There’s a new cholesterol lowering drug in town and its ability to lower cholesterol is like nothing we’ve ever seen before. It’s called Evolocumab, (trade name Repatha) but is it any good at reducing cardiovascular disease? This week, we delve into the FOURIER trial – a humongous randomised controlled trial that will answer this question.… Continue reading #13 Lowering cholesterol with evolocumab and cardiovascular risk
Night time leg cramps are very common and can ruin sleep. One study surveyed 490 veterans and found that 60% of them had suffered from night time leg cramps and 1/4 of those had them regularly. A lot of people use magnesium to ease their nocturnal cramps and they often swear by them, but do… Continue reading #12 Magnesium for Leg Cramps
Otitis media, or middle ear infection, is a very common issue. It is the second most common reason for a child to see a GP and is the most common reason antibiotics are prescribed to children. According to a large Australian database called the BEACH data, 80% of kids with otitis media are prescribed an… Continue reading #11 Antibiotics for Otitis Media with Paul Glasziou
Opioid addiction has been increasingly recognised as a public health crisis: Deaths from prescription painkillers have now surpassed the deaths from heroin. Opioid use disorder has risen 500% from 2010 to 2016 in the USA For the first time in history, the Surgeon General sent a letter to every single doctor in America. That’s over… Continue reading #10 Likelihood of chronic opioid use after first prescription
We want to reduce the use of antibiotics but at the same time we also want to keep our patients satisfied. Otherwise, they’ll just go and find another doctor. This week we look into a really great study that compared refusing to give that antibiotic script, to giving them the script straight away, to a… Continue reading #9 Delayed Antibiotics
Introduction The reason doctors like to lower their patients cholesterol is to decrease their risk of developing cardiovascular disease. There is no point decreasing cholesterol levels if it has no impact on cardiovascular disease. Ezetimibe (Zetia, Ezetrol or Vytorin when in combination with simvastatin), was on the market for 13 years before the manufacturers finally… Continue reading #8 Does Ezetimibe IMPROVE-IT?
Background Testosterone levels seem to naturally decline as men age. There has been an enormous rise in the amount of testing and treatment of this natural decline in testosterone. Testosterone clinics have been popping up all over the place and promise that treatment will restore energy, improve depression, increase libido and enhance overall well-being. In… Continue reading #7 Testosterone Trials – Should we treat age related testosterone deficiency?
Calcium channel blockers and alpha blockers are both smooth muscle relaxants and so could theoretically relax the smooth muscle of the ureter and speed up the passage of kidney stones. Given that kidney stones can take several weeks to pass and often are rated as 10/10 pain, treatments to speed up the passage of stones… Continue reading #6 Medication to speed up kidney stone passage
For show notes including all the results for this trial: http://www.ebmpodcast.com/breech The Term Breech Trial is one of the most important clinical trials in the history of obstetrics and has changed the way we manage breech presentation across the world. The term breech trial was as randomised controlled trial comparing planned caesarian section to planned vaginal… Continue reading #5 Caesarian Section versus Vaginal Delivery for Breech Presentation – The Term Breech Trial
This episode delves into the highest quality trial ever done on the treatment for warts. This randomised controlled trial published in the CMAJ compared cryotherapy with liquid nitrogen to salicylic acid wart creams to doing nothing. 250 patients were recruited in primary care and follows up for 13 weeks, The primary outcome was complete resolution… Continue reading #4 Wart is the best treatment for warts?