The Med List: ACE Inhibitors
Today I’m starting a new series called The Med List. Once or twice a month, I’d like take a closer look at a single class of home medications and explore the medical implications for our patients who take these meds. The patient’s medications list holds a wealth of information. Prescribed medications tell us about the patient’s medical history. They also give us clues to the patient’s possible current condition and presentation. Some medicines can better explain the clinical picture in front of us and others can be red flags regarding treatment options and the patients likely response. Let’s kic...
Source: The EMT Spot - November 9, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs

Cardiomyopathy in muscular dystrophies
Important muscular dystrophies due to mutations in structural cytoskeletal dystrophin gene are known as dystrophinopathies. They include Duchenne muscular dystrophy, Becker muscular dystrophy and X-linked dilated cardiomyopathy. Primary presentation of most dystrophinopathies is skeletal muscle weakness. Duchenne muscular dystrophy is caused by mutations leading to absence of functional dystrophin. Becker muscular dystrophy is due to mutations resulting in reduced amounts of shortened dystrophin protein. Cardiac muscle being a striated muscle, is affected in many types of muscular dystrophies. Cardiomyopathy would contrib...
Source: Cardiophile MD - August 30, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Left ventricular reverse remodeling
In this study, change in LVESV was the single most important predictor of all cause and cardiovascular mortality. Clinical parameters could not predict outcome events in this study. Similar beneficial effect on left ventricular remodeling was demonstrated long back in the trials with angiotensin converting enzyme inhibitors. SOLVD (Studies of Left Ventricular Dysfunction) study showed that in patients with heart failure and reduced left ventricular ejection fraction, chronic treatment with angiotensin converting enzyme inhibitor enalapril prevented progressive left ventricular dilatation, systolic dysfunction and increase ...
Source: Cardiophile MD - June 11, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Left ventricular remodeling
Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. ...
Source: Cardiophile MD - April 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Building a Biomarker of Aging from Frailty Measures
In this study, we tracked frailty longitudinally in a cohort of aging male mice from 21 months of age until their natural deaths and employed machine learning algorithms to build two clocks: FRIGHT (Frailty Inferred Geriatric Health Timeline) age, designed to model chronological age, and the AFRAID (Analysis of Frailty and Death) clock, which was modelled to predict life expectancy. FRIGHT age reflects apparent chronological age better than the frailty index alone, while the AFRAID clock predicts life expectancy at multiple ages. These clocks were then tested for their predicitve power on cohorts of mice treated with inter...
Source: Fight Aging! - January 3, 2020 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

Fight Aging! Newsletter, September 2nd 2019
In conclusion, in the absence of obesity, visceral adipose tissue possesses a pronounced anti-inflammatory phenotype during aging which is further enhanced by exercise. Methods of Inducing Cellular Damage are Rarely Relevant to Aging, and the Details Matter https://www.fightaging.org/archives/2019/08/methods-of-inducing-cellular-damage-are-rarely-relevant-to-aging-and-the-details-matter/ One of the major challenges in aging research is determining whether or not models of cellular or organismal damage and its consequences are in any way relevant to the natural processes of aging. One can hit a brick wit...
Source: Fight Aging! - September 1, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

A Large Polypill Clinical Trial Shows a Third Reduction in Cardiovascular Events
The research and medical communities are slow to undertake work on combination therapies. Regulation makes it exceedingly expensive to assess multiple combinations, and there are numerous other perverse incentives to challenge any effort to build combination therapies with components developed and manufactured by different groups. Short of working around the existing system of regulation, and methods of doing this at scale are lacking at the present time, this is a challenging problem to solve. People follow incentives. Given this, it it is entirely plausible that there are many largely unexplored instances in which existi...
Source: Fight Aging! - August 30, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

MKSAP: 62-year-old woman with hypertension
Test your medicine knowledge with the  MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated during a routine examination. She feels well and has no exercise limitations. Medical history is significant for hypertension treated with enalapril. She does not smoke. At her last examinati on 4 years ago, her blood pressure was […]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 - April 27, 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 Diabetes Endocrinology Source Type: blogs

The Doctor Who Thwarted the Charge of the General Medical Council – Part 1
By  SAURABH JHA After Dr. Hadiza Bawa-Garba was convicted for manslaughter for delayed diagnosis of fatal sepsis in Jack Adcock, a six-year-old boy who presented to Leicester Royal Infirmary with diarrhea and vomiting, she was referred to the Medical Practitioners Tribunal (MPT). The General Medical Council (GMC) is the professional regulatory body for physicians. But the MPT determines whether a physician is fit to practice. Though the tribunal is nested within the GMC and therefore within an earshot of its opinions, it is a decision-making body which is theoretically independent of the GMC. The tribunal met in 2017, 6 ...
Source: The Health Care Blog - August 5, 2018 Category: Consumer Health News Authors: at RogueRad Tags: NHS #BawaGarba @roguerad Source Type: blogs

Depression: Common medication side effect?
This study is especially thought-provoking, given that more and more people are taking medications with depression or suicidal thoughts as possible side effects. The CDC just released updated data showing a troubling recent rise in suicide rates, and that 54% of those who die from suicide do not have a known mental health disorder, so this is an important public health issue. That said, it is important to note: in this study, people who used these medications were more likely to be widowed and have chronic health problems, both of which are associated with a higher risk of depression. And many (but not all) of these medica...
Source: Harvard Health Blog - July 16, 2018 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Anxiety and Depression Drugs and Supplements Health Source Type: blogs

Might Depression Be Linked to One of These Popular Medications?
If you’re taking beta blockers, certain kinds of anxiety drugs, certain types of painkillers (including ibuprofen), proton pump inhibitors (PPIs) (used to treat acid reflux), ACE inhibitors (used to treat high blood pressure), or anti-convulsant drugs, you may be at greater risk for depression. That’s according to a new, large-scale study published earlier this week in JAMA. However, this was a correlational study, so it can’t say that these medications actually cause depression or not. It may be that people with greater health problems are more likely to take one of these medications and be depressed abo...
Source: World of Psychology - June 15, 2018 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: Depression General Medications Psychiatry Research Drugs cause depression popular medications Source Type: blogs

Why is not neprilysin inhibitor used alone? – Discussion
Neprilysin is a neutral endopeptidase involved in the degradation of natriuretic peptides (A, B and C), bradykinin, adrenomedullin and other vasoactive peptides. Combining neprilysin inhibitor with angiotensin converting enzyme inhibitor showed superior efficacy, but was associated with serious angioedema. ARNI (Angiotensin receptor blocker neprilysin inhibitor) valsaratn/sacubitril does not inhibit angiotensin converting enzyme inhibitor or aminopeptidase P, was not associated with increased risk of angioedema in the PARADIGM-HF trial [1]. Omapatrilat, a drug which inhibits all the three enzymes involved in degradation o...
Source: Cardiophile MD - June 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Switching from ACEI to ARNI – Cardiology MCQ – Answer
While switching over from an ACE inhibitor to ARNI, ARNI can be started — hours after ACEI: Correct answer: c) 36 hours Combination of ACEI (angiotensin converting enzyme inhibitor) and neprilysin inhibitor can lead to higher rates of angioedema as both can lead to accumulation of bradykinin [1]. Bradykinin is inactivated by angiotensin converting enzyme and neprilysin. Another drug omapatrilat which is an inhibitor of neprilysin, aminopeptidase P and ACE was tried for hypertension and heart failure. All the three enzymes are involved in inactivation of bradykinin [2]. The development of the drug was discontinued be...
Source: Cardiophile MD - June 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance 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