Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. To DRE or not to DRE? This is the question and the main event in this episode.

We have a fantastic interview with Amy Rylance, Head of Improving Care at Prostate Cancer UK, and Sam Merriel, GP and academic clinical lecturer, discussing their recent Clinical Practice paper in the BJGP: Is the digital rectal exam any good as a prostate cancer screening test?

In other research, we have two papers with a common theme. Firstly, a paper in the BMJ looking at long-term outcomes after diagnosis with atrial fibrillation, and secondly, a paper in the BJGP examining the role of BNP testing as a marker for future cardiovascular disease in patients with a new diagnosis of hypertension. Both show that while these conditions make us think of stroke and MI, we also should be thinking about heart failure.

Resources

BJGP Clinical Practice paper on DRE for prostate cancer screening
Prostate Cancer UK Patient Risk Checker
European Urology Oncology Journal Performance of DRE in PCa Screening
NEJM 2004 Prevalence of PCa in men with a PSA <4
BMJ AF and future risk paper
BJGP HT and future risk paper

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Welcome back to the Hot Topics podcast from NB Medical with host Dr Neal Tucker. In this episode, we start by thinking about the news. Firstly, the overwhelming consensus from GPs in England to not support the imposed contract.

Secondly, the ongoing discussion around physician associates in general practice, where we touch on an interesting report from South Mississippi around the costs and other outcomes of non-doctor-led primary care. Thirdly, NHS patient satisfaction - is important to take note but why does staff satisfaction never hit the headlines?

In research, we look at two papers. First, the rate of familial hypercholesterolaemia coded in practices - how far are we away from what we should expect? And in those with a diagnosis, how good are we at optimally treating them? Second, a paper on which interventions might help people maintain their independence. After an estimated £1.15 billion pounds of research in this area, what does this new systematic review and network meta-analysis tell us?

References

AMA Report on PA/NA from South Mississippi
NHS Staff Survery Results
BJGP Familial Hypercholesterolaemia rates in GP
NICE Guideline FH
Simon Broome Diagnostic Criteria for FH
BMJ Community Interventions to Maintain Independence

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Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about another year of imposed GP contract on practices in England, the BMA response and where it may lead. 

In research, we have three fascinating new papers. Firstly, a paper examining how to maintain weight loss after a low-calorie diet – is structured exercise, liraglutide or both better than usual care? Secondly, in the BMJ a systematic review exploring whether exercise should be considered a genuine treatment for depression. And finally, in the NEJM, a study looking at the link between microplastics in carotid arterial plaques and subsequent risk of cardiac vascular events (hint: it’s not good news…).

References

BMA GP Contract Changes 2024/25

Pulse Editorial

Lancet Discovery Science paper on weight loss maintenance

Weight maintenance author interview

BMJ Exercise and Depression

NEJM Micro/nanoplastics in your arteries

NEJM Microplastics editorial

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Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we think about the pay offer for practices in England, a new King’s Fund report on the under-funding of primary care for three decades, and the introduction of Pharmacy First. 

In new research, we have two papers. First, in the BMJ, can an online combined exercise and psychological programme improve quality of life for patients struggling after hospitalisation with covid? Second, in JAMA, can serum urate levels help predict future flares of gout and guide us on who might benefit the most from urate-lowering therapy

References

Kings Fund Report on Primary Care

BMJ Post-covid-19 syndrome and online programme

JAMA Serum urate and recurrent gout

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Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we consider the current state of general practice in the UK and what lessons the countries can learn from each other.

We examine a new paper in the BJGP on how patients feel about general practice in Scotland since the introduction of the 2018 GP contract. Is it meeting patient and policymaker goals?

In other research, we see what lessons a new paper in JAMA on weight loss and cancer association can tell us about a seemingly obvious connection, and from the NEJM what effect testosterone replacement for hypogonadism has on men's fracture risk.

References

BJGP Patient experiences of Scottish GP paper
BJGP Family physician's moral distress when managing health inequalities
JAMA Cancer diagnoses after weight loss
NEJM Testosterone replacement for hypogonadism and fracture risk

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Welcome to the Christmas Hot Topics Podcast from NB Medical with Dr Neal Tucker. It’s time for a bit of light-hearted festive fun so if you’ve finished signing all your scripts for Christmas then join us for a discussion with Dr Stephen Bradley and Dr Alice Harper about “Great Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultations”.

This new paper explores how long it REALLY takes to do everything that’s recommended in clinical guidance. If you’ve ever felt like there just isn’t enough time in your general practice day, this might explain it, and you are not the only one.

Merry Christmas everyone, see you in the New Year. Neal

References

Great Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultations

The Health Foundation: Identifying Operational Failures in General Practice

BMJ Guidelines should consider clinicians time needed to treat

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we talk to Prof Hazel Everitt, a GP and lead author of a recent Lancet paper exploring whether amitriptyline is effective for IBS, and where it might fit in to general practice management.

We also look at research in the Lancet on treating hand osteoarthritis with methotrexate - what's the rationale and does it work? - plus a BMJ paper on using a patient information leaflet to improve lower urinary tract symptoms in men. Are PILS better than pills?

Resources

Lancet ATLANTIS paper on IBS & amitriptyline
ATLANTIS trial website with patient information
Gut journal CBT for IBS
National Institute for Health and Care Research - how to get involved
NIHR Local research groups - how to get involved
Lancet Methotrexate for hand OA with synovitis
BMJ Leaflets for LUTS

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. The highlight of this episode is our interview with Prof Miriam Santer, lead author of recent research in the BMJ exploring the effectiveness of spironolactone for acne in women.

Does it work? Is it a treatment for general practice? And if so, is it safe, what monitoring is required, and where does it fit with current acne pathways?

In the news, we think about the current issues around physician associates in general practice. In research we have two papers on diabetes: first, in the Lancet, is a new once-weekly insulin injection as effective as a daily treatment for type 1 diabetes; and second, in JAMA, is the additional tirzepatide better than prandial insulin in addition to glargine for managing type 2 diabetes?

References

Eczema Care Online
BMJ Spiro for acne
Lancet Once weekly insulin vs daily insulin in T1DM
JAMA Tirzepatide vs prandial insulin in T2DM

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we talk to Dr Jessica Watson, lead author of the Why Test study, published in the BJGP exploring the use of blood tests in general practice and how often they make a difference - positive or negative.

In other research we look at a BMJ paper comparing rosuvastatin and atorvastatin for secondary prevention, and in the Lancet, the PATHFINDER study, exploring the role of multi-cancer early detection blood tests - will this be useful for diagnosing cancers earlier?

Plus the usual news, views, and a song about vaccinations.

www.nbmedical.com/podcast

References

BJGP Why Test Study
PACT - primary care academic collaborative website
BMJ Rosuva vs Atorva for secondary prevention
Lancet PATHFINDER MCED study
Lancet Editorial
RCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHS

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Welcome to the Hot Topics podcast from NB Medical with Dr. Neal Tucker. As we celebrate 25 years of NB Medical and the Hot Topics course, in this podcast we chat with co-founder Dr Simon Curtis about the changes in general practice and medical education since its inception, we discuss three of the most influential research papers over the era, and what the future may hold for GPs.

In research, we examine two new papers. The first in the NEJM is on semaglutide for patients with heart failure and preserved ejection fraction. Can it help improve symptoms and quality of life? Could it improve mortality? The second paper from the Lancet looks at a practice nurse-delivered insomnia intervention using sleep restriction therapy. Could this be a useful, cost-effective option for helping people struggling to sleep?

References

NEMJ Semaglutide + HFPEF with obesity
Lancet Nurse-led Insomnia intervention 

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Welcome to Season 5 of the Hot Topics podcast from NB Medical with Dr Neal Tucker. Despite celebrating our 25th birthday (don't forget to check out our NB Plus birthday special here) the world of medical news and research never stops.

In this episode we look at research in the BJGP about the motivations behind being a GP, whether adding NSAIDs may improve efficacy of emergency contraception, and whether we should be worried about cancer in patients with reflux.

www.nbmedical.com

References

BJGP Mapping GP Motivations
Lancet Levonorgestrel + piroxicam for EC
BMJ Non-erosive reflux and oesophageal cancer risk

www.nbmedical.com/podcast