NB Hot Topics Podcast

Welcome to Season 8 of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Lots of research, as usual, and some future medicine too. Do NHS health checks actually make a difference, or is it a waste of everybody's time? This month's BJGP has the answer. From the BMJ this week, which exercises should we recommend to patients (and ourselves...) to maintain bone mineral density and prevent fractures , and how long do we need to exercise for it to make a difference? And in JAMA, does t exting or emailing patients boost statin use in patients who don't really want to take statins, or can we save ourselves some typing? Finally, in Future Medicine, lipoprotein(a) . What is it, why should we care, and what can you do about it? References BJGP NHS Health checks and mortality BMJ Best exercises for BMD JAMA Statins vs text messages Lancet Kylo 11 and lipoprotein(a) www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this summer sizzler, we have three new pieces of research for clinicians in general practice. First, do antihistamines help with managing atopic eczema, or do they do more harm than good? Does which one we use matter? Second, exploring the pain relief achieved by opioids in the short and long term . Are there new lessons to be learned? Third, for an alternative way of managing chronic MSK pain, could self-directed CBT be the solution ? References BMJ Antihistamines and eczema UK data on use of antihistamines for eczema Eczema Care Online BJGP Opioid effects on pain over time JAMA Self-directed CBT for chronic MSK pain Podcast on chronic pain with Rangan Chatterjee and Howard Schubiner www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new pieces of research and a special interview later on discussing the recommendations of the National Screening Committee on prostate cancer screening in the UK. First up for research: nasal sprays versus the common cold . The BJGP reports on longer-term findings through this simple intervention. Can it help this age-old problem? Second, new kid on the block, orforglipron - could it replace SGLT2 inhibitors for management of type 2 diabetes? Third, home-based hypnotherapy. Can it help children struggling with functional abdominal pain or IBS? We have a RCT to tell us. Finally, our interview with Dr Liz Bancroft, consultant nurse in oncogentics research, and Natalia Norori, interim Head of Data and Evidence at Prostate Cancer UK join us to discuss the new recommendations from the National Screening Programme with targeted screening of men with BRCA2 , why they made this recommendation and how this affects us in general practice, plus what we need to know for our patients about the government-backed trial, TRANSFORM. References Prostate Cancer UK Information on NSC decision Prostate Cancer UK Health Professional NSC FAQs National Screening Committee report on prostate cancer screening BJGP Nasal sprays for the common cold Lancet Nasal Sprays original paper Lancet Orforglipron vs dapagliflozin and T2DM BJGP Hypnotherapy in children for abdo pain National Screening Committee report on prostate cancer screening www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Lots going on in this new episode! Three new pieces of research and an interview with Dr Anna Martinez, consultant paediatric dermatologist at GOSH, talking about a skin fragility condition many of us may not have heard of before - epidermolysis bullosa - in conjunction with DEBRA, the leading charity for EB awareness and research. In research, we look at two papers published this week in finerenone . Does it have a role in CKD management in patients without diabetes, and if so, how good is it? Second, retatruide - the latest injectable weight loss medication making a splash across the headlines - could it be used as monotherapy for recent onset type 2 diabetes? Resources NB Medical Epidermolysis bullosa free online educational module DEBRA NEJM Finerenone for CKD Lancet Finerenone MA Lancet Retatrutide for early T2DM www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker . More new research to discuss for the world of general practice. First, which antibiotic is actually best for managing uncomplicated UTI - is UK guidance offering the best choice to women? Second, are you using the Kidney Failure Risk Equation in your patients with CKD? New research on how your risk of death may be much more important than your risk of end-stage renal disease . Finally, does empathy work in telephone consultations, and can it improve important hard outcomes such as symptom control? References Lancet Abx for UTI BJGP Kidney Failure Risk Equation, Death and ESRD Kidneyfailurerisk.co.uk BJGP Empathy and the telephone CARE measure www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new pieces of research that affect us in general practice. First: What interim anti-coagulation would you give your patient with suspected VTE? One common option has 5 times the rate of major bleeding. Second: How much muscle mass do people lose with weight loss on GLP1s ? Is this different from lifestyle-based interventions, and is there anything patients can do about it? Third: Why don't we use clinical decision support tools for cancer? This research looks at the barriers and then I over-share my own thoughts on the subject... References NEJM Apixaban or rivaroxaban bleeding risk with acute VTE Diabetes, Obesity & Metabolism Lean mass loss with incretin therapies vs lifestyle interventions BJGP: Why don't we use clinical decision tools www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Three new research papers to help us along our way in general practice this month. First, how long do modern hip replacements last? How does this new data change our conversation with patients? Second, it's thought GLP1 agonists could have a role in addiction management, but so far, research has failed to show a definitive benefit. Could new data from the US on veterans with type 2 diabetes show a different picture? Finally, what analgesia would you recommend for a child in pain? This new paper compared ibuprofen with or without paracetamol or hydromorphone - yes, an extremely potent long-acting opioid for kids. Good idea? We find out. References Lancet Hip replacement longevity Lancet THR Editorial BMJ GLP1ra and addiction BJP editorial JAMA Analgesia and Child www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.Three new pieces of research to talk about in today's podcast. First, in the NEJM - could patients stop anti-coagulation after ablation for AF? Conventional practice says no. Does this paper change that? Second, in JAMA - can spinal manipulation, or clinician-guided self-management, or both help with low back pain? This paper is a good crack. Finally, in the BJGP - what do our patients think about advance care planning? Should we be talking about this more, and, if so, in whom and how? References NEJM Anti-coags after ablation in AF NEJM Editorial JAMA Low back pain BJGP Advance care planning www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new and interesting research papers to look at. First, hitting the headlines this week, weight regain after cessation of GLP1 receptor agonists . Not a surprise, perhaps, but how fast does the weight come back, can anything be done to prevent it, and what are the implications for patients and the NHS? Second, orforglipron - the new GLP1ra on the block and an oral treatment. Can it help weight loss and improvement in cardiometabolic markers in patients with obesity and type 2 diabetes? Finally, which is better for treating scabies - permethrin or oral ivermectin? Would a tablet be an easier option, or is it just not as good? References BMJ Weight regain after cessation of weight loss medications BMJ Editorial BMJ Opinion BMJ Side Effects of GLP1ras NEJM Orforglipron RCT in obesity Lancet Orforglipron RCT in obesity and T2DM BMJ Scabies treatment - ivermectin or permethrin? PCDS Scabies guideline BAD Scabies guideline www.nbmedical.com/podcast

Welcome to the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Merry Christmas, everyone! This is a special edition on empathy in general practice. Does it matter, and what does the research tell us? Can not being a grinch in surgery make a difference to our patients and ourselves? We are joined by NB colleague Dr Andy Ward , who is also Associate Professor of Medical Education and an Honorary Senior Academic General Practitioner at the Stoneygate Centre for Empathic Healthcare at the University of Leicester, who is going to get us through the data and explain why empathy might help get us through the festive period in practice too. References Stoneygate Centre for Empathic Healthcare website BJGP Just Do It! Ten Easy Ways To Enhance Empathy in the Consultation www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new and interesting research papers to look at. First, new data on the effects of social media use and cognitive development in younger adolescents . Is it really a problem? Second, can a simple urine sample be as accurate as a smear test for identifying cervical HPV , and what do women feel about this? Finally, if you're struggling to sleep could Tai chi be better than CBT for insomnia ? References JAMA SM & cognitive development JAMA Editorial BJGP Urine vs smear for cervical HPV BMJ Tai chi vs CBTi for insomnia www.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we look at three new pieces of research and have a special interview in conjunction with Prostate Cancer UK . First, do antidepressants have physiological side effects? How do they compare to each other, and how does this influence what we prescribe to whom? Second, exercise is a key treatment for knee osteoarthritis, but which type is best ? What should we recommend to our patients? Third, how has PSA testing changed over the past two decades? Is there variation in testing in high-risk groups? Discussing this further, we are joined by Dr Bunmi Olajide, a GP with a special interest in cancer, and Kevin Howell, Black Health Equity Engagement manager for Prostate Cancer UK. Resources Lancet Anti-depressants and physiological side effects BMJ Knee OA and Best Exercises NEJM Knee pain and home exercises BMJ PSA testing trends in England PCUK PSA Consensus statement 2024 PCUK Guide for Counselling Patients on the PSA Blood Test PCUK Online Education www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker! In this episode, we talk about some real research rather than stuff made up by over-tanned heads of state. Three papers. First, can researchers fill the gap on whether anti-inflammatory reliever therapy is best for mild asthma ? Second, how effective are SCAN pathways for suspected cancer in patients with non-specific symptoms who don't meet site-specific referral criteria, and what lessons can we learn from years of referrals? Third, how do the numbers of licensed GPs differ from actual GPs working , and how does this all compare to what's happening with hospital consultants? References Lancet AIR for kids asthma Lancet Primary Care SCAN referrals BMJ Trends in practising GPs www.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker . In this new season, we chat to Dr Simon Curtis about the upcoming Autumn 2025 Hot Topics course, then discuss three new pieces of research. First, in the Lancet, which are the best anti-hypertensives , what effect does increasing a dose actually have and how good are combinations? Second, in the NEJM, does giving all the drugs improve CKD outcomes ? The case for finerenone and empagliflozin. Third, do ADHD drugs help outcomes beyond core symptoms such as accidents, suicide and crime? But can we rely on the research method used...? References Lancet Antihypertensive Efficacy Paper NEJM Finerenone & Empagliflozin Report on trends in CKD BMJ ADHD meds & prevention of complications www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. I hope you are all enjoying the summer and that your IT treats you well. In this podcast, we have two new studies to think about. First, should children with gastroenteritis be given anti-emetics? Would ondansetron help and improve outcomes? Second, can methotrexate help knee osteoarthritis? It would be great if this would work, but hope only gets us so far. What does the research show? References NEJM Ondansetron in GE in kids JAMA Int Med Methotrexate and knee OA www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. While everyone tries to unpick the new NHS 10-year plan, we focus on the here and now with three new pieces of research. We kick off with two gems in the BJGP - first, examining whether anti-depressants actually help with insomnia , and second, whether anti-depressants cause postural hypotension in older people, and which may be the worst. Finally, we look at a good news story, with data publishing on a new treatment for cancers linked to mismatch repair genes . References BJGP Insomnia paper BJGP Anti-Ds and postural hypotension paper NEJM dMMR gene cancer therapy www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we look at three new pieces of research with implications for general practice. Firstly, can exercise prevent the recurrence of colorectal cancer ? Short answer, yes. But how much exercise did you need to do, and what on earth is a MET? Secondly, what are the concerns around low-dose amitriptyline use for IBS from patients and GPs ? How can we aid the discussion? Finally, can SLGT2 inhibitors improve liver disease ? Is this the new treatment for our patients with MASLD (the condition formerly known as NAFLD? References NEJM Exercise and CRC METs Wikipedia BJGP IBS & amitriptyline prescribing BMJ SGLT2i & MASLD NB Blog MASLD: The rebrand you never heard of www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this edition, we look at three new pieces of research. First, in the BMJ, a paper exploring whether a GP-led psychological intervention can help PTSD symptoms in our patients after ICU. Could this also be successful for other forms of trauma? Second, in the Lancet, research looking at whether semaglutide can improve walking distance in patients with diabetes and intermittent claudication . Finally, in the BJGP, can a practice-led physical activity intervention improve symptoms in survivors of cancer ? Will anyone actually want to do it? The answer, and who, may surprise you. References Poor by Katriona O'Sullivan BMJ PTSD paper Lancet GLP1ra and PAD BJGP Physical activity and cancer survivors Moving Medicine www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we are joined by Dr Stephen Bradley, lead author of a new paper published in the BJGP looking at rates of CXR use in general practice and how this influences lung cancer stage at diagnosis and mortality . He discusses the findings of his research and how this might influence our practice. In other research, we look at a new paper in the BMJ on orthostatic HYPERtension - yes, you read that correctly - does treatment help, and does it really matter in the first place? And from the Lancet, research looking at the role of urodynamic studies in women with refractory overactive bladder - does it improve outcomes, or should it be stopped? References BMJ Orthostatic hypertension and BP treatment BMJ OH editorial Lancet Refractory overactive bladder & urodynamic studies BJGP CXR in GP & lung cancer staging and mortality www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we look at three new papers with practice-changing consequences. Firstly, can treating partners of women with bacterial vaginosis prevent recurrence? Secondly, can semaglutide be effective in alcohol misuse? Finally, is tirzepatide an effective treatment for pre-diabetes in people with obesity (take a guess...!)? References NEJM Male partner treatment for BV JAMA Psychiatry GLP1a & alcohol NEJM Tirzepatide for Pre-diabetes www.nbmedical.com/podcast