Are polypills and population-based treatment the next big things?
Cardiovascular disease (CVD), such as heart attack and stroke, is a leading cause of death and disability in the US. High blood pressure and high cholesterol are major risk factors for CVD, and even though they are quite common and highly treatable, they tend to be undertreated. This is especially true among those who are poor or members of a minority. It’s estimated that thousands of lives could be saved each year if more people with high blood pressure and high cholesterol received treatment for these conditions.
The appeal of the polypill
One reason that high blood pressure and high cholesterol are poorly treated is t...
Source: Harvard Health Blog - January 13, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke Source Type: blogs
Fight Aging! Newsletter, December 16th 2019
This study shows that CA are released from periventricular and subpial regions to the cerebrospinal fluid and are present in the cervical lymph nodes, into which cerebrospinal fluid drains through the meningeal lymphatic system. We also show that CA can be phagocytosed by macrophages. We conclude that CA can act as containers that remove waste products from the brain and may be involved in a mechanism that cleans the brain. Moreover, we postulate that CA may contribute in some autoimmune brain diseases, exporting brain substances that interact with the immune system, and hypothesize that CA may contain brain markers that m...
Source: Fight Aging! - December 15, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Large Study of Aspirin Use Finds Reduced Mortality, Contradicting the Recent ASPREE Study Results
The back and forth over whether regular aspirin use is beneficial continues with the publication of results from analysis of a large patient population that show a 15% reduction in all cause mortality in patients using aspirin. This contradicts the much smaller (but still large in and of itself) ASPREE clinical trial, in which patients using aspirin exhibited a small increase in mortality in comparison to their peers. As in that earlier study, the data here strongly suggests that benefits and risks vary with patient characteristics, such as whether or not a patient is overweight.
Aspirin is thought to be a weak calo...
Source: Fight Aging! - December 13, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Medications as effective as stents for most with coronary artery disease
This study suggests that for most, managing CAD with medications alone (the conservative approach) is as safe and effective as the more invasive strategy of cardiac catheterization and opening of the blocked artery.
Findings of the ISCHEMIA trial
ISCHEMIA followed over 5,000 patients with significant narrowing in one or more coronary arteries. Half of the patients were randomly selected to receive conservative treatment with optimal medical therapy (OMT) and lifestyle changes to treat risk factors such as high blood pressure and high cholesterol. The other half were given OMT and also sent for cardiac catheterization (thre...
Source: Harvard Health Blog - December 9, 2019 Category: Consumer Health News Authors: Dara K. Lee Lewis, MD Tags: Health Source Type: blogs
NATO Summit 2019: The Remnants of a "Zombie Alliance"
Ted Galen CarpenterWhen French President Emmanuel Macron said that NATO was experiencing “brain death,” he spoke an important inconvenient truth. Unfortunately, it appears that the ongoing NATO summit intends to focus on traditional burden-sharing issues. In the days before the summit, European members released a plan to great fanfare that would increase their share of the Alliance’ s direct costs and reduce America’s share. But NATO’s problems go far, far beyond burden sharing. Greater European financial support is akin to taking an aspirin to deal with a terminal illness.Despite the usual talk about enduring tr...
Source: Cato-at-liberty - December 3, 2019 Category: American Health Authors: Ted Galen Carpenter Source Type: blogs
This Is Why We Science
While watching a television commercial from one of the world's largest pharmaceutical companies I suddenly heard something that attracted my attention. I am generally quite good at ignoring commercials and especially good at ignoring drug commercials because of their endless lists of side effects (this drug may cause sudden hideously painful death) among other uninteresting features. Thus, it has come a surprise that I appeared to hear the statement “This is why we science.” This is the new tag line from a series of commercials from Bayer Pharmaceuticals. These are not merely commercials that are trying to get ...
Source: blog.bioethics.net - December 2, 2019 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Author: Kaplan syndicated Source Type: blogs
Seizing the Opportunity in America ’ s Opioid Crisis
“Perhaps everything that is terrible is, in the deepest sense, something that wants our love.” – Rilke
The overdose epidemic in the U.S. has been called “the greatest public health crisis of our time.” It’s also our greatest opportunity.
The opioid crisis is an identity crisis: it’s a challenge to how we see ourselves. Do we truly believe that we are all in this together? One answer leads us deeper into despair. The other, into a hopeful future.
It’s been said that “doing more things faster is no substitute for doing the right things.” What are the “right things,” the measures that can r...
Source: World of Psychology - November 30, 2019 Category: Psychiatry & Psychology Authors: Psych Central Guest Author Tags: Addiction Publishers The Fix opioid crisis Source Type: blogs
MKSAP: 67-year-old man with a carotid bruit
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a carotid bruit detected on routine medical examination. He reports no history of previous focal neurologic symptoms or visual loss. He has type 2 diabetes mellitus and hyperlipidemia treat ed with metformin, moderate-intensity pravastatin, and aspirin. […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 23, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Cardiology Source Type: blogs
A 41 year old with chest pain and a Nondiagnostic Triage ECG. Thrombolytics prior to transfer for PCI.
Conclusion:Transfer for PCI without thrombolytics is best if PCI at receiving facility can be done in less than 120 minutes from first medical contact, or less than 90 minutes from STEMI diagnosis in first ED.Thrombolytics prior to Transfer to a PCI capable facility, then rescue PCI if no reperfusion for STEMITRANSFER AMI(Cantor et al. 2009).High risk STEMI: BP less than 100, HR greater than 100 Killip class II, III, ST depression of at least 2 mm in precordial leads, ST elevation in right precordial leads (right ventricular MIAll patients get TNK-tPA.80-90% received clopidogrel 300 mg (75 mg for age over...
Source: Dr. Smith's ECG Blog - November 7, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Stopping the vicious cycle of rebound headaches
Rebound headaches, also known as medication overuse headaches, are caused by the frequent or excessive use of pain-relieving and/or antimigraine drugs to treat headache attacks that are already in progress. (Note that these are not the same as oral prophylactic or preventive medicines, which should be taken daily.) In other words, the same medications that initially relieve headache pain can themselves trigger subsequent headaches if they are used too often. Medication overuse headaches can be disabling, forcing people with this condition to take sick leave and to be less productive at work and home.
To be diagnosed with m...
Source: Harvard Health Blog - November 7, 2019 Category: Consumer Health News Authors: Sait Ashina, MD Tags: Drugs and Supplements Headache Health Source Type: blogs
A young peripartum woman with Chest Pain
This is written by Brooks Walsh.https://twitter.com/BrooksWalshA 30 year-old woman was brought to the ED with chest pain.It had started just after nursing her newborn, about an hour prior, and she described it as a severe non-pleuritic “pressure” radiating to the back.She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying " I ' m just an anxious person. "A CXR and a CTA for PE were normal.The ECGsAn initial ECG was obtained as the pain was rapidly resolving:Minimal upsloping ST Elevation in III, with a steeply biphasic T wave, and&nbs...
Source: Dr. Smith's ECG Blog - October 23, 2019 Category: Cardiology Authors: Brooks Walsh Source Type: blogs
A 40-Something male with a " Seizure, " Hypotension, and Bradycardia
This is by one of ouroutstanding 3rd year residents, Aaron Robinson, with some edits and comments by SmithEMS responded to a reported seizure in a 42 year old male. Per bystanders, he went down after some intense sporting activity, and had “shaking” type movement. He reports no personal or familial history of seizures.One of our EMS Fellows along with a Senior EM Resident were on duty that evening, and arrived on the scene with the Fire Department. When the physicians approached him, he was ashen, diaphoretic, and appeared in shock. Fire was able to obtain a BP of 60/palp and a pulse in the 40s. The physicians quickly ...
Source: Dr. Smith's ECG Blog - October 6, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
How are hospitals supposed to reduce readmissions? Part II
By KIP SULLIVAN, JD
The
notion that hospitals can reduce readmissions, and that punishing them for
“excess” readmissions will get them to do that, became conventional wisdom
during the 2000s on the basis of very little evidence. The Medicare Payment
Advisory Commission (MedPAC) urged Congress to enact the Hospital Readmissions
Reduction Program (HRRP) beginning in 2007, and in 2010 Congress did so. State
Medicaid programs and private insurers quickly adopted similar programs.
The rapid adoption of readmission-penalty programs without evidence confirming they can work has created widespread concern that these prog...
Source: The Health Care Blog - October 1, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy CMS hospital readmissions Hospital Readmissions Reduction Program HRRP Kip Sullivan MedPAC Source Type: blogs
A man in his 70s with chest pain during a bike ride
Case written and submitted by Ryan Barnicle MD, with edits by Pendell MeyersWhile vacationing on one of the islands off the northeast coast, a healthy 70ish year old male presented to the island health center for an evaluation of chest pain. The chest pain started about one hour prior to arrival while bike riding. It was a constant ache on the left side of his chest that forced him to stop cycling and call for an ambulance. It was radiating to his bilateral upper arms. It was associated with nausea but he denied dyspnea, dizziness, and headache.He explained that he had the same chest pain the day prior as well, on and off....
Source: Dr. Smith's ECG Blog - September 29, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, September 23rd 2019
Discussion of Developmental Effects on Aging
Microtubule Function and Longevity in Nematodes
Quantifying the Correlation Between Poverty and Faster Pace of Aging
Matthew O'Connor Presenting on Underdog Pharmaceuticals at Undoing Aging 2019
https://www.fightaging.org/archives/2019/09/matthew-oconnor-presenting-on-underdog-pharmaceuticals-at-undoing-aging-2019/
Here Matthew O'Connor of the SENS Research Foundation talks about the research that led to founding of Underdog Pharmaceuticals, a biotech startup incubated by the foundation to commercialize a means of targeting 7-ketocholesterol in atheroscle...
Source: Fight Aging! - September 22, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
