“ Exclusion tests ” for primary aldosteronism
“Exclusion tests” for primary aldosteronism Oral sodium loading test Saline infusion test Captopril challenge test Fludrocortisone with salt loading test Though these tests were proposed as ‘confirmatory tests’ for primary aldosteronism, it was found that their negative predictive value was more than the positive predictive value. Reference Rossi GP. Primary Aldosteronism: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019 Dec 3;74(22):2799-2811. Rossi GP, Belfiore A, Bernini G, Desideri G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Palumbo G, Rizzoni D, ...
Source: Cardiophile MD - December 12, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Zero tolerance for low blood pressure
Just as we have zero tolerance for hypoglycemia in the Wheat Belly lifestyle, we also have zero tolerance for hypotension, or low blood pressure (BP). Follow the Wheat Belly lifestyle free of ciabattas, penne pasta, and tortellini, and blood sugars plummet. If you are injecting insulin or taking other diabetes drugs, hypoglycemia is a risk and can be dangerous, resulting in loss of consciousness and injury. We therefore urge everyone to talk to their doctor about discontinuing or reducing insulin and diabetes drugs immediately upon starting the Wheat Belly lifestyle. Unfortunately, the majority of doctors don’t under...
Source: Wheat Belly Blog - May 8, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle blood pressure blood sugar BP gluten-free grain-free grains health hypertension hypertensive Source Type: blogs

Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80 Consider lev albuterol Should give vaccines after coiling of spleen or before if possible No calcium channel blockers post MI definitely and post op in general Toradol inhibits spine healing Don’t do endoscopes with patients in supine position don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck. dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2016 Category: Surgery Authors: Editor Tags: General Source Type: blogs

ACE Inhibition Extends Life in Nematodes
This is an illustrative example of the continued exploration of modest life extension via metabolic manipulation in short-lived animals. A lot of effort is spent on sifting through the existing catalog of known and approved drugs for those that might impact life span, something I consider to be a waste of time and effort from the point of view of producing therapies to extend life in humans. It is an important part of purely scientific efforts to map the interaction of metabolism and aging, however: To identify drugs that delay age-related degeneration, we used the powerful Caenorhabdtitis elegans model system to screen f...
Source: Fight Aging! - March 3, 2016 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Rodent Control
A crotchety old fellow from the nursing home gets brought in for trouble breathing. After looking at the swelling in his legs and listening to the crackles in his lungs, it’s pretty obvious that he’s in congestive heart failure. We started an IV, drew labs, and performed a chest x-ray. Then he got some nitroglycerin, some captopril, and he even got Lasix just to spite all of the #FOAMed wonks. About 45 minutes later, the patient needs to go to the bathroom. We didn’t want him walking since he didn’t appear to be the steadiest on his feet, so he got a urinal. He grabbed the urinal and the nurse walke...
Source: WhiteCoat's Call Room - May 26, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs

How are drug companies making millions from generic drugs?
It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under the trade name Capoten. After making a fortune for the company, captopril went generic in 1996. By 2013, you could purchase a captopril pill for the lofty price of … hold your breath … 1.4 cent...
Source: Kevin, M.D. - Medical Weblog - April 17, 2015 Category: Journals (General) Authors: Tags: Meds Medications Primary care Source Type: blogs

Medications After a Heart Attack
From: www.secondscount.orgYour heart attack recovery will include medications. Taking these medications exactly as prescribed is one of the best tools at your disposal for avoiding death in the months following a heart attack. According to an article published in Circulation, the journal of the American Heart Association, heart attack patients who had not filled any of their prescriptions within 120 days of being discharged from the hospital had 80 percent greater odds of death than those who filled all of their prescriptions.Medications you are likely to be prescribed after a heart attack fall int...
Source: Dr Portnay - January 23, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs

Intravenous Nitroglycerine in STEMI, with data: Avoid its use if giving tPA
If you are giving tPA to patients with STEMI, it is wise to avoid IV nitroglycerine.  I am revisiting this topic because of a recent case I posted in which a patient who was on IV nitro received tPA.  This patient was very hypertensive, and thus needed something to control BP. But I would advise against nitroglycerine.This is data that very few cardiologists are aware ofBackground: First, know that, in the reperfusion era, there is absolutely no data to support the use of nitroglycerine in STEMI.  See the ACC/AHA recommendation below that puts the level of evidence at “C”.  I have paste...
Source: Dr. Smith's ECG Blog - September 11, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80 Consider lev albuterol Should give vaccines after coiling of spleen or before if possible No calcium channel blockers post MI definitely and post op in general Toradol inhibits spine healing Don’t do endoscopes with patients in supine position don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck. dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2013 Category: Surgeons Authors: Editor Tags: General Source Type: blogs

PCORI News Plus FDA Suggestons on Comparative Effectiveness Research
The Board of Governors of the Patient-Centered Outcomes Research Institute (PCORI) at its 19 November 2012 meeting in Boston, MA adopted 47 revised methodology standards that are intended to guide the comparative effectiveness research (CER) funded by PCORI, reported RAPS.  The Board also authorized at the meeting the development of three new CER funding announcements:   Treatment options for uterine fibroids, the safety and benefits of treatment options for severe asthma, and   fall prevention in the elderly.    One of the bigger pieces of the Patient Protection a...
Source: Policy and Medicine - February 14, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs