Statin scare
It is shocking that so many people are bullied by doctors into taking statin cholesterol drugs: “The evidence is overwhelming: statins save lives.” “You’re a walking time-bomb. I can’t be responsible for your safety if you don’t take it.” “Your cholesterol is so high that you could die of a heart attack any time.” I’ve even heard of many patients being “fired” by doctors because of a refusal to take the prescription for Lipitor, Zocor, Crestor, or other drug.
Why such strong-arm tactics? Several reasons:
People are given the wrong diet, a diet—r...
Source: Wheat Belly Blog - May 23, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle cardiovascular cholesterol HDL lipids lipoproteins small LDL particles statins triglycerides Source Type: blogs
Biosimilars are “me-too” drugs, not generics
Time to take off the blinders
Generic drugs are the biggest success story in healthcare cost containment. This great success has fooled policymakers, journalists, health plans and others into thinking that the same model will tame spending on biologic drugs the way it has for traditional, chemical based products.
The latest example can be found in the Wall Street Journal (Knockoffs of Biotech Drugs Bring Paltry Savings). The article blames the lack of savings on price increases by makers of the original products in the run-up to the introduction of competing products. That is happening, but it doesn’t get to...
Source: Health Business Blog - May 11, 2016 Category: Health Management Authors: dewe67 Tags: Economics Pharma Policy and politics Uncategorized biotech Generic drugs Source Type: blogs
Biosimilars are “ me-too ” drugs, not generics
Time to take off the blinders
Generic drugs are the biggest success story in healthcare cost containment. This great success has fooled policymakers, journalists, health plans and others into thinking that the same model will tame spending on biologic drugs the way it has for traditional, chemical based products.
The latest example can be found in the Wall Street Journal (Knockoffs of Biotech Drugs Bring Paltry Savings). The article blames the lack of savings on price increases by makers of the original products in the run-up to the introduction of competing products. That is happening, but it doesn’t get to...
Source: Health Business Blog - May 11, 2016 Category: Health Management Authors: dewe67 Tags: Economics Pharma Policy and politics Uncategorized biotech Generic drugs Source Type: blogs
99306 CPT ® Code Description, Progress Notes, RVU, Distribution (Level 3 Initial Nursing Facility Care)
This 99306 CPT ® lecture reviews the procedure code definition, progress note examples, RVU values, national distribution data and explains when this code should be used in the nursing facility setting (nursing home). CPT stands for Current Procedural Terminology. This code is part of a family of medical billing codes described by the numbers 99304-99306. CPT ® 99306 represents the high (level 3) initial nursing facility care visit (whether you are the attending or a consultant) and is part of the Healthcare Common Procedure Coding System (HCPCS). This procedure code lecture for initial nursing facility ca...
Source: The Happy Hospitalist - May 7, 2016 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
99306 CPT® Code Description, Progress Notes, RVU, Distribution (Level 3 Initial Nursing Facility Care)
This 99306 CPT® lecture reviews the procedure code definition, progress note examples, RVU values, national distribution data and explains when this code should be used in the nursing facility setting (nursing home). CPT stands for Current Procedural Terminology. This code is part of a family of medical billing codes described by the numbers 99304-99306. CPT® 99306 represents the high (level 3) initial nursing facility care visit (whether you are the attending or a consultant) and is part of the Healthcare Common Procedure Coding System (HCPCS). This procedure code lecture for initial nursing facility c...
Source: The Happy Hospitalist - May 6, 2016 Category: Internal Medicine Authors: Tamer Mahrous Source Type: blogs
99306 CPT ® Code Description, Progress Notes, RVU, Distribution (Level 3 Initial Nursing Facility Care)
< div dir="ltr" style="text-align: left;" trbidi="on" > This 99306 CPT ® lecture reviews the procedure code definition, progress note examples, RVU values, national distribution data and explains when this code should be used in the nursing facility setting (nursing home). & nbsp;CPT stands for Current Procedural Terminology. This code is part of a family of medical billing codes described by the numbers 99304-99306. & nbsp;CPT ® 99306 represents the high (level 3) initial nursing facility care visit (whether you are the attending or a consultant) and is part of the Healthcare Common Procedure Coding System (HCPCS). & nb...
Source: The Happy Hospitalist - May 6, 2016 Category: Internal Medicine Authors: Tamer Mahrous Source Type: blogs
Experts Foresee Major Role For Generic Crestor
— Finally there’s a challenger to the long reign of Lipitor The FDA approval on Friday of the first generic version of Crestor (rosuvastatin calcium) marks the end of an era and the beginning of a major shift in cardiovascular medicine. Over time, as the price of the drug drops with generic competition, it seems...Click here to continue reading... (Source: CardioBrief)
Source: CardioBrief - May 2, 2016 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Uncategorized atorvastatin Crestor generics Lipitor Rosuvastatin statins Source Type: blogs
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
Stephen’s return from the medical quagmire
Stephen shared his 60-day Wheat Belly experience:
“Started Wheat Belly 60 days ago after a major health crisis. I found out I had type 2 diabetes 2 and very bad cholesterol. My numbers 60 days ago were: cholesterol 189, triglycerides 475, LDL could not be measured as it was so bad, HDL was 32. Two weeks ago: 20 pound weight loss, wearing a 15.5-inch neck size shirt compared to an 18. Triglycerides 79, LDL 25, HDL 40, cholesterol 81.
“I was first told on January 24, 2016 that my glucose level was 157. Forty five days later, my average glucose was 107 when measured by my diabetes counselor by downloading the data...
Source: Wheat Belly Blog - April 7, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories cholesterol diabetes gluten grains HDL statins triglycerides Weight Loss Source Type: blogs
What, besides large anterior STEMI, is so ominous about this ECG?
This article by Widimsky illustrates the danger of this finding:See these cases:Chest Pain and Right Bundle Branch BlockTreatments:1. Aspirin 325 mg2. Ticagrelor 180 mg3. Atorvastatin 80 mg (small studies support this)4. Heparin bolus5. Fluid challenge6. Because cardiogenic shock is likely to get worse, even after reperfusion (because myocardial stunning lasts many days), we intubated the patient.7. Vecuronium paralysis8. Ketamine sedation (to avoid affecting hemodynamics)9. K replacement.10. Should have cardioverted, but did notBy this time, the cath team was ready.A proximal LAD thrombotic occlusion was opened. &nb...
Source: Dr. Smith's ECG Blog - March 21, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 13
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed.
Reference
1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - February 7, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Guideline-Centered Care
By JOHNATHON TOMLINSON, MD
Doreen, Ahmed and Henry have recently had their medication changed in response to a new guideline for prescribing Statins, cholesterol-lowering drugs.
None of them came to ask for a change in their medication. In each case the change was recommended by a clinician in response to a new guideline against which our practice will be judged and financially rewarded or penalised.
Here are the NICE guidelines 2015:
The NICE guideline on lipid modification recommends that the decision whether to start statin therapy should be made after an informed discussion between the clinician and the person about ...
Source: The Health Care Blog - January 30, 2016 Category: Consumer Health News Authors: John Irvine Tags: Featured NHS Source Type: blogs
Guest Blogger Dr. Mark Komrad on Evidence-Based Medicine and Clinician Experience
In my last post- Medications, Parrots, and Crazy Virginia Laws --, I talked about Robert Whitaker's post on Pete Earley's page. I put a link to Pete Earley's blog, but not my Shrink Rap post, up on my personal Facebook page. Now some of my Facebook friends are psychiatrists, so this turned my Facebook page into something of a blog post, with no cute animals. You followed all that, right? (It's some weird version of social media hell, and yes, I tweeted it as well). The commenters there gave me permission to put their responses as comments on Shrink Rap, but Dr. Mark Komrad's response exceeded the ch...
Source: Shrink Rap - January 29, 2016 Category: Psychiatry Authors: Dinah Source Type: blogs
