CLEAR Trial of Bempedoic Acid
Bempedoic acid is an ATP citrate lyase inhibitor, acting upstream of HMGCoA reductase targeted by statins, and reduces LDL cholesterol levels. It is associated with low incidence of muscle related adverse events compared to statins. US FDA had a prerequisite that patients should be already on maximally tolerated stating therapy before considering bempedoic acid and had noted that their effect on cardiovascular morbidity and mortality were considered as indeterminate. The manufacturers have reported that these clauses have been removed.
The CLEAR (Cholesterol Lowering via Bempedoic Acid [ECT1002], an ACL-Inhibiting Regime...
Source: Cardiophile MD - December 16, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Answer to Case 699
Answer:Clonorchis sinensis/Opisthorchiseggs. The location (South Korea) is consistent withC. sinensis.As noted by Sam, " Both eggs have an abopercular knob and an obvious operculum. So these could be eggs of eitherClonorchis sinensisorOpisthorchisspecies (both liver flukes). We can ' t differentiate based on morphology, but based on the patient being from/living in South Korea, we can likely narrow the identification down toClonorchis sinensis, as Korea is an endemic region for this parasite. WhereasOpisthorichis viverriniis endemic to South East Asia (i.e, Vietnam, Cambodia, Laos, Thailand). Biliary complications can aris...
Source: Creepy Dreadful Wonderful Parasites - October 23, 2022 Category: Parasitology Source Type: blogs
Why is there inferior ST elevation, and would you get posterior leads?
Written by Jesse McLaren, with comments by Smith and Grauer A 75 year-old presented with 8 hours of epigastric pain and one episode of vomiting. They had a history of gallstones but no cardiac history. Vitals were normal except a heart rate of 55, and below is the triage ECG.What do you think?There ’s bradycardia but it is not sinus: while the P wave is upright in I it is inverted in II so it is a low atrial rhythm. Conduction is otherwise normal, axis is indeterminate, and voltages are normal. There is early R wave progression with R>S in V1-2, primary ST depression in V2-3, and a Q wave with hyperacute T wave i...
Source: Dr. Smith's ECG Blog - May 3, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Cancer
I sometimes like to open my posts with a joke. But not this time. There isn ' t a joke for this.Mrs. Dalai has cancer.How ' s that for a kick in the ass? I am neither vain nor arrogant enough to think that I could write the ultimate treatise on dealing with a loved one ' s cancer. There are any number of engaging stories out there on Caring Bridge and the like. You don ' t want to read a tear-jerker anyway, nor do you want to endure every last boring and/or gory detail. Mrs. Dalai would be very upset with me if I shared all that. Hell, she ' s probably going to be upset with me for writing this at all. She is a very p...
Source: Dalai's PACS Blog - September 4, 2021 Category: Radiology Source Type: blogs
Why do we liberally record ECGs? And what do you think the angiogram showed?
Discussion:This ECG is Aslanger ' s pattern, and the angiogram is exactly what you expect with this ECG pattern, including the inferior OMI attributed to circumflex (more often than RCA).This pattern was recently published in J Electrocardiology: Aslanger and others (including Smith). A new electrocardiographic pattern indicating inferior myocardial infarction. https://pubmed.ncbi.nlm.nih.gov/32526537/This newly recognized ECG pattern is defined as:(1) any STE in III (with reciprocal STD in aVL), but not in other inferior leads, (2) STD in any of leads V4 to V6, (but not in V2) with a positi...
Source: Dr. Smith's ECG Blog - August 10, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Why losing weight can be dangerous to your health
So many people are embarking on weight loss programs that hold potential for health hazards. Here’s a video from my YouTube channel about how choosing the wrong weight loss program can lead you down the path of health disasters, as well as not provide the weight loss benefits you desire.
Losing weight per se is not dangerous—it’s the method you choose to lose weight that can introduce genuine risks to your health. Choose the wrong method and you can end up with gallstones and gallbladder surgery, osteopenia/osteoporosis, kidney stones, even heart attack. Here is some additional discussion about common we...
Source: Wheat Belly Blog - June 13, 2020 Category: Cardiology Authors: Dr. Davis Tags: Open grain-free low-carb Weight Loss wheat belly Source Type: blogs
When a mnemonic becomes dangerous
Fat. One tiny word. One voluptuous, full-figured concept. Several weeks ago, amidst a conversation regarding the risk factors for cholelithiasis (i.e., gallstones) during a chief concern small group session for preclinical students, my preceptor ushered in an aurally convenient yet unsettling mnemonic utilizing alliteration that has apparently been in the works among medical education for […]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 9, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/jay-wong" rel="tag" > Jay Wong < /a > < /span > Tags: Conditions Gastroenterology Surgery Source Type: blogs
“ 5 things I wish I knew before I spent a lot of money on a weight loss program! ”
You can spend–throw away?–a ton of money buying meal replacement shakes, subscription meal plans, nutritional supplements, prescription drugs, even weight loss surgery.
But understand these 5 basic principles and you can enjoy weight loss rapidly, effortlessly, and inexpensively. It does NOT involve cutting calories, reducing fat, extreme exercise, certainly not drugs or procedures. It applies simple logic and recent science to craft a hugely effective way to lose weight.
1) Cutting calories is useless–Yes, you can lose weight upfront, but the reduction in metabolic rate that develops over time will cause...
Source: Wheat Belly Blog - February 26, 2020 Category: Cardiology Authors: Dr. Davis Tags: Open gluten-free grain-free opiates Weight Loss wheat belly Source Type: blogs
Gallbladder: Use it or lose it
The post Gallbladder: Use it or lose it appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - November 13, 2019 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle bile calories Fat gallstones Weight Loss Source Type: blogs
The initial survey results are in – and they ’ re horrifying
The post The initial survey results are in–and they’re horrifying appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - September 21, 2019 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle gallstone Source Type: blogs
What you need to know about the DANGERS of weight loss and gallstones
The evidence is clear: The WAY you lose weight can determine whether or not you develop gallstones. Surprisingly, cutting calories and/or fat, as advised by many doctors, dietitians, and commercial weight loss programs, leaves you at high-risk for develop gallstones and gallbladder surgery.
The remedies to this dangerous situation are simple.
If you followed a low-fat and/or low-calorie diet, please take this brief survey from the Wheat Belly Blog.
The post What you need to know about the DANGERS of weight loss and gallstones appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - September 20, 2019 Category: Cardiology Authors: Dr. Davis Tags: Open bile calories cholecystectomy gallstones low-fat Weight Loss wheat belly Source Type: blogs
A Survey: Diet and Gallstones
The evidence is clear: Reduce calories and/or reduce dietary fat to lose weight and you are at high-risk for developing gallstones, even within a few weeks of starting such a diet. Serial gallbladder ultrasound studies have repeatedly demonstrated this phenomenon. Among the studies documenting this effect:
The greater the reduction in calories, the greater the likelihood of gallstones and need for cholecystectomy
It doesn’t take much in the way of fat intake to avoid gallstone formation during weight loss
Summary of the studies documenting that higher fat intake prevents gallstones during weight loss
This ha...
Source: Wheat Belly Blog - September 18, 2019 Category: Cardiology Authors: Dr. Davis Tags: Open gallstones low calorie low-fat undoctored Weight Loss wheat belly Source Type: blogs
How NOT to develop gallstones during weight loss
The post How NOT to develop gallstones during weight loss appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - September 9, 2019 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle bile gallbladder gallstones Source Type: blogs
Making sense of gallstones
The post Making sense of gallstones appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - August 31, 2019 Category: Cardiology Authors: Dr. Davis Tags: News & Updates bile biliary gallstones grain-free undoctored wheat belly Wheat Germ Agglutinin Source Type: blogs
The ECG was correct. The angiogram was not.
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina. If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI. If that is a result of plaque rupture, then it is a type I MI. The clinical presentat...
Source: Dr. Smith's ECG Blog - August 12, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
