MKSAP: 35-year-old man with persistent heartburn
Test your medicine knowledge with the  MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old man is evaluated during a follow-up appointment for persistent heartburn with chronic cough. He has a 1-year history of gastroesophageal reflux disease and takes pantoprazole twice daily. He reports no nausea, vomiting, or dysphagia. Upper endoscopy performed 1 year […]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 - August 10, 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 Gastroenterology Source Type: blogs

Where did all the magnesium go?
We pay special attention to restoration of magnesium in the Wheat Belly lifestyle. This is because magnesium deficiency is universal, affecting virtually everyone, is severe, and has substantial implications for health. But why? Why has everyone become so depleted in magnesium in the modern world? There are five major reasons: Water filtration—We filter our water out of necessity, since modern waterways are contaminated by sewage runoff, pesticide/herbicides, algal overgrowth, etc. So, rather than drinking from a nearby stream or river that runs freely over rocks and minerals rich in magnesium, we drink water filter...
Source: Wheat Belly Blog - May 30, 2019 Category: Cardiology Authors: Dr. Davis Tags: Magnesium grain-free phytates undoctored wheat belly Source Type: blogs

Seasoned medical professionals prescribe new medicines sparingly
I prescribe heartburn medicines every day. There ’s a gaggle of them now— Prilosec, Nexium, Prevacid, Protonix— to name a few. As far as experts know, their primary effect is to reduce the production of stomach acid. This is why they are so effective at putting out your heartburn fire. In simple terms: no […]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 - December 31, 2018 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/michael-kirsch" rel="tag" > Michael Kirsch, MD < /a > < /span > Tags: Meds Gastroenterology Source Type: blogs

Live the Wheat Belly lifestyle, get off prescription medications
Take a look at the list of medications people have been able to stop by following the Wheat Belly lifestyle. These represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, joint pain, high blood pressure, leg edema and other abnormal effects caused by wheat and grains. The list includes anti-inflammatory and pain medication, acid reflux drugs, injectable and oral drugs for diabetes, numerous anti-hypertensive agents, asthma i...
Source: Wheat Belly Blog - October 27, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune blood sugar bowel flora cholesterol Gliadin gluten-free grain-free grains Inflammation undoctored Weight Loss wheat belly Source Type: blogs

Bowel disaster
Something like 60 to 100 million of us live with a severe form of dysbiosis called small intestinal bacterial overgrowth, or SIBO, in which bowel microorganisms have ascended up the ileum, jejunum, duodenum, and stomach, a massive onslaught of infection and inflammation that results in increased intestinal permeability and entry of bacterial lipopolysaccharide, LPS, and other factors into the bloodstream that massively increase body-wide inflammation, absolute bowel disaster. But what sets this enormous disruption of human health in motion? Why would a perturbation of human health of such huge proportions get rooted in the...
Source: Wheat Belly Blog - September 3, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates bowel flora grain-free Inflammation sibo small intestinal wheat belly Source Type: blogs

Seven things you probably didn ’ t know about IBS
To an impressive degree, irritable bowel syndrome, IBS, vividly illustrates what consuming wheat and grains do to the human body, as well as the myriad effects of factors such as GMOs containing glyphosate and Bt toxin, veggies and fruits with herbicides and pesticides, water “purified” with awful chemicals such as chloramine (MUCH longer lasting than chlorine in the body and environment), and commonly prescribed drugs like Protonix, Prilosec, and other stomach acid-suppressing drugs. You may already know that many people obtain relief from IBS symptoms just by banishing wheat and grains from their diet. But so...
Source: Wheat Belly Blog - September 1, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune bowel flora dysbiosis gluten-free grain-free grains IBS Inflammation prebiotic probiotic small intestinal wheat belly Source Type: blogs

The fecalization of America
I’ve been lately discussing the issue of small intestinal bacterial overgrowth, or SIBO, a situation in which bowel microorganisms (especially of the undesirable Enterobacteriaceae variety such as E. coli and Shigella) ascend up from the colon and colonize the ileum, jejunum, duodenum, and stomach. This has numerous health implications that are only beginning to be appreciated: irritable bowel syndrome (IBS), fibromyalgia, psoriasis and other skin rashes, restless leg syndrome, diverticular disease, heightened body-wide inflammation, increased risk for colon cancer—SIBO is either synonymous with these condition...
Source: Wheat Belly Blog - July 10, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates bowel flora dysbiosis Inflammation microbiota prebiotic probiotic sibo small intestinal bacterial overgrowth undoctored wheat belly Source Type: blogs

One Barely Noticed Settlement by Pfizer Suggests the Futility of Polite Protests about Health Policy
A few days ago we noticed just one more marcher in theparade of legal settlements.  But it was once again a huge health care corporation, and it had aspects that demanded attention.Pfizer Makes $94 Million Settlement of Allegations of Fraud to Delay Generic CompetitionA tinyitem in Becker's Hospital News on November 28, 2017, stated:Pfizer will pay $94 million to resolve allegations that it used fraudulent patents to delay generic competition for its anti-inflammatory drug Celebrex.The lawsuit, brought by 32 direct purchasers of Celebrex in April and certified a class action lawsuit in August, claimed Pfizer attempted...
Source: Health Care Renewal - December 3, 2017 Category: Health Management Tags: adverse effects Celebrex deception impunity legal settlements Pfizer restraint of competition Source Type: blogs

An August Appendectomy
In August, (one month ago today)I had an appendectomy. There was very little drama involved, the doctors office visit led straight to a same day CT scan and an emergency review with the radiologist who informed me the appendix couldn't be seen but the colon was most definitely inflamed and I should go to the ER if it got worse. To the ER I went that night, to a hospital where the D Care is very good (had that going for it). They admitted me under observation, coursing enough pain medications through me to make me sick for the next 14 hours. The plan was to do another CT the next day. In observation, as I was trying not to ...
Source: The D-Log Cabin - September 20, 2017 Category: Endocrinology Authors: HVS Source Type: blogs

7 ways to save cash on prescription drugs
The prescription retinoid that my dermatologist suggested sounded like a great idea. It was a topical vitamin A-based cream, which has been shown to help reduce fine lines and wrinkles. Now that I’m a middle ager, I thought I’d give it a try. Then I got to the drugstore, and found that the little tube had a huge price: $371! I didn’t want to shell out that much for a mere face cream, so I didn’t fill the prescription. But my case was only skin-deep. What about people who can’t — or don’t want to — pay for prescription medications to treat chronic or serious illness? “It...
Source: Harvard Health Blog - May 18, 2017 Category: Consumer Health News Authors: Heidi Godman Tags: Drugs and Supplements Health Managing your health care Source Type: blogs

Did Big Pharma BUY Big Media?
Healthcare is at the top of the list of societal problems in the U.S. Healthcare interactions are unsatisfying to most people, costs are out of control and cost every American nearly $10,000 per person per year while bleeding 17.5% of GDP, more than any other nation on earth for a system that ranks low or last  in quality compared to other developed countries. For a problem as big as healthcare, big enough to cripple the entire economy in addition to bankrupting more and more Americans, you would think that media reporting would be filled with debate, criticisms, and in-depth coverage about the problems in healthcare....
Source: Wheat Belly Blog - May 2, 2017 Category: Cardiology Authors: Dr. Davis Tags: Undoctored abc bias big pharma cbs cnn drug industry fox gluten grains health healthcare illness media nbc pharmaceutical tv wheat Source Type: blogs

H. pylori, a true stomach “bug”: Who should doctors test and treat?
In 1982, two Australian scientists discovered that a certain bacterium, Helicobacter pylori, was a common cause of persistent stomach inflammation and stomach ulcers. This realization revolutionized ulcer treatment. While fairly common, this infection usually causes no symptoms, but it can sometimes lead to ulcers in the stomach or the very first part of the small intestine (duodenum), and to certain types of stomach cancer. There is also evidence linking H. pylori infection to other conditions like iron-deficiency anemia and vitamin B12 deficiency. The bacteria are thought to spread through contaminated water, vomit, or f...
Source: Harvard Health Blog - April 5, 2017 Category: Consumer Health News Authors: Wynne Armand, MD Tags: Digestive Disorders Health Infectious diseases Tests and procedures Source Type: blogs

Coronary artery disease: Primary care and prevention
Symptomatic coronary artery disease can be divided into stable coronary artery disease and acute coronary syndromes. Asymptomatic coronary artery disease seldom present to the primary care physician and is often detected by a routine health check up or pre-operative evaluation. Stable coronary artery disease usually presents in the form of chronic stable angina. Acute coronary syndromes could be either unstable angina or acute myocardial infarction. Acute myocardial infarction can be further subdivided into ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) depending on the prese...
Source: Cardiophile MD - December 18, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs

Are there raccoons in your garden?
Imagine that you are planning to plant a garden in springtime. You clear the soil of grass and weeds, sift out the rocks, fold in some manure or composted material to enrich the soil. You then plant seeds for squash, peppers, maybe some heirloom carrots. You water the garden and then wait for the seeds to sprout, hoping for a glorious bounty of veggies in a couple of months. But you forgot that there are raccoons, rabbits, and deer in the neighborhood, creatures eager to eat your work. Sprouts come up, leaves, then young vegetables—only to disappear overnight after a raccoon or rabbit feast. So it goes with the garde...
Source: Wheat Belly Blog - December 3, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle bowel flora gluten grains microbiome prebiotic probiotic Source Type: blogs

Diabetes, Inc.
For Big Pharma and others who profit from human disease, type 2 diabetes is the gift that keeps on giving. Approaching one trillion dollars in worldwide costs, type 2 diabetes is largely a man-made condition. For the majority of people, type 2 diabetes (and, to a substantial degree, type 1 diabetes also) is created by: Cutting dietary fat and cholesterol–as advised the U.S. Department of Health and Human Services, the USDA, the American Diabetes Association, the American Heart Association, and the Academy of Nutrition and Dietetics Increased consumption of grains–that raise blood sugar higher than table sugar,...
Source: Wheat Belly Blog - November 14, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle blood sugar diabetes gluten grains HbA1c low-carb low-fat Source Type: blogs

Is your doctor guilty of treating grain consumption?
Jennifer shared these comments about her husband’s early Wheat Belly transformation: “My husband found your site a while back while doing research into symptoms he’s been experiencing for years. After following your advice with food, the doctor visits have stopped and I have a normal husband back. “Prior to meeting him, he has always had issues with his weight and gut. He would exercise to the point of passing out and it just wouldn’t go anywhere. When I met him 5 years ago, he was jogging every night and exercising. He just couldn’t get the flabby stomach to go away and, every time the ...
Source: Wheat Belly Blog - August 4, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories abdominal distress diabetes gluten grains headache IBS Inflammation obesity overweight Source Type: blogs

Pfizer: Another Settlement Down
This article goes through the case, the settlement, and what it means for the future. Our readers may remember the “agreement in principle” reached between Pfizer, Inc. and the Department of Justice (“DOJ”) to settle the qui tam case with Wyeth, LLC. That agreement was recently made official by the parties, with the settlement being signed, sealed, and delivered on April 27, 2016.  As a refresher, allegations were made by Lauren Kieff, a former hospital sales representative for AstraZeneca Pharmaceuticals LP, and William St. John LaCorte, a physician, that Wyeth engaged in healthcare fraud fr...
Source: Policy and Medicine - July 22, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Pfizer/Wyeth Settlement Finalized and Signed: States Net Millions
The Department of Justice ("DOJ") recently entered into a settlement of a quit tam lawsuit against Pfizer, Inc. and Wyeth, LLC. We previously wrote about this settlement back in February, when an "agreement in principle" was reached between Pfizer and the United States government. As a refresher, allegations were made by Lauren Kieff, a former hospital sales representative for AstraZeneca Pharmaceuticals, LP, and William St. John LaCorte, a physician, that Wyeth engaged in healthcare fraud from 2001 to 2006. These allegations covered two medications, both commonly used to treat acid reflux disease, Pr...
Source: Policy and Medicine - May 3, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Can Your Antacid Cause Alzheimer’s Disease?
Can your antacid really cause Alzheimer’s Disease? Recent research suggests that, indeed, proton pump inhibitors, some of the most common drugs for reducing feelings of heartburn, can cause an increase in the ‘beta amyloid’ deposits in the brain that are indicative of Alzheimer’s Disease. This is in addition to some of the other serious Proton Pump Inhibitor Side Effects, like osteoporosis, magnesium deficiency and  heart rhythm problems; Antacid Medications can Even Ruin Your Gut. These problems can occur even when these heartburn relieving drugs are taken for short amounts of time. All too of...
Source: Immune Health Blog - February 26, 2016 Category: Nutrition Authors: Kerri Knox, RN Tags: Brain Health/ Neurologic Digestive Health Vitamin B12 alzheimers disease causes cause alzheimer's disease cause of alzheimers disease causes of alzheimers omeprazole side effects proton pump inhibitors proton pump inhibitors cause alzhei Source Type: blogs

Can Your Antacid Cause Alzheimer ’s Disease?
Can your antacid really cause Alzheimer’s Disease? Recent research suggests that, indeed, proton pump inhibitors, some of the most common drugs for reducing feelings of heartburn, can cause an increase in the ‘beta amyloid’ deposits in the brain that are indicative of Alzheimer’s Disease. This is in addition to some of the other serious Proton Pump Inhibitor Side Effects, like osteoporosis, magnesium deficiency and  heart rhythm problems; Antacid Medications can Even Ruin Your Gut. These problems can occur even when these heartburn relieving drugs are taken for short amounts of time. All too of...
Source: Immune Health Blog - February 26, 2016 Category: Nutrition Authors: Kerri Knox, RN Tags: Brain Health/ Neurologic Digestive Health Vitamin B12 alzheimers disease causes cause alzheimer's disease cause of alzheimers disease causes of alzheimers omeprazole side effects proton pump inhibitors proton pump inhibitors cause alzhei Source Type: blogs

Can Your Antacid Cause Alzheimer ’s Disease?
Can your antacid really cause Alzheimer’s Disease? Recent research suggests that, indeed, proton pump inhibitors, some of the most common drugs for reducing feelings of heartburn, can cause an increase in the ‘beta amyloid’ deposits in the brain that are indicative of Alzheimer’s Disease. This is in addition to some of the other serious Proton Pump Inhibitor Side Effects, like osteoporosis, magnesium deficiency and  heart rhythm problems; Antacid Medications can Even Ruin Your Gut. These problems can occur even when these heartburn relieving drugs are taken for short amounts of time. All too of...
Source: Immune Health Blog - February 26, 2016 Category: Nutrition Authors: Kerri Knox, RN Tags: Brain Health/ Neurologic Digestive Health Vitamin B12 alzheimers disease causes cause alzheimer's disease cause of alzheimers disease causes of alzheimers omeprazole side effects proton pump inhibitors proton pump inhibitors cause alzhei Source Type: blogs

Pfizer Reaches “Agreement in Principle” for Wyeth Whistleblower Case for $784.6 Million – Serial Whistle Blower Gains almost $100 Million
Pfizer and the United States government reached an "agreement in principle" on February 16, 2016 regarding two whistleblower complaints that accused the Wyeth unit of Pfizer of cheating Medicaid out of discounts the company made available to other customers. This agreement says that Wyeth/Pfizer will make a payment of $784.6 million to the government to resolve those claims. The deal is still subject to negotiation of a final agreement and court approval; a trial had been scheduled to begin March 7, 2016, in federal court in Boston, MA. The judge that was set to hear the cases has dismissed them because of the pr...
Source: Policy and Medicine - February 23, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Ho-hum, Another Month, Another Set of Multi-Million Dollar Settlements by Health Care Corporations Acting Badly
Amazingly, with a US presidential election looming, there is finally some public discussion here of the impunity of top corporate executives.  Columnist Gretcher Moregenson wrote on February 6, 2016 in the New York Times,Ho-hum, another week, another multimillion-dollar settlement between regulators and a behemoth bank acting badly.Then,As has become all too common in these cases, not one individual was identified as being responsible for the activities. Once again, shareholders are shouldering the costs of unethical behavior they had nothing to do with.It could not be clearer: Years of tighter rules from legislators ...
Source: Health Care Renewal - February 21, 2016 Category: Health Management Tags: adverse effects deception Fresenius health care prices impunity legal settlements Merck Pfizer Vioxx You heard it here first Source Type: blogs

Alkalotics Anonymous
​A 50-year-old man with a past medical history of alcoholism presented to the ED with altered mental status, nausea, and vomiting. He is arousable but a poor historian. His girlfriend said he drinks a half-gallon of rum daily, and had his last drink two days earlier. She reported that he started to feel nauseous, vomit, and go through alcohol withdrawal. She said he also has been taking a lot of calcium carbonate for an upset stomach, but she was unable to say exactly how much. ​ His blood pressure was 146/70 mm Hg, heart rate was 110 bpm, respiratory rate was 14 bpm, PO2 was 96% on room air, and blood glucos...
Source: The Tox Cave - February 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Their Cheating Hearts - Latest Allergan Settlement Is a Reminder of Merger Participants' Sketchy Pasts
A Huge, but Sketchy Merger The announced merger and "tax inversion" of Pfizer and Allergan would be one of the largest corporate marriages in US history.  It has drawn more than its share of criticism.  For example, per the Los Angeles Times, former US Senator and Secretary of State, and current presidential candidate Hilary Clinton said "this proposed merger, and so-called inversions by other companies, will leave U.S. taxpayers holding the bag." By creating the world's largest drug company, it could certainly further consolidate the US and global pharmaceutical market and raise already high ...
Source: Health Care Renewal - November 24, 2015 Category: Health Management Tags: Allergan crime deception fraud impunity kickbacks legal settlements obstruction of justice Pfizer RICO Source Type: blogs

What medications have you been able to stop on the Wheat Belly lifestyle?
I posed this question on the Wheat Belly Facebook page recently and received an overwhelming response. Here, I share a partial list of the responses: medications people have been able to stop by following the Wheat Belly lifestyle. Just take a look at this incredible list: these represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat the inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, and other abnormal effects all caused by wheat and grains. The list includes anti-infl...
Source: Wheat Belly Blog - October 6, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle asthma cholesterol diabetes drugs gluten grains hypertension prescription medication reflux Source Type: blogs

Pfizer's Latest International Pfiascos - Charges of Anti-Competitive Practices, Inflated Prices, Deception and Secrecy
Many big health care organizations seem to just be unable to keep out of trouble, and the bigger they are, the more kinds of trouble.  Pfizer Inc, considered to be one of the world's largest pharmaceutical companies, has supplied us with plenty of stories.  Enough new stories about Pfizer have accumulated since last year to do a roundup.    Presented in chronological order....Italy Demands Damages from Pfizer for Anti-Trust ViolationsThis story came out in May, 2014, via Reuters,Italy said on Wednesday it was seeking more than a billion euros in damages from multinational drug companies following a...
Source: Health Care Renewal - September 13, 2015 Category: Health Management Tags: adverse effects antitrust deception executive compensation health care prices legal settlements marketing Pfizer suppression of medical research vaccines Source Type: blogs

A physician’s ode to nurses
A few weeks ago, after feeding my face with rich, dense chocolate cake brought by a truly awesome nurse (for no particular reason other than a warm and generous spirit), I walked back into a room to check on a post-cardiac arrest patient. After surveying his vitals on the monitor, I turned my attention to two nurses and a pharmacist who were discussing the management of his six drips. He was on three pressors, fluids, antibiotics, Protonix, and blood was on the way. I looked at the tangle of tubes running from the subclavian central line I had placed and traced them back to the scrolling green characters on the IV pump scr...
Source: Kevin, M.D. - Medical Weblog - September 1, 2015 Category: Journals (General) Authors: Tags: Physician Nurse Source Type: blogs

Do proton pump inhibitors cause heart attacks?
This study used a technique called “data-mining” to extract information from years of electronic medical records (EMRs) and included about 70 thousand patients in their primary analysis.  They describe the data-mining technique in the article, which seems to boil down to assigning a mathematical function to certain defined variables (patients taking PPIs) and an outcome (heart attack) to see if the two events are associated. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 18, 2015 Category: Journals (General) Authors: Tags: Meds GI Heart Source Type: blogs

You’ve probably got dysbiosis: An excerpt from Wheat Belly Total Health
Here’s an excerpt from chapter 9, Full Recovery From Post-Traumatic Grain Gut Syndrome, of Wheat Belly Total Health about the exceptionally common issue of dysbiosis: “Up to 35 percent of people with no other gastrointestinal disease and no symptoms have bacterial overgrowth (dysbiosis) or other distortions of bowel flora composition. Even though many doctors regard irritable bowel syndrome (IBS) as a benign condition, 30 to 85 percent of people with IBS have varying degrees of dysbiosis at the time of their diagnosis–it is not benign. Overgrowth of unhealthy bacteria is common in people who have low stom...
Source: Wheat Belly Blog - July 17, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle bowel flora gluten grains health microbiota Source Type: blogs

Do heartburn drugs cause osteoporosis? A gastroenterologist answers.
Every week, I am asked by patients if their heartburn medicine causes osteoporosis. The most effective heartburn medicines are called proton pump inhibitors, or PPIs. If you watch more than an hour of TV per week, then you have seen ads for some of them. Nexium, Prilosec, and Protonix are three examples of these medicines. Many of them are now available over-the-counter at reduced dosages. Patients today are incredibly informed, and sometimes misinformed, about their medical conditions and their treatments. Most of their information is from the internet, and it’s easy for patients to become unwittingly trapped in the...
Source: Kevin, M.D. - Medical Weblog - July 8, 2015 Category: Journals (General) Authors: Tags: Meds Endocrinology GI Source Type: blogs

Joint pain, edema, acid reflux, skin rashes: All part of the inflammation from grains
Aibreanne shared her Wheat Belly experience and photos, since she has experienced some pretty impressive relief from inflammatory health problems: After following a friend’s astounding transformation while following Wheat Belly, I decided to try it for myself. The photo with me in the Kilkenny colors [left] is from September, 2014. I’ve had to wean myself off Protonix and Zantac. I’ve had some fits and starts and some major cheating episodes–grains are drugs, I’m addicted, I eat, I suffer, I clean up. I’m trying to reduce and eventually rid myself of sugar but my current work schedule ma...
Source: Wheat Belly Blog - June 19, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories edema fatigue gluten grains joint pain Source Type: blogs

The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.   Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.     One of the limitations of a urine d...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.   Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.     One of the limitations of a ...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Just how much “healthcare” do you need minus grains?
Jamilyn shared her early experience with this lifestyle: “I started Wheat Belly February 9th, 2015. I have lost 20 pounds in just over 2 months and 10 on my own in the 9 months prior to WB–30 pounds difference from the first picture to the 3rd picture. “I have eliminated all of the many medications I was taking for migraines, IBS, gastroparesis, chronic sinusitis, and joint pain. I haven’t taken Allegra or Flonase (which I have taken everyday since I was in my 20’s) since the second day of Wheat Belly. I no longer need my Protonix, Reglan, Carafate, or Zofran for my gastroparesis either. No m...
Source: Wheat Belly Blog - April 15, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories gastroparesis grains IBS joint pain sinusitis Source Type: blogs

LITFL Review 172
Welcome to the 172nd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the WeekDi McMath writes a touching post reminding us all to build and maintain our resilience in “caring for the invisible wounds”. Thanks to Minh Le Cong for the tip! [SO]The Best of #FOAMed Emergency MedicineNice review of core content on skin...
Source: Life in the Fast Lane - March 8, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review 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

Proton pump inhibitors and B12 deficiency: What to do now
We can now add vitamin B12 deficiency to the growing list of risks of long term use of the proton pump inhibitors (PPIs). The New York Times had an article outlining the evidence that prolonged use of both proton pump inhibitors (PPIs) like Prilosec, Protonix, Prevacid and others, as well as the less potent H2 blockers like Zantac and Pepcid, can lead to vitamin B12 deficiency.  This is in addition to previously documented concerns about reduced calcium absorption that can lead to osteoporosis, increased risk of pneumonia and increased risk of Clostridium difficile colitis. It seems simple to ask patien...
Source: Kevin, M.D. - Medical Weblog - December 20, 2013 Category: Family Physicians Tags: Meds GI Medications Source Type: blogs

FDA Asks Drugmakers: Where Are Those Pediatric Studies?
A decade ago, the Pediatric Research Equity Act was enacted and gave the FDA the authority to require drugmakers to complete studies in children for the same adult indications when existing medicines are expected to be used in a substantial number of youngsters (read more here). And last year, the agency was given the right to shame drugmakers that fail to comply. And so, the FDA has now posted on its web site a batch of letters that were recently sent to drugmakers that have not sought or obtained a deferral extension; submitted a deferred pediatric study by a final due date or requested approval for a required pediatric ...
Source: Pharmalot - December 5, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs

Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated  joy of working in healthcare.  Physicians often forget just how alien the language of medicine is to people who don't live it everyday.  The best part about being a physician is not helping people recover from critical illness. The best part is not  about  listening and understanding with compassion and empathy.  Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process.   Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

Pfizer's Umpteenth Settlement (for $491 Million Plus a Guilty Plea), but No Person Held Responsible
The world's largest research based pharmaceutical company was in court again, as reported by the New York Times, The drug maker Pfizer agreed to pay $491 million to settle criminal and civil charges over the illegal marketing of the kidney-transplant drug Rapamune, the Justice Department announced on Tuesday. In particular, The recent case centers on the practices of Wyeth Pharmaceuticals, which Pfizer acquired in 2009.Rapamune, which prevents the body’s immune system from rejecting a transplanted organ, was approved by the Food and Drug Administration in 1999 for use in patients receiving a kidney tra...
Source: Health Care Renewal - July 31, 2013 Category: Health Medicine and Bioethics Commentators Tags: Wyeth impunity crime marketing Pfizer whistle-blowers legal settlements Source Type: blogs

How Much? Pfizer And Teva Reach $2.1B Deal Over Patent Dispute
This is an example of why at-risk launches are, well, risky. After nearly a decade of squabbling, Teva Pharmaceutical and Sun Pharmaceutical have agreed to settle a heated patent dispute with Pfizer over the Protonix acid-reflux by paying $2.15 billion. More specifically, Teva will shell out $1.6 billion – half this year and half next year - and Sun will pay the rest. At issue was a bet by Teva to begin selling a generic version of Protonx in December 2007 while simultaneously challenging the patent on the medicine that, at the time, was sold by Wyeth, which Pfizer subsequently acquired. The hope was that Teva, which...
Source: Pharmalot - June 12, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs

A Court Ruling Against Merck May Also Hurt Pfizer
In a setback for Merck, a federal judge refused to dismiss a whistleblower lawsuit that accuses the drugmaker of distorting so-called nominal pricing in order to build a huge customer base for its Nuvaring contraception device and three contraceptive pills. The lawsuit, which was filed by two former employees, also claims the drugmaker offered kickbacks to physicians in exchange for prescribing a cancer medication. At issue is an alleged scheme in which Organon – which Merck (MRK) inherited as part of its 2009 purchase of Schering-Plough – offered a steep discount to Planned Parenthood for its contraceptive pro...
Source: Pharmalot - February 26, 2013 Category: Pharma Commentators Authors: Ed Silverman Tags: Uncategorized Birth Control Pills Contraception Contraceptives Medicaid Merck Nuvaring Organon Pfizer Planned Parentood Schering Plough Wyeth Source Type: blogs

Pharmalot… Pharmalittle… Good Morning
Rise and shine. Another busy day is on the way. As usual, we are dashing about as we hustle the short people off to their schoolhouses and hunt for our to-do list. If only we could remember everything that must be done without prompting. Yes, there is a pill for that. Anyway, please join us in our daily coping ritual by grabbing a cup of stimulation. And as always, here are some tidbits to get you started. Hope your day is grand and keep in touch. One more thing: a happy valentine’s day to our favorite sweetie, Mrs. Pharmalot… J&J Loses $63M Verdict In Motrin Case (Boston Globe) Obama Medicare Rebate Plan...
Source: Pharmalot - February 14, 2013 Category: Pharma Commentators Authors: Ed Silverman Tags: Uncategorized Actavis Caronia Hospira Medicare Mylan Laboratories Obama Protonix Teva Laboratories Source Type: blogs

Pfizer's Pfourteenth Settlement - a Small Reminder of Continuing Impunity
Well, that did not take long.  Less than a month after its last legal settlements were announced, Pfizer had to settle again. The Details of the Settlement This case, involving charges filed by the Texas Attorney General, was only reported locally, e.g., here in the Houston Business Journal:The state of Texas will receive more than $36 million from two civil Medicaid fraud settlements with Pfizer Inc and Endo Pharmaceuticals,  Attorney General Greg Abbott said Friday. Both companies will pay $18.17 million to the state, plus attorney fees and relator shares. The federal government is also entitled to a share...
Source: Health Care Renewal - January 11, 2013 Category: Health Medicine and Bioethics Commentators Tags: executive compensation deception boards of directors impunity Pfizer legal settlements governance Source Type: blogs