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Questioning Medicine
Questioning Medicine
Category: Medicine
Location: Florida
Followers (30)
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June 13, 2019 05:18 PM PDT

vitamin d- if you cant give up on it then give up on checking the lab value- fire and forget.

https://www.nejm.org/doi/full/10.1056/NEJMoa1800566 induction at 39 weeks is okay with me

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2698631 cardio test and all test have varibility

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31131-0/fulltext our evaluation of you prior to surgery is basically worthless based on current evaluation or stress test


https://annals.org/aim/article-abstract/2708163/kidney-damage-biomarkers-incident-chronic-kidney-disease-during-blood-pressure kidney disease from lower bp doesnt seem to be actual damage just hemodynaic effect

https://www.ncbi.nlm.nih.gov/pubmed/30688979 lower that bp and doesnt seem to have an effect on dement and might even be protective

https://www.gastrojournal.org/article/S0016-5085(18)35193-X/fulltext pt going for elective colonoscopy- keep the clopidogril

June 04, 2019 08:08 PM PDT

http://www.bloodadvances.org/content/3/5/789?sso-checked=true#T1 if not bleeding nad on warfarin with supertheraputic INR then you can likely hold off on vit k

https://jamanetwork.com/journals/jama/article-abstract/2728676
https://jamanetwork.com/journals/jama/article-abstract/2728675 ablation lead to happier (5 pts on 100 pt scale) but no other improvement

https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0196064419301398?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0196064419301398%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.jwatch.org%2Fna48926%2F2019%2F04%2F16%2Fshould-we-add-muscle-relaxants-ibuprofen-acute-low-back
yep acute back pain- 7 days later- just give ibprofen

https://onlinelibrary.wiley.com/doi/10.1002/oby.22347 Gelesis100 made you lose 4 pounds in 24wks--- I guess it is better than nothing but it is still something

https://www.fda.gov/news-events/press-announcements/first-fda-approved-vaccine-prevention-dengue-disease-endemic-regions dengue vaccine is out- make sure it is confirmed first

http://www.onlinejacc.org/content/73/16/2025 skipping breakfast is still likely a good idea- unless you are overweight, smoke, htn, and overall poor picture of health then in this study you seem to have some protective benefit for eat breakfast

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733171 if you get your appt. later in the day you dont get cancer screening as much maybe cause it is not ordered or cause you are smart or cause better shared decision making conversation

A doctor "fired" me for refusing screening mammography: Here's why I decline: Gotzsche RCT >600,000 no mortality benefit; Canadian Study, Miller 25 year follow up-no mortality benefit; Danish-Norwegian study 2018 - no mortality benefit

May 21, 2019 04:56 PM PDT

afib- new guidelines!
https://www.google.com/search?q=2019+American+Heart+Association%2C+American+College+of+Cardiology+and+the+American+Rhythm+Society+focused+update+from+their+2014+guidelines+for+the+management+of+patients+with+atrial+fibrillation&rlz=1C1CHFX_enUS708US708&oq=2019+American+Heart+Association%2C+American+College+of+Cardiology+and+the+American+Rhythm+Society+focused+update+from+their+2014+guidelines+for+the+management+of+patients+with+atrial+fibrillation&aqs=chrome..69i57.1079j0j7&sourceid=chrome&ie=UTF-8

FIT test has high sensitivity and specificity for crc and it gets more people to do colon cancer screening and lets be honest it is only a good test or a good drug if people actually do it

https://www.ncbi.nlm.nih.gov/pubmed/30802902

afib can wait to be converted and over 50% of the time will convert on its own
https://www.nejm.org/doi/full/10.1056/NEJMoa1900353

good news for you lazy people listening to this on the couch you can still inprove your all cause mortality with increase exercise in your midlife crisis.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2727269

if a person has an arterial blood clot they dont always have cancer but most likely they have cancer and we have not found it... yet

http://www.bloodjournal.org/content/133/8/781?sso-checked=true

UTI and foley cath- probably dont need to replace the foley cath give the correct antibiotic

https://www.ncbi.nlm.nih.gov/pubmed/30094820

May 09, 2019 02:00 PM PDT

https://www.bmj.com/content/364/bmj.l42 skip breakfast- it doesn't help you 'lose weight'


https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2723074 Automated BP cuffs are the new rage and for good reason they are about equal to awake ambulatory blood pressure

https://www.ncbi.nlm.nih.gov/pubmed/30653040 if you have a pt. going to surgery for their knee because of osteoarthritis-- let it be and DONT do an injection.

https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(18)30191-1/fulltext if you have a choice-- give apixaban


https://jamanetwork.com/journals/jama/article-abstract/2719307 you can not pay physicians for readmission but then they will try and game the system and in the pt. misses out and dies more often-- oops

https://jamanetwork.com/journals/jama/article-abstract/2727448 tramadol increase mortality! WOW shocker-- maybe this isn't real but it is really is worthing making us stop to think.

April 22, 2019 06:48 PM PDT

shared decision making for lung cancer rarely happens in the community and when it does happen 2/5 said no thanks to cancer screening
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2720126

vit d. - does not work on a bus it doesn't work with white women or black women anyone
https://www.ncbi.nlm.nih.gov/pubmed/29905969

achilles tendon rupture- if you go to surgery NNT for rerupture of 1 and 66 but risk of infection 1/33
https://www.bmj.com/content/364/bmj.k5120

Topical pain creams dont work for chronic pain- BUT low risk of side effects and still getting almost 2 point decrease on 10 point scale-- I will take it!
https://annals.org/aim/article-abstract/2724041/compounded-topical-pain-creams-treat-localized-chronic-pain-randomized-controlled

Alirocumab is still way too expensive
https://www.ncbi.nlm.nih.gov/pubmed/30597485

concussion in an athlete-- get them to the sub-symptom heart rate
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2723523

April 16, 2019 07:18 PM PDT

https://www.emrap.org/episode/rightonprime/introduction RIGHT ON PRIME IF YOU NEED CME

10% likely isn't high risk but it certainly deserves more than 0.6% of people on statins so don't forget your statins
https://annals.org/aim/article-abstract/2725144/characteristics-high-cardiovascular-risk-1-7-million-chinese-adults

Oxycodone "the best high of all" https://link.springer.com/article/10.1007/s11916-019-0751-7

Smart phones are actually being smart
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32993-3/fulltext

You lose weight and want to keep it off you better keep moving
https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22373

Dont be that guy that gives 1.2million extra days of antibiotics
https://www.bmj.com/content/364/bmj.l440

March 14, 2019 06:38 PM PDT
February 23, 2019 05:31 PM PST

https://annals.org/aim/article-abstract/2719218/long-term-outcomes-among-patients-discharged-from-hospital-moderate-anemia#an_fo_ho Anemia is not being fixed 6months after hospitalization but that is okay because they are not going back to the hospital or dying

https://jamanetwork.com/journals/jama/fullarticle/2679928 Have the shared decision making conversation with your pt about mammograms!

https://www.youtube.com/watch?v=UZlY6Q4m-MM MAMMOGRAM THEATER

https://www.nejm.org/doi/full/10.1056/NEJMoa1710926 Oral antibiotics for osteo instead of IV-- yep it looks like times are a changing!

https://jamanetwork.com/journals/jama/article-abstract/2721178
Aspirin time of death 2/23/2019!

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