Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the first in a series of special podcasts where we talk to the movers and shakers of general practice.

We will talk to people in GP politics, leadership, media and research and discuss how their careers evolved, how they see current general practice and how they may be influencing the future of the specialism.

We start with Dr Claire Fuller, GP and current primary care medical director for NHS England. Hugely influential, you will probably know her as the author of the Fuller Stocktake report. We discuss how she came to the job, what this report found, and how it is impacting general practice in England. 

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Welcome to the latest Hot Topics Podcast from NB Medical with Dr Neal Tucker. In this episode, we look at two new papers on the drugs de jour: GLP1 receptor agonists and SGLT2 inhibitors. Can the former reduce pain in knee osteoarthritis and can the latter prevent recurrent renal stones?

Our third paper is a consensus paper published in the BJGP on optimising PSA testing for the early detection of prostate cancer in asymptomatic men. Sponsored by Prostate Cancer UK, Neal is joined by Dr Alex Norman, a GP, and Dr Oliver Hulson, a consultant radiologist who undertakes prostate biopsy, to discuss the outcomes of this paper and the latest research in this area. For further information from Prostate Cancer UK including educational resources and webinars see the links below.

References

NEJM Semaglutide & knee OA
BMJ SGLT2i & renal stones
BJGP Consensus Paper on PSA Testing in Asymptomatic Men
NB Podcast on role of DRE in identifying prostate cancer
PCUK Prostate Cancer Education for Health Professionals
PCUK Consensus Paper Webinar

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three exciting new papers.

Firstly, in the BMJ a network meta-analysis on acute migraine treatments - can the new GEPANTs drugs beat existing therapies? Secondly, a paper in NEJM does screening for prostate cancer using MRI actually help? Finally in the BJGP can first contact physio be better than a GP appointment? Listen on!

References

BMJ Acute migraine therapies
NEJM Prostate cancer screening with MRI
BJGP First contact physio in GP

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Welcome to Season 6 of the Hot Topics podcast with Dr Neal Tucker. The summer holidays are over and it’s back to work so time for a new podcast.

In this episode, we look at research on whether SGLT2i might prevent dementia, on if it is safer to de-escalate sooner rather than later from dual anti-platelet therapy post-MI, and how effective is the new RSV vaccine at preventing hospitalisation in older people.

References

BMJ - SGLT2i & dementia
Lancet - De-escalation of DAPT post-MI
JAMA - RSV Vaccination Efficacy in Older People

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Have you ever walked into a pharmacy and wondered whether those nasal sprays suggesting they can stop the common cold actually do anything?

Ahead of the inevitable coughs and colds of the autumn, the Lancet Respiratory provides some answers and they won’t be the ones you think... Still, right now it's the summer and time to get outside and active - especially if you have recurrent back pain. We look at a paper in the Lancet exploring whether just simply walking can be the problem. Finally, from the BJGP we examine a paper looking at what being a "full-time GP" means and how, sometimes, definitions can be REALLY important.

Resources

BJGP Trends in Full-Time Working in GP
Lancet Effectiveness of Walking for Back Pain
Lancet Resp Nasal Sprays for URTIs

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Welcome to a new episode of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Today is election results day but we're not talking about politics, we're focusing on the research.

We look at a paper in the latest BJGP which looks at which factors influence a patient's decision to discontinue anti-depressants, explore a paper in the Lancet on whether a symptom-clinic led by GPs can improve outcomes for patients with multiple and persistent symptoms, and discuss trends in cardiovascular disease in the UK over the past 20 years, published in the BMJ this week.

References

NB Blog on Discontinuation of Antidepressants
BJGP Discontinuation of antidepressants
Lancet Symptom clinic
BMJ CVD trends

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Welcome to the Hot Topics Podcast from NB Medical with Dr Neal Tucker. It's election time but we're going to put aside politics and focus on the latest medical research!

In this episode, we look at an important BJGP paper highlighting the rates of follow-up after a significant asthma attack, a paper in the Journal of Infection showing the high rates of second antibiotic prescription in ongoing cough, and a RCT in JAMA examining if, as suggested by observational data, aspirin can truly prevent recurrence or metastasis of breast cancer.

References

BJGP Post-hospitalisation asthma management in primary care
BJGP  Editorial Asthma Deaths in Children
J of Infection Repeat Antibiotics for Cough
eCancer Aspirin for Cancer
JAMA Aspiring & Breast Cancer Recurrence

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about the GP workforce courtesy of four papers in this month's BJGP - does more GPs boost life expectancy (of the patients...)? do PCNs help health inequalities? is practice-based continuity as good as individual continuity?

For a more directly clinical update, we look at new research in the BMJ on which is the best oral option in T2DM after metformin. Can the SGLT2 inhibitors prove their worth?

References

BJGP Does the shortage of GPs matter?
BJGP PCNs, deprivation and funding
BJGP Continuity in GP
BJGP Continuity in Norwegian GP
BMJ Best drug after metformin in T2DM

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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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