Explore every episode of the podcast NB Hot Topics Podcast

Welcome to the latest Hot Topics podcast from NB Medical with Dr Neal Tucker. Three great pieces of research, all from the New England Journal of Medicine, to discuss today. 

First up. Retatrutide - how effective is this injectable weight-loss medication? Can it help other problems like knee OA and OSA? Is there a downside?

Second, starting statins in the elderly. Is there any benefit in over-70-year-olds?

Third, can the Galleri multi-cancer early detection blood test improve the stage of cancer at diagnosis? We now have strong NHS data, but what does it show? 

References

Retatrutide and weight loss

Retatrutide editorial

STAREE trial

STAREE editorial

NHS Galleri trial

Galleri editorial

www.nbmedical.com/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 texting 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)

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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

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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  

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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

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the fourth in our series of special podcasts where we talk to interesting and influential people from the world of general practice.

In this interview, we talk to Dr Helen Salisbury, GP & BMJ columnist.

A working GP for more than 20 years, Helen has also reached the wider medical community through her regular column in the BMJ. A fierce advocate for general practice, we talk about her career, how general practice has changed over the past 20 years, what writing for the BMJ involves, her work with the BMA and vision for general practice in the future.

www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. This week we look at three new pieces of research.

First, we have a paper in the BMJ exploring arterial thrombosis risk with modern hormonal contraceptives including newer treatments such as the combined patch and ring. Second, we have a BJGP paper looking at which type of safety net advice is the most effective. Finally, a new paper in JAMA Internal Medicine collates trials on anti-virals for influenza. Can any of them provide genuine benefit? 

And don't forget our NB Plus offer - £25 discount on an annual subscription until the 17th of February.

Resources

BMJ

BJGP

JAMA

Healthier Together patient info

www.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the third in our series of special podcasts where we talk to interesting and influential people from the world of general practice.

In this interview, we talk to Dr Euan Lawson, GP and editor of the BJGP.

The journal will be familiar to all clinicians in general practice and has gone from strength to strength over the past few years. We talk about his career and how he became editor, discuss the world of research including the most influential papers published during his tenure, consider the importance of inclusion health in the changing face of GP, and discuss his vision for the future.

And remember our recent NB Clinic in Inclusion Health can be watched on demand here.

www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. A belated Happy New Year! In our round-up of new research, we look at three papers.

Firstly, what have been the effects of increased hybrid working in general practice, particularly with the introduction of digital tools and triage?

Secondly, do patient decisions aids help patients with choices on anticoagulation in AF and does this help us?

Finally, can appendicitis be safely treated with antibiotics and could we be doing this in general practice soon?

References

BJGP Hybrid working in general practice
BMJ Patient decision aids in AF
Lancet Appendicectomy vs antibiotics in kids

www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. It's Christmas time and that means a song to get you in the festive spirit. We'll be back with the regular podcast in the New Year. 

Happy holidays everyone!

Neal

www.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the second in a series of special podcasts where we talk to interesting and influential people in general practice.

In this interview we talk to Dr Katie Bramall-Stainer, GP and chair of the BMA GPC England, who is currently leading much of UK general practice through 'collective action'. We talk about her career and how she came to her current role, about the BMA collective action in England and what impact this is achieving, and what is the end goal for general practice in England.

www.nbmedical.com/podcast

References

BMA GP Collective action site

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 research papers.

Firstly, can eating chocolate actually reduce our chance of type 2 diabetes? Sounds too good to be true... Secondly, could a blood test predict your 30-year cardiovascular risk? Finally, how does general practice access going digital affect minoritised ethnic populations?

Look out next week for the second of our special interviews. We talk to Dr Katie Bramall-Stainer, chair of the GPC in England, about what does she hope general practice will look like in the future and the effects of collective action in England.

References

BMJ Chocolate vs diabetes
NEJM 30 year CVD risk prediction
BJGP Digitalising GP access and minoritised ethnic populations

www.nbmedical.com/podcast

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. 

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

www.nbmedical.com/podcast

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

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  Wondering where the sunshine is? Then this song is for you. Have a good summer everyone and the podcast will be back in September.

In the meantime have a look at www.nbmedical.com for our latest courses - we have live webinars for the new Hot Topics course, our new Paediatrics and Child Health course, our updated dermatology course and much more in September.

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  School's out for summer but general practice never stops. This week we look at the medical news story of the week: donanemab for Alzheimer's disease - can this monoclonal antibody revolutionise dementia care?

Also in research, prevention is better than a cure, so can a Mediterranean-DASH diet keep cognitive decline at bay? For you weekend warriors out there, is cramming exercise into the weekend as good as exercising throughout the week. A new paper in JAMA answers this question. And is there ANY role for opioids in acute back pain? A new Australian study goes strong to see if there is benefit with this common problem.

Don't forget to check out all our upcoming courses including the new Hot Topics course in September and much more on www.nbmedical.com.

References

JAMA Donanemab
NEJM MIND diet for dementia prevention
JAMA Weekend warriors and CVD risk
Lancet Opioids for Low back and neck pain

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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  NHS Long Term Workforce Plan is all over the news today. In this episode we have a look at some of the key statements, seeing what is positive for general practice, what is wishful thinking, and what could be even worse.

In research we look at new observational data from Denmark, published in the BMJ, finding an association between HRT and dementia; also a study examining the effectiveness of an intra-pulmonary artery device for identifying earlier deterioration of heart failure; and two papers in the NEJM on more weight loss medications for obesity.

References

NHS Long term workforce plan
BMJ HRT & dementia
Lancet HF device
NEJM Retatrutide & Orforglipron

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