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2 Docs Talk: Medicine | Health | Healthcare Policy | Evidence Based Medicine

Welcome to 2 Docs Talk, the podcast about healthcare, the science of medicine and everything in between. Join cohosts Kendall Britt, MD and Amy Rogers, MD for a 15 minute check-up on current issues in medicine and health policy. The doctor is always in.
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2 Docs Talk: Medicine | Health | Healthcare Policy | Evidence Based Medicine
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Oct 10, 2016

A BMJ report earlier this year declared that 1 in 3 hospital deaths were the result of medical errors. A flurry of headlines about the dangers of hospitals soon followed.

Just what is a medical error? What are the dangers of being in a hospital? And what can we do about it? We talk about these questions in today's episode. 

Resources:

BMJ on medical error

KATZ scale

To Err is Human: Building a Safer Health System

Hospital at Home

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Oct 3, 2016

If you've ever felt like you had a handle on the evidence about a certain medical topic only to read a headline telling you science now says the opposite, you aren't alone. 

But science isn't about headlines. It's about evaluating the evidence to decide what's real, and it doesn't always conform to what we want. But that doesn't stop the media, (and maybe some journals), from selectively reporting the research that will generate the most buzz.

Today we talk about this issue and ideas that are being discussed to help be sure all the evidence, including the unremarkable evidence, is adequately reported.

Resources:

Nurse's Health Study

Women's Health Initiative

Calcium and Heart Disease Risk

Results-Blind Study

PLOS on Data

2 Docs Talk about Hormone Replacement Therapy

2 Docs Talk about Supplements

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Sep 26, 2016

These days you can buy e-Books  for your e-Reader and participate in e-Commerce. You can send your friends Evites, e-file your taxes, and meet the love of your life on eHarmony. 

So it's really no surpise that e-Cigarettes have become as popular as they are. Hats off to whoever named them, since they are actually physical items that you can hold in your hands, unlike most e-products.

The question, of course, is if there are any health advantages to e-Cigarettes. Do they really help you stop smoking?

And, do they create their own set of health problems? 

That's what we're talking about this week.

 

Resources:

E-Cigs and Poison Control

Southern California Children's Health Study

USPSTF on Smoking Cessation

Aphthous Ulcers and Nicotine

 

Sep 19, 2016

If there is a hot button issue in politics these days, it's abortion. But abortion is the result of a long line of issues that are being inadequately addressed in this country. Today we take a look at contraception - what it is, how it works, its history and its future. 

We also offer a look at an innovative program that has the potential to help both pro-choice and pro-life groups happy. 

 

Resources:

Details on various types of birth control

The Choice Project

Use of LARCs in Colorado

Slang for using a condom (adult humor - you've been warned)

 

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Sep 12, 2016

In a country (the U.S.) where people drink, on average, 44.7 gallons of soda per person, it's smart to think about what we are putting into our bodies. 

Most of us have figured out that all that sugar is a bad idea, but what about sugar substitutes? Diet sodas make up a big portion of that 44.7 gallons. But is it really any better than plain old sugar?

Resources:

Generally Recognized as Safe

San Antonio Heart Study

Fueling the obesity epidemic: Artificially sweetened beverage use and long term weight gain

Artificial Sweeteners and Gut Microbiota in Rats

 

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Sep 5, 2016

Thousands of people die each year from influenza. The CDC recommends that almost all people (with a few rare exceptions) receive the flu vaccine every year. But the disease and the vaccine are poorly understood. In this episode, we discuss the flu, its treatment and its prevention.

Resources:

Influenza vaccine effectiveness in preventing outpatient, inpatient, and severe cases of laboratory-confirmed influenza

Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials.

 

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Aug 29, 2016

Urinary tract infections are one of the most common infections we humans get. In fact, estimates suggest 60-70% of women will have at least one in their lifetime. And many women suffer from them repeatedly.

So what causes these infections and how can you treat them? Is there any way to prevent them? And what does diet have to do with it? 

We discuss these issues and more in this episode. 

Resources:

CDC article on E. coli in our food supply and its role in UTIs

 

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Aug 22, 2016

America has a weight problem. A full one third of us are classified as obese, and other third are obese. This has implications for individuals, families and society that cut across social and economic factors. 

We take a look at a handful of studies that take a look at the weight problem from a variety of angles. 

Metabolic rate, BMI, whole grain intake,physical inactivity, and more. 

 

Resources:

CDC Info on Obesity

"The Biggest Loser" Study

BMI study

Whole Grain Study

Exercise to Offset Sitting

Cost of Physical Inactivity

 

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Aug 15, 2016

Everyone thinks of the sun in a different way. Some people crave it and some avoid it. And it turns out there are good health reasons for both.

Today on 2 Docs Talk, we'll be covering how the sun affects your health and how to maximize its benefits while minimizing its damage. We'll talk about:

  • UVA vs. UVB rays
  • The UV Index
  • Sunscreen
  • Skin cancer
  • Vitamin D 
  • and more.

 

Take a listen and get a little info to help you stay sun healthy.

 

EPA UV Index Database

Swedish Studyon Sun Exposure and Smoking

American Academy of Dermatology Sunscreen FAQ

 

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Aug 8, 2016

 

Our understanding of what sleep is and why it is important grows daily. It's clear that poor sleep plays a role in all sorts of disease states. Sadly, more and more people report sleep disturbances to their doctors. 

Is this a new epidemic we are facing, or is it just our awareness of the issue that makes it seem so?

In this episode, we take a look at the role sleep plays in our health, what happens when sleep is disturbed, and how insomnia can be treated. Take a listen and see what you think. We try not to put you to sleep, but you might want to grab a cup of coffee whiel you listen anyway.

Resources:

Arianna Huffington's story

Sleep and Chronic Disease

Sleep loss and inflammation

Sleep, ghrelin, leptin and weight gain

Meta analyis of melatoning and sleep duration

Cognitive Behavioral Therapy for insomnia

 

Aug 1, 2016

Because individuals with high cholesterol levels often develop heart disease, we've come to accept that high cholesterol - especially "bad" cholesterol, or LDL - causes heart disease.

But it can't be said often enough that correlation does not equal causation, and it is beginning to look more and more like a causal realtionship between cholesterol and heart disease just isn't there. 

In this episode we talk about the status of treating cholesterol to prevent heart disease and about a drug trial that punctuates the whole process with a giant question mark. 

Take a listen and see what you think.

Resources:

Number Needed to Treat with Statins for Primary Prevention

Number Needed to Treat with Statins for Secondary Prevention

Evacitrapib Study Stopped Because of Clinical Futility

American Heart Association Guidelines for Prevention with Statins

 

Jul 25, 2016

In this episode, we dig into the terms being bandied about by politicians this year. Medicare for all, single-payer, socialized medicine. What do they all mean? Are they all the same or are there differences between these systems. 

And what would we do, today, to start making healthcare work a little better?

Resources:

Per Capita Health Spending by Country

Gallup Poll on Healthcare Satisfaction by Country

 

Jul 18, 2016

One of the big scary pieces of growing old is the possiblity of developing Alzheimer Dementia. This progressive neurological disease is poorly understood, meaning the options for prevention and treatment have a long way to go.

In this episode, we talk about what the disease is, current options for treatment, the reality of prevention, and an approach to choosing long term care.

 

Resources:

Systematic review of studies on cholinesterase inhibitors

JAMA Neurology meta analysis of memantine

Risk reducing effect of education on in Alzheimer's disease

Lumosity fined $2 million for deceptive advertising

Non-profit vs. for profit nursing homes

CMS Five Star Rating

 

Jul 11, 2016

The gluten-free phenomenon has grown into a $2.5 billion industry in the U.S. The question we have to ask is if the medical concern from gluten is enough to justify such a huge national expenditure. In this episode, we look at the disorders behind gluten and wheat allergies, gluten sensitivities and the science that supports these diagnoses.

 

Jul 4, 2016

The supplement industry is a big one - estimates place it anywhere from $12 billion to $37 billion. 

However, if you put that number in the context of healthcare spending overall, it's not too crazy...if supplements are effective and safe.

But issues with the approval and regulations of dietary supplements make leave us with many unanswered questions about the so-called "natural" products on the market.

In this episode we examine supplements, homeopathic remedies, the placebo effect and much more. So take a listen, and leave a comment if you have thoughts on the topic.

References:

Dietary Supplement Health and Education Act of 1994

National Center for Complementary and Integrative Health

Placebos Without Deception

Perception of Drug Cost Influences Placebo Effect

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Jun 27, 2016

 

 

Hepatitis C infection is on the rise in recent years. The growing opioid epidemic has multiplied the problem, as the primary means of spread is IV drug use. 

Surprisingly only 35 percent of those infected received treatment even though excellent treatment available is for this devastating disease. Not surprisingly, drug costs are a major factor in this issue.

Join us as we discuss the issue of Hep C and what can be done about it.

Resources:

American Journal of Managed Care Special Issue on Hepatitis C Virus

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Jun 20, 2016

 

If you watch any tv at all, it's likely you've seen a drug ad. These ads generally show seemingly healthy people living normal lives, the message being the drug did this for them.

But are the drug ads telling the whole story? And should they even be advertising directly to consumers to begin with? We discuss this issue on today's episode.

 

Resources:

Nivolumab Research from New England Journal of Medicine

What the FDA has to say about drug ads

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Jun 13, 2016

 

Lice are an issue that many parents of elementary students have to deal with, often more than once.

In this episode we discuss the three different types of lice - body lice, pubic lice, and head lice - how to get them, the health threats associated with them, and what works to get rid of them. 

Resources:

The CDC on head lice treatment

An Interesting Paper if You Want to Get Totally Geeky on Lice

Dr. Pearlman's Site on the Cetaphil Treatment and Lice

 

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Jun 6, 2016

Back pain is second only to cancer as a cause of long term disability. This health problem is damaging to individuals and costly to society. And we don't have much in our arsenal that is effective at treating it.

This week, we discuss the difference between acute and chronic back pain with regard to treatment and outcomes. We also discuss the role of surgery, medications, alternative therapies, and some interesting new research on what helps resolve chronic back pain.

Resources:

Research on efficacy of epidural steroid injections for back pain

Trends in spinal fusion surgery

American College of Physicians Guidelines for the Treatment of Chronic Low Back Pain

May 30, 2016

 

Our understanding of what sleep is and why it is important grows daily. It's clear that poor sleep plays a role in all sorts of disease states. Sadly, more and more people report sleep disturbances to their doctors. 

Is this a new epidemic we are facing, or is it just our awareness of the issue that makes it seem so?

In this episode, we take a look at the role sleep plays in our health, what happens when sleep is disturbed, and how insomnia can be treated. Take a listen and see what you think. We try not to put you to sleep, but you might want to grab a cup of coffee whiel you listen anyway.

Resources:

Arianna Huffington's story

Sleep and Chronic Disease

Sleep loss and inflammation

Sleep, ghrelin, leptin and weight gain

Meta analyis of melatoning and sleep duration

Cognitive Behavioral Therapy for insomnia

May 23, 2016

In a world when concerns about healthcare costs, access to care, and medical complications create significant barriers to medical care, telemedicine has an obvious role to fill. 

But what are the potential downsides of a technology that is being adopted faster than we can track? Is it effective? Is it safe? Is it a door for the unscrupulous ot take advantage of the unsuspecting?

We discuss these and other issues of the growing field of telemedicine. 

Resources:

AMA policy on telemedicine

AAFP debate on telemedicine policy

AAP on telemedicine and the "medical home"

Hospital at Home

Use of telemedicine to prevent preterm labor

May 16, 2016

Both of us, Kendall and Amy, have dogs named Goose. This was purely coincidental, and we are as surprised by that fact as anyone. It's a little uncanny how much they resemble one another, too. If you'd like to see the Geese, we've added their pictures over at 2DocsTalk.com. These two certainly live the life of Riley, but they aren't the only canines who have it so good.

We are a country of pet lovers. We spend over $60 billion annually on food, vet bills, toys, and silly extravagances for our animal companions. We love them, and can't imagine life without them. But did you know your pet can make you sick - and the other way around? 

Today we discuss zoonotic infections - those infections that are spread from animal to human. Rabies, toxoplasmosis, and leptospirosis are a few diseases that fall into this category. We'll talk about how they are spread and treated, and give some tips on how to prevent the.

We'll also talk about how we can make our pets sick, too. It's a fun show!

Resources:

The Thanksgiving Effect

The CDC on pets and salmonella

CDC info on rabies 

May 9, 2016

Over the last couple of decades, the conversation surrounding hormone replacement therapy and menopause has been confusing. Does it work? Is it safe? What about alternative therapies? it's hard to sort out conflicting information coming from various sources. In this episode we discuss:

  • The recent history of hormone replacement therapy (HRT)
  • HRT for symptom relief
  • HRT, endometrial hyperplasia, and uterine cancer
  • HRT and cardiovascular disease
  • HRT and breast cancer
  • Bioidentical hormones
  • And more.

Resources

The Bitch is Back

Study of Women's Health Across the Naiton (SWAN)

The Women's Health Initiative

May 2, 2016

Because individuals with high cholesterol levels often develop heart disease, we've come to accept that high cholesterol - especially "bad" cholesterol, or LDL - causes heart disease.

But it can't be said often enough that correlation does not equal causation, and it is beginning to look more and more like a causal realtionship between cholesterol and heart disease just isn't there. 

In this episode we talk about the status of treating cholesterol to prevent heart disease and about a drug trial that punctuates the whole process with a giant question mark. 

Take a listen and see what you think.

Resources:

Number Needed to Treat with Statins for Primary Prevention

Number Needed to Treat with Statins for Secondary Prevention

Evacitrapib Study Stopped Because of Clinical Futility

American Heart Association Guidelines for Prevention with Statins

Apr 25, 2016

For decades we've been told that our high fat diet is making us obese and killing us with heart disease. But here's the deal. The concept of a lowfat diet, exemplified in the Mediterranean Diet, is based on faulty science. 

In this episode, we discuss how the high fat hypothesis became accepted science and public policy, without any good research to back it up. We also talk about the various kinds of fats that are out there and what we think is the biggest culprit in our obesity problems.

Resources:

The Big Fat Surprise

PREDIMED Study

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis

Profiling Food Consumption in America

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