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: Kristin Prentiss Ott, MD 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: Frederick Gandolfo, MD 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 wor...
Source: Kevin, M.D. - Medical Weblog - July 7, 2015 Category: Journals (General) Authors: Michael Kirsch, MD 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 drug s...
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 urine drug screen 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 and sof...
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 patients to just stop ...
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 has...
Source: Pharmalot - June 12, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
