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Questioning Medicine
Questioning Medicine
Category: Medicine
Location: Florida
Followers (30)
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November 06, 2019 02:16 PM PST
September 17, 2019 05:24 PM PDT

Let's look at the numbers behind CAC! The best evidence is found here https://jamanetwork.com/journals/jama/fullarticle/2687224 but the largest study is found here https://www.sciencedirect.com/science/article/pii/S0735109715072253?via%3Dihub but in the end they use this https://en.wikipedia.org/wiki/Net_reclassification_improvement which might trick many people but I know it won't trick the smart people that listen to questioning medicine

September 06, 2019 03:42 PM PDT
September 02, 2019 07:27 AM PDT

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2739056 not all guidelines are equal, think for yourself. Some guidelines even do harm when you actually look at the evidence.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2740207 doacs and surgery what do you do-- low risk surgery stop one day prior and start one day after surgery. with high risk surgery you stop two days prior and start two days after

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2747871?guestAccessKey=90abe76b-3a15-4b95-9b42-4f751c5fbe64&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=081919 Pt in the hospital for a non-cardiac condition and they have a high bp== don't worry about it- no evidence for what one week of high bp will do but we do have evidence that starting medications while in an acute state will cause harm. just let it be!!

GINA guidelines- budesonide formoterol prn OR SABA plus ICS prn for stage 1 or for stage two still budesonide formoterol prn OR scheduled ICS twice daily with prn SABA

August 12, 2019 08:56 PM PDT

https://www.nejm.org/doi/full/10.1056/NEJMoa1813959 even when we dont know where the stroke is coming from- aspirin is still king all these years later

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30840-2/fulltext Aspirin is such a king that is doesn't matter if you have a spontaneous brain bleed or intracerebral hemorrhage it does appear safe to restart aspirin after a 2-3 month break

https://jamanetwork.com/journals/jama/article-abstract/2736564 smart-choice trial looked 3 months compared to 12 months of DAPT and

https://jamanetwork.com/journals/jama/article-abstract/2736563 STOPDAPT-2 trial looked at 1 months followed by monotherapy clopidogrel compaed to 12 months of DAPT and BOOM 1 month is winner winner chicken dinner

https://www.ncbi.nlm.nih.gov/pubmed/31063082 all of medicine has variation- some pcp will give an antibiotic for otitis media. some will not. Some radiologist will say follow up is needed and some will not

https://ginasthma.org/pocket-guide-for-asthma-management-and-prevention/ new asthma guidelines from the global initiative for asthma says NO MORE EVER solo albuterol it is now soooooooo simple you get budesonide/fomotorol PRN

August 02, 2019 03:03 PM PDT

https://www.cdc.gov/mmwr/volumes/68/wr/mm6825a2.htm we are not testing people for HIV even though guidelines https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/human-immunodeficiency-virus-hiv-infection-screening1 since 2006 have recommended that everyone be tested! 13yrs later!! Time to do it!!

https://www.ncbi.nlm.nih.gov/pubmed/30658933 The self swab is as good if not better than provider or clinician testing- it is time to educate the population and move to at home cancer screening- save the office visits for important things- like what to do in the 7% of women that are hpv positive.

https://www.fda.gov/drugs/medication-health-fraud/public-notification-big-penis-contains-hidden-drug-ingredient?utm_campaign=CDER%20New%2007%2F17%2F2019&utm_medium=email&utm_source=Eloqua&elqTrackId=6371f8c053574a478fea3a734e8041ed&elq=1631be58825d49e3803c4b92a2cb8553&elqaid=8776&elqat=1&elqCampaignId=7246 Big Penis is a drug that has the drug Viagra in it- over the counter medications are not regulated and this is a perfect example of you really have no idea what you are taking even if you think it is 'all natural'

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2737752 everyone thinks they will live forever, including those on dialysis but in reality 60% will die within 5yrs-- have the end of life conversation sooner than later

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2737844 want to live longer and longer without disability then be happy

July 23, 2019 07:08 PM PDT

https://www.ncbi.nlm.nih.gov/pubmed/30608562 A1C level low is not good and high is not good cause both seem to wind up have you the pt. in the hospital for hypoglycemia- the low point of the U curve is around 7-8% which ironically seems to fit perfectly with recent guidelines

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2735985 pts don't take the medications and if they have hypertension at least in this candania study 1/3 were magically curred of their hypertension one they were monitored

https://www.ncbi.nlm.nih.gov/pubmed/31147311 PPI are still a drug with real side effects and should not be given out like candy but if your patient needs them they lets make no mistake about it they do work really really well

http://cancerpreventionresearch.aacrjournals.org/content/12/5/305 smoking puts you at 2-3 times risk of bladder cancer-- peeing blood is not for me so I choose not to smoke

https://www.ncbi.nlm.nih.gov/pubmed/31112386 no more PRN albuterol -- instead when you want to write for albuterol inhaler you will instead right for daily ICS or PRN ICS/LABA --- GAME CHANGING!! Lets have a moment of silence for prn albuterol in mild asthma-----

July 12, 2019 06:09 AM PDT

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31942-1/fulltext If you are over 70 or 75 and primary prevention then likely no benefit in statins and secondary benefit is very small

https://www.nejm.org/doi/full/10.1056/NEJMoa1806802 Get the glucose down! After you max out other risk factors as intensive control doesn't have a legacy effect

https://www.nejm.org/doi/full/10.1056/NEJMoa1809944 vit d doesnt beat placebo for anything- ever. Except for the vit d lab number

https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-hypoactive-sexual-desire-disorder-premenopausal-women Vyleesi (bremelanotide) will make you have more sexual desire on a sexual desire scale but not more sex-

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