not to Treat: Do Antibiotics Make a Difference with OME? - Frankly Speaking Ep 377

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-377 Overview: Fluid in the middle ear, or otitis media with effusion (OME), is common in children with upper respiratory infections and typically resolves without treatment. Most guidelines do not recommend antibiotics for treatment; however, they are often prescribed, and the persistence of effusion can cause a significant impact on quality of life. Join us as we discuss recent review findings on antibiotics in OME treatment and the potential impact on your practice. Episode resource links: Mulvaney CA, Galbraith K, Webster KE, et al. Antibiotics for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023;10(10):CD015254. Published 2023 Oct 23. doi:10.1002/14651858.CD015254.pub2 Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., Payne, S. C., Poe, D. S., Veling, M., Vila, P. M., Walsh, S. A., & Corrigan, M. D. (2016). Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(1 Suppl), S1–S41. https://doi.org/10.1177/0194599815623467 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
4/23/202410 minutes, 45 seconds
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New Benefits Give SGLT2 Inhibitors Their Turn to Shine - Frankly Speaking Ep 376

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-376 Overview: While GLP-1 agents are center stage in the medical and lay press, drugs in the class of sodium-glucose cotransporter 2 inhibitors (SGLT2is) are also quite remarkable at improving a variety of health endpoints. This episode provides an overview of studies supporting the use of SGLT2is to improve patient outcomes. Episode resource links: DM/HF:  Age Ageing 2024 Jan 2;53(1):afad254. doi: 10.1093/ageing/afad254 Kidney stones: JAMA Intern Med. 2024 Jan 29:e237660. doi: 10.1001/jamainternmed.2023.7660 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
4/15/20248 minutes, 15 seconds
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Breast Cancer: Increased Incidence Doesn’t Mean Increased Mortality - Frankly Speaking Ep 375

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-375 Overview: Listen in as we discuss trends seen in breast cancer incidence over recent decades. Despite a notable rise in its prevalence, we’ve witnessed a decline in mortality rates. This positive shift owes itself to improvements in medication and screening efforts. Explore with us the multifaceted factors shaping this evolving landscape of breast cancer diagnosis and treatment. Episode resource links: https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html https://www.uspreventiveservicestaskforce.org/uspstf/ Caswell-Jin, J. L., Sun, L. P., Munoz, D., Lu, Y., Li, Y., Huang, H., ... & Plevritis, S. K. (2024). Analysis of Breast Cancer Mortality in the US—1975 to 2019. JAMA, 331(3), 233-241. Xu, S., Murtagh, S., Han, Y., Wan, F., & Toriola, A. T. (2024). Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status. JAMA Network Open, 7(1), e2353331-e2353331. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
4/8/20248 minutes, 9 seconds
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Sleep Lab in Your Pocket: Smartphone Diagnostics for Sleep Apnea - Frankly Speaking Ep 374

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-374 Overview: This episode explores the use of data from smartphone recordings as a diagnostic tool for obstructive sleep apnea (OSA), highlighting at-home testing as a more accessible, convenient, and appropriate option for some patients. Hear how the evidence can inform your practice and improve the diagnosis and treatment of patients with OSA. Episode resource links: Han SC, Kim D, Rhee CS, Cho SW, Le VL, Cho ES, Kim H, Yoon IY, Jang H, Hong J, Lee D, Kim JW. In-Home Smartphone-Based Prediction of Obstructive Sleep Apnea in Conjunction With Level 2 Home Polysomnography. JAMA Otolaryngol Head Neck Surg. 2024 Jan 1;150(1):22-29. doi: 10.1001/jamaoto.2023.3490. PMID: 37971771; PMCID: PMC10654929. OSA and CV disease in adults, UpToDate Home sleep apnea testing for adults, UpToDate Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
4/1/202410 minutes, 59 seconds
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Type 2 Diabetes Mellitus: Can Lifestyle Reverse It? - Frankly Speaking Ep 373

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-373 Overview: In this episode, we review the effectiveness of intensive lifestyle intervention for type 2 diabetes mellitus (T2DM) remission. We unpack study findings on total diet replacement and consider its potential for improving weight loss and maintenance in patients. Tune in to enrich your clinical toolkit, empowering you to optimize patient outcomes and enhance quality of life. Episode resource links: Hocking, S. L., Markovic, T. P., Lee, C. M. Y., Picone, T. J., Gudorf, K. E., & Colagiuri, S. (2024). Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus. Diabetes care, 47(1), 66–70. https://doi.org/10.2337/dc23-0781   Centers for Disease Control:  Diabetes Care for Providers: https://www.cdc.gov/diabetes/professional-info/index.html   Optifast USA: https://www.optifast.com/   Pattinson, A. L., Seimon, R. V., Harper, C., Nassar, N., Grech, A., Santoso, E. A., Franklin, J., Inan-Eroglu, E., Gibson, A. A., & Sainsbury, A. (2021). Diet Quality following Total Meal Replacement Compared with Food-Based Weight-Loss Diets in Postmenopausal Women with Obesity: A Secondary Analysis of the TEMPO Diet Trial. The Journal of nutrition, 151(11), 3299–3312. https://doi.org/10.1093/jn/nxab311 Guest: Jill M. Terrien, PhD, ANP-BC    Music Credit: Richard Onorato
3/25/202411 minutes, 13 seconds
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Chocolate—Get the Lead Out! - Frankly Speaking Ep 372

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-372 Overview: Listen in as we unwrap Consumer Reports’ findings on heavy metals found in commonly consumed chocolate products. Our discussion looks into concerns about high levels of metals like lead and cadmium in these treats and offers advice on how to counsel your patients for worry-free chocolate enjoyment.  Episode resource links: A Third of Chocolate Products Are High in Heavy Metals, CR T - Consumer Reports Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
3/18/202410 minutes, 30 seconds
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Beta-Blockers Post-Myocardial Infarction: Are They Still Needed? - Frankly Speaking Ep 371

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-371 Overview: Beta-blockers have traditionally been used indefinitely after a myocardial infarction (MI), but this is now only recommended for a subset of patients. Listen in as faculty review new recommendations for managing patients with chronic cardiac disease, including how to determine which patients are good candidates for beta-blocker therapy and for how long. Episode resource links: Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2023 Sep 26;148(13):e148] [published correction appears in Circulation. 2023 Dec 5;148(23):e186]. Circulation. 2023;148(9):e9-e119.  Joo SJ. Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it. Acute Crit Care. 2023;38(3):251-260.  Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
3/11/20247 minutes, 39 seconds
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Low Back Pain—More Evidence for the Effectiveness of Nonnarcotic Modalities - Frankly Speaking Ep 370

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-370 Overview: Low back pain is one of the most common symptoms presenting in primary care. Listen in as we analyze the results of a recent systematic review supporting the use of a variety of effective nonnarcotic treatments for this condition. Gain evidence-based insights to help you choose the most informed option for managing low back pain. Episode resource links: Gianola S, Bargeri S, Del Castillo G, et al. Br J Sports Med 2022;56:41–50. doi.org/ 10. 1136/ bjsports- 2020- 103596). Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
3/4/202411 minutes, 8 seconds
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Be a Flamingo: 1-Legged Stance Test Predicts Risks - Frankly Speaking Ep 369

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-369 Overview: Uncover a simple, 10-second intervention—the 1-legged stance test—for predicting the risk of falling in adults. Join us as we discuss how this swift assessment can help identify patients who are prone to falls, fractures, and increased mortality. This episode brings you a practical tool to enhance patient assessments and tailor interventions, contributing to a more proactive and personalized approach to care. Episode resource links: JAMA. 2023;329(18):1605-1607. doi:10.1001/jama.2023.3054 Br J Sports Med. 2022;56:975–980. Pharmacoepidemiol Drug Saf. 2021 Aug;30(8):1049-1056. doi: 10.1002/pds.5201 PLoS Med 18(11): e1003821. https://doi.org/10.1371/journal.pmed.1003821 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
2/26/20249 minutes, 28 seconds
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Data-Driven Perspectives on Prescriptive Authority and the Quality Quandary - Frankly Speaking Ep 368

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-368 Overview: In this insightful episode, we explore compelling data comparing inappropriate prescribing practices among physicians and nonphysician prescribers. This discussion covers the nuances and restrictive scope of prescribing authority and aims to take an evidence-based approach to encouraging collaboration between clinicians and expanding patients’ access to care. Episode resource links: Huynh, J., Alim, S. A., Chan, D. C., & Studdert, D. M. (2023). Inappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians. Annals of internal medicine, 176(11), 1448–1455. https://doi.org/10.7326/M23-0827 American Association of Nurse Practitioners https://www.aanp.org/ American Academy of Physician Associates https://www.aapa.org/ Jiao, S., Murimi, I. B., Stafford, R. S., Mojtabai, R., & Alexander, G. C. (2018). Quality of Prescribing by Physicians, Nurse Practitioners, and Physician Assistants in the United States. Pharmacotherapy, 38(4), 417–427. https://doi.org/10.1002/phar.2095 2023 Beers Criteria American Geriatrics Society: Free to read https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18372 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
2/19/20248 minutes, 17 seconds
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The Portfolio Diet—Another Approach to Eating Healthy? - Frankly Speaking Ep 367

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-367 Overview: Join us for a look at the Portfolio Diet, a plant-based approach with potential to improve cardiovascular outcomes. We’ll take you through the details of this regimen and what the evidence says about its effect on the risks of cardiovascular diseases. Stay informed on the latest research and feel prepared to answer your patients’ questions about the Portfolio Diet. Episode resource links: Circulation. 2023;148:00–00. DOI: 10.1161/CIRCULATIONAHA.123.065551 Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
2/12/202412 minutes, 37 seconds
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Synching Up: Time-Restricted Eating for T2DM Management - Frankly Speaking Ep 366

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-366 Overview: Join us as we explore the nuances of healthy eating patterns, distinguishing between time-restricted and calorie-restricted approaches. We also review a randomized controlled trial that found time-restricted eating for people with type 2 diabetes mellitus (T2DM) can benefit HbA1c levels and weight reduction. Gain insights to elevate patient care in understanding and implementing these impactful dietary strategies. Episode resource links: Pavlou V, Cienfuegos S, Lin S, et al. Effect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2339337. doi:10.1001/jamanetworkopen.2023.39337 Jefcoate PW, Robertson MD, Ogden J, Johnston JD. Exploring Rates of Adherence and Barriers to Time-Restricted Eating. Nutrients. 2023 May 16;15(10):2336. doi: 10.3390/nu15102336. PMID: 37242218; PMCID: PMC10223820. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
2/5/202411 minutes, 29 seconds
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Your Gut Doesn’t Have to Be Irritated: Treatment Options for IBS - Frankly Speaking Ep 365

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-365 Overview: The chronic nature of irritable bowel syndrome (IBS) necessitates persistence when trialing treatment options. After reviewing key identifiers of IBS, we discuss a second-line treatment’s efficacy in reducing symptoms and improving quality of life for patients with continued IBS symptoms. Tune in for valuable insights to make informed recommendations for your patients. Episode resource links: Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial - PubMed (nih.gov) https://www.aafp.org/pubs/afp/issues/2005/1215/p2501.html Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
1/29/20249 minutes, 6 seconds
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Can Saline Rinsing and Gargling Clear the Path to COVID-19 Relief? - Frankly Speaking Ep 364

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-364 Overview: In this episode, we explore a nonpharmacologic approach to easing symptoms of COVID-19 in patients who are at lower risk of progression. Supported by a small study, a nasal saline rinse and gargle regimen was associated with more rapid symptom resolution and lower hospitalization rates. Learn how a simple salt solution can be an effective step in preventing adverse outcomes of COVID-19 for patients who are at low risk. Episode resource links: Am Col Allergy Asthma and Immunology: https://acaai.org/news/new-study-gargling-with-salt-water-may-help-prevent-covid-hospitalization/ Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
1/22/20248 minutes, 33 seconds
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Vitamins and Supplements for T2DM: What’s the Best Approach? - Frankly Speaking Ep 363

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-363 Overview: Patients often reach for vitamins and supplements in type 2 diabetes mellitus (T2DM) management, but what does the research show? In this episode, you’ll hear expert faculty discuss the efficacy of vitamins and supplements, debunk common myths, and explore the power of dietary changes and exercise. Deepen your knowledge to guide your patients toward taking evidence-based steps in their T2DM management. Episode resource links: Cinnamon J Pharmacy Practice. 2017;30(6):631-638. J Med Food . 2011 Sep;14(9):884-9. doi: 10.1089/jmf.2010.0180 J Endocr Soc. 2020 Nov 1; 4(11): bvaa094 Chromium Biol Trace Elem Res. 2022 Feb;200(2):516-525.  Vitamin C Diabetes Metab Syndr. 2023 Jul 7;17(8):102824. Vitamin D Ann Intern Med. 2023 Mar;176(3):355-363. doi: 10.7326/M22-301 Soluble Fiber:   Diabetes Care. 2019 Jan 7. pii: dc181126. doi: 10.2337/dc18-1126 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
1/15/202413 minutes, 2 seconds
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”I Am Tired!” How Common is Iron Deficiency in Women? - Frankly Speaking Ep 362

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-362 Overview: Recorded live at Pri-Med East! Iron deficiency and IDA are common, especially in women of childbearing age, and often under diagnosed. These conditions carry with them risk for increased morbidity and mortality. Screening is focused on high-risk groups, specifically toddlers and pregnant women, however these conditions in women of childbearing age are also common. Please join us to discuss the recent data on the prevalence of ID/IDA, how to appropriately screen and treat this common condition.  Episode resource links: Weyand AC, Chaitoff A, Freed GL, Sholzberg M, Choi SW, McGann PT. Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020. JAMA. 2023;329(24):2191-2193. doi:10.1001/jama.2023.8020 Dyna-Med: https://www-dynamed-com.umassmed.idm.oclc.org/management/treatment-of-iron-deficiency-anemia-in-adults#IRON_DEFICIENCY_WITHOUT_ANEMIA   NIH Iron Fact Sheet for Health Professionals: https://ods-od-nih-gov.umassmed.idm.oclc.org/factsheets/Iron-HealthProfessional/ Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
1/8/20249 minutes, 2 seconds
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Psilocybin for Depression: Are Magic Mushrooms Doing the Trick? - Frankly Speaking Ep 361

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-361 Overview: In this episode, we delve into a topic of growing interest in medicine—the use of psilocybin to treat depression. Join us as we discuss the pharmacotherapeutic action of psilocybin and the results of a recent study that has suggested that a one-time dose of psilocybin can be an effective treatment for depression. Hear valuable insights into the potential benefits and limitations and feel prepared to respond to patient questions about this treatment. Episode resource links: JAMA. 2023;330(9):843-853. doi:10.1001/jama.2023.14530 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
1/1/202410 minutes, 35 seconds
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Medical Myths: Grapefruit Juice, Broccoli, and Biotin - Frankly Speaking Ep 360

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-360 Overview: Join us as we examine common medical myths encountered in primary care. Hear what the evidence has to say about grapefruit and statins, vitamin K-rich vegetables and warfarin, and biotin for treating hair loss. Stay informed, challenge assumptions, and enhance your practice with insights on these long-held beliefs. Episode resource links: Grapefruit: Am J Med 2016; Vol 129 (1): 26-29, Br J Clin Pharmacol. 2011 Sep;72(3):434-41.   Warfarin: Medicine (Baltimore). 2016 Mar;95(10):e2895   Biotin: The Journal of Clinical and Aesthetic Dermatology. 2020;13(3):37-40 Guest: Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
12/25/202311 minutes, 14 seconds
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Walking, Riding, Lifting—Is One Exercise Better than Another? - Frankly Speaking Ep 359

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-359 Overview: There is plenty of evidence linking exercise to improved overall health. It is associated with weight loss, improved biomarkers, improved sleep, and mood. The few studies comparing types and intensity of exercise have resulted in varied and inconsistent findings. Listen in as we discuss a recent prospective cohort study examining associations between combinations of exercise and reduction in all-cause, cardiovascular, and cancer mortality and how the evidence can inform your practice to improve patients’ health. Episode resource links: López-Bueno, R., Ahmadi, M., Stamatakis, E., Yang, L., & Del Pozo Cruz, B. (2023). Prospective Associations of Different Combinations of Aerobic and Muscle-Strengthening Activity With All-Cause, Cardiovascular, and Cancer Mortality. JAMA internal medicine, 183(9), 982–990. https://doi.org/10.1001/jamainternmed.2023.3093   Standards of Care, 2023 American Diabetic Association. https://diabetesjournals.org/care/issue/46/Supplement_1   https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults   https://diabetes.org/health-wellness/fitness Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
12/18/20239 minutes, 41 seconds
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Prophylactic Power: Doxycycline’s Role in STI Prevention - Frankly Speaking Ep 358

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-358 Overview: In this episode, we explore new data that could reshape how we approach sexually transmitted infection (STI) prevention in clinical practice. Discover how doxycycline can serve as prophylaxis for bacterial STIs in populations who are at high risk and come away with practical strategies for counseling patients on STI prevention. Tune in to enhance your clinical expertise and provide superior care to your patients. Episode resource links: Luetkemeyer AF, Donnell D, Dombrowski JC, et al. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. N Engl J Med. 2023;388(14):1296-1306.  Guest: Alan M. Ehrlich MD, FAAFP   Music Credit: Richard Onorato
12/11/20239 minutes, 46 seconds
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Emergency Contraception—Can It Be More Effective? - Frankly Speaking Ep 357

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-357 Overview: Progesterone-based emergency contraception (EC) is established as a method to reduce the risk of pregnancy after unprotected intercourse. This EC works by blocking or delaying ovulation. However, if taken after ovulation, there is a higher failure rate. A recent study showed increased efficacy of levonorgestrel when given with a COX-2 inhibitor (NSAID). Please join us as we discuss the results of the randomized controlled trial, including the efficacy of levonorgestrel when taken with piroxicam and their potential to reduce EC failure. Episode resource links: Li, R. H. W., Lo, S. S. T., Gemzell-Danielsson, K., Fong, C. H. Y., Ho, P. C., & Ng, E. H. Y. (2023). Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet (London, England), 402(10405), 851–858. https://doi.org/10.1016/S0140-6736(23)01240-0 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
12/4/20238 minutes, 33 seconds
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Addressing Penicillin Allergies in Primary Care - Frankly Speaking Ep 356

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-356 Overview: Patient-reported penicillin allergies are common; however, more than 95% of such patients have negative penicillin allergy testing and will tolerate subsequent antibiotic use. Currently, disproving a penicillin allergy includes negative skin testing followed by an oral challenge, which is considered the gold standard to remove the penicillin allergy label, as skin testing alone lacks 100% negative predictive value. Recent reports have suggested that low-risk individuals can be assessed with a direct oral challenge, but the safety and efficacy of such an approach has not been rigorously studied. Listen in as expert faculty discuss a recent randomized controlled trial that validates such an approach. Episode resource links: Trubiano JA, Vogrin S, Chua KYL et al. Development and Validation of a Penicillin Allergy Clinical Decision Rule. JAMA Internal Med. Published March 16, 2020. doi:10.1001/jamainternmed.2020.0403 JAMA Intern Med. doi:10.1001/jamainternmed.2023.2986 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
11/27/20239 minutes, 38 seconds
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Keep Engaged and Moving to Prevent Dementia: Anything Is Better than Nothing! - Frankly Speaking Ep 355

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-355 Overview: Discover how primary care providers can actively combat dementia risk in aging patients. In this episode, expert faculty explore recent studies revealing the benefits of dementia prevention and evidence-based activities for reducing risks. Learn how to provide encouragement and social activity prescriptions during visits, and gain essential knowledge to preserve cognitive function, ultimately improving patient care and quality of life. Episode resource links: Cho, G., Betensky, R. A., & Chang, V. W. (2023). Internet usage and the prospective risk of dementia: A population-based cohort study. Journal of the American Geriatrics Society, 71(8), 2419–2429. https://doi.org/10.1111/jgs.18394 Raichlen DA, Aslan DH, Sayre MK, et al. (2023). Sedentary Behavior and Incident Dementia Among Older Adults. JAMA. 330(10):934–940. https://doi:10.1001/jama.2023.15231 Su, S., Shi, L., Zheng, Y., Sun, Y., Huang, X., Zhang, A., Que, J., Sun, X., Shi, J., Bao, Y., Deng, J., & Lu, L. (2022). Leisure Activities and the Risk of Dementia: A Systematic Review and Meta-Analysis. Neurology, 99(15), e1651–e1663. Advance online publication. https://doi.org/10.1212/WNL.0000000000200929 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
11/20/202312 minutes, 34 seconds
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Clearing the Air: Are Antibiotics Necessary for Childhood Sinusitis? - Frankly Speaking Ep 354

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-354 Overview: There is an overlap of acute sinusitis symptoms and viral upper respiratory tract infection, such that many children are treated unnecessarily with antibiotics. In this episode, we review 2 recent studies that inform recommendations on whether or not to treat childhood sinusitis with amoxicillin/clavulanate. Gain practical strategies and the confidence to appropriately address sinusitis in the children you treat. Episode resource links: JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854 JAMA. 2023;330(11):1064-1073. doi:10.1001/jama.2023.15503 Journal of Pediatrics, The, 2019-04-01, Volume 207, Pages 103-108.e1 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
11/13/202311 minutes, 56 seconds
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RSV in Infants: An Ounce of Prevention - Frankly Speaking Ep 353

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-353 Overview: Bronchiolitis caused by respiratory syncytial virus (RSV) infection in infants is common and can lead to hospitalization if severe. There are now 2 ways to prevent this: immunizing the mother during pregnancy or giving monoclonal antibodies. Listen in as we discuss the recommendations for RSV prevention and how to best incorporate them into your practice. Episode resource links: Fleming-Dutra KE, Jones JM, Roper LE, et al. Use of the Pfizer Respiratory Syncytial Virus Vaccine During Pregnancy for the Prevention of Respiratory Syncytial Virus–Associated Lower Respiratory Tract Disease in Infants: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023. MMWR Morb Mortal Wkly Rep 2023;72:1115–1122. Jones JM, Fleming-Dutra KE, Prill MM, et al. Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023. MMWR Morb Mortal Wkly Rep 2023;72:920–925 Kampmann B, Madhi SA, Munjal I, et al. Bivalent Prefusion F Vaccine in Pregnancy to Prevent RSV Illness in Infants. N Engl J Med. 2023;388(16):1451-1464. Guest: Alan M. Ehrlich MD, FAAFP   Music Credit: Richard Onorato
11/6/20238 minutes, 20 seconds
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From Hype to Hope: COVID-19 Outpatient Treatment Recommendations - Frankly Speaking Ep 352

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-352 Overview: Keep your practice at the forefront of outpatient COVID-19 management with this informative episode. Listen in as expert faculty discuss the latest recommendations and review ineffective treatments, helping you provide the best care during this new phase of the endemic. Episode resource links: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/clinical-management-of-adults-summary/?utm_source=site&utm_medium=home&utm_campaign=highlights Abdool Karim, S. S., & Devnarain, N. (2022). Time to stop using ineffective COVID-19 drugs. New England Journal of Medicine, 387(7), 654-655. Hayden, M. K., Hanson, K. E., Englund, J. A., Lee, F., Lee, M. J., Loeb, M., ... & Mustafa, R. A. (2023). The Infectious Diseases Society of America guidelines on the diagnosis of COVID-19: antigen testing. Clinical Infectious Diseases, ciad032. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
10/30/202311 minutes, 34 seconds
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Screen Time and Developmental Delays in Children - Frankly Speaking Ep 351

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-351 Overview: Live at Pri-Med East! In this episode, we will examine the association of developmental delays with amount of screen time in children. Episode resource links: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2808593 https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/social-media-and-youth-mental-health-q-and-a-portal/middle-childhood/middle-childhood-questions/screen-time-guidelines/ https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx Guest: Jillian Joseph, MSPAS, PA-C Music Credit: Richard Onorato
10/23/20239 minutes, 32 seconds
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Cracking into the Evidence: Does Eating Nuts Affect Cognitive Performance? - Frankly Speaking Ep 350

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-350 Overview: Nuts have a reputation for providing a variety of health benefits, but how far do their nutritional superpowers reach? In this episode, we take a look at the findings of a study showing the association between nut consumption and cognitive performance. Listen in as expert faculty discuss the implications for managing patients at risk for cognitive decline. Episode resource links: The American Journal of Clinical Nutrition https://doi.org/10.1016/j.ajcnut.2023.05.032 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
10/16/20239 minutes, 17 seconds
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Bariatric Surgery: A Great Option to Lower Breast Cancer Risk - Frankly Speaking Ep 349

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-349 Overview: Recent observational data has shown the potential for bariatric surgery to lower breast cancer risk in women with obesity. Tune in as faculty discuss what the evidence says about this connection and when to consider exploring the option for your patients’ weight-loss management. Episode resource links: AMA Surg. 2023 Jun 1;158(6):634-641. doi: 10.1001/jamasurg.2023.0530. J Natl Cancer Inst. 2003;95(16):1218. J Natl Cancer Inst. 2015;107(2) Epub 2015 Mar 10.  Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
10/9/202310 minutes, 20 seconds
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Smart Prevention: Wearable Devices and Stroke Defense - Frankly Speaking Ep 348

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-348 Overview: Discover how wearable fitness devices are transforming early detection of atrial fibrillation with their potential to reduce stroke risk. In this episode, we share insights on leveraging smartwatches to improve health outcomes and when to encourage their use in patient care. Episode resource links: Bedi, A., Al Masri, M. K., Al Hennawi, H., Qadir, S., & Ottman, P. (2023). The Integration of Artificial Intelligence Into Patient Care: A Case of Atrial Fibrillation Caught by a Smartwatch. Cureus, 15(3). Long, K. Y., Shanmugam, K., & Rana, M. E. (2023, January). An Evaluation of Smartwatch Contribution in Improving Human Health. In 2023 17th International Conference on Ubiquitous Information Management and Communication (IMCOM) (pp. 1-4). IEEE. Mattison, G., Canfell, O. J., Forrester, D., Dobbins, C., Smith, D., Reid, D., & Sullivan, C. (2023). A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care. The Medical Journal of Australia, 218(9), 384-388. Meza, C., Juega, J., Francisco, J., Santos, A., Duran, L., Rodriguez, M., ... & Pagola, J. (2023). Accuracy of a Smartwatch to Assess Heart Rate Monitoring and Atrial Fibrillation in Stroke Patients. Sensors, 23(10), 4632. https://www.stroke.org/en/about-stroke/types-of-stroke/cryptogenic-stroke   Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
10/2/20238 minutes, 31 seconds
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A Wake-Up Call: Sleep Apnea’s Impact on Cognitive Health - Frankly Speaking Ep 347

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-347 Overview: In this episode, we’re diving into recent research that uncovers a compelling link between obstructive sleep apnea and cognitive decline in older adults. Join expert faculty as they dissect the findings and provide invaluable insights to comprehensively address this connection in your practice. Episode resource links: Discuss recent evidence that links obstructive sleep apnea (OSA) to cognitive decline risk in older people Describe ways to incorporate this new evidence to identify OSA and reduce the risk of cognitive decline  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
9/25/20239 minutes, 26 seconds
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RSV Vaccine for Adults: Studies, Uses, and Patient Conversations - Frankly Speaking Ep 346

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-346 Overview: As we encounter more patients asking about the recent FDA approval of a new respiratory syncytial virus (RSV) vaccine for older adults, it’s crucial that we keep up to date. Join us as we review the supporting studies, indications, and precautions, giving you confidence in conversations with inquiring patients.  Episode resource links: https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
9/18/202310 minutes, 37 seconds
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A Cool New Treatment for Hot Flashes? - Frankly Speaking Ep 345

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-345 Overview: In this episode, we discuss the findings of a recent Lancet publication on a novel neurokinin 3 (NK3) receptor antagonist for treating hot flashes. Tune in as we talk about how this nonhormonal treatment addresses menopausal hot flashes, the prescribing precautions issued by the FDA, and the implications for patients seeking your help with alleviating symptoms. Episode resource links: Lancet 2023; 401: 1091–102. doi.org/10.1016/ S0140-6736(23)00085-5 Am Fam Physician. 2023;108(1):28-39 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
9/11/202311 minutes, 7 seconds
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Risky Pain Management Choices in Patients with Dementia - Frankly Speaking Ep 344

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-344 Overview: Navigating the intricate landscape of pain management in older patients with dementia can be challenging. Join us as we explore strategies for mitigating pain, consider the equilibrium between opioid benefits and risks, and discuss where to start when tailoring management plans for patients with dementia and joint pain. Don’t miss this important conversation. Episode resource links: https://www.neurologylive.com/view/mortality-risk-significantly-increased-with-new-opioid-use-older-adults-dementia https://www.practicalpainmanagement.com/resource-centers/opioid-prescribing-monitoring/risk-assessment-safe-opioid-prescribing-tools Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
9/4/202310 minutes, 25 seconds
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Screens Off, Play On: How Parental Phone Use Shapes Kids’ Physical Activity - Frankly Speaking Ep 343

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-343 Overview: In this episode, we take a look at a study exploring the effects on children’s activity levels when their parents reduce smartphone use. Listen in as we discuss compelling findings that shed light on the connection, and come away with guidance on how to navigate the evolving digital landscape to promote healthier, more active lifestyles among children. Episode resource links: JAMA Pediatr. 2022 Aug; 176(8): 741–749 BMJ Open. 2019 Jan 3;9(1):e023191. doi: 10.1136/bmjopen-2018-023191 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
8/28/202310 minutes, 30 seconds
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Beyond the Prescription Pad: Over-the-Counter Oral Contraceptive Gains FDA Approval - Frankly Speaking Ep 342

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-342 Overview: In July of 2023, the FDA made a monumental decision to approve Opill, marking the first time an oral contraceptive will be made available without a prescription. The inaugural over-the-counter oral contraceptive is a progesterone-only pill. Join us to discuss the underlying rationales driving this decision and the prospective implications it might have on medical practice as well as women’s health. Episode resource links: Biggs, AM, Ralph, L, Morris, N, Ehrenreich, K, Perritt, J, Kapp, N, Blanchard, K, White, K,  Barar, Grossman, RD. A cross-sectional survey of U.S. abortion patients’ interest in obtaining medication abortion over the counter, Contraception, Volume 109, 2022, Pages 25-31, ISSN 0010-7824, https://doi.org/10.1016/j.contraception.2022.01.010.   Chen, Q.J. Xiang, W.P. Zhang, D.K., Wang, R.P. Luo, Y.F. Kang, J.Z. Cheng, L.N. Efficacy and safety of a levonorgestrel enteric-coated tablet as an over-the-counter drug for emergency contraception: a Phase IV clinical trial, Human Reproduction, Volume 26, Issue 9, September 2011, Pages 2316–2321, https://doi.org/10.1093/humrep/der181   Raine, TR; Ricciotti, N; Sokoloff, A; Brown, B; Hummel, A; Harper, C. An Over-the-Counter Simulation Study of a Single-Tablet Emergency Contraceptive in Young Females. Obstetrics & Gynecology 119(4):p 772-779, April 2012. | DOI: 10.1097/AOG.0b013e31824c0aed   https://www.fda.gov/news-events/press-announcements/fda-approves-first-nonprescription-daily-oral-contraceptive   https://www.accessdata.fda.gov/drugsatfda_docs/nda/2023/017031Orig1s041SumR.pdf Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
8/21/202311 minutes, 20 seconds
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Should We Personalize Our Approach to Treating Hypertension? - Frankly Speaking Ep 341

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-341 Overview: Listen in as we review a recent JAMA publication of a randomized controlled trial that quantified the benefits of a targeted approach to prescribing antihypertensive medications. Don’t miss this opportunity to keep your management of patients with hypertension up to date. Episode resource links: Sundström J, Lind L, Nawrouzi S, et al. Heterogeneity in blood pressure response to 4 antihypertensive drugs: a randomized clinical trial. JAMA. Published April 11, 2023. doi:10.1001/jama.2023.3322 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
8/14/20239 minutes, 11 seconds
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Get Up, Move, and Feel Better: Exploring Physical Activity’s Link to Reduced Suicidal Ideation - Frankly Speaking Ep 340

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-340 Overview: Depression and anxiety rates are escalating, with a 36% increase in suicide cases between 2018 and 2021, as reported by the CDC. This distressing trend can be attributed to various significant stressors that have arisen in recent times, such as pandemic-related illness and isolation. Medications alone are not as effective as when other modalities are incorporated into the treatment regime. Recent meta-analysis has revealed a strong correlation between engaging in physical activity and reducing suicidal ideation across all levels. Listen in as we discuss these findings and explore practical strategies for their implementation in your clinical practice. Episode resource links: Vancampfort, D., Hallgren, M., Firth, J., Rosenbaum, S., Schuch, F. B., Mugisha, J., Probst, M., Van Damme, T., Carvalho, A. F., & Stubbs, B. (2017). Physical activity and suicidal ideation: a systematic review and meta-analysis. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.08.070 https://www.healio.com/news/primary-care/20230403/metaanalysis-exe Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
8/7/202310 minutes, 40 seconds
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CBD Use and Liver Injury: Practical Considerations for Primary Care - Frankly Speaking Ep 339

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-339 Overview: In this episode, we dive into a recent systematic review and meta-analysis confirming the association between cannabidiol (CBD) use and hepatotoxicity. Gain a deeper understanding of clinical applications and the delicate balance of risks and benefits when discussing CBD use with your patients. Episode resource links: Lo LA, Christiansen A, Eadie L, Strickland JC, Kim DD, Boivin M, Barr AM, MacCallum CA. Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis. J Intern Med. 2023 Mar 13. doi: 10.1111/joim.13627. Epub ahead of print. PMID: 36912195. https://store.samhsa.gov/sites/default/files/pep22-06-04-003.pdf Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
7/31/20239 minutes, 10 seconds
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Asthma May Induce Some Cancers—Can That Be Prevented? - Frankly Speaking Ep 338

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-338 Overview: Listen in as we explore the connection between asthma and cancer. We examine new Global Initiative for Asthma (GINA) guidelines and recent observational data correlating an asthma diagnosis with an increased cancer risk. Don't miss out on this essential discussion that will empower you with valuable knowledge for enhanced patient care. Episode resource links: Guo, Y, Bian, J, Chen, Z, et al. Cancer incidence after asthma diagnosis: Evidence from a large clinical research network in the United States. Cancer Med. 2023; 00: 1- 7. doi:10.1002/cam4.5875 GINA guidelines 2022: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
7/24/20238 minutes, 34 seconds
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When Is the Best Time to Take Blood Pressure Medications? - Frankly Speaking Ep 337

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-337 Overview: There has been uncertainty as to the best time for patients to take blood pressure medications. Tune in as we review the Treatment in Morning versus Evening (TIME) study, which assessed whether morning or evening dosing improves cardiovascular outcomes. Episode resource links: Mackenzie IS, Rogers A, Poulter NR, et al. 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;400(10361):1417-1425.  Guest: Alan M. Ehrlich MD, FAAFP   Music Credit: Richard Onorato
7/17/202310 minutes, 14 seconds
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Breathe Easy—Updated Recommendations for Asthma Management - Frankly Speaking Ep 336

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-336 Overview: In 2020, the National Asthma Education and Prevention Program (NAEPP) updated its guidelines for asthma management, incorporating significant changes. This marked the first update since 2007. A recent study revealed that >280 providers of the new asthma guidelines had an average knowledge score of <45%, indicating that these guidelines have likely not been fully incorporated into their practice. We invite you to join us as we discuss the new guidelines and explore strategies for integrating them into your practice. Episode resource links: Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update from the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301–2317. doi:10.1001/jama.2020.2197   https://jamanetwork.com/journals/jama/article-abstract/2773482 https://www.jacionline.org/programs_abstracts https://www.healio.com/news/primary-care/20230225/physicians-show-lack-of-knowledge-on-latest-updates-to-asthma-management-guidelines   Cloutier MM, Teach, SJ., Lemanske RF, Blake KV. The 2020 Focused Updates to the NIH Asthma Management Guidelines: Key Points for Pediatricians. PEDIATRICS Volume 147, number 6, June 2021:e2021050286; https://publications.aap.org/pediatrics/article/147/6/e2021050286/180305/The-2020-Focused-Updates-to-the-NIH-Asthma?autologincheck=redirected   GINA Guidelines: https://ginasthma.org/pocket-guide-for-asthma-management-and-prevention/ Pocket Guide: https://ginasthma.org/wp-content/uploads/2022/07/GINA-2022-Pocket-Guide-WMS.pdf Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
7/10/202310 minutes, 33 seconds
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Does Metformin Make an Impact in Lowering Cardiovascular Risk in Patients with Prediabetes? - Frankly Speaking Ep 335

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-335 Overview: In this episode, we review recent updates from the Diabetes Prevention Program (DPP) trial and Diabetes Prevention Program Outcomes Study (DPPOS). Join us as we discuss the impact of the updates on diabetes prevention strategies for cardiovascular outcomes. Episode resource links: Goldberg RB, Orchard TJ, Crandall JP, Boyko EJ, Budoff M, Dabelea D, Gadde KM, Knowler WC, Lee CG, Nathan DM, Watson K, Temprosa M; Diabetes Prevention Program Research Group*. Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation. 2022 May 31;145(22):1632-1641. doi: 10.1161/CIRCULATIONAHA.121.056756. Epub 2022 May 23. PMID: 35603600; PMCID: PMC9179081. Galaviz KI, Weber MB, Suvada K BS, Gujral UP, Wei J, Merchant R, Dharanendra S, Haw JS, Narayan KMV, Ali MK. Interventions for Reversing Prediabetes: A Systematic Review and Meta-Analysis. Am J Prev Med. 2022 Apr;62(4):614-625. doi: 10.1016/j.amepre.2021.10.020. Epub 2022 Feb 10. PMID: 35151523. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
7/3/202310 minutes, 50 seconds
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What Do You Mean That Glass of Red Wine Is No Longer OK to Drink? - Frankly Speaking Ep 334

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-334 Overview: It can be tricky to navigate conflicting data when discussing alcohol intake with patients, so we’re here to discuss the topic’s most recent evidence. In this episode, we take a look at the findings to help you and your patients make informed decisions about daily alcohol consumption and their health. Episode resource links: JAMA Network Open. 2023;6(3):e236185. doi:10.1001/jamanetworkopen.2023.6185 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
6/26/20238 minutes, 33 seconds
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Navigating Perceived Stress in Older Adults: From Awareness to Action - Frankly Speaking Ep 333

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-333 Overview: Tune in as we discuss the potential consequences of perceived stress on the cognition and well-being of older adults. We explore screening and intervention opportunities to better help you recognize and manage stress in your patients aged ≥45 years. Episode resource links: Kulshreshtha, A., Alonso, A., McClure, L. A., Hajjar, I., Manly, J. J., & Judd, S. (2023). Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA network open, 6(3), e231860. https://doi.org/10.1001/jamanetworkopen.2023.1860 Top 12 Apps for Mindfulness https://positivepsychology.com/mindfulness-apps/ 15 Simple Ways to Relieve Stress 15 Simple Ways to Relieve Stress and Anxiety (healthline.com) Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
6/19/202310 minutes, 25 seconds
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Decoding Hyperlipidemia Management: What Does the Evidence Say? - Frankly Speaking Ep 332

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-332 Overview: In this episode, we take a look at the dynamic landscape of hyperlipidemia management, discussing current guidelines for hyperlipidemia treatment and the interplay between evidence-based recommendations and expert opinions. Tune in to gain a broader understanding of hyperlipidemia management and unlock fresh perspectives to enhance patient care. Episode resource links: JAMA Intern Med. March 14, 2022. doi:10.1001/jamainternmed.2022.0134 JAMA. Published online March 6, 2023. doi:10.1001/jama.2023.2487 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
6/12/202312 minutes, 58 seconds
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When to Start Screening for Breast Cancer—Does Race Make a Difference? - Frankly Speaking Ep 331

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-331 Overview: Current recommendations for when to start breast cancer screening do not consider race or ethnicity, which may be a source of racial disparity in breast cancer outcomes. In this installment, we take a closer look at these recommendations and how you can incorporate them into individualized patient care. Episode resource links: Chen T, Kharazmi E, Fallah M. Race and Ethnicity-Adjusted Age Recommendation for Initiating Breast Cancer Screening. JAMA Netw Open. 2023;6(4):e238893. Published 2023 Apr 3. Siu AL; U.S. Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement [published correction appears in Ann Intern Med. 2016 Mar 15;164(6):448]. Ann Intern Med. 2016;164(4):279-296 Oeffinger KC, Fontham ET, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society [published correction appears in JAMA. 2016 Apr 5;315(13):1406]. JAMA. 2015;314(15):1599-1614.  Draft Update of USPSTF Screening for Breast Cancer: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults Guest: Alan M. Ehrlich MD, FAAFP   Music Credit: Richard Onorato
6/5/202311 minutes, 6 seconds
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Long COVID: Strategies for Approaching Patient Care - Frankly Speaking Ep 330

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-330 Overview: The CDC’s Household Pulse Survey data indicate that more than 10% of adults who contracted COVID-19 have had symptoms that lasted at least 3 months. While patients worry about long COVID, there are no specific tests to confirm its diagnosis. In this episode, we discuss a recent JAMA article that addresses the primary care approach to long COVID. Episode resource links: Landhuis EW. How Primary Care Physicians Can Recognize and Treat Long COVID. JAMA. Published online May 03, 2023. doi:10.1001/jama.2023.6604 JAMA. 2022;328(16):1604. PMID: 36215063 Post-COVID Conditions: Information for Healthcare Providers (cdc.gov) Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato
5/29/20239 minutes, 18 seconds
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Can Cocoa or a Multivitamin Prevent Dementia? - Frankly Speaking Ep 329

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-329 Overview: Do you have older patients asking for guidance on what supplements can be used to prevent cognitive decline? Listen in to hear the findings of a recent Alzheimer’s & Dementia publication of a randomized controlled trial looking at the benefits and harms related to using cocoa and multivitamins for preventing cognitive decline. Episode resource links: Baker LD,Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimer’s Dement.2022;1-12. https://doi.org/10.1002/alz.12767 Recommendation: Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: Preventive Medication | United States Preventive Services Taskforce https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/22/20239 minutes, 28 seconds
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Live Longer by Eating Better - Frankly Speaking Ep 328

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-328 Overview: Are you tired of sifting through conflicting information about nutrition and mortality? Look no further than this podcast episode, where we dive deep into the latest dietary research. With so much conjecture and small data sets out there, it can be challenging to know what advice to give. Tune in to this discussion to gain valuable insights and to make informed recommendations about healthy eating habits for your patients. Episode resource links: JAMA Intern Med. doi:10.1001/jamainternmed.2022.6117 Nutrients 2021 Jul 9;13(7):2342. doi: 10.3390/nu13072342. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/15/202312 minutes, 8 seconds
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As We Wave Goodbye to the Waiver! - Frankly Speaking Ep 327

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-327 Overview: Congress has recently made changes to help fight the opioid epidemic and allow for an increase in access to treatment for opioid use disorder (OUD). Join us as we review these changes, and learn how you can use them to promote health equity in a clinical setting. Episode resource links: Hawk, K., Hoppe, J., Ketcham, E., LaPietra, A., Moulin, A., Nelson, L., ... & D’Onofrio, G. (2021). Consensus recommendations on the treatment of opioid use disorder in the emergency department. Annals of emergency medicine, 78(3), 434-442. Jones, K. F., O'Reilly-Jacob, M., & Tierney, M. (2022). Eliminating the buprenorphine DEA X waiver is critical to promote health equity. Nursing outlook, 70(1), 5-7. Jones, K. F. , Jacob, M. O. , Spetz, J. , Hailer, L. & Tierney, M.  (9000). Eliminate the buprenorphine DEA X waiver: Justification using a policy analysis approach.  Journal of Nursing Scholarship,  , doi: 10.1111/jnu.12871. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Richard Onorato
5/8/20239 minutes, 38 seconds
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Screening for Alcohol Use and Abuse: Prevention with a Capital P - Frankly Speaking Ep 326

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-326 Overview: Alcohol abuse has become more prevalent in the past decade, which means that primary care providers must play a crucial role in treating this preventable disorder. Don’t miss this discussion on the current state of alcohol abuse and how to use evidence-based screening tools for prevention. Episode resource links: Esser,M., Leung, G., Sherk, A., Bohm, M., Liu, Y., Lu, H. & Naimi, T.  Estimated Deaths Attributable to Excessive Alcohol Use Among US Adults Aged 20 to 64 Years, 2015 to 2019. JAMA Network Open. 2022;5(11):e2239485. doi:10.1001/jamanetworkopen.2022.39485 National Institute on Drug Abuse Screening and Assessment Tools Resource Chart: https://nida.nih.gov/nidamed-medical-health-professionals/screening-tools-resources/chart-screening-tools Substance Abuse and Mental Health Services Administration (SAMHSA):  National Help Line:  https://www.samhsa.gov/find-help/national-helpline Alcoholics Anonymous:  Find AA near you https://www.aa.org/find-aa Paradis, C., Butt, P., Shield, K., Poole, N., Wells, S., Naimi, T., Sherk, A., & the Low-Risk Alcohol Drinking Guidelines Scientific Expert Panels. (2023). Canada’s Guidance on Alcohol and Health: Final Report. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction.  Fairbanks J, Umbreit A, Kolla BP, et al. Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls. Mayo Clin Proc. 2020;95(9):1964-1977. doi:10.1016/j.mayocp.2020.01.030 Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
5/1/202313 minutes, 4 seconds
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Treating Children and Adolescents with Obesity—Understanding the New AAP Clinical Practice Guidelines - Frankly Speaking Ep 325

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-325 Overview: Obesity in children and adolescents is a complex and very often chronic condition. Besides encouraging healthy eating and increasing activity—both excellent behavioral measures—healthcare providers did not have a clear, evidence-based plan for managing this chronic condition until recently. In January, the AAP published its long-awaited new, evidence-based guidelines for the evaluation and treatment of children and adolescents with obesity. Greatly anticipated, it did, however, create some controversy. Please join us as we discuss the new guidelines, the evidence that it is based on, and how it may change practice.  Episode resource links: The American Academy of Pediatrics. Clinical Practice Guideline. S. E. Hampl. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. January 9, 2023.  Pediatrics e2022060640. https://doi.org/10.1542/peds.2022-060640 The American Academy of Pediatrics. S. E. Hampl. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity, January 9, 2023. Pediatrics e2022060641.https://doi.org/10.1542/peds.2022-060641;  https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-060641/190440/Executive-Summary-Clinical-Practice-Guideline-for?autologincheck=redirected AAP News release https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-issues-its-first-comprehensive-guideline-on-evaluating-treating-children-and-adolescents-with-obesity/  The American Academy of Pediatrics Technical report; January 9, 2023. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions. Pediatrics (2023) 151 (2): e2022060642.; https://doi.org/10.1542/peds.2022-060642 The American Academy of Pediatrics Technical report; January 9, 2023. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities. Pediatrics (2023) 151 (2): e2022060643. https://doi.org/10.1542/peds.2022-060643   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
4/24/20238 minutes, 11 seconds
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Is It OK to Let Your Infant Cry Themselves to Sleep? - Frankly Speaking Ep 324

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-324 Overview: Parents who struggle with infant sleep problems may turn to primary care providers for guidance to help their child, but what are the evidence-based options? Hear what the experts have to say about the findings of a recent Journal of Pediatrics study of parents’ use of a variety of behavioral interventions for infant sleep problems.  Episode resource links: Implementation of Behavioral Interventions for Infant Sleep Problems in Real-World Settings: J Pediatr. November 11, 2022. https://doi.org/10.1016/j.jpeds.2022.10.038 Blunden, S. and Dawson, D. (2020), Behavioural sleep interventions in infants: Plan B – Combining models of responsiveness to increase parental choice. J Paediatr Child Health, 56: 675-679. https://doi.org/10.1111/jpc.14818 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
4/17/202311 minutes, 48 seconds
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Chalk It Up to Stress and Anxiety or Is There More to It? - Frankly Speaking Ep 323

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-323 Overview: This episode will explore a common syndrome that is often misdiagnosed and underdiagnosed. Listen in as we discuss the cardinal symptoms and diagnostic criteria for postural orthostatic tachycardia syndrome (POTS) and learn about different management options, including the benefits of salt.  Episode resource links: Zha K, Brook J, McLaughlin A, Blitshteyn S. Gluten-free diet in postural orthostatic tachycardia syndrome (POTS). Chronic Illness. 2022;0(0). doi:10.1177/17423953221076984 Cooperrider, J., Kriegler, J., Yunus, S., & Wilson, R. (2022). A Survey-Based Study Examining Differences in Perception of Postural Orthostatic Tachycardia Syndrome Between Patients and Primary Care Physicians. Cureus, 14(10). Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022). Diagnosis and management of postural orthostatic tachycardia syndrome. Cmaj, 194(10), E378-E385. Williams, E. L., Raj, S. R., Schondorf, R., Shen, W. K., Wieling, W., & Claydon, V. E. (2022). Salt supplementation in the management of orthostatic intolerance: Vasovagal syncope and postural orthostatic tachycardia syndrome. Autonomic neuroscience, 237, 102906. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
4/10/20238 minutes, 20 seconds
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2022 CDC Clinical Practice Guidelines: What’s the Update on Prescribing Opioids for Pain? - Frankly Speaking Ep 322

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-322 Overview: Patients deserve compassionate, safe, and effective pain management. But it’s important to remember that safe prescribing does not mean no prescribing. Join us as we discuss the 2022 CDC Clinical Practice Guidelines for prescribing opioids in the adult population. The updated and expanded guidelines can assist you in delivering patient-centered care for management of acute, subacute, and chronic pain. Episode resource links: Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain —United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1 Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. 2016;315(15):1624–1645. doi:10.1001/jama.2016.1464 Guest: Jill Terrien PhD, ANP-BC    Music Credit: Richard Onorato
4/3/20239 minutes, 7 seconds
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Menopausal Symptoms—Are You Providing the Best Care to Improve Function and Quality of Life? - Frankly Speaking Ep 321

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-321 Overview: Most perimenopausal and menopausal individuals will experience some symptoms. Up to 80% of women report some symptoms, with vasomotor symptoms being the most commonly reported; however, other symptoms such as sleep disturbance, sexual dysfunction, and mood can be present. These symptoms can have a tremendous negative impact on quality of life and well-being, yet many women remain untreated for their symptoms even though evidence-based treatments exist. Join us to discuss effective treatments and ways you can overcome barriers to providing evidence-based menopausal therapy. Episode resource links: DePree, Barbara MD, NCMP, MMM1; Houghton, Katherine MSc2; Shiozawa, Aki DrPH, MBA3; Esterberg, Elizabeth MS4; King, Deanna D. MS, PhD3; Kim, Janet PhD3; Mancuso, Shayna DO, FACOG3. Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records. Menopause 30(1):p 70-79, January 2023. | DOI: 10.1097/GME.0000000000002095 https://journals.lww.com/menopausejournal/Fulltext/2023/01000/Treatment_and_resource_utilization_for_menopausal.11.aspx The North Amrican Menopause Society. (NAMS) The 2022 Hormone Therapy Position Statement of the North American Menopause Society. Menopause: The Journal of the North American Menopause Society. 29 (7)  pp 767-794. DOI: 10.1097/GME.0000000000002028 The North American Menopause Society (NAMS). Menopause Practice: A Clinician's Guide. 6th Pepper Pike, Ohio. September 2019.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
3/27/202311 minutes, 39 seconds
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CURING Anxiety vs Treating Its Symptoms - Frankly Speaking Ep 320

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-320 Overview: New evidence points to the efficacy of a simple approach to managing and potentially curing generalized anxiety disorder. Join us to discuss this simple intervention and to review the diagnosis and treatment options for this prevalent disorder. Episode resource links: JAMA Psychiatry. 2023;80(1):13-21. doi:10.1001/jamapsychiatry.2022.3679 https://positivepsychology.com/mindfulness-based-stress-reduction-mbsr/ Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato 
3/20/202311 minutes, 19 seconds
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Antibiotics for Infectious Conjunctivitis: Efficacy Is in the Eye of the Beholder - Frankly Speaking Ep 319

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-319 Overview: In children, bacterial infections are a common cause of infectious conjunctivitis. But, like many clinicians, you may be uncertain about the efficacy of using antibiotic drops in these pediatric patients. Join us to get an evidence-based answer to the important question, “Are antibiotic drops needed in children with acute infectious conjunctivitis?” Episode resource links: Honkila M, Koskela U, Kontiokari T, et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(10):e2234459. Published 2022 Oct 3. Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
3/13/202310 minutes, 13 seconds
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Do They Know I Don’t Know? Overcoming Impostor Syndrome - Frankly Speaking Ep 318

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-318 Overview: Have you ever experienced impostor syndrome? Or do you mentor someone struggling with this sense of inadequacy? If so, you won’t want to miss this podcast episode. You will formulate a clear definition of impostor syndrome, understand its components, and walk away with practical tips to help overcome it... Episode resource links: J Am Coll Surg  2021 Nov;233(5):633-638. Curr Pharm Teach Learn 2022 Feb;14(2):130-132. doi: 10.1016/j.cptl.2021.11.019. Epub 2021 Dec 27 Guest: Mariyan L. Montaque, DNP, FNP-BC & Susan Feeney, DNP, FNP-BC, NP-C & Jill M. Terrien, PhD, ANP-BC   Music Credit: Richard Onorato To learn more about Primary Care Bootcamp for NPs and PAs: https://bootcamp.pri-med.com/app 
3/6/202318 minutes, 52 seconds
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Exercise for Migraine Prophylaxis: Strength Training vs Aerobics - Frankly Speaking Ep 317

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-317 Overview: Exercise has been shown to be an effective way of decreasing migraine frequency, but the best type of exercise for this has not been established. A systematic review compared strength training to both high-intensity aerobic exercise and low-intensity aerobic exercise. Episode resource links: Woldeamanuel YW, Oliveira ABD. What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials. J Headache Pain. 2022;23(1):134. Published 2022 Oct 13. Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
2/27/202312 minutes
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Proton Pump Inhibitors—We Know Their Benefits, But What Are Their Risks? - Frankly Speaking Ep 316

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-316 Overview: While the benefits of proton pump inhibitors (PPIs) are widely known, the same cannot be said of the risks. These common medications are generally considered “safe,” but new data suggest the potential for long-term risks. Join us to discuss these long-term risks of PPI use and whether some of your patients should step down from PPIs to H2RAs.  Episode resource links: Gut : 28 September 2020. doi: 10.1136/gutjnl-2020-322557 Gut 2022 Jan; 71:16. (https://doi.org/10.1136/gutjnl-2021-325097) Front Pharmacol. 2022 Sep 14;13:979215. doi: 10.3389/fphar.2022.979215. eCollection 2022 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
2/20/20239 minutes, 3 seconds
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Exercise Patterns and Effect on Mortality - Frankly Speaking Ep 315

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-315 Overview: A recent publication shows that being a “weekend warrior” exerciser provides the same benefit to mortality risk as spreading the physical activity out across the week. Listen to this podcast to hear the data from this study and to optimally counsel your patients on how to lower their mortality risk through physical activity. Episode resource links: Physical Activity Guidelines for Americans, 2nd Edition.; 2018. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf. dos Santos M, Ferrari G, Lee DH, et al. Association of the “Weekend Warrior” and Other Leisure-time Physical Activity Patterns With All-Cause and Cause-Specific Mortality: A Nationwide Cohort Study. JAMA Intern Med.2022;182(8):840–848. doi:10.1001/jamainternmed.2022.2488 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
2/13/202310 minutes, 3 seconds
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Strokes: Which Vaccine Can Reduce Your Risks? - Frankly Speaking Ep 314

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-314 Overview: The herpes zoster virus, or shingles, is more than just a rash. Oftentimes we don’t consider the long-term risk of viruses, but we should. This episode focuses on the association between the herpes zoster virus and an increased risk of stroke. Join us to discuss data that show a reduction in stroke risk in individuals who receive the herpes zoster vaccine.  Episode resource links: Andrew N Bubak, Christina Coughlan, Janelle Posey, Anthony J Saviola, Christy S Niemeyer, Serena W R Lewis, Sara Bustos Lopez, Adriana Solano, Stephen K Tyring, Cassidy Delaney, Keith B Neeves, Ravi Mahalingam, Kirk C Hansen, Maria A Nagel, Zoster-Associated Prothrombotic Plasma Exosomes and Increased Stroke Risk, The Journal of Infectious Diseases, 2022;, jiac405, https://doi.org/10.1093/infdis/jiac405 https://www.idse.net/Review-Articles/Article/10-22/Immunization-Vaccine-Updates-Beyond-COVID-19/68244 https://www.cdc.gov/shingles/index.html https://familydoctor.org/condition/shingles/ Yang, Q., Chang, A., Tong, X., & Merritt, R. (2021). Herpes zoster vaccine live and risk of stroke among medicare beneficiaries: a population-based cohort study. Stroke, 52(5), 1712-1721. https://news.cuanschutz.edu/news-stories/researchers-reveal-why-shingles-can-cause-strokes Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
2/6/20238 minutes, 35 seconds
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Screening for Depression and Suicide Risk in Adolescents—Do You Know What to Do? - Frankly Speaking Ep 313

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-313 Overview: The prevalence of anxiety and depression has been increasing in US youth over the past decade with noted increases during the pandemic. The USPSTF recently released its recommendations supporting general screening for depression in 12- to 18-year-olds. Join us while we discuss the recommendations, the basis for these recommendations, how to integrate them into practice, and some strategies on how to support adolescents and families with a positive screen. Episode resource links: CDC Children’s Mental Health: https://www.cdc.gov/childrensmentalhealth/depression.html i. Data and Statistics on Children’s Mental Health https://www.cdc.gov/childrensmentalhealth/data.html Screening for Depression and Suicide Risk in Children and Adolescents - US Preventive Services Task Force Recommendations Statement; JAMA. doi:10.1001/jama.2022.16946. Published online October 11, 2022.  US Preventive Services Task Force Recommendation Statement on Depression and Suicide Risk in Children and Adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-children-adolescents Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
1/30/202312 minutes, 31 seconds
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5-Across: A 9-Letter Word That Can Improve Cognitive Function - Frankly Speaking Ep 312

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-312 Overview: Brain training activities have been advocated to slow or prevent cognitive decline. Crossword puzzles can be cognitively demanding and have recently been shown to be superior to some of the brain training activities that have been promoted on apps and websites. Join us for discussion on how to counsel patients looking to improve their cognitive function. Episode resource links: Pillai JA, Hall CB, Dickson DW, Buschke H, Lipton RB, Verghese J. Association of crossword puzzle participation with memory decline in persons who develop dementia. J Int Neuropsychol Soc. 2011;17(6):1006-1013. Devanand DP et al. Computerized Games versus Crosswords Training in Mild Cognitive Impairment. NEJM Evidence October 27,2022 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
1/23/20239 minutes, 32 seconds
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Reducing Senior Falls and Fractures with Milk? - Frankly Speaking Ep 311

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-311 Overview: Join us to discuss the results of a randomized controlled trial that evaluated the influence of increased dairy intake on fractures in older adults. Learn how this simple intervention can significantly mitigate the risk of falls and fractures in this vulnerable population. Episode resource links: BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2364 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
1/16/20237 minutes, 53 seconds
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A Cancer Diagnosis Doesn’t Have to Cancel Sex in Young Women - Frankly Speaking Ep 310

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-310 Overview: Join us as we discuss the importance of assessing for sexual dysfunction in young women with a cancer diagnosis.  Episode resource links: Lena Wettergren, Lars E. Eriksson, Charlotta Bergström, Christel Hedman, Johan Ahlgren, Karin E. Smedby, Kristina Hellman, Roger Henriksson & Claudia Lampic (2022): Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis – a population-based study, Acta Oncologica, DOI: 10.1080/0284186X.2022.2112283 https://doi.org/10.1080/0284186X.2022.2112283 Guest: Jill Terrien PhD, ANP-BC   Music Credit: Richard Onorato
1/10/202310 minutes, 44 seconds
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Big and Strong: Vitamin D in the First Year of Life - Frankly Speaking Ep 309

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-309 Overview: Listen to this podcast to get answers to important questions about vitamin D supplementation in the first year of life. We will review a recent systematic review and meta-analysis on the relationship between vitamin D supplementation in the first year of life and outcomes, and we will discuss how these findings can be applied to your practice. Episode resource links: Nutrients; 2021 Feb 5;13(2):524. doi: 10.3390/nu13020524 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
1/2/20239 minutes, 29 seconds
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Favorite Podcast of 2022 - Frankly Speaking Ep 308

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-308 Overview: In this episode, each podcaster will discuss the most impactful paper and podcast of the year. Episode resource links: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-302 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-299 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-281 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-275 https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-268 Guest: Alan Ehrlich MD, FAAFP, Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C, Mariyan L. Montaque, DNP, FNP-BC, Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
12/26/202212 minutes, 46 seconds
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Should There Be a Contraindication to CPR? - Frankly Speaking Ep 307

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-307 Overview: The COVID-19 epidemic resulted in overflowing ICUs and significant numbers of deaths among older adults. A recent study looked at the differences in outcomes between patients admitted with “No-code” vs “CPR” status and found no difference for high-risk individuals. Listen to this brief podcast to explore the data from this study and, in turn, give patients the information they need to make informed decisions regarding their desired code status on their advanced directives. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
12/19/20229 minutes, 33 seconds
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Preventing Peanut Allergies—Are You Following the Recommendations? - Frankly Speaking Ep 306

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-306 Overview: In 2015, a landmark study, LEAP (Learning Early About Peanut Allergy), found that early introduction to peanuts, at 4 to 6 months, significantly reduced the incidence of peanut allergies in all children but especially in those at high risk for allergies. A recent survey of pediatric residents and attendings in a large academic center regarding knowledge and implementation of the guidelines uncovered a significant knowledge gap impacting the health of children. Join us as we discuss this gap and review the guidelines for preventing peanut allergies in infants and children.   Episode resource links: Sandhu S, Hanono M, Nagarajan S, Vastardi MA. Knowledge assessment of early peanut introduction in a New York City population [published online ahead of print, 2022 Jun 18]. Ann Allergy Asthma Immunol. 2022;S1081-1206(22)00534-8. doi:10.1016/j.anai.2022.06.013 Greer FR, Sicherer SH, Burks AW, AAP COMMITTEE ON NUTRITION, AAP SECTION ON ALLERGY AND IMMUNOLOGY. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 2019;143(4): e20190281 Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118(2):166-173.e7. doi:10.1016/j.anai.2016.10.004 Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants. Pediatr Dermatol. 2016;33(1):103-106. doi:10.1111/pde.12685 Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., Brough, H. A., Phippard, D., Basting, M., Feeney, M., Turcanu, V., Sever, M. L., Gomez Lorenzo, M., Plaut, M., Lack, G., & LEAP Study Team (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine, 372(9), 803–813. https://doi.org/10.1056/NEJMoa1414850 Koplin JJ, Soriano VX, Peters RL. Real-World LEAP Implementation. Curr Allergy Asthma Rep. 2021;22(6):61-66. doi:10.1007/s11882-022-01032-3 https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-notification-regarding-health-claim-related-peanut-allergies Guest: Susan Feeney, DNP, FNP   Music Credit: Richard Onorato
12/12/202212 minutes, 34 seconds
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Risks of Long-Term Use of PPIs - Frankly Speaking Ep 305

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-305 Overview: We will review the general treatment approach to gastroesophageal reflux disease (GERD) and the risks of using proton pump inhibitors (PPI) for long durations. In particular, we will examine a new study that links PPI use, in comparison with H2 receptor antagonist (H2RA) use, with a significant increase in the risk of gastric cancer. This episode will highlight the importance of looking at PPIs on a medication review and evaluating whether patients are taking them for longer than needed.   Episode resource links: Abrahami D, McDonald EG, Schnitzer ME, et al. Proton pump inhibitors and risk of gastric cancer: population-based cohort study. Gut. 2022;71(1):16-24. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
12/5/20229 minutes, 28 seconds
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Selecting Medication for Depression: Do Genomics Matter? - Frankly Speaking Ep 304

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-304 Overview: Pharmacogenomic testing has been suggested as a way to personalize medicine, particularly where the metabolism of medications can vary significantly. Unfortunately, despite increasing use of this testing, there has been little evidence showing a benefit in clinical outcomes. Listen to this podcast to explore the data on clinical outcomes for pharmacogenetic testing and how to best select medication for patients with depression. Episode resource links: Oslin DW, Lynch KG, Shih MC, et al. Effect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial. JAMA. 2022;328(2):151-161. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
11/28/202210 minutes, 27 seconds
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Time to Stop Recommending Vitamin D? - Frankly Speaking Ep 303

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-303 Overview: Millions of Americans take Vitamin D supplementation to prevent a variety of illnesses, from COVID-19 and osteoporosis to heart disease and cancer. While most studies have failed to show a benefit in preventing COVID-19, heart disease, and cancer, the evidence has been mixed, at best, in showing benefits for preventing bone fractures. Despite this, vitamin D supplementation remains popular for fracture prevention. Join us to review a study published in the New England Journal of Medicine that failed to find any benefits for preventing fractures. Episode resource links: N Engl J Med 2022;387:299-309. DOI: 10.1056/NEJMoa2202106 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
11/21/20229 minutes, 57 seconds
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New AACE Guidelines for Non-Alcoholic Fatty Liver Disease - Frankly Speaking Ep 302

Credits: 0.25 AMA PRA Category 1 Credit™     CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-302   Overview: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, with a prevalence rate of more than 30% of US adults. Most have not been diagnosed or treated. Join us to discuss the new AACE guidance on the diagnosis and treatment of NAFLD to reduce the burden of this common disease.   Episode resource links: AACE Guideline:  Endocrine Pract: May 2022, 28(5): 528-562 Coffee: Front Pharmacol. 2021 Dec 13;12:786596. doi: 10.3389/fphar.2021.786596   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato  
11/14/202211 minutes, 15 seconds
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Walking and Osteoarthritis of the Knee: A Simple Strategy to Slow Cartilage Loss - Frankly Speaking Ep 301

Credits: 0.25 AMA PRA Category 1 Credit™     CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-301   Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population.   Episode resource links: Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601 Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B., Altman, R.D., DiRenzo, D., Fontanarosa, J., Giradi, G., Ishimori, M., Misra, D., Shah, A.A., Shmagel, A.K., Thoma, L.M., Turgunbaev, M., Turner, A.S. and Reston, J. (2020), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res, 72: 149-162. https://doi.org/10.1002/acr.24131 Lo GH, Vinod S, Richard MJ, et al. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort [published online ahead of print, 2022 Jun 8]. Arthritis Rheumatol. 2022;10.1002/art.42241. doi:10.1002/art.42241 Thudium C. Markers of synovial inflammation matrix turnover and symptoms. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Ooman JMH. Babs on a mission: An experimental study on the effects of message framing and exemplification on treatment intentions of osteoarthritis patients. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Zeng C, Doherty M, Persson MSM, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242-1251. doi:10.1016/j.joca.2021.06.004   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato  
11/7/202210 minutes, 51 seconds
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Cats Causing Psychosis! - Frankly Speaking Ep 300

Credits: 0.25 AMA PRA Category 1 Credit™     CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-300   Overview: Most primary care clinicians are unaware of a possible association between childhood cat ownership and adult psychosis. Join us to hear the results of a recent retrospective study that suggests this link. Hear practical tips to share with patients who own an outdoor cat to help them avoid the toxoplasmosis that may be a potential etiologic agent for psychiatric illness.   Episode resource links: Journal of Psychiatric Research. Volume 148, April 2022, Pages 197-203 doi.org/10.1016/j.jpsychires.2022.01.058   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato  
10/31/20228 minutes, 30 seconds
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Deprescribing in Patients with Dementia: Less Is More - Frankly Speaking Ep 299

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-299 Overview: Polypharmacy is a burden on patients with dementia. Adverse drug reactions, side effects, the cost, and inappropriate medications that may lead to falls and morbidity/mortality may be conferring more harm than benefit. Unfortunately, 44% of men and 57% of women >65 years take five or more nonprescription and/or prescription medications per day. Join us as we discuss methods for deprescribing polypharmacy in this patient population.  Episode resource links: Growdon, M. E., Gan, S., Yaffe, K., & Steinman, M. A. (2021). Polypharmacy among older adults with dementia compared with those without dementia in the United States. Journal of the American Geriatrics Society, 69(9), 2464–2475. PMID: 34101822 https://doi.org/10.1111/jgs.17291 Narayan, S. W., & Nishtala, P. S. (2017). Discontinuation of Preventive Medicines in Older People with Limited Life Expectancy: A Systematic Review. Drugs & aging, 34(10), 767–776. PMID: 28853000  https://doi.org/10.1007/s40266-017-0487-1 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato  
10/24/202211 minutes, 16 seconds
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Leave the Antibiotics on the Shelf for Kids with Lower Respiratory Tract Infections - Frankly Speaking Ep 298

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-298 Overview: :  Lower respiratory tract infections are a common presentation in children, and many of those children receive antibiotic prescriptions. Join us for this episode to review evidence that supports avoiding such treatment unless pneumonia or other bacterial infections are suspected. Episode resource links: Little P, Francis NA, Stuart B, et al. Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial. Lancet. 2021;398(10309):1417-1426 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
10/17/20228 minutes, 41 seconds
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Probiotics to Prevent Diarrhea During Antibiotic Course in Children - Frankly Speaking EP 297

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-297   Overview: The efficacy of probiotic formulations in the prevention of antibiotic-associated diarrhea remains unclear. Join us to review a recent study in JAMA Pediatrics that attempts to answer this question.   Episode resource links: Multispecies Probiotic for the Prevention of Antibiotic-Associated Diarrhea in Children A Randomized Clinical Trial   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato
10/10/202211 minutes, 6 seconds
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Preventing Overdose Deaths with Naloxone: Harm Reduction vs Encouraging Use - Frankly Speaking EP 296

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-296   Overview: The number of drug overdoses in the United States continues to rise in tandem with the growing opioid epidemic. In 2020, nearly 92,000 people died from drug overdoses in the United States, which was an approximate 31% increase in just one year. This episode will highlight perceived barriers to harm reduction and show primary care providers how they can play a key role in overdose prevention.    Episode resource links: https://www.cdc.gov/opioids/overdoseprevention/reverse-od.html https://www.cdc.gov/drugoverdose/deaths/index.html#:~:text=Drug%20Overdose%20Deaths%20Remain%20High&text=Opioids%E2%80%94mainly%20synthetic%20opioids%20(other,of%20all%20drug%20overdose%20deaths). Bonner, L. (2022). As the opioid epidemic takes a turn for the worse, do we need more potent forms of naloxone?. Pharmacy Today, 28(3), 26. Messmer, S., & Jarrett, J. (2022). When Naloxone Isn’t Enough. New England Journal of Medicine. Tse, W. C., Djordjevic, F., Borja, V., Picco, L., Lam, T., Olsen, A., ... & Nielsen, S. (2022). Does naloxone provision lead to increased substance use? A systematic review to assess if there is evidence of a ‘moral hazard’associated with naloxone supply. International Journal of Drug Policy, 100, 103513.   Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
10/3/20229 minutes
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Suspecting COPD: What If the Spirometry Result Is Normal? - Frankly Speaking EP 295

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-295   Overview: Chronic obstructive pulmonary disease (COPD) is typically diagnosed based on spirometry findings, but what if that finding isn’t what you expect? Spirometry measurements are compared to standard values for age, sex, and race. The use of race-based equations has been questioned in several clinical situations, and researchers are now raising similar concerns about the use of race-based equations in spirometry, which may lead to health inequities. Join us for an important discussion on how to overcome these potential disparities in diagnosing COPD.   Episode resource links: Liu GY, Khan SS, Colangelo LA, et al. Comparing Racial Differences in Emphysema Prevalence Among Adults With Normal Spirometry: A Secondary Data Analysis of the CARDIA Lung Study [published online ahead of print, 2022 Jul 19]. Ann Intern Med. 2022;10.7326/M22-0205.   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
9/26/20229 minutes, 24 seconds
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The Best Evidence for Treating Fibromyalgia - Frankly Speaking EP 294

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-294   Overview: Fibromyalgia is a common and difficult to diagnose disease, with highly subjective symptoms. Another challenge is that treatment is dependent on a patient’s implementation lifestyle changes. This brief podcast walks you through the diagnosis of fibromyalgia and offers best evidence on effective treatments.   Episode resource links: Mediations:  JAMA Netw Open. 2022;5(5):e2212939 Acupuncture:  J Pain Res. 2022; 15: 315–329   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
9/19/202211 minutes, 21 seconds
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Wait Before Writing That Antibiotic Prescription! Is it appropriate? - Frankly Speaking EP 293

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-293   Overview: Evidence informs us that almost one-third of antibiotic prescriptions written for children in the United States are inappropriate, meaning they are not in line with evidence-based guidelines. Antibiotics are tremendous tools and beneficial when used appropriately; however, as with all pharmacological therapy, there are risks of adverse effects and healthcare cost. When prescribed inappropriately, they unnecessarily put children at risk and cause financial burden on individuals and the system. Please join the podcast team as we discuss recent evidence on these risks and burden and consider how this evidence can help improve practice.    Episode resource links: Butler AM, Brown DS, Durkin MJ, et al. Association of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events and Health Care Expenditures. JAMA Netw Open.2022;5(5):e2214153. doi:10.1001/jamanetworkopen.2022.14153   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
9/12/202212 minutes, 4 seconds
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Reducing the Risk of Alcohol-Associated Liver Disease - Frankly Speaking EP 292

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-292   Overview: Alcohol use disorder is common, but effective medications to treat this disorder are not widely prescribed in the outpatient primary care setting, despite being available and having relatively good formulary coverage. Join us to hear how the use of medical treatment can decrease the incidence and progression of alcohol-associated liver disease.   Episode resource links: Augustin G. L. Vannier et al, Incidence and Progression of Alcohol-Associated Liver Disease After Medical Therapy for Alcohol Use Disorder, JAMA Network Open (2022).  DOI: 10.1001/jamanetworkopen.2022.13014   Tetreault JM, O'Connor PG. Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis. UpToDate. Published April 28, 2022. Accessed June 11, 2022.    Holt SR, Tetrault, JM. Ambulatory Management of alcohol withdrawal. UpToDate. Published May 19, 2022. Accessed June 11, 2022.   Holt SR. Approach to treating alcohol use disorder. UpToDate. Published March 22, 2022. Accessed June 11, 2022.   Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
9/5/202212 minutes, 6 seconds
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Is Less More When Treating BP in Older Adults? - Frankly Speaking EP 291

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-291   Overview: Concerns have been raised over guideline recommendations for lowering systolic blood pressure (BP) to 60 years. To achieve such targets often requires intensive BP treatments, which can result in harms from syncope or falls. Join us to review the results of a recently published meta-analysis done to estimate the time needed to potentially derive clinical benefit from such BP treatments in patients 60 years and older.    Episode resource links: JAMA Intern Med. 2022;182(6):660-667. doi:10.1001/jamainternmed.2022.1657   Guest: Robert A. Baldor, MD   Music Credit: Richard Onorato
8/29/202210 minutes, 45 seconds
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When Do Food Allergies Resolve? - Frankly Speaking EP 290

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-290   Overview: This brief podcast discusses the prevalence of egg and nut allergies in children, how to lower the risk of developing these allergies, and which patients are at greatest risk. Hear how to best counsel parents about their child’s allergies and help them anticipate their child’s future health.   Episode resource links: The natural history of peanut and egg allergy in children up to age 6 years in the HealthNuts population-based longitudinal study; Am Aca Allergy, Asthma & Immunol 2022; https://doi.org/10.1016/j.jaci.2022.04.008 Dietary Interventions to pRevent Atopic Disease in Children, AAP 3/19: https://publications.aap.org/aapnews/news/8699   Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
8/22/202210 minutes, 26 seconds
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Limit Screen Time to Increase Physical Activity - Frankly Speaking Ep 289

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 Overview: Excessive screen time has been associated with numerous adverse health outcomes. Join us for a look at a fascinating new study that explores how limiting screen time can increase physical activity in children. Listen to this brief podcast before you counsel your next patient on how screen time can affect their children’s (and their) health. Episode resource links: Pedersen J,et al. Effects of Limiting Recreational Screen Media Use on Physical Activity and Sleep in Families With Children: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2022 May 23:e221519 Screen Time and Children. American Academy of Child and Adolescent Psychiatry: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
8/15/20228 minutes, 41 seconds
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A Spoonful of Sugar in Your Cup of Joe—Does It Affect Your Health? - Frankly Speaking Ep 288

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-288 Overview: Coffee is one of the most consumed beverages worldwide. An estimated 500 million cups are consumed per day in the United States. As testimony to this, count the number of coffee shops available—most with drive-through access—the next time you are out for a drive. A growing body of evidence indicates that moderate coffee consumption (2-3 cups per day) is associated with reduction in all-cause mortality. What hasn’t been looked at closely is the effect of coffee with sugar and artificial sweeteners on these measures. Join us while we discuss recent evidence regarding consumption of coffee—with or without sweeteners—and its association with all-cause mortality. Episode resource links: Liu D, Li ZH, Shen D, Zhang PD, Song WQ, Zhang WT, Huang QM, Chen PL, Zhang XR, Mao C. Association of Sugar-Sweetened, Artificially Sweetened, and Unsweetened Coffee Consumption With All-Cause and Cause-Specific Mortality : A Large Prospective Cohort Study. Ann Intern Med. 2022 May 31. doi: 10.7326/M21-2977. Epub ahead of print. PMID: 35635846. Wee CC. The Potential Health Benefit of Coffee: Does a Spoonful of Sugar Make It All Go Away? Ann Intern Med. 2022 May 31. doi: 10.7326/M22-1465. Epub ahead of print. PMID: 35635845. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato
8/8/20229 minutes, 58 seconds
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Biennial Screening Could Decrease False Positives in Screening Mammography - Frankly Speaking Ep 287

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-287 Overview: Join us to discuss the rates of false positives in mammography and how to decrease them. Specifically, this session reviews data from an observational comparative effectiveness study suggesting that the type of mammography, interval, and other factors can affect the probability of false positive results.  Episode resource links: Ho TH, Bissell MCS, Kerlikowske K, et al. Cumulative Probability of False-Positive Results After 10 Years of Screening With Digital Breast Tomosynthesis vs Digital Mammography. JAMA Netw Open. 2022;5(3):e222440. doi:10.1001/jamanetworkopen.2022.2440 Breast Cancer Screening Guidelines for Women (CDC Chart)—Last reviewed 9-2020 chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.cdc.gov/cancer/breast/pdf/breast-cancer-screening-guidelines-508.pdf Canelo-Aybar, C., Posso, M., Montero, N. et al. Benefits and harms of annual, biennial, or triennial breast cancer mammography screening for women at average risk of breast cancer: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC). Br J Cancer 126, 673–688 (2022). https://doi.org/10.1038/s41416-021-01521-8 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
8/1/202210 minutes, 39 seconds
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USPSTF: Aspirin No Longer Recommended for Primary Prevention - Frankly Speaking Ep 286

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-286 Overview: The controversy surrounding whether to prescribe aspirin for primary prevention of cardiovascular disease in adult patients has left many clinicians unsure of the right approach. In this podcast, we’ll review the latest USPSTF recommendation on this topic and dig into the evidence behind the recommendation. Episode resource links: JAMA. 2022;327(16):1577-1584. doi:10.1001/jama.2022.4983 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
7/25/20229 minutes, 51 seconds
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Tirzepatide: A New Treatment for Diabetes - Frankly Speaking Ep 285

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-285 Overview: Join us for a closer look at tirzepatide, a first-in-class glucose-dependent insulinotropic peptide (GIP) and a glucagon-like peptide-1 receptor agonist (GLP-1 RA). See how this novel glucose-lowering agent can help raise the bar in both HbA1c lowering and weight loss in patients with type 2 diabetes mellitus. Episode resource links: Karagiannis T, Avgerinos I, Liakos A, Del Prato S, Matthews DR, Tsapas A, Bekiari E. Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and meta-analysis. Diabetologia. 2022 May 17:1–11. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
7/18/202211 minutes
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What Are the Best Agents to Treat Male Baldness? - Frankly Speaking Ep 284

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-284 Overview: Most primary care clinicians treating patients with male androgenetic alopecia are unfamiliar with studies looking at off-label use of medications for this condition. In this episode, you will hear a review of an important recent meta-analysis published in JAMA Dermatology that highlights the efficacy of commonly used agents to treat this condition. Episode resource links: JAMA Dermatol. doi:10.1001/jamadermatol.2021.5743 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
7/11/20229 minutes, 32 seconds
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Clearing the Air in COPD - Frankly Speaking Ep 283

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-283 Overview: Listen to this podcast to hear a simple method to help those with COPD improve their symptom control and lower exacerbation rates.  Episode resource links: Am J Respir Crit Care Med Vol 205, Iss 4, pp 421–430, Feb 15, 2022 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
7/4/202210 minutes, 38 seconds
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A Primer on Monkeypox - Frankly Speaking Ep 282

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-282 Overview: Monkeypox is endemic in certain parts of Africa, but outbreaks in Europe and North America have recently occurred. While still uncommon, clinicians need to be alert to the possibility of this diagnosis. This podcast gives you the tools you need to identify risk factors and distinguish the disease from other infections. Episode resource links: World Health Organization Health Topics/Monkeypox https://www.who.int/health-topics/monkeypox#tab=tab_1 Disease outbreak New/Item/Multi-country monkeypox outbreak: situation update 6-10-2022 https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON392 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
6/27/202214 minutes, 1 second
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Access to Care: Safety of Medication Abortion - Frankly Speaking Ep 281

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-281 Overview: Clinicians may hesitate to provide medication abortion without first performing a pelvic ultrasound or pelvic examination, but recent data may give clinicians more confidence in their decision to do so. This episode explores the evidence for the safety of telehealth-based, or no-test screening, approaches to providing medication abortion for pregnant women at less than 10 weeks’ gestation.  Episode resource links: Upadhyay UD, Raymond EG, Koenig LR, et al. Outcomes and Safety of History-Based Screening for Medication Abortion: A Retrospective Multicenter Cohort Study. JAMA Intern Med. Published online March 21, 2022. doi:10.1001/jamainternmed.2022.0217 Upadhyay UD, Koenig LR, Meckstroth KR. Safety and Efficacy of Telehealth Medication Abortions in the US During the COVID-19 Pandemic. JAMA Network Open. 2021;4(8):e2122320. doi:10.1001/jamanetworkopen.2021.22320 Endler M, Lavelanet A, Cleeve A, Ganatra B, Gomperts R, Gemzell-Danielsson K. Telemedicine for medical abortion: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2019;126(9):1094-1102. doi:10.1111/1471-0528.15684 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
6/20/202212 minutes, 16 seconds
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Statins for Cardiovascular Disease—It’s All Relative - Frankly Speaking Ep 280

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-280 Overview: Statins are widely used for lowering cholesterol in patients at risk for cardiovascular disease. While the benefit is more established with secondary prevention compared with primary prevention, most of the benefits are reported in relative risk reduction, which can exaggerate the benefit to an individual person. In this podcast, you’ll hear a discussion of a recent systematic review that looked at the absolute risk reduction and relative risk reduction with statins for preventing death, myocardial infarctions, and stroke. Episode resource links: Byrne, P. , Demasi, M. , Jones, M. , et al. Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment. JAMA Internal Medicine Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
6/13/202212 minutes, 50 seconds
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Step It Up! But by How Much? - Frankly Speaking Ep 279

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-279 Overview: Clinicians (and patients) know that walking is beneficial for overall health, but what are the specifics? How many steps per day lower health risks? What impact does walking have on mortality? What’s the best way to count steps? Join us to hear answers to these questions and more as we discuss evidence-based recommendations for steps/day. Episode resource links: Paluch, A. E., Bajpai, S., Bassett, D. R., Carnethon, M. R., Ekelund, U., Evenson, K. R., Galuska, D. A., Jefferis, B. J., Kraus, W. E., Lee, I. M., Matthews, C. E., Omura, J. D., Patel, A. V., Pieper, C. F., Rees-Punia, E., Dallmeier, D., Klenk, J., Whincup, P. H., Dooley, E. E., Pettee Gabriel, K., … Steps for Health Collaborative (2022). Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. The Lancet. Public health, 7(3), e219–e228. https://doi.org/10.1016/S2468-2667(21)00302-9     https://www.cdc.gov/physicalactivity/index.html This website includes data, resources and information for patients and providers for physical activity. Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
6/6/202210 minutes, 2 seconds
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Forget About Weed - Frankly Speaking Ep 278

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-278 Overview: Misconceptions abound on the long-term effects of chronic use of marijuana. This episode tackles these misconceptions head-on, highlighting new data on marijuana’s adverse effects on central nervous system function, including loss of memory, IQ points, and executive functioning. It’s a must-listen for clinicians caring for patients engaging in regular marijuana use. Episode resource links: Am J Psych 8 Mar 2022 https://doi.org/10.1176/appi.ajp.2021.21060664 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
5/30/20229 minutes, 2 seconds
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Pneumococcal Vaccines Simplified! - Frankly Speaking Ep 277

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-277 Overview: Join us to discuss a summary of the newly published guidelines for pneumococcal vaccines and to review the most recently approved vaccines. We’ll begin by describing the challenges from the previous guidelines and how these new guidelines address these challenges. Given the burden of pneumococcal disease and that vaccination is our best weapon to combat the disease, you won’t want to miss this episode.  Episode resource links: Morga, A., Kimura, T., Feng, Q., Rozario, N., & Schwartz, J. (2022). Compliance to Advisory Committee on Immunization Practices recommendations for pneumococcal vaccination. Vaccine.   https://www.medscape.com/viewarticle/967675#vp_1   Schulz, P. S., Moore, S. E., Smith, D., Javed, J., & Wilde, A. M. (2022, April). Missed Pneumococcal Vaccination Opportunities in Adults With Invasive Pneumococcal Disease in a Community Health System. In Open Forum Infectious Diseases (Vol. 9, No. 4, p. ofac075). US: Oxford University Press.   Center for disease Control and Prevention Resources: App for iphone and android PneumoRecs Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
5/23/202211 minutes, 23 seconds
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Does Acetaminophen Increase Stroke Risk? - Frankly Speaking Ep 276

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-276 Overview: The concerns over the use of NSAIDs have been well documented. The medications can raise blood pressure and have been linked to an increased risk of heart disease and stroke when used long term. These known risks, supported by the FDA’s warning in 2005, has prompted many clinicians to prescribe acetaminophen instead. But do acetaminophen products confer a lower risk of cardiovascular effects? Join us for this episode to review the results from recent trials assessing similar blood pressure effects from regular use of acetaminophen.  Episode resource links: https://doi.org/10.1161/CIRCULATIONAHA.121.056015 Circulation. 2022;145:416–423 https://doi.org/10.1093/eurheartj/ehac059; European Heart Journal.  2,24,2022 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/16/20229 minutes, 27 seconds
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Breastfeeding Really Is Best—New Evidence for Improved Health in Infants - Frankly Speaking Ep 275

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-275 Overview: The multitude of benefits of breastfeeding for both mother and baby are well documented. However, we’ve seen mixed evidence for the relationship between breastfeeding and certain childhood lung conditions, with some studies suggesting an increase in risk. A recent study found that exclusive breastfeeding was associated with decreased lower respiratory tract infection (LRTI), asthma, and allergic rhinitis. A potential connection between these conditions, breastfeeding, and the infant’s gut microbiome was also found. Join us as we discuss these findings and how to incorporate them into your practice to improve the health of women and infants. Episode resource links: Rosas-Salazar C, Shilts MH, Tang ZZ, Hong Q, Turi KN, Snyder BM, Wiggins DA, Lynch CE, Gebretsadik T, Peebles RS Jr, Anderson LJ, Das SR, Hartert TV. Exclusive Breastfeeding, the Early-life Microbiome and Immune Response, and Common Childhood Respiratory Illnesses. J Allergy Clin Immunol. 2022 Mar 10:S0091-6749(22)00292-5. doi: 10.1016/j.jaci.2022.02.023. Epub ahead of print. PMID: 35283139. Rosas-Salazar C, Forno E, Brehm JM, Han YY, Acosta-Pérez E, Cloutier MM, Wakefield DB, Alvarez M, Colón-Semidey A, Canino G, Celedón JC. Breastfeeding duration and asthma in Puerto Rican children. Pediatr Pulmonol. 2015 Jun;50(6):527-34. doi: 10.1002/ppul.23061. Epub 2014 Aug 6. PMID: 25100626; PMCID: PMC4320027. AAP Breastfeeding Guidelines. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Where-We-Stand-Breastfeeding.aspx ACOG. https://www.acog.org/womens-health/infographics/breastfeeding-benefits CDC Recommendations and Benefits of Breastfeeding. https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/recommendations-benefits.html CDC Breastfeeding Report Card. https://www.cdc.gov/breastfeeding/data/reportcard.htm US Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf#page=65 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
5/9/202210 minutes, 23 seconds
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Recurrent UTIs—Prevention Without Antibiotics - Frankly Speaking Ep 274

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-274 Overview: Recurrent urinary tract infections (UTIs) can be a frustrating problem for both patients and clinicians. Antibiotics are often used, but a prevailing concern is that the overuse of antibiotics may lead to more resistant bacteria. This podcast discusses methenamine hippurate as an important nonantibiotic alternative for UTI prophylaxis. Episode resource links: Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ. 2022 Mar 9;376:e068229.    Lee BS, Bhuta T, Simpson JM, Craig JC. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;10(10):CD003265. Published 2012 Oct 17.  Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
5/2/202210 minutes, 35 seconds
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A Smoke Screen? Is Secondhand Aerosol Exposure From E-Cigarettes harmful? - Frankly Speaking Ep 273

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-273 Overview: The evidence continues to grow and evolve on the potential harms of e-cigarette use and on their efficacy and safety as a harm reduction strategy. One aspect of e-cigarette use that has not received much attention is the effect of secondhand exposure to the exhaled aerosol from e-cigarettes. Previous small studies have suggested some exposure risk, but a recent study of >2,000 participants found that secondhand exposure to e-cigarette aerosol increased the risk of bronchitic symptoms and shortness of breath in young adults. Join us as we discuss these findings and their implications to practice. Episode resource links: Islam T, Braymiller J, Eckel SP, et al Secondhand nicotine vaping at home and respiratory symptoms in young adults Thorax Published Online First: 10 January 2022. doi: 10.1136/thoraxjnl-2021-217041 Caponnetto P, Caruso M, Maglia M, et al. Non-inferiority trial comparing cigarette consumption, adoption rates, acceptability, tolerability, and tobacco harm reduction potential in smokers switching to Heated Tobacco Products or electronic cigarettes: Study protocol for a randomized controlled trial. Article. Contemporary Clinical Trials Communications. 2020;17100518. doi:10.1016/j.conctc.2020.100518 Gaiha SM, et al. J Adolesc Health. Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19. J Adolesc Health. Vol 67, issue 4, pp 519-523; DOI: https://doi.org/10.1015/j.jadolhealth.2020.07.002 Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5 Mayo Clinic. (2022, January 13). E-cigarette users who test positive for COVID-19 are more likely to experience COVID-19 symptoms. ScienceDaily. Retrieved January 17, 2022 from www.sciencedaily.com/releases/2022/01/220113151402.htm McAlinden KD, Eapen MS, Lu W, Chia C, Haug G, Sohal SS. COVID-19 and vaping: risk for increased susceptibility to SARS-CoV-2 infection? Eur Respir J. 2020. vol. 1.   McFadden, DD, Bornstein, SL, Vassallo, R, Salonen, BR, Nadir Bhuiyan, M, Schroeder, DR, Croghan, IK. Symptoms COVID 19 Positive Vapers Compared to COVID 19 Positive Non-vapers. Journal of Primary Care & Community Health, 2022; 13: 215013192110626 DOI: 10.1177/21501319211062672 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
4/25/20228 minutes, 55 seconds
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Estimating Jugular Venous Pressure: Point-of-Care Ultrasound Can Help - Frankly Speaking Ep 272

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-272 Overview: Clinicians need to accurately assess the degree of heart failure at the bedside to make appropriate management decisions. However, the common bedside practice of estimating right atrial pressure by measuring jugular venous pressure (JVP) has several accuracy limitations. This session focuses on the use of point-of-care ultrasound (POC-US) to improve the accuracy of JVP measurements. Join us to hear the salient findings from a recent study comparing POC-US measurements to right heart catheterization measurements, and walk away with a clear understanding of how POC-US can quickly and easily improve accuracy. Episode resource links: Wang L, Harrison J, Dranow E, Aliyev N, Khor L. Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion. Ann Intern Med. 2021 Dec 28. doi: 10.7326/M21-2781. Epub ahead of print. Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
4/18/202211 minutes, 7 seconds
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Cardiovascular Disease and Exercise - Frankly Speaking Ep 271

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-271 Overview: Given the prevalence of cardiovascular disease (CVD) in the United States, it is key for primary care providers to counsel patients on the importance of exercise for CVD prevention. This brief podcast explores data that will help clinicians understand the need to prescribe exercise and rehabilitation in the primary care setting. You’ll walk away with clear guidance to offer patients and ultimately improve outcomes in CVD as well as multiple chronic diseases. Episode resource links: Naci, H., & Ioannidis, J. P. (2015). Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. British journal of sports medicine, 49(21), 1414–1422. https://doi.org/10.1136/bjsports-2015-f5577rep   Sanchis-Gomar, F., Lavie, C. J., Marín, J., Perez-Quilis, C., Eijsvogels, T. M., O’Keefe, J. H., ... & Blair, S. N. (2021). Exercise effects on cardiovascular disease: from basic aspects to clinical evidence. Cardiovascular Research.  Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
4/11/202210 minutes, 44 seconds
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Boosting Weight Loss with Medications: New support for GLP-1 RAs - Frankly Speaking Ep 270

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-270 Overview: You know GLP-1 RAs are an important class of agents for weight loss, but do you know which drug within this class is right for your patient? This brief podcast walks you through the recent evidence from the STEP 8 randomized clinical trial, comparing the efficacy and adverse reaction profiles for 2 GLP-1 RAs: semaglutide (Wegovy) and liraglutide (Saxenda). This is a must-listen for anyone looking to optimally individualize care for patients with obesity. Episode resource links: Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. doi:10.1001/jama.2021.23619 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
4/4/202210 minutes, 2 seconds
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Screen Patients Early and Routinely for Prescription Drug Misuse - Frankly Speaking Ep 269

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-269 Overview: Join us as we discuss the trajectories of prescription drug misuse from adolescence through adulthood. This session explores the findings from a longitudinal cohort study demonstrating the need for screening patients from adolescence through adulthood for substance use disorder. You’ll walk away with the tools and resources you need to accurately screen patients and determine next best steps for each individual. Episode resource links: McCabe, S. E., Schulenberg, J. E., Schepis, T. S., Evans-Polce, R. J., Wilens, T. E., McCabe, V. V., & Veliz, P. T. (2022). Trajectories of Prescription Drug Misuse Among US Adults From Ages 18 to 50 Years. JAMA network open, 5(1), e2141995. https://doi.org/10.1001/jamanetworkopen.2021.41995 PMID: 34982159 National Institute on Drug Abuse (NIDA) Drug Screening Tool for use in general medical settings:  https://archives.drugabuse.gov/nmassist/ National Institute on Drug Abuse (NIDA) Evidence Based Screening and Assessment Tools and Resources (Includes adults and adolescents)   https://www.drugabuse.gov/nidamed-medical-health-professionals/screening-tools-resources/chart-screening-tools Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
3/28/202210 minutes, 2 seconds
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PrEP: Are We Educating Patients Effectively? - Frankly Speaking Ep 268

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-268 Overview: This episode will help bring awareness to the importance of educating patients about post-exposure prophylaxis (PrEP) in the primary care setting. This talk will also discuss how to reduce the stigma surrounding this prevention method. Finally, you will hear about the newly FDA approved PrEP treatment option that could potentially improve outcomes for patients.    Episode resource links: https://www.healio.com/news/infectious-disease/20211220/fda-approves-first-longacting-injectable-for-hiv-prevention Philbin, M. M., Parish, C., Kinnard, E. N., Reed, S. E., Kerrigan, D., Alcaide, M. L., ... & Metsch, L. R. (2021). Interest in long-acting injectable pre-exposure prophylaxis (LAI PrEP) among women in the women’s interagency HIV study (WIHS): a qualitative study across six cities in the United States. AIDS and Behavior, 25(3), 667-678.   Kim Y. S. (2021). Long-Acting Injectable Antiretroviral Agents for HIV Treatment and Prevention. Infection & chemotherapy, 53(4),      686–695. https://doi.org/10.3947/ic.2021.0136   CDC Practice guidelines  https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
3/21/202210 minutes, 6 seconds
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Bad News for E-Cigarette Users—Possible Link Between E-Cigarettes And ED - Frankly Speaking Ep 267

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-267 Overview: The clinical literature is filled with new and evolving evidence on the use of e-cigarettes and potential harms. The question of their use as a harm reduction strategy is a hotly debated topic—pitting traditional combustible tobacco with its well-known effect on morbidity and mortality against electronic nicotine delivery systems (ENDS), which although not harmless, are considered less harmful than smoked cigarettes. Recent evidence is emerging on the potential cardiovascular risks posed by newer generations of ENDS with far greater delivery of nicotine. Join us while we discuss the findings from a recent study that examines ENDS use and associated increase rates of erectile dysfunction (ED) and how this information may impact your practice. Episode resource links: El-Shahawy O, Shah T, Obisesan OH, Durr M, Stokes AC, Uddin I, Pinjani R, Benjamin EJ, Mirbolouk M, Osei AD, Loney T, Sherman SE, Blaha MJ. Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study. Am J Prev Med. 2022 Jan;62(1):26-38. doi: 10.1016/j.amepre.2021.08.004. Epub 2021 Nov 30. PMID: 34922653. Caponnetto P. Well-being and harm reduction, the consolidated reality of electronic cigarettes ten years later from this emerging phenomenon: A narrative review. Health Psychol Res. Dec 30 2020;8(3):9463. doi:10.4081/hpr.2020.9463 Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5 Guest: Susan Feeney, DNP, FNP-BC, NP-   Music Credit: Richard Onorato
3/14/202212 minutes, 50 seconds
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Fever Free: Acetaminophen or Ibuprofen? - Frankly Speaking Ep 266

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-266 Overview: ‘Tis the season for pediatric fevers! Join us to review a recent meta-analysis looking at 18 studies with patients younger than 2 years old who received acetaminophen or ibuprofen for fever or pain to determine if one medication should be recommended first, before the other. After this session, you’ll be able to confidently advise parents of young children on how best to manage fever and/or pain at home with over-the-counter medications.   Episode resource links: Long B, Gottlieb M. Ibuprofen vs. Acetaminophen for Fever or Pain in Children Younger Than Two Years. Am Fam Physician. 2022 Jan ;105(1):19. Wong T, Stang AS, Ganshorn H, Hartling L, Maconochie IK, Thomsen AM, Johnson DW. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Evid Based Child Health. 2014 Sep;9(3):675-729. doi: 10.1002/ebch.1978. PMID: 25236309. Sullivan JE, Farrar HC. Fever and Antipyretic Use in Children. Pediatrics (2011) 127 (3): 580-587. (Reaffirmed 2016) Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
3/7/20228 minutes, 44 seconds
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“Could It Be My Thyroid?” The Quandary of Subclinical Hypothyroidism - Frankly Speaking Ep 241

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-241   Overview: Seven percent of the US population has an active levothyroxine prescription, which is significantly greater than the number of people diagnosed with overt hypothyroidism. Many of these prescriptions appear to be for the treatment of subclinical hypothyroidism and other conditions in euthyroid individuals. Join us to uncover the latest findings on the use of levothyroxine and what the evidence tells us about appropriate use and misuse of this drug.   Episode resource links: Brito, J., Ross, J., El Kawkgi, O., Maraka, S., Deng, Y., Shah, N., Lipska, K. & (9000). Levothyroxine Use in the United States, 2008-2018. JAMA Internal Medicine, Publish Ahead of Print, doi: 10.1001/jamainternmed.2021.2686. Johansen, M., Marcinek, J., Yun, J. & (2020). Thyroid Hormone Use in the United States, 1997–2016. Journal of the American Board of Family Medicine, 33 (2), 284-288. doi: 10.3122/jabfm.2020.02.190159. Jeffrey R. Garber, Rhoda H. Cobin,Hossein Gharib,James V. Hennessey, Irwin Klein, Jeffrey I. Mechanick, Rachel Pessah-Pollack, Peter A. Singer,Kenneth A. Woeber. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association; November–December 2012. https://www.endocrinepractice.org/article/S1530-891X(20)43030-7/fulltext; https://www.endocrinepractice.org/action/showPdf?pii=S1530-891X%2820%2943030-7   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
3/3/202211 minutes, 12 seconds
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Fluvoxamine as a Treatment for COVID-19 - Frankly Speaking Ep 265

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-265 Overview: Most cases of COVID-19 will resolve without interventions, but some patients are at high risk for complications. Several treatment options for high-risk patients are now available to help prevent the need for hospitalization. Join us to review a recent large, randomized trial evaluating fluvoxamine as a treatment for high-risk patients who were diagnosed with COVID-19.   Episode resource links: Reis G, et al. TOGETHER investigators. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health. 2022 Jan;10(1):e42-e51 Berwanger O. Fluvoxamine for outpatients with COVID-19: where do we stand? Lancet Glob Health. 2022 Jan;10(1):e2-e3. doi: 10.1016/S2214-109X(21)00501-5 https://activ6study.org/ Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato
2/28/202212 minutes, 27 seconds
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COVID-19 and Children - Frankly Speaking Ep 264

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-264 Overview: Get answers to your questions on COVID-19 infection in children. Listen to this podcast to review outcomes and potential risk factors associated with acute COVID-19 infection in this population. Finally, learn the status of immunizations for children younger than 5 years of age.   Episode resource links: JAMA Netw Open. 2022;5(1):e2142322. doi:10.1001/jamanetworkopen.2021.42322 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
2/22/20228 minutes, 2 seconds
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Oral Anti−COVID-19 Medications—a Game Changer? - Frankly Speaking Ep 263

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-263   Overview: The FDA’s recent emergency use authorization (EUA) for oral agents to treat COVID-19 means that primary care providers (PCPs) will be on the frontline of treating patients with COVID-19. Therefore, PCPs must understand who is eligible for such treatments and how to prescribe them. We will discuss the results of the recent FDA EUA for Pfizer’s Paxlovid and Merck’s molnupiravir antiviral agents and give you the information you need to confidently prescribe them.   Episode resource links: FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR MOLNUPIRAVIR (fda.gov) FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR PAXLOVID (fda.gov) Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
2/14/202212 minutes, 31 seconds
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Menopausal Transition: Bothersome Symptoms Sooner Than You Expect! - Frankly Speaking Ep 262

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-262   Overview: Join us as we discuss menopausal transition and the unique qualities and symptoms that are bothersome to women at an early age.   Episode resource links: Coslov, N., Richardson, M. K., & Woods, N. F. (2021). Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey. Menopause (New York, N.Y.), 28(9), 1012–1025. https://doi.org/10.1097/GME.0000000000001805 https://pubmed.ncbi.nlm.nih.gov/34313615/   ACOG Practice Guidelines: Clinical Guidelines on the Management of Menopausal Symptoms: https://www.aafp.org/afp/2014/0901/p338.html Women Living Better Website:  https://womenlivingbetter.org/ Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., Bobo, W. V., Rubin, L. H., Koleva, H. K., Cohen, L. S., Soares, C. N., & Board of Trustees for The North American Menopause Society (NAMS) and the Women and Mood Disorders Task Force of the National Network of Depression Centers (2018). Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause (New York, N.Y.), 25(10), 1069–1085. https://doi.org/10.1097/GME.0000000000001174 https://pubmed.ncbi.nlm.nih.gov/30179986/ Johnson, A., Roberts, L., & Elkins, G. (2019). Complementary and Alternative Medicine for Menopause. Journal of evidence-based integrative medicine, 24, 2515690X19829380. https://doi.org/10.1177/2515690X19829380 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419242/ Barnard, N; Kahleova, H; Holtz, D; del Aguila, F; Neola, M; Crosby, Lelia M.& Holubkov, R (2021). The Women's Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women, Menopause 28 (10), 1150-1156 doi: 10.1097/GME.0000000000001812 Guest: Jill M. Terrien PhD, ANP-BC    Music Credit: Richard Onorato
2/7/202212 minutes, 7 seconds
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Getting in the LOOP About Atrial Fibrillation and Stroke - Frankly Speaking Ep 261

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-261   Overview: Stroke is a major health problem, and the risk of stroke is five-times higher in individuals with atrial fibrillation (AF) than those without. AF can be asymptomatic or subclinical. In 18% of AF patients, the condition is only detected at the time of stroke. It is not known whether individuals whose AF is deterred via screening carry a similar risk to individuals with known AF. A recent randomized trial evaluated a screening program for AF in individuals at high risk of stroke; for individuals identified with AF, anticoagulation was given for stroke prevention.   Episode resource links: Svendsen JH, Diederichsen SZ, Højberg S et al. Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial. Lancet. 2021 Oct 23;398(10310):1507-1516 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
1/31/202212 minutes, 32 seconds
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Avoiding Aspirin in the Elderly: More Than Increased Bleeding Risk - Frankly Speaking Ep 260

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-260   Overview: We will review the current USPSTF recommendations regarding aspirin use to reduce the risk of CVD and colorectal cancer. Additionally, we will discuss as well as the findings of the ASPREE (ASPirin in reducing events in the elderly) randomized clinical trial.   Episode resource links: POEMs: In Older Adults, Aspirin Increases the Risk of Metastatic of Stage 4 Cancers and Cancer Mortality. Barry, Henry C. Am Fam Physician. 2021 Sep; 104(2):online Effect of Aspirin on Cancer Incidence and Mortality in Older Adults. McNeil, John. JNCI: Journal of the National Cancer Institute Volume: 113 Issue 3 (2021) ISSN: 0027-8874 Online ISSN: 1460-2105 Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
1/24/20228 minutes, 23 seconds
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Improving Recovery from Concussion: New Evidence That May Help Post-Concussion Recuperation - Frankly Speaking Ep 259

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-259   Overview: Per CDC data, approximately 2.5 million Americans present each year to emergency departments with head injuries, and 15% of all high school students report experiencing at least one concussion. Current guidelines recommend physical and cognitive rest for 24-48 hours post-concussion with minimal guidance on screen time parameters. Recent evidence is emerging that supports avoidance of screen time and encouragement of aerobic activity as strategies to shorten and lessen post-concussion symptoms. Join us as we discuss 2 recent studies regarding screen-time and aerobic exercise that add critical information to best practice for reducing post-concussion symptoms.   Episode resource links: John J Leddy, Christina L Master, Rebekah Mannix, Douglas J Wiebe, Matthew F Grady, William P Meehan, Eileen P Storey, Brian T Vernau, Naomi J Brown, Danielle Hunt, Fairuz Mohammed, Andrea Mallon, Kate Rownd, Kristy B Arbogast, Adam Cunningham, Mohammad N Haider, Andrew R Mayer, Barry S Willer. Early targeted heart rate aerobic exercise versus placebo stretching for sport-related concussion in adolescents: a randomised controlled trial. The Lancet Child & Adolescent Health, 2021; DOI: 10.1016/S2352-4642(21)00267-4   Macnow T, Curran T, Tolliday C, et al. Effect of Screen Time on Recovery From Concussion: A Randomized Clinical Trial. JAMA Pediatr. Published online September 07, 2021. doi:10.1001/jamapediatrics.2021.2782 https://jamanetwork.com/journals/jamapediatrics/article-abstract/2783638#graphical-abstract-tab   DePadilla L, Miller GF, Jones SE, Peterson AB, Breiding MJ. Self-reported concussions from playing a sport or being physically active among high school students—United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(24):682-685. doi:10.15585/mmwr.mm6724a3   University at Buffalo. (2021, September 30). Aerobic exercise after a sport-related concussion speeds recovery in adolescent athletes, study suggests: Daily aerobic exercise significantly reduced the risk of prolonged recovery. ScienceDaily. Retrieved October 2, 2021 from www.sciencedaily.com/releases/2021/09/210930213654.htm   McCrory P ,Meeuwisse W,Dvorak J,etal. Consensus statement on concussion in sport—the 5th International Conference on Concussion in Sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838-847. doi:10.1136/bjsports-2017- 097699   Centers for Disease Control and Prevention. Recovery from concussion. Centers for Disease Control and Prevention; 2019. Accessed October 12, 2020. https://www.cdc.gov/headsup/basics/ concussion_recovery.html. Guest: Guest   Music Credit: Richard Onorato
1/17/202211 minutes, 30 seconds
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A Brainy Approach to Treating Chronic Low Back Pain - Frankly Speaking Ep 258

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-258   Overview: Chronic pain affects 20% of people in the United States, and chronic low back pain is the most common cause of chronic pain. Although some treatments can reduce the severity of the pain, the persistence of chronic low back pain is a source of frustration for both patients and clinicians. Join us to discuss how behavioral and psychological therapy should be part of the treatment for chronic low back pain and how new approaches may be much more effective than existing therapies.   Episode resource links: Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. Published online September 29, 2021. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
1/10/202210 minutes, 9 seconds
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Recommendations for the Treatment of Gout - Frankly Speaking Ep 257

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-257   Overview: Gout is a common condition seen in primary care, and the incidence and prevalence continue to rise. Despite previous recommendations from the American College of Rheumatology, urate-lowering therapy is still underused. Listen to this episode for a concise overview of the American College of Rheumatology’s updates for the management of gout and walk away with a clear understanding of the first-line treatment options for acute gout flares.   Episode resource links: Management of Gout: Update from the American College of Rheumatology. Dakkak, M., Lanney, H. Am Fam Physician. 2021 Aug ;104(2):209-210. 2020 American College of Rheumatology Guideline for the Management of Gout. Fitzgerald, J. D. et al. Arthritis Care Res (Hoboken). June 2020;72(6):744–760 [published corrections appear in Arthritis Care Res (Hoboken). 2020;72(8):1187, and Arthritis Care Res (Hoboken). 2021;73(3):458] Guest: Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
1/3/20229 minutes, 37 seconds
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Favorite Podcast of 2021 - Frankly Speaking EP 256

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-256   Overview: Live at Pri-Med East! In this episode, each podcaster will discuss the most impactful paper and podcast of the year.   Episode resource links: Ngan, H.Y, et al (2021), Diabet Med, 38: e14525. https://doi.org/10.1111/dme.14525 J Clin Gastroenterol 2021: DOI: 10.1097/MCG.0000000000001561 Mehta RS, etal. JAMA Intern Med. doi:10.1001/jamainternmed.2020.7238 https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication Hypertension. 2021;78:591–603. DOI: 10.1161/HYPERTENSIONAHA.120.16667   Guest: Susan Feeney, DNP, FNP-BC, NP-C, Alan M. Ehrlich, MD, FAAFP, Jill M. Terrien, PhD, ANP-BC, Jillian Joseph, MSPAS, PA-C   Music Credit: Richard Onorato
12/27/202119 minutes, 40 seconds
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Peaceful, Easy Feeling: Can Mindfulness Exercise Improve Asthma-Related Quality of Life? - Frankly Speaking Ep 255

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-255   Overview: Asthma is one of the most prevalent conditions, affecting almost 340 million individuals across the globe and approximately 25 million Americans, or 7.8% of the US population. Treatment is complex and goals of therapy are elusive for many. Anxiety and other concerns are common in those diagnosed with asthma and can worsen outcomes. A recent study from the UK found the use of a mindfulness app was associated with improved asthma-related quality-of-life indicators. Join us while we discuss this study’s implications for helping patients with asthma in primary care.   Episode resource links: Ainsworth, B., Stanescu, S., Stuart, B., Russell, D., Liddiard, M., Djukanovic, R., & Thomas, M. (2021). A feasibility trial of a digital mindfulness-based intervention to improve asthma-related quality of life for primary care patients with asthma. Journal of Behavioral Medicine. Advance online publication. https://doi.org/10.1007/s10865-021-00249-3 CDC Most Recent National Asthma Data: https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato  
12/20/202111 minutes, 29 seconds
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Older Adults and Loneliness—Avoid High-Risk Medications - Frankly Speaking Ep 254

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-254   Overview: Older adults who suffer from loneliness may be at risk of overusing medications prescribed for pain, insomnia, depression, or anxiety. Replacing these medications with social interventions may improve outcomes and help patients avoid adverse consequences. Join us as we discuss the importance of reviewing medications and assessing for loneliness in older adults to prevent adverse events and outcomes.   Episode resource links: Kotwal, A. A., Steinman, M. A., Cenzer, I., & Smith, A. K. (2021). Use of High-risk Medications Among Lonely Older Adults: Results From a Nationally Representative Sample. JAMA internal medicine, e213775. Advance online publication. https://doi.org/10.1001/jamainternmed.2021.3775 https://pubmed.ncbi.nlm.nih.gov/34309620/ Education for Patients: Tips on Staying Connected—National Institutes on Aging https://www.nia.nih.gov/health/loneliness-and-social-isolation-tips-staying-connected Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
12/13/202110 minutes, 37 seconds
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The End of ACE Inhibitors? - Frankly Speaking Ep 253

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-253   Overview: ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are both recommended as first-line treatments for hypertension. ACE inhibitors have known side effects, such as cough, that are frustrating for many patients, while ARBs appear to have less annoying side effects. This podcast will review a recently published retrospective, comparative cohort study comparing the effectiveness and safety of ACE inhibitors vs ARBs in the first-line treatment of hypertension.   Episode resource links: Hypertension. 2021;78:591–603. DOI: 10.1161/HYPERTENSIONAHA.120.16667   ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/ NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–e248. doi: 10.1016/j.jacc.2017.11.006 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
12/6/20218 minutes, 1 second
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Contraception: When Do We Start Them? - Frankly Speaking Ep 252

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-252   Overview: For patients who would like to prevent pregnancy, many options—both hormonal and nonhormonal—exist. Despite the availability of multiple options, many patients do not use them because of either a lack of knowledge or a lack of access, the latter being especially true in uninsured and non−English-speaking communities. Research has shown over the years that while unintended pregnancies have decreased in the United States, more can be done, and primary care providers can play an important role in helping to further decrease and eliminate barriers to contraception.   Episode resource links: Lesnewski, R. (2021). Initiating Hormonal Contraception. American Family Physician, 103(5), 291-300. Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato
11/29/20218 minutes, 44 seconds
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Primary HPV Testing Alone for Cervical Cancer Screening: a Review of Recent Guideline Updates - Frankly Speaking Ep 251

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-251   Overview: Primary care providers should be up to date on the changes to the guidelines for cervical cancer screening to be able to guide patients in shared decision-making about health maintenance. Join us to review the recent changes to cervical cancer screening guidelines as recommended by the American Cancer Society.   Episode resource links: Cervical Cancer Screening: Updated Guidelines from the American Cancer Society. Am Fam Physician. 2021 Sep; 104(2):314-315. American College of Obstetricians and Gynecologists. Updated cervical cancer screening guidelines. Practice advisory. April 2021. Accessed September 30, 2021. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin. 2020. https://doi.org/10.3322/caac.21628. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
11/22/20219 minutes, 3 seconds
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Time to Recommend the Use of Salt Substitutes for CVD Prevention? - Frankly Speaking Ep 250

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-250   Overview: While the data conflict on how much sodium intake is optimal for preventing cardiovascular disease, it is clear that daily salt intake for most Americans exceeds what is recommended. However, restricting salt intake on an individual or on a public health level has been controversial. An interesting alternative is the use of salt substitutes, which can help to decrease sodium intake while increasing potassium intake, and both have been associated with lowering blood pressure. Join us to hear a discussion on the results of the recently published studies on salt and cardiovascular disease, along with an overview of the Salt Substitute and Stroke Study (SSaSS).   Episode resource links: Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med. DOI: 10.1056/NEJMoa2105675 O’Donnell M, Mente A, Alderman MH, et al. Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake, European Heart Journal, Volume 41, Issue 35, 14 September 2020, Pages 3363–3373, https://doi.org/10.1093/eurheartj/ehaa586 Circulation. 2021;143:1542–1567. DOI: 10.1161/CIRCULATIONAHA.120.050371 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
11/15/20219 minutes, 39 seconds
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Using DOACs for Valvular Atrial Fibrillation - Frankly Speaking Ep 249

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-249   Overview: For non-valvular atrial fibrillation, physicians, patients, and guideline organizations all prefer direct oral anticoagulants (DOACs) over vitamin K antagonists, such as warfarin, for thromboembolic prophylaxis. For those with valvular atrial fibrillation, the data for safety and efficacy have been limited because randomized trials comparing DOACs to warfarin often exclude patients with valvular atrial fibrillation. Join us to explore new data that shed light on the use of DOACs in valvular atrial fibrillation.   Episode resource links: Dawwas GK, Dietrich E, Cuker A, Barnes GD, Leonard CE, Lewis JD. Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study. Ann Intern Med. 2021;174(7):910-919. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
11/8/202110 minutes, 42 seconds
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Aspirin—Not Really for Primary Prevention - Frankly Speaking Ep 248

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-248   Overview: Join us to hear a discussion on the important changes the AHA/ACC and USPSTF have made to their positions on the use of aspirin for primary prevention of cardiovascular disease. The organizations note that while aspirin for primary prevention lowers the risk of a myocardial infarction, its harmful effects may outweigh its benefits. Learn the aspirin recommendations for your patients in their 40s, 50s, and 60s who are at higher risk for a cardiovascular event.   Episode resource links: New: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication Old: https://www.aafp.org/afp/2016/1015/od1.html https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
11/1/20218 minutes, 57 seconds
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A Fishy Method to Prevent Migraines - Frankly Speaking Ep 247

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-247   Overview: When it comes to chronic migraines, your first-line prevention is probably medication, but according to a new study, it may not have to be. Certain foods may play a role in increasing and decreasing migraine recurrence. Join us to review a recent randomized controlled trial aimed at preventing migraines in those with chronic migraines.   Episode resource links: BMJ 2021; 374 :n1448 doi:10.1136/bmj.n1448; doi: https://doi.org/10.1136/bmj.n1448 The association of dietary patterns with migraine attack frequency in migrainous women. Nutritional Neuroscience 23:9, pages 724-730 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
10/26/202110 minutes, 39 seconds
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Muscle Relaxants for Low Back Pain: Are They Worth the Risk? - Frankly Speaking Ep 246

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-246   Overview: Low back pain often leads to disability and loss of income and is a significant burden on patients and the healthcare system. While muscle relaxants are the third most common prescribed drugs in the treatment of low back pain, recent data demonstrating its use and efficacy are limited. This session discusses a recent systematic review of the safety, efficacy, and accepted use of muscle relaxants in the treatment of low back pain. Don’t miss this opportunity to learn how to provide low back pain treatments that have clear benefits for your patients.   Episode resource links: Cashin A G, Folly T, Bagg M K, Wewege M A, Jones M D, Ferraro M C et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis BMJ 2021; 374 :n1446 doi:10.1136/bmj.n1446 https://pubmed.ncbi.nlm.nih.gov/34233900/ Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
10/18/20219 minutes, 21 seconds
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MRI for Elevated PSA - Frankly Speaking Ep 245

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-245   Overview: When your patient has an elevated screening PSA level, your first inclination may be to refer for a biopsy, but have you considered obtaining a pre-biopsy MRI? In this podcast, we will review the appropriate management for an elevated screening PSA. You’ll want to hear about the new benefit of obtaining a pre-biopsy MRI to guide diagnostic procedures.   Episode resource links: NEJM July 9, 2021; DOI: 10.1056/NEJMoa2100852\ Urology 2016 Apr;90:32-7. doi: 10.1016/j.urology.2015.11.046 Guest: Frank J. Domino, MD   Music Credit: Richard Onorato
10/11/202111 minutes, 48 seconds
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Can Artificial Intelligence Predict and Prevent Suicide? - Frankly Speaking Ep 244

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-244   Overview: Suicide and attempted suicide are significant health issues affecting the United States and the world. Are you aware of the tools available to you that can support suicide prevention strategies and save lives? Don’t miss this session to learn about how the use of an electronic health record in a large health system may help predict suicide attempts.   Episode resource links: Walsh CG, Johnson KB, Ripperger M, Sperry S, Harris J, Clark N, Fielstein E, Novak L, Robinson K, Stead WW. Prospective Validation of an Electronic Health Record-Based, Real-Time Suicide Risk Model. JAMA Netw Open. 2021 Mar 1;4(3):e211428. doi: 10.1001/jamanetworkopen.2021.1428. PMID: 33710291; PMCID: PMC7955273 doi: 10.1001/jamanetworkopen.2021.1428 Liang, Angela, and Paul Nestadt S . "Suicide Risk in the COVID-19 Pandemic." Johns Hopkins Psychiatry Guide, 2021. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787393/all/Suicide_Risk_in_the_COVID_19_Pandemic. Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
10/4/202114 minutes, 1 second
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“Can You Hear Me Now?”— Aging, Hearing Impairment, and Physical Function - Frankly Speaking Ep 243

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-243   Overview: Evidence strongly supports a correlation between hearing impairment in older adults and decline in physical functioning. A recent population cohort study of older adults revealed that hearing impairment was associated with poorer physical function, reduced walking endurance, and accelerated decline. Join us while we discuss this evidence and how to apply it to your practice. You’ll walk away with strategies to promote hearing assessment and to help optimize physical functioning in your older adult patients.   Episode resource links: Brenowitz WD, Wallhagen MI. Does Hearing Impairment Affect Physical Function?: Current Evidence, Potential Mechanisms, and Future Research Directions for Healthy Aging. JAMA Netw Open. 2021 Jun 1;4(6):e2114782. doi: 10.1001/jamanetworkopen.2021.14782. PMID: 34170308. Martinez-Amezcua P, Powell D, Kuo PL, Reed NS, Sullivan KJ, Palta P, Szklo M, Sharrett R, Schrack JA, Lin FR, Deal JA. Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US. JAMA Netw Open. 2021 Jun 1;4(6):e2113742. doi: 10.1001/jamanetworkopen.2021.13742. PMID: 34170305; PMCID: PMC8233700. Martinez-Amezcua P, Kuo PL, Reed NS, Simonsick EM, Agrawal Y, Lin FR, Deal JA, Ferrucci L, Schrack JA. Association of hearing impairment with higher level physical functioning and walking endurance: Results from the Baltimore Longitudinal Study of Aging (BLSA). J Gerontol A Biol Sci Med Sci. 2021 May 18:glab144. doi: 10.1093/gerona/glab144. Epub ahead of print. PMID: 34003883. Croll, P.H., Vinke, E.J., Armstrong, N.M. et al. Hearing loss and cognitive decline in the general population: a prospective cohort study. J Neurol 268, 860–871 (2021). https://doi.org/10.1007/s00415-020-10208-8 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
9/27/202110 minutes, 11 seconds
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Cutting Through the Fog: Recognizing Gluten-Induced Neurocognitive Impairment - Frankly Speaking Ep 242

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-242   Overview: Gluten exposure is known to cause a number of problems in both those with celiac disease and those with non-celiac gluten sensitivity. One aspect that has not received much attention from the research community is the neurocognitive impairment that can occur following gluten exposure in these individuals. Join us for this podcast to dive into a recent article that describes these effects.   Episode resource links: Edwards George JB, Aideyan B, Yates K, et al. Gluten-induced Neurocognitive Impairment: Results of a Nationwide Study [published online ahead of print, 2021 May 28]. J Clin Gastroenterol. 2021 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
9/20/202111 minutes, 8 seconds
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Continuous Glucose Monitoring (CGM) for Type 2 Diabetes Mellitus (T2DM) - Frankly Speaking Ep 240

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-240   Overview: Have you considered continuous glucose monitoring (CGM) for your patients with suboptimally controlled type 2 diabetes mellitus (T2DM) on at least 3 injections of insulin per day? This session will give you the information you need to confidently initiate CGM in appropriate patients. You’ll walk away with a clear understanding of the different CGM options and the benefits and challenges of CGM.   Episode resource links: Ida S, Kaneko R, Murata K. Utility of Real-Time and Retrospective Continuous Glucose Monitoring in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. J Diabetes Res. 2019 Jan 15;2019:4684815. doi: 10.1155/2019/4684815. PMID: 30775385; PMCID: PMC6350576. Maiorino et al. Diabetes Care. 2020;43:1146–1156 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato
9/6/20219 minutes, 20 seconds
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Update From the CDC: New Gonorrhea Guidelines - Frankly Speaking Ep 239

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-239   Overview: Join us to discuss the CDC’s new guidelines for the management of sexually transmitted infections due to Neisseria gonorrhoeae. You’ll walk away with recommendations for how to address urogenital, rectal, and pharyngeal infections. You’ll also discover alternative regimens for patients allergic to first-line therapy and understand how to manage coinfection with chlamydia.   Episode resource links: St. Cyr S, Barbee L, Workowski KA, et al. Update to CDC’s Treatment Guidelines for Gonococcal Infection, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1911–191 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
8/30/20218 minutes, 59 seconds
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Lung Cancer Screening—Expanded Recommendations! - Frankly Speaking Ep 238

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-238   Overview: Join us to discuss important changes in the 2021 USPSTF recommendation on lung cancer screening. Given lung cancer’s high prevalence and poor prognosis in later stages, it is important for primary care clinicians to know which patients to screen and what method to use. You’ll also learn the appropriate time to stop screening.   Episode resource links: Screening for Lung Cancer US Preventive Services Task Force Recommendation Statement JAMA. 2021;325(10):962-970. doi:10.1001/jama.2021.1117 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
8/23/202111 minutes, 49 seconds
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Identifying Risk in Women to Prevent CVD - Frankly Speaking Ep 237

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-237   Overview: Solid evidence shows that adverse pregnancy outcomes (APOs) correlate with an increased risk of cardiovascular disease (CVD) in women. Evidence is also becoming clearer that lactation and breastfeeding may have CV protective benefits as well. Social determinants of health play a significant role in these diseases; facts support that Black, Hispanic and Asian American women suffer from worse pregnancy outcomes than White American women. Join us while we discuss the recent American Heart Association (AHA) guideline update regarding the association of increased risk of CVD and metabolic disease with APOs and what can be done to reduce these risks.   Episode resource links: Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women. Nisha I. Parikh, MD, MPH, Chair, Juan M. Gonzalez, MD, Cheryl A.M. Anderson, PhD, Suzanne E. Judd, PhD, Kathryn M. Rexrode, MD, Mark A. Hlatky, MD, Erica P. Gunderson, PhD, Jennifer J. Stuart, ScD, Dhananjay Vaidya, PhD, Vice Chair, On behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. https://www.ahajournals.org/doi/abs/10.1161/CIR.000000000000096 Schwartz, EB. (reviewing Parikh NI et al. Circulation 2021 Mar 29). Preventing Heart Disease in Women: New Guidance from the American Heart Association. NEJM: Journal Watch, April 12, 2021. https://www.jwatch.org/na53433/2021/04/12/preventing-heart-disease-women-new-guidance-american-heart?ijkey=3l3eCvQLl Clinical Statements and Guidelines. AHA/ACOG Presidential Advisory. Volume 137, Issue 24, 12 June 2018, Pages e843-e852. https://doi.org/10.1161/CIR.0000000000000582 https://www.jwatch.org/na53433/2021/04/12/preventing-heart-disease-women-new-guidance-american-heart Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
8/16/20219 minutes, 30 seconds
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Continuous Glucose Monitoring—What’s All the Hype? - Frankly Speaking Ep 236

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-236   Overview: Continuous glucose monitoring (CGM) for patients with diabetes has been available for several years now, but its utility in managing diabetes care is unclear. Join us to discuss the results of a systematic review examining the benefits of CGM for patients with both type 1 and type 2 diabetes mellitus.   Episode resource links: Effects of continuous glucose monitoring on metrics of glycemic control in diabetes: a systematic review with meta-analysis of randomized controlled trials. Diabetes Care. 2020;43(5):1146-1156. Implementing Continuous Glucose Monitoring in Clinical Practice. www.aafp.org/fpm March/April 2021 Longo R, Sperling S. Personal versus professional continuous glucose monitoring: when to use which on whom. Diabetes Spectr. 2019;32(3):183-193.   Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
8/9/202110 minutes, 1 second
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Nasal Steroids for Perennial Allergic Rhinitis: Is PRN Use Enough? - Frankly Speaking Ep 235

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-235   Overview: Perennial allergic rhinitis affects both children and adults, and management includes both allergy avoidance as well as medication management. Intranasal steroids are the mainstay of treatment and have traditionally required consistent use, but new data are emerging. Find out the results of a new study evaluating PRN use as an alternative approach.   Episode resource links: Thongngarm T, Wongsa C, Phinyo P, Assanasen P, Tantilipikorn P, Sompornrattanaphan M. As-Needed Versus Regular Use of Fluticasone Furoate Nasal Spray in Patients with Moderate to Severe, Persistent, Perennial Allergic Rhinitis: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2021 Mar;9(3):1365-1373 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
8/2/20218 minutes, 43 seconds
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Shorter Antibiotic Duration for Outpatient Infections - Frankly Speaking Ep 234

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-234   Overview: Many providers overtreat outpatient infections for fear of not treating until resolution or causing a complication, but this can lead to antibiotic resistance and adverse events. Join us to discuss the new ACP guidelines on antibiotic use in the outpatient setting and the pediatric treatment recommendations. Walk away with a clear understanding of the guidelines for optimal duration of antibiotic treatment for individuals with an outpatient infection.   Episode resource links: ACP: Ann Intern Med. doi:10.7326/M20-7355; https://www.acpjournals.org/doi/pdf/10.7326/M20-7355 Low risk for PCN allergy: Am J Respir Crit Care Med 2020 Feb 21; [e-pub]. (https://doi.org/10.1164/rccm.202001-0089LE); Mayo Clinic Proceedings 2018, 93 (1): 101-107 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
7/26/20219 minutes, 31 seconds
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Taking the Distress out of Diabetes—Mindfulness and Acceptance Therapies May Help - Frankly Speaking Ep 233

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-233   Overview: T2DM is an epidemic, and its impact on quantity of life is well documented. In most cases, treatment involves significant lifestyle changes in combination with medication. Distress about the T2DM diagnosis and necessary behavioral changes occurs in about one-third of people, and this distress is associated with poor glycemic management. Join us as we discuss a recent meta-analysis on mindfulness and learn how cognitive therapies may be effective in reducing distress and HbA1c.   Episode resource links: Ngan, H.Y., Chong, Y.Y. and Chien, W.T. (2021), Effects of mindfulness‐ and acceptance‐based interventions on diabetes distress and glycaemic level in people with type 2 diabetes: Systematic review and meta‐analysis. Diabet Med, 38: e14525. https://doi.org/10.1111/dme.14525; https://onlinelibrary-wiley-com.umassmed.idm.oclc.org/doi/epdf/10.1111/dme.14525 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
7/19/202111 minutes, 43 seconds
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Community-Acquired Pneumonia: How Long Do We Need to Treat? - Frankly Speaking Ep 232

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-232   Overview: For patients with community-acquired pneumonia (CAP), wide variation in the duration of treatment exists. Longer duration of treatment may increase the risk of adverse effects and lead to antibiotic resistance. However, shorter duration of treatment may result in treatment failure. See what new evidence shows may be the best antibiotics treatment duration in most patients with CAP.   Episode resource links: Dinh A et al. Pneumonia Short Treatment (PTC) Study Group. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet. 2021 Mar 27;397(10280):1195-1203 Metlay JP et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
7/12/202110 minutes, 13 seconds
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Pain in EVERYONE’s Neck - Frankly Speaking Ep 231

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-231   Overview: Who couldn’t use a refresher on how to diagnose and treat neck pain in the primary care setting? Review the techniques for assessing neck pain, determining its cause, and providing relief. Immediately apply what you learn to start helping patients with neck pain feel better.   Episode resource links: Am Fam Physician 2016 May 1;93(9):746-54. Sub occipital Release: J Electromyogr Kinesiol 2016 Oct;30:31-7. doi: 10.1016/j.jelekin.2016.05.007 Self Myofascial Release: Spine 2020 Nov 1;45(21):E1367-E1375 Guest: Robert A. Baldor MD, FAAFP/Frank   Music Credit: Richard Onorato
7/5/202110 minutes, 59 seconds
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Perioperative Management for Patients Taking DOACs - Frankly Speaking Ep 230

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-230   Overview: Join us to discuss the results of the Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE) cohort study, aimed at understanding the safety of using a simplified perioperative management approach for patients with atrial fibrillation taking DOACs. After this episode, you’ll be able to make sense of the controversy over current guidelines around surgical care in this patient population. More importantly, you’ll walk away with practical knowledge to help these patients minimize their risk of adverse events.   Episode resource links: Perioperative Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant. JAMA Intern Med.2019; 179(11 ): 1469-14 78. doi: 10.1001 /jamainternmed.2019.2431   Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
6/28/20219 minutes, 45 seconds
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Acknowledging the Pain—Incorporating Trauma-Informed Care into Your Practice - Frankly Speaking Ep 229

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-229   Overview: Ample evidence shows that adverse childhood experiences (ACEs) and trauma in adulthood may lead to poor health outcomes, such as cardiovascular disease and other chronic diseases. These traumas may also affect a person’s inclination to seek care and participate in plans of care. As a provider, it is important to consider this history and ensure the psychological and physical safety of these affected individuals. Join us to learn proven strategies to help you practice trauma-informed care, including how to recognize trauma and offer effective interventions to help patients dealing with these issues.   Episode resource links: ACOG Committee Decision: Caring for Patients who have Experienced Trauma. Obstetrics and Gynecology. VOL. 37, NO. 4. April 2021. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/04/caring-for-patients-who-have-experienced-trauma Dicola, D. & Spaar, E. Intimate Partner Violence. American Family Physician. October 15, 2016, VOL. 94, NO. 8. www.aafp.org/afp https://www.cdc.gov/violenceprevention/aces/index.html https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4816.pdf Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
6/21/202110 minutes, 40 seconds
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Antibiotics for Respiratory Tract Infections: Fewer May Be Better - Frankly Speaking Ep 228

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-228   Overview: Join us for this episode as we discuss the results of a systematic review examining the benefits and risks from delaying the use of antibiotics to treat patients in the community for a respiratory infection.   Episode resource links: Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis. BMJ 2021;372:n808 http://dx.doi.org/10.1136/bmj.n808 Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
6/14/202113 minutes, 8 seconds
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Protecting Feet in People With Diabetes: Monofilaments or Tuning Forks? - Frankly Speaking Ep 227

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-227   Overview: Join us as we discuss a recent review article on the evidence behind monofilament testing for peripheral neuropathy in people with diabetes.   Episode resource links: J Diabetes Res. 2017; 2017: 8787261. Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis Diabetes Care 2017 Jan;40(1):136-154   Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
6/7/202110 minutes, 1 second
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Risk-Stratifying Patients with a TIA - Frankly Speaking Ep 226

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-226   Overview: Patients with a history of transient ischemic attack (TIA) are at increased risk of stroke in the future. The ABCD2 score is the most used risk assessment tool for people with acute TIA, but it is not recommended for this purpose by the National Institute for Heath and Care Excellence (NICE). Join us for today’s episode as we describe a new validated risk assessment tool developed in Canada you can use to classify patients as low, medium, or high-risk for stroke over the 7 days following a TIA.   Episode References and Resource Links: Perry JJ et al. Prospective validation of Canadian TIA Score and comparison with ABCD2 and ABCD2i for subsequent stroke risk after transient ischaemic attack: multicentre prospective cohort study. BMJ. 2021 Feb 4;372:n49   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
5/31/202112 minutes, 3 seconds
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How Long Should You Continue Bisphosphonate Treatment for Osteoporosis? - Frankly Speaking Ep 225

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-225   Overview: Join us for this episode as we review the recently published (Dec. 2020) cohort study in JAMA on using bisphosphonates to prevent hip fractures. We will review the utility of bisphosphonates after 5 years and how to discuss their risks and benefits with patients.   Episode resource links: JAMA.2020;3(12):e2025190.doi:10.1001/jamanetworkopen.2020.25190 JAMA. 2018;319(24):2521-2531. doi:10.1001/jama.2018.7498 https://www.sheffield.ac.uk/FRAX/tool.aspx?country=9 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/24/20218 minutes, 52 seconds
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Do Sensible Shoes Improve Function for People with Knee Arthritis? - Frankly Speaking Ep 224

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-224   Overview: More than 250 million individuals worldwide have osteoarthritis (OA) of the knee and the burden on individuals and healthcare systems is enormous. There is no cure for OA, with treatments such as NSAIDs and acetaminophen aimed towards symptom reduction and improved functioning. Most evidence-based guidelines include the use of supportive shoes, however little evidence exists on effectiveness of these types of shoes. It is also unclear what the characteristics of a supportive shoe are and what type of shoe is best for OA. Join us as we discuss a recent randomized controlled trial that compared 2 types of shoes, and their benefits in symptom reduction and functional improvement of knee OA   Episode resource links: AAOS EBG: Lateral Wedge Insole. https://www.orthoguidelines.org/guideline-detail?id=1209&tab=all_guidelines AAOS EBG Treatment of Osteoarthritis of the Knee; https://www.aaos.org/globalassets/quality-and-practice-resources/osteoarthritis-of-the-knee/osteoarthritis-of-the-knee-2nd-editiion-clinical-practice-guideline.pdf Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
5/17/20219 minutes, 56 seconds
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Surviving Burnout: Caring for Ourselves - Frankly Speaking Ep 223

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-223   Overview: Clinical psychologist Dr. Christine Runyan joins host, Dr. Frank Domino, in today’s episode to discuss the various self-care methods to help healthcare workers overcome stressors related to the COVID-19 pandemic, and to describe the potential future impact of the COVID-19 crisis on this population.   Episode resource links: https://tend.health/ https://www.pri-med.com/online-education/webcast/west-2019-well-being https://www.pri-med.com/online-education/podcast/pri-med-podcasts-well-being   Guest: Christine Runyan, PhD, ABPP   Music Credit: Richard Onorato
5/10/202121 minutes, 52 seconds
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Save the Toenails! Topical Treatments for Onychomycosis - Frankly Speaking Ep 222

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-222   Overview: Join us for this episode as we discuss a recent Cochrane review of the safety and effectiveness of topical treatments for toenail onychomycosis, and review when and how to prescribe these agents for patients.   Episode resource links: Topical and device-based treatments for fungal infections of the toenails. Cochrane Database Syst Rev. 2020; (1): CD012093 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
5/3/20219 minutes, 36 seconds
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With GERD, Diet and Lifestyle Win Out - Frankly Speaking Ep 221

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-221   Overview: Join us as we discuss another finding of the Nurses Health Study II—this podcast focuses on the findings of a prospective look at GERD, and the effect of diet and lifestyle on the prevention of GERD.   Episode resource links: Mehta RS, Nguyen LH, Ma W, Staller K, Song M, Chan AT. Association of Diet and Lifestyle With the Risk of Gastroesophageal Reflux Disease Symptoms in US Women. JAMA Intern Med. Published online January 04, 2021. doi:10.1001/jamainternmed.2020.7238 For Patients: Eating, Diet, & Nutrition for GER & GERD https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/eating-diet-nutrition Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
4/26/202111 minutes, 44 seconds
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Thawing The Frozen Shoulder - Frankly Speaking Ep 220

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-220   Overview: Join us for this episode as we review a recent meta-analysis that addresses best treatment modalities for adhesive capsulitis.   Episode resource links: JAMA Netw Open. 2020 Dec 1;3(12):e2029581. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
4/19/202110 minutes, 54 seconds
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Nearsighted: Possible Connection Between COVID Lockdown and Increase in Childhood Myopia - Frankly Speaking Ep 219

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-219   Overview: The COVID pandemic and the precautionary changes in behavior put into practice are creating an immeasurable cost in ways that are still being identified – social isolation, stresses on mental health, as well as neglect of chronic disease management – to name a few. In a recent study out of China, it was found that 6, 7 and 8-year-olds had a significant increase in myopia associated with the lockdown and school closures. This level of myopia places these children at much greater risk of poor vision in adulthood. Join us as we discuss these findings and how they may impact prevention strategies and assessment parameters in children during and after the pandemic.   Episode References: Klaver CCW, Polling JR, Enthoven CA. 2020 as the Year of Quarantine Myopia. JAMA Ophthalmol. Published online January 14, 2021. doi:10.1001/jamaophthalmol.2020.6231 Wang J, Li Y, Musch DC, et al. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol. Published online January 14, 2021. doi:10.1001/jamaophthalmol.2020.6239   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
4/12/202110 minutes, 23 seconds
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Aspirin (ASA) to Prevent Colorectal Cancer - Frankly Speaking Ep 218

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-218   Overview: Join us for this session where we will discuss the data behind the recent USPSTF recommendations on the use of ASA as a colorectal cancer (CRC) preventive agent, and when to incorporate this recommendation into practice.   Episode resource links: www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-and-cancer doi:10.1001/jamaoncol.2020.7338 N Engl J Med 2018; 379:1519-1528 DOI: 10.1056/NEJMoa1803955 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato
4/5/202110 minutes, 2 seconds
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Direct Communication Improves Vaccine Receipt - Frankly Speaking Ep 217

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-217   Overview: Join us as we review communication styles that influence vaccination uptake by the adolescent population. We will discuss a recent article examining the effects of provider’s recommendation styles with adolescent patients regarding HPV and meningococcal vaccines.   Episode resource links: Anny T.H.R. Fenton, Chelsea Orefice, Terresa J. Eun, Dea Biancarelli, Amresh Hanchate, Mari-Lynn Drainoni, Rebecca B. Perkins, Effect of provider recommendation style on the length of adolescent vaccine discussions, Vaccine, Volume 39, Issue 6, 2021, Pages 1018-1023, ISSN 0264-410X,https://doi.org/10.1016/j.vaccine.2020.11.015. (https://www.sciencedirect.com/science/article/pii/S0264410X20314419) HPV Vaccine recommendations CDC: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html 5 Ways to boost your HPV Vaccination Rates CDC: https://www.cdc.gov/hpv/hcp/boosting-vacc-rates.html Meningococcal Vaccine Recommendations CDC: https://www.cdc.gov/vaccines/vpd/mening/hcp/recommendations.html   Guest: Jill M. Terrien PhD, ANP-BC   Music Credit: Richard Onorato
3/29/202110 minutes, 14 seconds
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Curcumin for osteoarthritis - Frankly Speaking Ep 216

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-216   Overview: Osteoarthritis (OA) is a very common problem seen in the primary care setting, but pharmacologic treatments do not alter the course of the disease and they are often associated with side effects or contraindicated in many older patients. Curcumin is an herbal treatment that has been shown to be effective for treating symptoms of OA. Join us for this episode as we discuss the evidence for curcumin in treating OA, and how to counsel patients on its use.   Episode resource links: Wang Z. et al. Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion-Synovitis of Knee Osteoarthritis : A Randomized Trial. Ann Intern Med. 2020 Dec 1;173(11):861-869. Daily JW, Yang M, Park S. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016 Aug;19(8):717-29 Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
3/22/202111 minutes, 28 seconds
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Managing Stress in Pregnancy: Good News Regarding Mind-Body Interventions (MBI) - Frankly Speaking Ep 215

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-215    Overview: Times are stressful. Recent evidence has shown that stress, anxiety, and depression experienced by pregnant women may have a negative impact on the wellness of the newborn. Stress management is constrained during pregnancy due to concerns that pharmaceutical approaches may be harmful to the baby. Non-pharmaceutical approaches are accessible and safe. Join us as we review recent evidence on the effectiveness of mind-body interventions (MBI) in reducing stress and decreasing depression and anxiety in pregnant women, and discuss how MBI can be incorporated into patient care.   Episode resource links: Re-Engineering Your Clinical Practice for Patient and Clinician Well-Being Guo P, Zhang X, Liu N, Wang J, Chen D, Sun W, Li P, Zhang W. Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs. 2020 Oct 13. doi: 10.1111/jan.14588. Epub ahead of print. PMID: 33048358. Leaviss J, Davis S, Ren S, Hamilton J, Scope A, Booth A, Sutton A, Parry G, Buszewicz M, Moss-Morris R, White P. Behavioural modification interventions for medically unexplained symptoms in primary care: systematic reviews and economic evaluation. Health Technol Assess. 2020 Sep;24(46):1-490. doi: 10.3310/hta24460. PMID: 32975190; PMCID: PMC7548871   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
3/15/202114 minutes, 36 seconds
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Teens and Vaping: A Gateway to Cigarette Smoking? - Frankly Speaking Ep 214

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-214   Overview: Rates of electronic cigarettes or vaping in teens has increased exponentially over the last 3 years. Prior to the introduction of the sleek 4th generation vaping device, tobacco use in the teen population was decreasing, and rates were low. Recent evidence indicates that teens with low intention to smoke, once they start vaping, are at increased risk of smoking cigarettes in future. Join us as we discuss the implications of this new evidence on our clinical practice and discuss strategies to reduce risk to adolescents.   Episode Resources: Barrington-Trimis JL, Kong G, Leventhal AM, et al. E-cigarette Use and Subsequent Smoking Frequency Among Adolescents. Pediatrics. 2018;142(6):e20180486 Gaiha SM, et al. J Adolesc Health. Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19. J Adolesc Health. Vol 67, issue 4, pp 519-523; DOI: https://doi.org/10.1015/j.jadolhealth.2020.07.002 Owotomo O, Stritzel H, McCabe SE, et al. Smoking Intention and Progression from E-Cigarette Use to Cigarette Smoking. Pediatrics. 2020;146(6):e2020002881; DOI: 10.1542/peds.2020-002881 https://pediatrics.aappublications.org/content/early/2020/11/05/peds.2020-002881 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
3/8/202111 minutes, 50 seconds
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Clinical Guidelines: Acute Pain Management of Musculoskeletal Injuries (Non-low Back) in the Outpatient Setting - Frankly Speaking Ep 213

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-213   Overview: Join us as we discuss the American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) newly released clinical guideline on the non-pharmacologic and pharmacologic management of acute pain from non-low back musculoskeletal injuries in adults.   Guest: Jill Terrien PhD, ANP-BC   Music Credit: Richard Onorato
3/1/202110 minutes, 25 seconds
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COVID-19 in the Office: Outpatient Management

Credits: 0.50 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-covid-outpatient   Overview: So much has changed concerning COVID-19 management, but few interventions are clearly beneficial in the outpatient management of patients.  This podcast will try to answer some of the common questions community based providers have about handling their patients’ illness. Episode reference links:  Vitamin D for COVID-19 (VIVID) study STOP COVID Trial Rise Above COVID   Guest: Paul E. Sax, MD   Music Credit: Richard Onorato
2/25/202129 minutes, 7 seconds
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Vitamin D: What It Helps, and What It Doesn’t - Frankly Speaking Ep 212

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-212   Overview: During this episode, we will review some of the recent data on Vitamin D supplementation and its association with cardiovascular outcomes, falls, vertigo, and general health.   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato
2/22/202114 minutes, 44 seconds
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Let’s Get Physical: Consider PT for Initial Treatment of Sciatica - Frankly Speaking Ep 211

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-211   Overview: There are various treatment options for patients with acute sciatica. Choosing the best option should be tailored to the specific needs of the patient, and when possible, include early recommendation for physical therapy (PT). In this episode we review research on use of PT for treatment of sciatica and discuss how you can incorporate PT recommendations into patient care.   Click here to view a prone piriformis release for sciatic pain   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
2/15/202113 minutes, 15 seconds
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A Fundamental Change in Asthma Management! Treatment of Moderate to Severe Asthma Now Includes Combined ICS-LABA Therapy as Maintenance and Rescue The...

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-210   Overview: This session will review the evidence used by the National Asthma Education and Prevention Program (NAEPP) in making their newer recommendations and the new asthma management protocols.   Guest: Robert A. Baldor, MD, FAAFP   Music Credit: Richard Onorato
2/8/202111 minutes, 17 seconds
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PolyPill, One Pill, or No Pill? - Frankly Speaking Ep 209

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-209   Overview: In this episode, we will review a recent publication examining how the polypill might lower atherosclerotic cardiovascular disease (ASCVD) risk in the general population.   Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato
2/1/202112 minutes, 39 seconds
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USPSTF Colorectal Cancer Screening: Back Up the Bus! - Frankly Speaking Ep 208

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-208    Overview: Join us as we review the United States Preventive Services Task Force’s (USPSTF) recently published draft recommendation statement on colorectal cancer (CRC) screening and the implications it has for primary care practice and your patients.   Guest: Jill Terrien PhD, ANP-BC   Music Credit: Richard Onorato
1/25/202111 minutes
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Statin Use in the Elderly – Start or Stop? - Frankly Speaking Ep 207

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-207 Overview: Data are limited regarding statin therapy for primary prevention of atherosclerotic cardiovascular disease in adults 75 years and older. During this episode we will review recent studies on the use of statins in elderly patients and discuss how to consider this data in your clinical practice. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
1/18/202110 minutes, 50 seconds
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A Big Change for the 2021 Medicare Physician Fee Schedule: New Guidance on Coding

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-coding-update Overview: This session will overview the new 2021 changes for outpatient E&M billing documentation requirements. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
1/12/202113 minutes, 32 seconds
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Making a Real Difference: High-Intensity Lifestyle Intervention Can Aid Weight Loss in Individuals With Obesity in Underserved Populations - Frankly Speaking Ep 206

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-206 Overview: The evidence of the impact of obesity and sedentary lifestyles on health and disease states is well established. Finding and applying strategies to assist people with the necessary behavior changes is a monumental task, but for Americans who are at lower income levels and in traditionally underserved populations, the evidence on what is effective is tragically lacking. The social determinants of health (SDOH) impact all aspects of care delivery, from access to care, to knowing what really works. Join us as we discuss a recent randomized controlled trial that evaluated a strategy that demonstrated weight loss in underserved populations, and may have promise to aid in this important aspect of care. Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato
1/11/202113 minutes, 19 seconds
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COVID-19 VACCINE: Get the Facts and Bust the Myths - Frankly Speaking Covid Immunization Update

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-covid-immunization-update Overview: This podcast will give an overview of the two mRNA vaccines granted emergency use authorization in the US including their efficacy and side effect profile. Guest: Alan Ehrlich, MD Music Credit: Richard Onorato
1/8/202124 minutes, 34 seconds
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New-onset Atrial Fibrillation: Revisiting Rate vs. Rhythm Control - Frankly Speaking EP 205

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-205 Overview: In patients with new-onset atrial fibrillation, the decision to aim for rate control versus rhythm control is controversial. Older data suggested rhythm control did not result in better outcomes, but advances in medications and techniques have led to a new trial to evaluate this question. Guest: Alan Ehrlich, MD Music Credit: Richard Onorato
1/4/202112 minutes, 3 seconds
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Counseling About Healthy Lifestyles: Time to Simplify - Frankly Speaking EP 183

Credits: 0.25 AMA PRA Category 1 Credit™ Claim CME/CE Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-183 Overview: While it is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, it has been unclear which combinations of these factors are associated with disease-free life-years. This session presents the result of a recent meta-analysis that provides insights into this important subject. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
8/3/202010 minutes, 13 seconds
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Gout - An Updated Treatment Guideline from the American College of Rheumatology - Frankly Speaking EP 180

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-180 Overview: The American College of Rheumatology (ACR) updated their 2012 guidelines for treating gout. To do this, they used established evidenced-based methods including population, intervention, comparator, outcomes (PICO) questions.  Guest: Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
7/13/202012 minutes, 36 seconds
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For Osteoarthritis of the Knee, What’s the Point of Injecting Steroids? - Frankly Speaking EP 179

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-179 Overview: The comparative efficacy of corticosteroid and physical therapy for managing osteoarthritis of the knee is controversial. This podcast will review a recent randomized trial comparing the efficacy of the 2 treatments in 156 patients who were followed for 1 year. Guest: Guest: Alan Ehrlich, MD Music Credit: Richard Onorato
6/29/20209 minutes, 35 seconds
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An Epidemic That Nobody is Talking About - Frankly Speaking EP 178

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-178 Overview: As men age, over-active bladder (OAB) symptoms (urgency, frequency, nocturia) are commonly seen. Typically, these symptoms are secondary to the development of benign prostate hypertrophy (BPH). Alpha-blocking and/or antimuscarinic agents are commonly prescribed to treat such symptoms. In this podcast we review the COBALT study which examines the benefits of behavioral treatments (pelvic floor muscle training and fluid restriction before bedtime) alone or combined with drug therapy to treat OAB symptoms. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
6/22/20208 minutes, 52 seconds
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Concussion Risk and Prevention Among High School Student Athletes - Frankly Speaking EP 177

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-177 Overview: This session will discuss the latest evidence on concussion occurrence among high school athletes and review return-to play-guidelines and laws. It will also provide a nuanced and realistic discussion of concussion prevention. Guest: Guest: Hillary Mullan Music Credit: Richard Onorato
6/15/20207 minutes, 12 seconds
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Getting to Remission—Not Just Better: Can a Web-Based CBT Tool Help Resolve Residual Depressive Symptoms in People Treated for Depression? - Frankly S...

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-176 Overview: Achieving a euthymic state can be very challenging for individuals with depression and anxiety. Many people live with residual symptoms even while on anti-depressive medications. Changing pharmacotherapy, escalating doses, and adding medications are common. Join us while we discuss the results of a recent RCT of primary care patients, which demonstrated improved resolution of residual depressive symptoms for those who used a web-based CBT tool as adjunctive therapy. Guest: Guest: Susan Feeney, DNP, FNP-BC Music Credit: Richard Onorato
6/8/202010 minutes, 49 seconds
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Pap Smears and Bimanual Exams: Do Teens Really Need Them? - Frankly Speaking EP 175

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-175  Overview: Clinical practice guidelines from the American College of Obstetrics and Gynecology and the United States Preventive Services Task Force recommend against routine Pap smears and bimanual exams in adolescents. This recommendation includes those planning on starting oral contraceptives or with possible sexually transmitted diseases. A recent study found nearly half of all such exams in this age group lack indications. While the evidence indicates a new direction, clinicians have been slow to change their practice. Join us as we discuss the reasons for these guidelines and review appropriate indications for these exams.  Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
6/1/20208 minutes, 5 seconds
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Frankly Speaking Update: COVID-19 and Special Populations (Recorded 5/22/20)

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-covid-19-5-27  Overview: Listen to this Q&A session about special topics on COVID-19 infection, including COVID in pregnancy and pediatric patients   Guest: Guest: Alan Ehrlich, MD Music Credit: Richard Onorato
5/27/202017 minutes, 16 seconds
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What Happened to My Furosemide? Torsemide for Congestive Heart Failure - Frankly Speaking EP 174

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-174 Overview: In this episodes, we will discuss a systematic review and meta-analysis that examines outcomes from the use of furosemide compared to torsemide in patients with congestive heart failure. Guest: Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
5/25/20209 minutes, 9 seconds
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The Prescribing Cascade: What Is It and How Do We Prevent It? - Frankly Speaking EP 173

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-173 Overview: In primary care we are tasked with treating multiple conditions, therefore many of our patients are on numerous medications. Some of these medications are prescribed to deal with side effects of other medications. Often clinicians may not be aware that they are treating preventable drug side effects and wind up prescribing even more medications. This causes a cascade effect that results in significant polypharmacy. Join us while we discuss this common phenomenon and strategies to minimize or avoid it entirely. Guest: Guest: Susan Feeney, DNP, FNP-BC Music Credit: Richard Onorato
5/18/202010 minutes, 29 seconds
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Kegels for Men? - Frankly Speaking EP 172

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-172 Overview: As men age, over-active bladder (OAB) symptoms (urgency, frequency, nocturia) are commonly seen. Typically, these symptoms are secondary to the development of benign prostate hypertrophy (BPH). Alpha-blocking and/or antimuscarinic agents are commonly prescribed to treat such symptoms. In this podcast we review the COBALT study which examines the benefits of behavioral treatments (pelvic floor muscle training and fluid restriction before bedtime) alone or combined with drug therapy to treat OAB symptoms. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
5/11/20208 minutes, 26 seconds
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Caution! Falling Seniors Ahead! - Frankly Speaking EP 171

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-171 Overview: Join us as we discuss falls: a clinical issue that warrants regular assessment in adults over the age of 65. Guest: Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
5/4/20209 minutes, 41 seconds
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Corticosteroid Injection for Plantar Fasciitis: All Pain, No Gain - Frankly Speaking EP 170

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-170 Overview: Plantar fasciitis is a common and often unsuccessfully treated chronic, painful condition. Multiple interventions have been suggested with varying degrees of effectiveness. Corticosteroid injections are sometimes used, but the evidence for efficacy has been limited with significant bias present in many of the trials. A Cochrane review in 2017 found a small degree of short-term benefit. Since then, a number of additional trials have been performed, and a newer systematic review finds no benefit. Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
4/27/20208 minutes, 16 seconds
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Ask the ID Expert: Common COVID-19 Questions in Primary Care (Recorded 3/28/20)

Credits: 0.50 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/ask-the-id-experts-covid19-coronavirus Overview: With information changing rapidly around the COVID-19 pandemic, it is difficult for primary care clinicians on the front lines of care to stay up to date on the most accurate information regarding prevention, testing, and treatment. Join this live discussion between family physician Dr. Frank Domino and infectious disease specialist Dr. Paul Sax as they discuss common questions related to COVID-19 that will help you give your patients the best possible care and advice during these uncertain times. Please note that any data, indications, and guidelines presented in this activity are current as of the recording on 3/28/2020 and they are subject to change as new information is published.  Guest: Frank J. Domino, MD & Paul E. Sax, MD 
3/30/202038 minutes, 46 seconds
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Alcohol and A-fib: Is Abstinence the Best Medicine? - Frankly Speaking EP 166

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-166 Overview: Alcohol consumption has been associated with negative cardiovascular outcomes, yet many clinicians still counsel patients that it is okay in moderation. Past observational studies have supported this idea, showing a dose-dependent relationship between alcohol consumption and the incidence of a-fib. In this episode we will explore the latest RCT out of Australia, which suggest that no level of alcohol intake is safe when it comes to a-fib. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
3/30/20209 minutes, 33 seconds
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Frankly Speaking Update: Common Questions About Coronavirus (Recorded 3/21/20)

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-coronavirus   Overview: Review the latest data on the Pandemic in a patient centered manner  Music Credit: Richard Onorato
3/22/202014 minutes, 2 seconds
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Coronavirus Update, March 6, 2020 - Frankly Speaking EP 164

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-164   Overview: Review the latest recommendations from the CDC to assist in responding to patient questions and concerns.  Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato 
3/13/20208 minutes, 17 seconds
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Safe Sex – Counseling Makes a Difference - Frankly Speaking EP 163 (Live from Pri-Med South)

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-163   Overview: STIs in the US are a major public health risk with an estimated 20 million new cases per year, more than half occurring in 15-24-year-olds. The USPSTF found intensive counseling in young adults to reduce the likelihood of STIs. Join us as we discuss how to apply these recommendations to your practice. Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato
3/9/202013 minutes, 17 seconds
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Milk: Whole, Skim or Something In Between? - Frankly Speaking EP 162 (Live from Pri-Med South)

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-162    Overview: This episode will review four recent publications that help guide milk consumption in children and adults.  Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato 
3/2/202012 minutes, 46 seconds
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Treating Strep Throat in Half the Time - Frankly Speaking EP 160

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-160     Overview: This episode will review clinical decision-making tools for diagnosing and treating streptococcal pharyngitis and will discuss a recent randomized controlled trial utilizing a 5-day course of Penicillin for treatment.  Guest: Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
2/17/202010 minutes, 27 seconds
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Adolescent Mental Health: Family Relationships Matter - Frankly Speaking EP 159

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-159   Overview: Join us as we discuss data from the National Longitudinal Study of Adolescent to Adult Health examining how family relationships impact depression.   Guest: Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
2/10/202010 minutes, 12 seconds
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Coronavirus: Frankly Speaking Special Update

Listen to Dr. Frank Domino provide a timely update regarding the recent Coronavirus outbreak, and provide resources in order to get the most up-to-date information. 
2/3/20203 minutes, 10 seconds
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Heartburn – Why “Test and Treat” Is Best - Frankly Speaking EP 157

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-157 Overview: Heartburn is a frequent complaint in primary care practices. The etiology is broad, from reflux to H. pylori infection and PUD. While many clinicians treat symptomatically, this may not lead to patient satisfaction. A recent network meta-analysis published in The BMJ, concluded that a ‘test and treat’ approach resulted in the lowest reports for patients to remain symptomatic at follow-up. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
1/27/202011 minutes, 21 seconds
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Cannabis Use in Pregnancy: A Worrisome Trend - Frankly Speaking EP 156

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-156 Overview: Cannabis use has been increasing as numerous states have decriminalized or even legalized cannabis possession and use. As a result, the rates of pregnant women who use cannabis have been rising. Learn more about these trends and the risks associated with cannabis use in pregnancy. Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
1/20/20209 minutes, 28 seconds
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A Brief Update of the Guidelines on the Management of Type 2 Diabetes - Frankly Speaking EP 155

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-155 Overview: Join us as we discuss key points from the 2019 update to the American Diabetes Association and the European Association for the Study of Diabetes consensus report. This update is now reflected in the American Diabetes Association's Standards of Medical Care—2020.  Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
1/13/202010 minutes, 8 seconds
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Improving Communication Between Parents and Teens - Frankly Speaking EP 153

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-153  Overview: Discuss a recently published randomized controlled trial that examined methods to help parents improve their ability to discuss important health issues with their teenagers (ex. sexual activity, substance use). Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
12/30/201911 minutes, 16 seconds
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Winter’s Here – Time to Review the Latest Community-Acquired Pneumonia Guidelines - Frankly Speaking EP 152

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-152 Overview: The Infectious Disease Society of America in conjunction with the American Thoracic Society have updated their guidelines on diagnosing and treating Community Acquired Pneumonia (CAP) in adults. Recommended changes from the 2007 guidelines include how to address the growing issue of antibiotic resistance. We will review this latest recommendation, focusing on the best approach for outpatient care. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
12/23/201910 minutes, 59 seconds
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Vaping: Health Threats in a Rapidly Changing Landscape - Frankly Speaking EP 151

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-151 Overview: Every day new information on e-cigarettes is in the media – the explosion of teen use with a resulting epidemic of nicotine addiction and most recently, increasing cases of serious lung related illness associated with vaping. Join us as we discuss this epidemic and the emergence of VAPI (Vaping Associated Pulmonary Injury) Guest: Susan Feeney, DNP, FNP-BC Music Credit: Richard Onorato
12/16/201911 minutes, 52 seconds
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Red Meat: Confusion and Conflicts of Interest - Frankly Speaking EP 150

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-150  Overview: Join us as we review a landmark paper that reached the conclusion that limiting red meat would not have a large impact on patient outcomes. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
12/9/201914 minutes, 6 seconds
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Breast Density and Supplemental Imaging: Detecting Advanced Breast Cancer - Frankly Speaking EP 146

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-146 Overview: Join us as we discuss breast density and the use of supplemental imaging to assess risk for advanced breast cancer. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
11/11/20198 minutes, 57 seconds
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COPD Exacerbations: Who Needs Antibiotics? - Frankly Speaking EP 145

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-145 Overview: Patients with COPD frequently have exacerbations, often triggered by an acute upper respiratory infection (URI). C-reactive protein (CRP) testing is a new way of assessing whether or not antibiotics are needed to treat.  Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
11/4/201910 minutes, 26 seconds
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Getting Glutened: Early Childhood Gluten Consumption and the Risk of Celiac Disease - Frankly Speaking EP 144

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-144 Overview: The degree to which early exposure to gluten-containing foods affects the risk of developing celiac disease is controversial. Join us as we discuss a recent Norwegian study suggesting that the timing of introduction of gluten in the diet may be less important than the amount of gluten in the diet at 18 months of age. Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato
10/28/201910 minutes, 59 seconds
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Antibiotic Use in the US: A Look into How Americans Use Antibiotics Without a Prescription - Frankly Speaking EP 143

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-143 Overview: A recent scoping review revealed that nonprescription antibiotic use is a prevalent and understudied public health concern in the US. Inappropriate antibiotic prescribing and use has been a well-documented concern and these new findings only reinforce the need for more comprehensive approaches to this problem. Join us while we discuss the scoping review findings and some strategies for implementing antibiotic stewardship into your practice. Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Richard Onorato
10/21/201911 minutes, 42 seconds
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Saving the Brain: How Long Is Too Long to Pursue Endovascular Reperfusion After a Stroke? - Frankly Speaking EP 142

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-142 Overview: There has been increasing interest in the use of endovascular reperfusion for patients who have suffered an ischemic stroke. The American Heart Association (AHA) and the American Stroke Association (ASA) have jointly developed a nationwide registry to evaluate the benefits of these techniques on stroke outcomes. During this episode we will review a recent retrospective cohort study of almost 7,000 patients presenting with an acute ischemic stroke that demonstrates a significant benefit to endovascular reperfusion, even several hours after the onset of symptoms. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
10/16/201911 minutes, 9 seconds
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Gun Safety in Pediatric Populations: Exploring New Data and Assessing Risk - Frankly Speaking EP 141

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-141 Overview: Join us as we discuss gun safety and injury prevention in primary care practice. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
10/7/20199 minutes, 56 seconds
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Weight Loss with Apps – Do they Work? - Frankly Speaking 140

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-140 Overview: This session will discuss the utility of digital apps and daily self-weight measurement for weight loss. Guest: Robert A. Baldor, MD, FAAFP Music Credit: Richard Onorato
9/30/201911 minutes, 15 seconds
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Needlepoint for the Heart: An Integrative Option for Chronic Stable Angina - Frankly Speaking EP 139

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-139 Overview: Join us as we discuss acupuncture as an adjunctive therapy in patients with chronic stable angina. Guest: Jill Terrien PhD, ANP-BC Music Credit: Richard Onorato
9/23/20199 minutes, 40 seconds
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What Does Exercise Have to Do with It: What Is the Relationship Between a Healthy Lifestyle and Genetic Risk of Dementia? - Frankly Speaking EP 138

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-138 Overview: Genetic and lifestyle risk factors have been implicated in the development of Alzheimer’s dementia (AD) as well as other subtypes of dementia. Specific genetic protein mutations have been identified in individuals who develop AD. There is also an abundant amount of evidence that suggests the risk of dementia can be reduced by avoiding tobacco smoking, limiting alcohol consumption, keeping physically active, and maintaining a healthy diet. Join our discussion of a recent study that shows a healthy lifestyle is associated with decreased risk of dementia in those with both low and high genetic risk. Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato 
9/16/201910 minutes, 5 seconds
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Statins After 75 Years of Age in Healthy Seniors? Still No - Frankly Speaking EP 137

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-137 Overview: In this episode we expand on the rationale for not screening and treating hyperlipidemia in patients without CV disease, diabetes, renal failure or heart failure. Guest: Robert A. Baldor, MD Music Credit: Richard Onorato 
9/9/201910 minutes, 57 seconds
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What’s the Skinny on Treating Blood Fats? - Frankly Speaking EP 106

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-106-lipids Overview: Managing cholesterol is one of the most common clinical problems. Recently, the American College of Cardiology and the American Heart Association issued new guidance on the management of blood cholesterol. Ten other societies participated in the development of the guidelines. Listen to find out who should be treated with statins, what the treatment targets are, and when other cholesterol-lowering medications should be added. Guest: Alan Ehrlich MD Music Credit: Richard Onorato 
2/4/201910 minutes, 38 seconds
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Leg Cramps in Seniors: Could Alcohol be the Cause? - Frankly Speaking EP 105

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-105-leg-cramps Overview: This episode will discuss a Case Control study of seniors to determine if there is a relationship between regular alcohol consumption and nocturnal leg cramps. Guest: Alan Ehrlich MD Music Credit: Richard Onorato 
1/28/201910 minutes, 6 seconds
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Is Aspirin Effective for Primary Prevention? - Frankly Speaking EP 104

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-104-aspirin Overview: For patients with established cardiovascular disease,aspirin is clearly beneficial as part of secondary prevention. However, when used as primary prevention in patients without documented cardiovascular disease, its benefit is much less certain. This podcast will explore 3 recent trials that evaluated aspirin in different populations and found nobenefit for its use as primary prevention. Guest: Alan Ehrlich MD Music Credit: Richard Onorato 
1/21/201910 minutes, 18 seconds
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Screening and Management of High Blood Pressure in Children and Teens – Who, When, Why and What? - Frankly Speaking EP 103

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-103-bp-screening Overview: The AAP released new guidelines for the screening and management of high BP in children and teens in 2017. The last recommendations were published in 2004. Join us as we discuss these updated recommendations and their impact on your practice.  Guest: Susan Feeney, DNP, FNP Music Credit: Richard Onorato 
1/14/20199 minutes, 45 seconds
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Technology: Tetris Improves Flow, Lowers Stress; Social Media Increases Depression and Loneliness – Frankly Speaking EP 102

Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-102-flow  Overview: This podcast will explore the results of 3 recent studies that evaluate how the “state of flow” or mental absorption (also called being “in the zone”) alters a person’s ability to handle stress and how intentional use of distractions affect emotions. Guest: Alan Ehrlich MD  Music Credit: Richard Onorato 
1/7/201911 minutes, 56 seconds
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Cannabis and e-Cigarette: What Is in That Juul? - Frankly Speaking EP 99

Recently, there has been a deluge of research and news surrounding e-cigarettes and vaping – particularly regarding adolescent usage. Join us as we discuss a recent study describing the prevalence of cannabis use in e-Cigarettes and some strategies for addressing this in your practice.   Guest: Susan Feeney, DNP, FNP-BC   Landing Page: https://www.pri-med.com/online-education/Podcast/99-eCigarettes-frankly%20speaking  
12/17/201811 minutes, 22 seconds
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More is Not Better: Overutilization of Breast Imaging - Frankly Speaking EP 98

This episode reviews a study that looked at imaging that was performed over a one year period for women with a complaint of breast pain. Guest: Jill Terrien PhD, ANP-BC   Landing Page: https://www.pri-med.com/online-education/Podcast/98-breast-imaging-frankly-speaking  
12/10/20189 minutes, 57 seconds
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Statins and the Older Population: When Is It Beneficial and When Is It Not? - Frankly Speaking EP 96

Evidence of the efficacy of statins to reduce ASCVD morbidity and mortality in individuals > 75 years who have known clinical ASCVD (secondary prevention) is well established. Primary prevention in this population has not been as clear. Join us while we discuss a recent study in the BMJ which assessed the benefits of statins for primary prevention of ASCVD morbidity and mortality in individuals > 75 years with and without DM.   Guest: Susan Feeney, DNP, FNP-BC   Landing Page:  https://www.pri-med.com/online-education/Podcast/96-statin-therapy-frankly-speaking.aspx#sm.0000akbf5ldmtfh2s4u14ah34rz3b
11/26/201810 minutes, 28 seconds
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Easy Weight Loss for Type 2 Diabetes - Frankly Speaking EP 95

This episode will review a randomized controlled trial of adding 10.5 grams of a soluble fiber, psyllium, to a Type 2 Diabetes diet and its influence on weight loss, BMI and other parameters of diabetes.   Guest: Jill Terrien PhD, ANP-BC   Landing Page: https://www.pri-med.com/online-education/Podcast/95-psyllium-frankly-speaking.aspx
11/19/201810 minutes, 35 seconds
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Why Get A Flu Shot? - Frankly Speaking EP 94

As fall arrives, many patients question the need for an influenza vaccine while clinicians urge patients to get it. 2017-18 flu season data shows high influenza mortality. Learn how to help motivate patients to accept the vaccine.   Guest: Susan Feeney, DNP, FNP-BC   Landing Page: https://www.pri-med.com/online-education/Podcast/94-influenza-frankly-speaking
11/12/201810 minutes, 44 seconds
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Penicillin Allergy: Danger Is in the Diagnosis - Frankly Speaking 93

8% of patients believe they have a penicillin allergy, yet the actual number is far less. Listen to this episode to learn about the incidence of penicillin allergy, the risks associated with reporting a believed allergy, and how you can better manage these patients. Guest: Susan Feeney, DNP, FNP-BC Landing Page: http://www.pri-med.com/online-education/Podcast/93-penicillin-frankly-speaking  
11/5/20189 minutes, 28 seconds
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Eliminating the Unnecessary: Updates on Screening for Cervical Cancer - Frankly Speaking 92

Listen to this episode to learn about the update to the 2012 United States Preventive Services Task Force (USPSTF) recommendation on screening for cervical cancer. 
10/29/20188 minutes, 36 seconds
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Lose Weight While Eating Whatever You Like; Maybe? - Frankly Speaking EP 91

Listen to this episode to learn about a small study which found that adding 35 grams of fiber and 0.8 grams of protein/kg/day to the diets of obese patients—without making any other diet changes—led to weight loss at 12 weeks. Guest: Susan Feeney, DNP, FNP-BC
10/22/201813 minutes, 45 seconds
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A Good Night’s Sleep: The Possible Association Between the Early Introduction of Food and Infant Sleep - Frankly Sleeping EP 90

Both the WHO and AAP recommend exclusive breastfeeding until 6 months of age then solids and breast milk until 12 months of age. The well-established benefits of breastfeeding include support of infant growth and development of immunity. Recently, a clinical trial from the UK found an association between the early introduction of foods and infant sleep. Join us while we discuss the findings of this study and possible implications to your care of moms and their infants.
10/12/201812 minutes, 34 seconds
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Preventing Opioid Dependence While Effectively Treating Pain - Frankly Speaking EP 89

Best practices in treating acute and chronic pain have been clouded by years of misinformation. Listen to this podcast episode to learn an evidence-based recommendations that dispels these myths and encourages a new and better approach to pain management.
10/8/201811 minutes, 8 seconds
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Depression and Medication Side Effects: Is Your Depression Due to Something You Are Taking? - Frankly Speaking EP 88

The number of adults in the US on prescription medications is rising, with approximately 15% taking five or more daily medications. A recent study found that depression is a common side effect—37.2% prevalence among American adults taking prescription medications—and is associated with an increased risk of concurrent depression. Guest: Susan Feeney, DNP, FNP-BC
10/1/201812 minutes, 41 seconds
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Chronic Non-Cancer Pain in Older Adults: Can We Teach Our Patients to “Unlearn” it? - Frankly Speaking EP 87

Chronic non-cancer pain in adults over 60 years old is common. The consequences are a decreased quality of life, disability and increased healthcare costs which can be due to the cost of therapies or from adverse pharmacologic effects to name a few. This episode discusses the results of a systematic review and meta-analysis by Niknejad et al (2018) that looked at pain outcomes in this population using psychological modalities. Guest: Jill Terrien PhD, ANP-BC
9/24/201811 minutes, 36 seconds
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Shoulder Surgery Usually Not Beneficial For Most - Frankly Speaking EP 86

Adults often present with atraumatic shoulder pain around age 50 and are diagnosed with impingement syndrome (rotator cuff tendonitis). However, as this recent study demonstrates, the standard of care for treatment should not be surgery. Guest: Susan Feeney, DNP, FNP-BC
9/17/201810 minutes, 37 seconds
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Digital Media Use and ADHD Symptoms in Teenagers – Is There an Association? - Frankly Speaking EP 85

A recent longitudinal study of high school students in the LA area found a modest but significant association between high-frequency digital media use (phones, tablets) and subsequent ADHD symptoms. Join us as we discuss these findings and the possible impact on adolescent primary care. Guest: Susan Feeney, DNP, FNP-BC
9/10/201811 minutes, 16 seconds
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Physician Burnout: What Degree Have We Reached? - Frankly Speaking EP 84

This episode is an introductory discussion of the very real problem of physician burnout. It affects you and those around you. What do we know about burnout and how can we move beyond it? Guest: Jill Terrien PhD, ANP-BC
9/3/201811 minutes, 26 seconds
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Should You Use Budesonide-Formoterol as Needed for Mild Asthma? - Frankly Speaking EP 83

In this episode, we will discuss using an inhaled steroid twice a day to control mild asthma symptoms, versus using the combination budesonide and formoterol. Guest: Jill Terrien PhD, ANP-BC
8/27/201810 minutes, 2 seconds
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More Than Beauty: Length and Quality of Sleep and Its Impact on CV Risk Factors in Teens - Frankly Speaking EP 82

It has been fairly established that short duration of sleep is associated with obesity in teens and adults; however, the impact of quantity and quality of sleep has not been as well established. A cross-sectional study by Feliciano et al. found that longer and better sleep was associated with better cardiometabolic profiles in early adolescence – independent of other factors. Guest: Susan Feeney, DNP, FNP-BC
8/20/201811 minutes, 3 seconds
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Goals of Care Discussions in Patients with Serious Illness: Is It a Downer? - Frankly Speaking EP 81

Discussing goals of care with patients that have a serious, life-limiting illness does not affect the patient’s anxiety or depression—but can increase the quality of the communication. Listen to this podcast episode for tips that are easily adaptable to any outpatient or specialty practice. Guest: Jill Terrien PhD, ANP-BC
8/13/201811 minutes, 43 seconds
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Breastfeeding Supplemented with Formula; When Is It the Right Thing to Do? - Frankly Speaking EP 80

Breastfeeding exclusively in the first six months of life is widely recommended. However, in this study of newborns who were losing weight because their mother’s milk had not yet come in, post-breastfeeding supplementation improved weight and did not alter breastfeeding rates at one month.  Guest: Susan Feeney, DNP, FNP-BC 
8/6/201811 minutes
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Mangia: What Is the Truth about the Mediterranean Diet and CVD Health? - Frankly Speaking EP 79

In 2013, a groundbreaking clinical trial from Spain touted the benefits of the Mediterranean Diet to reduce CVD risk. A recent review of the study found some irregularities in the randomization procedure that cast concern on the validity of the findings. After reanalysis of the data, however, the results were essentially the same. Guest: Susan Feeney, DNP, FNP-BC
7/30/20189 minutes, 53 seconds
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Binge Drinking in Adolescents: A Sober Subject That Begs for Attention - Frankly Speaking EP 78

For adolescents who binge drink, when they begin and how often they do it affects academic performance. This episode discusses the findings of a longitudinal analysis of secondary school students in Canada: The COMPASS study. Guest: Jill Terrien PhD, ANP-BC
7/23/201810 minutes, 9 seconds
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Treatment of Post-Op Pain Following Spine and Joint Surgery - Frankly Speaking EP 77

This study looked at how pain was treated following spine and joint surgery and found the majority of patients were not encouraged to use non-opioid analgesia and that most had a supply of unused opioids at home. Guest: Jill Terrien PhD, ANP-BC
7/16/201810 minutes, 5 seconds
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Assessing Blood Pressure: How Accurate Are the Blood Pressure Measurements You Use to Care for Your Patients? - Frankly Speaking EP 76

Hypertension affects an estimated 80 million Americans. We diagnose, determine the need for medication therapy, and monitor treatment efficacy based on a simple office blood pressure measurement – but how accurate is that measurement, and what is the most valid method to obtain it? Guest: Susan Feeney, DNP, FNP-BC
7/9/201812 minutes, 41 seconds
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Moving Fast, Moving Slow - Frankly Speaking EP 75

Fibromyalgia can be difficult to treat and often requires a multifaceted approach combining exercise, medications, cognitive behavioral therapy, and health education. For many patients, pain hinders participation in a vigorous exercise regimen. Listen to this review of a randomized trial comparing aerobic exercise to tai chi in a patient population with fibromyalgia. Guest: Alan Ehrlich, MD 
7/2/201812 minutes, 36 seconds
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Uncomplicated UTI in Women: What a Pain! - Frankly Speaking EP 74

For women experiencing an uncomplicated UTI, nitrofurantoin and fosfomycin are two first-line options for treatment. Is one more effective than the other? Listen to this episode to learn about the results from a multinational, open-label, randomized clinical trial. Guest: Jill Terrien PhD, ANP-BC
6/25/201811 minutes, 38 seconds
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Put That Finger Down! The End of the Screening Rectal Exam - Frankly Speaking EP 73

Listen to this week’s podcast episode to learn about a meta-analysis showing no benefit to rectal examinations in men. Guest: Susan Feeney, DNP, FNP-BC 
6/18/201811 minutes, 11 seconds
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Don’t Make Me Exercise – Give Me Some Tea & a Pill! - Frankly Speaking EP 72

A recent AHA presentation offered data that showed an overwhelming amount of patients would prefer to take a pill or drink tea rather than exercise to lower their BP. This begs the questions: How much does drinking tea lower BP? Does exercise help those with primary HTN or resistant HTN who are already on medication? Finally, how do we get our patients to exercise?  Guest: Robert A. Baldor, MD, FAAFP
6/11/201810 minutes, 29 seconds
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Mom, Do I Have to Practice the Piano Again? The Benefit of Music Instruction on Executive Function - Frankly Speaking EP 71

Listen to this week's episode to learn about a randomized trial of children in music vs. visual arts instruction. Music instruction led to improvements in verbal intelligence, executive functions, and academic performance. Guest: Susan Feeney, DNP, FNP-BC
6/4/201810 minutes, 23 seconds
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Hot Flashes, Night Sweats, and Insomnia: Will I Ever Sleep Through the Night Again? - Frankly Speaking EP 70

This episode will review The Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) series of 4 randomized controlled trials, pooling individual data that will provide guidance for discussing pharmacologic and non-pharmacologic options for your peri- and postmenopausal patients. Guest: Jill Terrien PhD, ANP-BC  
5/28/20189 minutes, 33 seconds
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Biomarkers for Alzheimer’s Diagnosis? - Frankly Speaking EP 69

The National Institute on Aging-Alzheimer’s Association (NIA-AA) just released an updated Framework of the 2011 Guidelines for Alzheimer’s Disease Research, focusing on the use of biomarkers rather than clinical criteria to make the diagnosis. Listen to this week’s episode to learn more. Guest: Robert A. Baldor, MD, FAAFP
5/21/201810 minutes, 25 seconds
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My Joints Are Killing Me! Opioids vs. NSAIDs for Chronic Pain - Frankly Speaking EP 68

Chronic pain is a difficult but common problem in primary care. Patients are often desperate for any form of relief, and as a result, many are eventually started on opioid analgesics. This can be associated with many adverse effects. But is it worth it? A recent randomized trial compared opioid to non-opioid management of patients with chronic low back pain or chronic hip pain or knee pain due to osteoarthritis. Guest: Alan Ehrlich, MD
5/14/201812 minutes, 18 seconds
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Antibiotics and Sinusitis – How Long is Too Long? - Frankly Speaking EP 67

A recent research study published in JAMA Internal Medicine examined the use of antibiotics to treat acute sinusitis based upon the Infectious Diseases Society of America (IDSA) guideline recommending 5-7 days when antibiotics are indicated and found that most courses of antibiotics are too long. Listen to this week’s episode to learn more. Guest: Robert A. Baldor, MD, FAAFP
5/7/201810 minutes, 49 seconds
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Best Evidence Goals for Type 2 Diabetes - Frankly Speaking EP 66

The American College of Physicians supported an evidence-based review of the topic guidelines for type 2 diabetes and concluded clinicians should aim for an A1c goal between 7.0-8.0 and recommended even less aggressive care for those over the age 80 years. Listen to this podcast episode to learn more about these new guidelines. Guest: Alan Ehrlich MD
4/30/201810 minutes, 51 seconds
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Is Screen Time Taking Your Child’s Sleep Time? - Frankly Speaking EP 65

Listen to this podcast episode for a brief summary of the literature on electronic media and its relation to sleep—specifically delayed bedtimes and decreased sleep duration. Screen-based media consumption is eating up our sleep health! Guest: Jill Terrien PhD, ANP-BC
4/23/201811 minutes, 27 seconds
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Diet! Diet! Who’s Got the Best Diet? - Frankly Speaking EP 64

71% of adults in the United States are overweight or obese. To tackle this problem, primary care providers must stay up to date on the best evidence for addressing overweight and obese status in their patients. The DIETFITS Randomized Clinical Trial offers direction for nutritional advice in this important and serious public health concern. Guest: Kenneth Peterson, PhD, FNP-BC
4/16/201810 minutes, 35 seconds
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Changing Immunization Practices: 2-Dose Vaccines - Frankly Speaking EP 63

Immunization practices are constantly in flux as new vaccines are approved and guidelines are updated. Recently, the FDA approved a 2-dose hepatitis B virus (HBV) vaccine and a new 2-dose herpes zoster (HZ) vaccine. Additionally, the CDC now recommends a 2-dose human papillomavirus (HPV) vaccine schedule, a change from the previous recommendation for a 3-dose schedule. This session will discuss the changing landscape of immunization practices and recent changes to recommendations. Guest: Robert A. Baldor, MD, FAAFP
4/9/201811 minutes, 27 seconds
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I’ve Got Rhythm: Catheter Ablation Therapy for Patients with Atrial Fibrillation and Heart Failure - Frankly Speaking EP 62

Management of patients with atrial fibrillation has long centered on the relative merits of rate control versus rhythm control. The CASTLE-AF trial evaluated catheter ablation as a treatment for patients with both heart failure with reduced ejection fraction and atrial fibrillation. Listen to this week’s podcast episode to learn about the results of this new trial and how the catheter ablation impacted clinical outcomes.  Guest: Alan Ehrlich MD
4/2/20189 minutes, 9 seconds
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How to Best Treat Cognitive Impairment – 2018 AAN Recommendations - Frankly Speaking EP 61

In this week’s episode, we’ll be continuing the discussion on the AAN’s updated practice guideline on mild cognitive impairment. Last week’s podcast episode provided overview of the updated practice guideline, and this week’s episode focuses on treatment recommendations. Guest: Robert A. Baldor, MD, FAAFP
3/26/201811 minutes, 28 seconds
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Screening for Dementia; Better Than MMSE (Mini Mental Status Exam) - Frankly Speaking EP 60

The American Academy of Neurology recently published the first updated practice guideline on mild cognitive impairment since 2001. Listen to this week’s episode for an overview of the updated practice guideline, which includes a systematic review of prevalence, prognosis, screening, and treatment research with clear recommendations for practicing clinicians. Guest: Robert A. Baldor, MD, FAAFP
3/19/20189 minutes, 59 seconds
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GET UP: A Small Bit of Movement Makes a Big Impact - Frankly Speaking EP 59

This observational study found adding very little activity, akin to going for a 30-minute walk or converting to a standing desk for half your workday, lowered all-cause and cardiovascular mortality. Guest: Alan Ehrlich, MD
3/12/20188 minutes, 37 seconds
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Do We Still Use Warfarin? - Frankly Speaking EP 58

Direct acting oral anticoagulants are increasingly used for stroke prevention for individuals with atrial fibrillation. Whether these agents are as safe and effective as warfarin has been a concern for many clinicians, but recent comparative effectiveness analyses are providing answers. In this week’s podcast episode, we will review these recent studies and draw some conclusions about which agents are best. Guest: Robert A. Baldor, MD, FAAFP
3/5/20189 minutes, 48 seconds
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Helping Depressed Patients Change: Behavioral Activation - Frankly Speaking EP 57

Listen to this week’s episode to learn about the basic concepts of behavioral activation (BA), what research has demonstrated about its use in depression, and how to apply BA in everyday care.  Guest: Susan Feeney, DNP, FNP-BC
2/26/20189 minutes, 45 seconds
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The Flu is Bad for Your Heart - Frankly Speaking EP 56

Patients with chronic diseases, including coronary artery disease, are advised to get yearly flu shots because they are at higher risk for having a more severe illness. Canadian researchers have found that in the week following being diagnosed with the flu, adults over 65 years old have a significantly increased risk of myocardial infection.
2/19/20189 minutes, 5 seconds
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Too Little, Too Much: How Much Sleep is Just Right? - Frankly Speaking EP 55

In this session we discuss the impact of length of sleep on obesity and DM II.
2/12/201810 minutes, 45 seconds
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Your Morning “Cup of Joe” Could Be Doing More Than Starting Your Day - Frankly Speaking EP 54

This session will review the existing evidence between coffee consumption and multiple health outcomes. 
2/5/20189 minutes, 39 seconds
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An Oral Fecal Transplant for Lunch?- Frankly Speaking EP 53

Treating recurrent C. difficile colitis can be difficult, but recent trials have demonstrated the benefit of treating with fecal transplantation. Questions exist, however, about around the best mode of administration. Listen to this week’s episode to learn about a recent RCT that compares oral and colonoscopic delivery methods and provides an answer.   Learning Objectives:  Appreciate the current guidelines for treating recurrent difficile colitis Understand the pharmacology of fecal transplantation Learn about the latest research on how best to administer such treatment
1/29/201811 minutes, 30 seconds
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The New Hypertension Guidelines - Frankly Speaking EP 52

New hypertension guidelines from the American College of Cardiology have introduced a new blood pressure classification system and lowered the threshold for initiating pharmacotherapy in certain patient populations. Learning Objectives: Understand the new classification categories of hypertension Understand the new thresholds for starting treatment Understand the limitations of the new recommendations to specific patient populations
1/22/201811 minutes, 47 seconds
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Preventing Opioid Addiction: Treating Acute Pain Safely - Frankly Speaking EP 51

For severe, acute pain, 1000 mg of acetaminophen PLUS 400 mg of ibuprofen is as effective as acetaminophen/oxycodone, acetaminophen/hydrocodone, or acetaminophen/codeine. Listen to this week’s episode to learn more about treating acute pain safely.    Learning Objectives:  Review the current trial comparing Acetaminophen plus Ibuprofen to other acetaminophen/opioid combinations on pain outcomes Summarize the other data supporting this combination in children and adults Understand the path that can lead from acute pain to dependence.
1/15/201810 minutes, 24 seconds
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Herpes Zoster Vaccination: New Recommendations for Shingles Prevention - Frankly Speaking EP 50

This session will review the recommendations put forth by the CDC’s Advisory Committee on Immunization Practices for the use of a new shingles vaccine. Dosing, use, and efficacy will be discussed.   Learning Objectives: Review the new vaccine recommendations for the prevention of shingles. Discuss the use of the current vaccine and new vaccine with dosage and schedule. Provide a resource for the treatment of post herpetic neuralgia.
1/8/20189 minutes, 56 seconds
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Diabetes Remission with Weight Loss - Frankly Speaking EP 49

Diabetes remission is defined as a return to normal blood sugar control without the use of medications. Listen to this episode to learn about a trial in which the use of a very low calorie diet in a primary care setting resulted in significant weight loss and remission of diabetes.   Learning Objectives: Understand what is meant by diabetes remission Understand what treatments can lead to diabetes remission  
1/2/201810 minutes, 52 seconds
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What Does the Evidence Tell Us About Diagnosing and Treating Sinusitis? - Frankly Speaking EP 48

Listen to this episode to learn about the evidence-based guidelines for the diagnosis and management of acute sinusitis. Learning Objectives: Discuss the most recent EBP Guidelines on diagnosis and management of acute sinusitis Discuss application of best practices for appropriate management of acute sinusitis and strategies for good antibiotic stewardship. Guest: Susan Feeney, DNP, FNP-BC
12/26/201712 minutes, 1 second
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Treatment Options in Opioid Dependence - Frankly Speaking EP 47

Medication-based maintenance therapy is recommended for patients with opioid dependence. Listen to this week’s episode to learn how once monthly naltrexone injections are as effective as daily treatment with buprenorphine/naloxone.   Learning Objectives:  Understand data comparing long-acting naltrexone to daily buprenorphine/naloxone Understand importance of medication-based maintenance therapy
12/18/20179 minutes, 57 seconds
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New Treatment for Asthma - Frankly Speaking EP 46

We will discuss the use of azithromycin as a therapeutic option for patients with persistent symptomatic asthma despite controller maintenance therapy with inhaled corticosteroids and a long-acting bronchodilator. Learning Objectives: Understand the effect of chronic azithromycin for reducing asthma exacerbation Understand the role azithromycin can play in asthma step-wise therapy
12/11/201710 minutes, 10 seconds
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Endurance Sports: In it for the long haul - Frankly Speaking EP 45

What do you say when your 50-year-old patient that has been relatively sedentary in the last 3 decades wants to do a triathlon? In this episode, we will review a U.S. case series of participants in triathlon races from 1985-2016, and discuss risk, reward, and reality. Learning Objectives:  Review data collected over 30 years on triathlon events and the risks to participants. Discuss recommendations for patients embarking on extreme physical activity. Review strategies to promote well-being and lower risk when considering endurance sports.
12/4/201711 minutes, 9 seconds
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Blood Pressure Determination on Obese Arms - Frankly Speaking EP 44

If you become frustrated trying to get a thigh cuff onto the arm of an obese patient, we may have the answer. Learning Objectives:  Review the comparison of standard BP determination with using the forearm and radial pulse with a large cuff Appreciate the benefits of systolic hypertension control Review the causes of secondary hypertension in obese patients 
11/27/20178 minutes, 57 seconds
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Tattooing and Body Modification: From Risky to Mainstream – What are the Implications for Patient Care? - Frankly Speaking EP 43

In this episode, we discuss the first evidence-based guidelines by the American Academy of Pediatrics on body modification, piercing, and scarification, including complications and assessment of risk.  Learning Objectives:  Discuss the AAP’s EBP Guidelines on body modification, piercing and scarification in children, adolescents and young adults Discuss best practices for counseling adolescents and strategies for reducing associated risks regarding these practices.    
11/20/201713 minutes, 55 seconds
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‘Tis the Season … for Depression; Get Your Patients Moving. - Frankly Speaking EP 42

How much exercise makes a difference in the primary prevention of depression and anxiety? Find out in this podcast which will provide insights from Norway’s HUNT cohort study that followed a healthy cohort of 33,908 individuals for 11 years. Learning Objectives:  Review the relation of exercise and the development of depression and anxiety in a healthy population. Discuss strategies and options to alleviate stress and promote wellness.  
11/13/20178 minutes, 18 seconds
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Is Oxygen Helpful for Patients with Acute Stroke? - Frankly Speaking EP 41

Learning Objectives:  Understand the results of the Stroke Oxygen Study Understand which patients will benefit from supplemental oxygen
11/6/20179 minutes, 49 seconds
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The Sun is Setting for Sulfonylureas - Frankly Speaking EP 40

Learning Objectives:  Review the data on the risks of SU use Consider other second line approaches to Type 2 DM Review Primary Treatment Goals for T2DM
10/30/201712 minutes, 18 seconds
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Rare Risks with Pediatric Cough & Cold Medications - Frankly Speaking EP 39

Learning Objectives: Discuss the AAP position and why Review findings of adverse events and where the danger lies Offer advice on what to use and how to dose.
10/23/201710 minutes, 54 seconds
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Treating Major Depressive Disorder: Considerations in Applying the Evidence - Frankly Speaking EP 38

Learning Objectives:  Identify the concerns surrounding depression screening and treatment. Discuss the numerous factors primary care providers need to take into consideration to improve management of depression in their patients.
10/16/201711 minutes, 26 seconds
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PPIs: Too Much of a Good Thing? When and How to Discontinue Them - Frankly Speaking EP 37

Learning Objectives:  Discuss EBP Guidelines on management of Acid related GI condition and PPI prescribing Discuss best practice for appropriate PPI use in primary care and strategies for discontinuation. 
10/9/201714 minutes, 16 seconds
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The Flu Stops with You – 2017/2018 Influenza Vaccination Recommendations - Frankly Speaking EP 36

Learning Objectives: Discuss the 2017-2018 American College of Advisory Committee on Immunization Practices (ACIP) 2017-2018 Seasonal Influenza Vaccine. Review age recommendations, high-risk populations and contraindications for seasonal influenza vaccination. Discuss best practices and dispel myths your patients may believe that prevent influenza vaccination.
10/2/201712 minutes, 17 seconds
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Tonsillectomy Improves Sleep Disordered Breathing In Children - Frankly Speaking EP 35

Learning Objectives:  Understand the scope of the problems associated with sleep disordered breathing in children Review outcomes from this systematic review and meta analysis Appreciate the possible indications for surgery in children with sleep disordered breathing
9/25/201712 minutes, 27 seconds
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Putting E-cigarettes to Good Use: Evidence on Smoking Cessation Impact and Population Health - Frankly Speaking EP 34

Learning Objectives: Clarify the concerns surrounding e-cigarette use. Discuss the potential for incorporating e-cigarette use as a smoking cessation strategy for patients.
9/18/201711 minutes, 51 seconds
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Treating an Abscess: When are Antibiotics Needed? - Frankly Speaking EP 33

Learning Objectives:  Know which patients are most likely to benefit from antibiotics following incision and drainage of and abscess Know which antibiotics are preferred to use for patients following incision and drainage 
9/11/201711 minutes, 55 seconds
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Infant Sleep Safety: AAP Recommendations Explained - Frankly Speaking EP 32

Learning Objectives: Discuss the most recent evidence based practice guidelines on safe infant sleep environment Discuss barriers to implementing the EBP safe sleep environment guidelines Discuss strategies to improve compliance with EBP safe sleep environment guidelines
9/4/201712 minutes, 25 seconds
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Late Breaking News: Let’s Talk About Alcohol Consumption and Health Outcomes - Frankly Speaking EP 31

Learning Objectives: Discuss the results of a longitudinal cohort study re: alcohol consumption and cognitive decline. Review U.S. Guidelines for alcohol consumption. Discuss best practice recommendations for primary care patient discussions on the use of alcohol.
8/28/20179 minutes, 22 seconds
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Help Me with My Headache—Please! - Frankly Speaking EP 30

Learning Objectives:  Review best practices in the identification of migraine headache. Discuss recent updates for the prevention and treatment of migraines. Review the use of technology in the care of headache patients.  
8/21/201711 minutes, 8 seconds
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Practical Approaches to the New Guidelines on Breast Cancer Screening - Frankly Speaking EP 29

Learning Objectives: Review and compare current EB guidelines from the ACS, ACOG and USPSTF Discuss breast cancer risk and its impact on screening recommendations Discuss strategies to apply guidelines in practice
8/14/201714 minutes, 5 seconds
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E-Cigarettes – Risks of Teen Vaping - Frankly Speaking EP 28

Learning Objectives: Discuss the history of e-Cigarettes and how they function Discuss the findings of the recent meta-analysis/systematic review regarding US teen use and the association with future tobacco smoking behavior Discuss the potential public health concerns, implication for health policy and best practice for family and pediatric providers
8/7/201711 minutes, 39 seconds
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The American Heart Association Update on the Role of Fat in Your Diet - Frankly Speaking EP 27

Learning Objectives: Discuss the AHA position statement on fats in the diet Review the types of fat and what is known about their relationship to heart disease Recommend a dietary approach that is based upon best evidence
7/31/201710 minutes, 29 seconds
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The Opioid Epidemic: Is Your Practice Changing? - Frankly Speaking EP 26

Learning Objectives: Discuss the findings of Martins et al survey results in the context of primary care practice Identify validated tools useful in your practice to identify opioid misuse Discuss methods to promote effective pain management including utilizing safe prescribing strategies
7/24/201712 minutes, 7 seconds
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Artificial Sweeteners: Does Diet Soda Do More Harm Than Good? - Frankly Speaking EP 25

Learning Objectives: Review how the correlation of artificial sweeteners and CNS outcomes were related Summarize how artificial sweeteners may increase risk for obesity and Type 2 Diabetes Remind listeners that use of sucrose in appropriate dosages is safer than artificial sweeteners
7/17/20179 minutes, 30 seconds
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Whole Milk Does Not Increase Adverse Cardiovascular Outcomes - Frankly Speaking EP 24

This podcast reviews the results of a meta-analysis that found no negative relationship between whole milk consumption and cardiovascular disease or with mortality. Learning Objectives Understand the rationale that led to decreased milk intake in the 80's and 90's Appreciate how a meta analysis can shed light on the role whole milk might play on heart disease Be reminded that using "logic" without scientific rigor can lead to false conclusions
7/10/201711 minutes, 21 seconds
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Here’s to Your Health: What Meat Shall You Eat? - Frankly Speaking EP 23

Teaching patients lifestyle management strategies to improve health is no easy task. First steps involve increasing provider knowledge of the impact foods have on health. This episode discusses the latest evidence on different types of meat intake and meat associated compounds on health.   Learning Objectives: Review the current evidence on meat intake and mortality Discuss the “real” world impact for patients in primary care
7/3/201710 minutes, 35 seconds
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Fruit Juice and Kids: How Sweet it is - Frankly Speaking EP 22

Kids love fruit juice. But how much is OK? What are the facts on fruit juice consumption in kids and what should you advise the families you care for? In this episode, we will discuss the latest recommendations from the American Academy of Pediatrics and how they may impact your practice. Learning Objectives: Identify the AAP recommendations for fruit juice consumption across childhood from infancy through adolescence Discuss health risks associated with increased fruit juice consumption Discuss strategies to promote healthy consumption of beverages in children and families
6/26/201710 minutes, 27 seconds
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New Simpler HPV Vaccine Schedule - Frankly Speaking EP 21

HPV immunization has been recommended for pre-teens and teens for over a decade, however vaccination rates remain low. In October 2016 the CDC changed their recommendations to 2 doses of HPV vaccine in teens before their 15th birthday (from 3 doses), does this make it easier for completion?  Learning Objectives: Review the current recommendations for Human Papilloma Vaccination (HPV) in the young adolescent population including immunogenicity. Discuss the prevalence of HPV and associated diseases and cancer Review strategies to increase vaccination rates
6/19/20179 minutes, 9 seconds
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Are Short-term Corticosteroids Dangerous? - Frankly Speaking EP 20

Corticosteroids are often prescribed for short-term use for conditions such as asthma exacerbation, contact dermatitis, gout, and Bell’s palsy. Adverse effects from chronic use of corticosteroids is well known, but many clinicians believe that the risk of significant adverse effects from short-term use is minimal. A recent retrospective cohort study was done reviewing the records of 1.5 million adults to assess the adverse effects of treatment with corticosteroids for less than 30 days. Learning Objectives:  Review the conditions for which corticosteroids may be used for short-term treatment Understand the potential risks associated with short-term treatment Understand the magnitude of the potential risks relative to possible benefits
6/12/20178 minutes, 58 seconds
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Alternate-day Fasting for Weight Loss - Frankly Speaking EP 19

Is Alternate day fasting the future of weight loss?  Maybe not... Learning Objectives Understand how Alternate day fasting is practiced Appreciate why Alternate day fasting might make physiologic sense Review the recent literature on its strengths and weaknesses
6/5/201711 minutes, 30 seconds
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Do Corticosteroids Decrease the Pain of Acute Pharyngitis? - Frankly Speaking EP 18

When patients present with symptoms of a sore throat, an option for managing the pain  that is sometimes used is corticosteroids. A randomized trial of a 1-time dose of 10 mg in patients with moderate to severe pharyngitis who were deemed to not need antibiotics found higher rates of symptom resolution at 48 hours. Learning Objectives: Understand potential benefits of corticosteroids for treatment of pain of acute pharyngitis Understand limitations of evidence for benefit Understand other options for symptom relief
5/29/201710 minutes, 24 seconds
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Contraception: The Pill Needs to Share - Frankly Speaking EP17

Sensitive and important conversations with your adolescent population include contraceptive options.  How do long acting reversible contraceptive methods (LARC’s) fit into your conversation?  Let’s discuss a recent review and update your talk! Learning Objectives: Discuss the use of long acting reversible contraceptive methods (LARC’s). Describe the efficacy or LARC’s compared to other birth control methods. Describe communication strategies useful in discussing contraception with adolescents. 
5/22/20178 minutes, 22 seconds
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Safe and Effective Narcotic Use in Chronic Pain - Frankly Speaking EP 16

Based upon CDC data of death, narcotic prescription length of less than 5 days provided the best outcomes and the lowest risk of continued narcotic use. Learning Objectives: Understand the scope of the death attributable to narcotics Learn how to prevent a patient from becoming dependent upon opioids Consider methods to wean off opioids and use other proven agents for chronic non-cancerous pain
5/15/201713 minutes, 29 seconds
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Oxygen for patients with STEMI: Who benefits? - Frankly Speaking EP 15

Oxygen is frequently  given to patients routinely during the initial treatment of a myocardial infarction, but there is a lack of data to support or refute this. A recent systematic review found no benefit in patients who did not have baseline hypoxia. Oxygen therapy continues to be indicated for those with hypoxia and needs to be used with caution in COPD patients with carbon dioxide retention. Learning Objectives Understand the role of oxygen in the management of acute myocardial infarction Understand the potential for harm of unnecessary oxygen therapy
5/8/201711 minutes, 19 seconds
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Back Pain is Here to Stay! - Frankly Speaking EP 14

What are your evidence-based strategies for managing acute, subacute and chronic low back pain?  A review of the current American College of Physicians Clinical Practice Guideline can renew your toolkit as you help your patients with back pain maintain a healthy and active lifestyle. Learning Objectives Review the latest guidelines on acute, subacute and chronic low back pain (ACP 2/2017) Discuss non-pharmacologic and pharmacologic therapies available to the primary care provider
5/1/201712 minutes, 8 seconds
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When Can We Start Preventing Recurrence of Acute Gout? - Frankly Speaking EP13

Most patients who suffer an acute gout attack should be started on urate lowering therapy. It is known that starting urate lowering therapy can itself precipitate a gout attack and concern for not worsening the acute symptoms has been the reason some guidelines recommend waiting until after the acute episode has subsided to start urate lowering therapy. A look at recent data indicates waiting for the acute attack to subside may not be necessary Learning Objectives: Understand the principles of urate lowering therapy for preventing gout attacks Be familiar with the risks and benefits or starting urate lowering therapy during an acute gout attack
4/24/201711 minutes, 10 seconds
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Constipation: Going With the Flow - Frankly Speaking EP12

In this week's podcast episode, we will review recent literature on ineffectiveness of laxatives and learn about indications for newer agents. 
4/17/201713 minutes, 42 seconds
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Physical Activity Following a Concussion - Frankly Speaking EP11

In this podcast episode, we will discuss current guidelines for a concussion evaluation or work-up as well as return to activity following a concussion. We will also put into context this paper and consider what impact this should have on your practice.
4/10/201718 minutes, 36 seconds
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Treating Systolic Hypertension in the Elderly - Frankly Speaking EP10

In this podcast episode, we will talk about how systolic hypertension effects outcomes, put into context a recent JACC systematic review paper on the topic and JNC 8 and discuss NNT and NNH.
4/3/201714 minutes, 40 seconds
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Obstructive Sleep Apnea: Recommendations for Screening Adults - Frankly Speaking EP9

In this week's podcast episode, we will identify the known health risks of OSA and outcomes of OSA treatment, discuss the new USPSTF screening recommendations on OSA and consider application of the new recommendations, known risks and outcomes of practice.
3/27/201715 minutes, 6 seconds
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Non-Fasting Lipids for Cardiovascular Risk Evaluation - Frankly Speaking EP8

In this podcast episode, we will consider the rationale for using non-fasting labs to screen for ASCVD as well as review the controversies around their use and talk about the differential diagnosis of hypertriglyceridemia.
3/20/201714 minutes
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Helping Kidney Stones Pass: Use of Alpha Antagonists – Frankly Speaking EP7

In this podcast episode, we will talk about the benefits of alpha antagonists on passing larger kidney stones as well as discuss the need for stone collection and analysis to prevent future stones. We will also learn how to effectively counsel patients about alpha antagonist use including risks and benefits.
3/13/201717 minutes, 44 seconds
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Breast Cancer and the Harms of Overdiagnosis - Frankly Speaking EP6

In this podcast episode, we consider the premise of overdiagnosis and how it applies to women being screened for breast cancer and highlight ways to mitigate the risks of overdiagnosis of breast cancer.
3/6/201717 minutes, 48 seconds
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Weekend Warrior: Exercising on the Weekends can be enough - Frankly Speaking EP5

Objectives: Appreciate the data on different exercise timelines Learn new options when counseling patients for exercise Understand the need to include exercise counseling for most adults
2/27/201715 minutes, 34 seconds
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Easy Management of Statin Induced Myalgias - Frankly Speaking EP4

Have a patient with Statin Induced Myalgias? This episode will give you the best evidence on a simple and cost effective solution, and dispel common myths about this problem.
2/17/201716 minutes, 45 seconds
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Introduction of Food to Infants: Preventing Peanut Allergies - Frankly Speaking EP3

Can peanut allergy be prevented in children? This podcast will review the newest AAP recommendations on feeding in the first year of life, with a special emphasis on preventing atopic disorders. After listening to the podcast, listeners will be able to summarize essential points of current AAP EBP guidelines for introduction of complementary foods to infants and current EBP recommendations for introducing potentially allergenic foods, specifically peanut products, to low risk and high risk infants. 
1/25/201713 minutes, 55 seconds
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Getting the Complicated Asthmatic Under Control - Frankly Speaking EP2

This episode will build on the previous podcast with a focus on how to apply the management guidelines in Asthma with a focus on critical features to know for board preparation.
1/24/201718 minutes, 36 seconds
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Asthma: Critical Risk Stratification to Decide Care - Frankly Speaking EP1

This episode will review the basics of asthma diagnosis and management, covering the critical content for both patient management and board preparation.
1/10/201715 minutes, 14 seconds