#14 Evidence for low fat diet and decreasing saturated fat – PURE Study

Almost all guidelines are recommending that we should reduce dietary fats and restrict saturated fats. The PURE study has called to question these recommendations and in this episode, we explore the evidence. It’s very hard to find a guideline that does not recommend reducing total fat and saturated fat intake: The Australian Heart foundation guidelines… Continue reading #14 Evidence for low fat diet and decreasing saturated fat – PURE Study

#13 Lowering cholesterol with evolocumab and cardiovascular risk

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

#12 Magnesium for Leg Cramps

Cramp in calf

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

#11 Antibiotics for Otitis Media with Paul Glasziou

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

#10 Likelihood of chronic opioid use after first prescription

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

#9 Delayed Antibiotics

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

#8 Does Ezetimibe IMPROVE-IT?

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?

#7 Testosterone Trials – Should we treat age related testosterone deficiency?

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?

#6 Medication to speed up kidney stone passage

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

#5 Caesarian Section versus Vaginal Delivery for Breech Presentation – The Term Breech Trial

Breech presentation is shown on the left and is more complicated to deliver vaginally compared to the standard cephalic presentation on the right

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