Senescent Cells Make Everything Worse in the Aging Lungs
Here I'll point out a recent open access paper that covers the various ways in which accumulated senescent cells harm the lungs in old age. The count of senescent cells rises with age in all tissues, the consequence of increased cellular damage on the one hand and progressive failure of the immune system to destroy these cells on the other. The presence of these cells is one of the contributing root causes of aging, in fact. They generate a mix of signals known as the senescence-associated secretory phenotype (SASP) that promotes chronic inflammation, destructively remodels the extracellular matrix structures necessary for...
Source: Fight Aging! - March 3, 2017 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Rockpointe and Potomac Center for Medical Education Author an Article in the Alliance Almanac
Teams from Rockpointe and Potomac Center for Medical Education worked together to draft an article recently published in the Alliance Almanac, walking readers through the outcomes-based activity design. Throughout the article, readers learn how they structured their ground rounds courses and the modifications needed to address different audiences. They also illustrate how relying upon expert opinions during a needs assessment could create a disconnect between the content and learners’ true needs.
The article focused on “Type 2 Diabetes Management: A Team Approach to Managing Hypoglycemia, Comorbidities, and Patient Ch...
Source: Policy and Medicine - March 1, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CME Outcomes Increase with Local Participation in Content
Teams from Rockpointe and Potomac Center for Medical Education worked together to draft an article recently published in the Alliance Almanac, walking readers through the outcomes-based activity design. Throughout the article, readers learn how they structured their ground rounds courses and the modifications needed to address different audiences. They also illustrate how relying upon expert opinions during a needs assessment could create a disconnect between the content and learners’ true needs.
The article focused on “Type 2 Diabetes Management: A Team Approach to Managing Hypoglycemia, Comorbidities, and Patient Ch...
Source: Policy and Medicine - March 1, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
MKSAP: 74-year-old woman with altered mental status
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with relatives. One of her young relatives was recently ill with gastrointestinal symptoms. The patient developed anorexia 3 days ago and vomiting 2 days ago. She has been unable to tolerate any liquid or solid foods for the last 24 hours. Medical history is significant for type 2 diabetes mellitus, hypertension, hyperlipidemia, and hypothyroidism. Medications are aspi...
Source: Kevin, M.D. - Medical Weblog - February 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Source Type: blogs
MKSAP: 68-year-old man with a right intertrochanteric fracture
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but no other symptoms. He has hypertension and type 2 diabetes mellitus and was in his usual state of health prior to the fall. He checks his blood glucose level several times daily; his average blood glucose level is 150 mg/dL (8.3 mmol/L), with a low of 92 mg/dL (5.1 mmol/L) and a high of 208 mg/dL (11.5 mmol/L). Surgical repair is scheduled for tomorrow at 7 a.m. with...
Source: Kevin, M.D. - Medical Weblog - January 28, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Orthopedics Source Type: blogs
What is prediabetes and why does it matter?
When I’m seeing a new patient, I am especially alert to certain pieces of their history. Do they have a strong family history of diabetes? Are they of Latino, Asian, Native-American, or African-American ethnicity? Did they have diabetes in pregnancy? Are they overweight or obese? Do they have polycystic ovarian syndrome (PCOS)?
Why do I care about these things? Because they may be clues that the patient is at risk for developing adult-onset (type 2) diabetes, and that can lead to multiple major medical problems.
Many people have heard of type 2 diabetes, a disease where the body loses its ability to manage sugar levels. ...
Source: Harvard Health Blog - January 25, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Diabetes Diet and Weight Loss Exercise and Fitness Healthy Aging Prevention Source Type: blogs
MKSAP: 40-year-old man with type 1 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise routine in preparation for participation in a 10-K race. He reports prolonged hypoglycemia during intense exercise, despite eating a meal prior to the activity. His insulin regimen is insulin glargine and insulin glulisine. His most recent HbA1c level was 7.0%.
Which of the following is the most appropriate management of this patient’s hypoglycemia on the days th...
Source: Kevin, M.D. - Medical Weblog - December 31, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Endocrinology Source Type: blogs
Quiz on statins
Short quiz on statins
Quiz on statins
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Question 1
Which of the following should not be combined with statin?
AFenofibrateBEz...
Source: Cardiophile MD - December 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
MKSAP: 68-year-old woman with progressive abdominal distention
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension. She also has had a 10-year history of elevation of serum aminotransferase levels, which was attributed to nonalcoholic fatty liver disease. She does not consume alcohol. Her medications are metformin, lisinopril, low-dose aspirin, and simvastatin.
On physical examination, vital signs are n...
Source: Kevin, M.D. - Medical Weblog - December 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions GI Source Type: blogs
Coronary artery disease: Primary care and prevention – 5
Previous
Statin for primary prevention
Very high lipid levels of the order of LDL cholesterol above 190 mg/dL calls for usage of statins for primary prevention. High intensity statins can be considered in this scenario as in acute coronary syndrome. When the LDL cholesterol level is between 70-189 mg/dL, primary prevention with moderate intensity statin may be considered if they are diabetic and have significant other risk factors for CAD. It is reasonable to measure SGPT/ALT levels before initiating statins and while on treatment so that values above 3 times the upper limit are not reached. Caution is advised in those abo...
Source: Cardiophile MD - December 21, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Coronary artery disease: Primary care and prevention – 4
Previous
Prevention of CAD
Prevention is classified into primordial, primary and secondary. Primordial prevention is community level intervention to reduce risk factors and mostly not under the purview of the individual physician. Primary prevention is by controlling the risk factors.
Non modifiable risk factors for CAD
Age, gender, race/ethnicity and genetic predisposition or family history are considered the non modifiable risk factors for CAD. Prevalence of CAD increases as age advances and it is definitely more common in males. A strongly positive family history of premature coronary artery disease increases the risk ...
Source: Cardiophile MD - December 20, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Elevated LDL cholesterol – Cardiology MCQ
Which of the following is not a cause for elevated LDL cholesterol ?
a) Pregnancy
b) Hyperthyroidism
c) Uncontrolled diabetes mellitus
d) Obesity
Correct answer: b) Hyperthyroidism
Hypothyroidism is associated with elevated LDL cholesterol and triglycerides. Cholesterol and triglycerides rise progressively through out pregnancy. It may be noted that treatment with statins, niacin and ezetimibe are contraindicated in pregnancy and lactation. Triglycerides are elevated in poorly controlled diabetes mellitus. Both triglycerides and cholesterol are elevated in obesity [1].
Reference
1. Stone NJ et al. 2013 ACC/AHA guidel...
Source: Cardiophile MD - December 1, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Sarcopenia Finally Obtains an ICD Code
A recent commentary celebrates the granting of an International Classification of Disease (ICD) code to sarcopenia, an important step in the lengthy formal definition of a disease. Sarcopenia is the characteristic age-related decline of muscle mass and strength - though many would say that it only counts as sarcopenia if that decline is significantly greater than normal, and that "normal aging" should not be treated. Hopefully those voices will decline in the years ahead. The carving up of degenerative aging into named conditions is a long, slow, and messy process. It is driven by regulation rather than any sort of common ...
Source: Fight Aging! - November 30, 2016 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Deep T inversion
First few conditions which come to our mind when we see deep T wave inversions are coronary artery disease, hypertrophic cardiomyopathy, post cardiac arrest state and takotsubo cardiomyopathy. Other conditions in which deep T wave inversion have been reported are nonischemic cardiomyopathy [1], after cardioversion [2], acute pulmonary embolism [3] and acute pulmonary edema [4].
References
Ambhore A, Teo SG, Poh KK. Diabetes mellitus and heart disease. Singapore Med J. 2013 Jul;54(7):370-5; quiz 376.
Sovari AA, Farokhi F. When the heart remembers. Am J Emerg Med. 2007 Sep;25(7):831-3.
Punukollu G, Gowda RM, Khan IA, Wilbur...
Source: Cardiophile MD - November 6, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology ECG / Electrophysiology ECG Library Source Type: blogs
Complicating the Picture for Aging, Cellular Senescence, and Bcl-xL
Efforts to build rejuvenation therapies that work by selectively destroying senescent cells are very much in the news of late. One class of senolytic drug candidates works by inducing apoptosis, a form of programmed cell death, via reduced levels of Bcl-2 family proteins, such as Bcl-2 itself, Bcl-xL, and Bcl-W, all of which normally act to suppress apoptosis. Senescent cells are inclined towards apoptosis already, so a modest nudge in that direction can destroy a fair proportion of these unwanted cells without causing harm to healthy cells. These apoptosis-related proteins have numerous other roles as well, however, since...
Source: Fight Aging! - November 4, 2016 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
