In this latest episode of the Hot Topics podcast, Neal Tucker considers why the press have been attacking general practice and who stands to gain. We also look at new research in to giving anti-emetics for children with gastroenteritis, the accuracy of PHQ9 in assessment of depression and what are safe levels of air pollution.ReferencesBMJ Air pollutionBJGP Ondansetron in children with gastroBMJ PHQ 9 accuracy

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S3 E2 - The press, corporations & conspiracies; ondansetron for kids with gastro; PHQ9, what is it good for?

Welcome, to Season 3 of the Hot Topics podcast with Dr Neal Tucker.In this episode, we lament why Health Secretaries appear to hate healthcare. We also look at the rationale for covid boosters with new research on the vaccine response in the immunosuppressed and waning efficacy in the general population.In other research, can a 4-in-1 pill be a helpful 1st line treatment for hypertension?  And should we all be prescribing medical cannabis? The BMJ says yes, but not how.A technical issue today means the SQ is not my best (or muppet-itis), but I&apos;ve figured it out for next time!ReferencesBMJ Report Covid Vax & ImmunosuppressedNEJM Vaccine Efficacy 6 months onNEJM Israel & 3rd Dose ResultsLancet Quadpill & BPBMJ Medical Cannabis

S3 E1 - Heath secretaries, COVID boosters, Quadpill for BP & Cannabis for pain

In this summer holidays episode of the Hot Topics Podcast, Neal Tucker looks at the latest research for the primary care community.Firstly, three treatments for covid-19 in community-managed patients - do they work?Next rotator cuff injury - can progressive exercise beat usual care and is there ANY role for steroid injections?Finally, FIT testing for suspected colorectal cancer - do we now have the data to replace colonoscopy?ReferencesNHS England Blood Bottle GuidanceCommunity Covid and Azithromycin, Doxycycline and ColchicineLancet Rotator Cuff Injury BJGP letterBJGP editorials - infection and CVD, expanding the role of GPBJGP FIT testing

S2 E16 - Blood bottle crisis; community covid treatments; rotator cuff injury; FIT testing for cancer

In this episode, Neal Tucker squeezes in a podcast between childcare during self-isolation. When he&apos;s let out there will be a new sort of Freedom in England, should the rest of the UK be jealous? We think about rising covid numbers, how this impacts general practice (and the rest of the health service), and what role vaccination for children should play in this complex situation.Also, we look at new research on evidence-based drug optimisation strategies in multimorbid and question why they don&apos;t work and whether this matters, and antispasmodics for low back pain. Most of us prescribe them, are they really helpful?ReferencesNew Scientist Is it time for the UK to vaccination children against covid 19?JAMA Long term Symptoms After COVID infection in children and adolescentsBMJ OPERAM studyBMJ Antispasmodics in LBP

S2 E15 - Self-isolation, Freedom and GP; Drug Optimisation for the Multimorbid; Antispasmodics for Low Back Pain

In this episode of the Hot Topics Podcast, Neal Tucker considers if there is a crisis of identity in GP and how the ever-increasing workload has changed the traditional role of a GP. Is there a solution? Possibly, but not everyone will agree.In new research, we focus on new technology. Are implantable rhythm monitors helpful after stroke? Do wearable glucose monitors improve diabetes care? Is more data always better?References:BJGP Editorial from Euan LawsonBJGP Editorial from Clare GeradaBJGP Editorial on crisis of identity in GPNICE Diagnostic Guideline Implantable Arrythmia MonitorsJAMA Implantable arrythmia monitors after strokeJAMA continuous glucose monitoring in T2DMLancet continuous glucose monitoring in T1DM

S2 E14: Crisis of identity in GP; implantable arrythmia monitors for AF; wearable glucose monitors for diabetes

Approach a wounded animal with caution. Someone should have told this to NHS England before they wrote THAT letter. In this podcast in classic GP style we reflect on how this makes us feel and come to the only obvious conclusion. (We&apos;ve kept it family friendly...)Meanwhile, Neal Tucker has a look at new research on COVID vaccinations and their efficacy against variants from around the world. New data on long covid which begs the question where id the tsunami we were expecting? Also getting to the heart of general practice, is there a role for grommets in recurrent acute otitis media? And finally what intervention has an NNT of 8 to prevent death in diabetics? Here&apos;s a clue: it isn&apos;t a medication.ReferencesLancet Efficacy of Pfizer vaccine against UK variantBMJ Efficacy of AZ/Pfizer against Indian variantNEJM Efficacy of AZ against South African variantBMJ Re-infections from Brazilian variantBMJ Clinical sequalae after acute covidNEJM Grommets or medicine for recurrent acute otitis mediaLancet Bariatric surgery long term follow up

S2 E13 - Wounded animals

Welcome back! Neal Tucker takes you through the latest Hot Topics podcast from NB Medical.In this edition after a "cry for help" from a UK practice written in a 16-page letter to patients we look at new research in the BJGP on remoting consulting and ask for your thoughts on the state of general practice.Are we complicit in pathologising normal life? 8% of the population are on anti-depressants - what does new research tell us about how to withdraw them?We also explore new research on the benefits of lowering blood pressure even when it&apos;s not low, and how to improve motor recovery after stroke.ReferencesRob Walker&apos;s Blog on NB MedicalIvy Grove Practice letter to patientsBJGP paper on remote consultingCochrane review on antidepressant withdrawal and blogLancet Paper on Blood Pressure LoweringLancet Paper on Vagus Nerve Stimulation after stroke

S2 E12 - Remote consulting and the state of GP; Antidepressant withdrawal techniques; Blood pressure lowering for normotensives; Vagus nerve stimulation after stroke

The big news this week has been the risk of cerebral venous sinus thrombosis post-AZ vaccine and it&apos;s been giving us all a headache, but this has overshadowed further new data confirming benefit of inhaled corticosteroids for acute mild covid and guidance that we can offer this to older patients on a case-by-case basis.In the latest Hot Topics podcast Neal Tucker discusses the facts, figures, management and ethics of post-AZ vaccine thrombosis, reviews the Principle trial showing we now have a viable treatment for mild covid; and data on the rate of multi-organ dysfunction and death at 4 months post-hospital discharge for covid.ReferencesMHRA data on AZ vaccine and thrombosis riskCDC Data on Johnson&Johnson vaccine and thrombosis riskCDC Data on Transmission ReductionSTOIC trial Lancet RespPrinciple trialNHS recommendations from the Principle trial dataBMJ post-covid syndrome dataUnHerd Did I Give My Patients COVID?

S2 E11 - Headaches, AZ and Thrombosis; Green Light for Inhaled Steroids in GP; Risk of death on discharge post-COVID

Big news in this new Hot Topics podcast as we discuss very positive data on the role of inhaled budesonide for early mild COVID in community-based patients - the STOIC trial may radically change our management of COVID but why hasn&apos;t this been a huge story and should we wait to change our practice?Also, we look at a BMJ paper examining the risk of catching and dying from COVID if you are an adult with children at home, a Lancet paper looking at only 3 days of antibiotics for pneumonia and more data on semaglutide and it&apos;s role in weight loss and improvement in non-alcoholic steatohepatitis.References:STOIC website and pre-printBMJ COVID and kids cohort studyLancet Pneumonia trialLancet Semaglutide and weight loss in T2DMNEJM Semaglutide and NASH

S2 E10 - Inhaled steroids for COVID in GP; risk of COVID in adults with kids; 3 days of antibiotics for pneumonia; more semaglutide stuff

Welcome back to the Hot Topics Podcast. In this episode, Neal Tucker talks about Long COVID in children, changes in violence injuries during lockdown, the prospect of a universal coronavirus vaccine, and the challenges of increasing vaccination rates in general practice.In new research, we discuss papers from the BJGP on health inequalities, who is faring badly and how consultation length impacts on inequality. Also, novel research in the BMJ examining muscle symptoms with statins. Or not as the case may be...ReferencesLong COVID in childrenJAMA Lockdown violence in CardiffBJGP Inequalities in health-related quality of lifeBJGP Multimorbidity, deprivation and consultant lengthBMJ Statins and muscle symptoms

S2 E9 - Long COVID in kids, statins and muscle pain, health inequalities and consultation length

Welcome to another Hot Topics Podcast! As we rapidly vaccinate the UK our thoughts today turn to the longer term and how environmental issues affect our patients and what practices can do about it. Neal Tucker is joined by Terry Kemple, GP and founder of the Green Impact for Health Toolkit, to chat about how practices can make positive changes to save money, improve the health of our patients now, and help save the world in the longer term. Too much for general practice? A year ago I might have said yes, but now I think we can do anything.We also talk about COVID  vaccine efficacy and how PCNs might help my summer holiday, plus the latest research - do BP meds cause falls (the surprise answer) and a new treatment for weight loss that actually works. If you can stomach it...ReferencesGreen Impact for Health ToolkitPfizer vaccine efficacy after single doseBMJ Antihypertensive therapy and fallsNEJM Semaglutide and weight loss

S2 E8 - GP and the Environment - interview with Terry Kemple; BP meds & falls; Semaglutide & weight loss; a little COVID...

Belated Happy New Year! In this new podcast, Dr Neal Tucker chats about the latest news and research in general practice. Firstly, what do the SARS-CoV-2 variants mean for the efficacy of the vaccines and should we continue the vaccine programme? The new GP contract is out and the most controversial aspects is financial incentivisation for weight loss referrals. What works? We look at two Lancet papers. New research in the BMJ on antidepressants for back pain and OA - can this be the magic cure? And finally, research on parental burnout - feeling it during lockdown? You are not alone.ReferencesVaccine and variants infoGP Contract detailsLancet Weight loss studyLancet Metabolic Surgery studyBMJ Antidepressants for Back and OAParental Burnout

S2 E7 - Variants and the vaccine; GP Contract, Obesity and Surgery; Anti-depressants for OA; Parental Burnout

Merry Christmas and a Happy New Year! There&apos;s no time to take stock of 2020 in this latest podcast. Instead Neal Tucker talks about the latest science on the new, highly transmissible variant of SARS-CoV-2 sweeping the south of England. He also looks at the success of general practice in starting the Covid vaccinations for thousands of vulnerable patients. And research on clowns in hospitals - should we have jesters in surgeries???See you in 2021 everyone, NealReferencesNew Scientist and Variant SARS-CoV-2Lancet Oxford/AZ Vaccine in ElderlyBMJ Clowns in Hospitals

S2 E6 - Mutant covid, the success of GP and covid vaccinations, clowns in hospitals and merry Christmas!

There's really only one topic of conversation: COVID vaccines, when will we get them, how do we give them and what's going to happen about Christmas...In this latest episode, Neal Tucker discusses the latest on general practice's role in vaccinating the nation, mistakes in the Oxford/AstraZeneca vaccine trial, the cost of vaccines and vaccinating, and how to keep thing below minus 70 degrees. We also have a look at some new research examining whether it really matters which blood pressure medication we give first, and two papers suggesting 100 year-olds should get statins.ReferencesBMJ What do we know about the covid vaccines?BMJ 1st BP medLancet LDL levels and CVD risk in the elderlyLancet Efficacy of Lipid LoweringWest Yorkshire Healthy Hearts AlgorithmBMA COVID guidance

S2 E5 - Covid vaccines, the story continues... & BP meds and statins for 100 year olds.

Welcome back to the Hot Topics podcast with Neal Tucker.Finally some hope with an imminent COVID vaccine. But how good is it really and where is the data? Meanwhile general practice has been set up as the saviour of the nation but can we really vaccinate the entire population? The Committee of Horribly Absurd Orders thinks so or is it part of their long-game to say CHAO to GPs? And also some good news that we may not have to store this new vaccine at -70oC after all...For published research we look at SSRIs for acute COVID in the community, suspect rapid antibody tests and the harm from delayed cancer treatments.ReferencesNS Vaccine review and report on storageJAMA SSRI and COVID trialBMJ Accuracy of Rapid Antibody TestsBMJ Mortality due to cancer treatment delay

S2 E4 - COVID Vaccines and missing data, PCN DES and the Committee of Horribly Absurd Orders, SSRIs for acute mild COVID, Cancer Delay and Death

The Hot Topics podcast from NB Medical brings you the latest in general practice current affairs, reviews the latest research relevant to primary care, explores interesting and important topics in-depth, and looks at cutting edge medicine.

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