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The Evidence Crisis: Causal Inference – Don ’ t be a chicken (Part 3)
By ANISH KOKA
Part 1
Part 2
Physicians have been making up numbers longer than people have been guessing weights at carnivals. How much does this statin lower the chances of a heart attack? How long do I have to live if I don’t get the aortic valve surgery?
In clinics across the land confident answers emerge from doctors in white coats. Most of the answers are guesses based on whatever evidence about the matter exists applied to the patient sitting in the room. The trouble is that the evidence base used to be the provenance of experts and anecdotes that have in the past concluded leeches were good for pneumonia...
Source: The Health Care Blog - June 29, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
Life as a doctor is selfless and selfish at the same time
It was 5:45 in the morning on a Monday after a full weekend of call. Thoroughly exhausted, I shuffled into the elevator and was met by the stench of stale clothing mixed with cigarette smoke. A painfully thin teenager exited, looking lost. I allowed him to wander out, grateful to be spared his odor. I was apathetic, overtaken by a weariness I vowed as a medical student never to have.
Morning rounds passed without incident. All our CABG patients were more or less stable. I collected each patient’s overnight events, vital signs, laboratory values, daily chest X-ray, EKG, fluid balance and wound status. With my attending’...
Source: Kevin, M.D. - Medical Weblog - June 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/farah-karipineni" rel="tag" > Farah Karipineni, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Surgery Source Type: blogs
Roche Unveils Blood Coagulation Checker with Bluetooth Features
Roche has announced that next month it will be releasing a new device for patients to test their own blood coagulation parameters, the CoaguChek Vantus. The device, which looks like a cellular phone from a few years ago, has Bluetooth connectivity bu...
Source: Medgadget - June 13, 2018 Category: Medical Devices Authors: Editors Tags: Cardiology Medicine Source Type: blogs
A Tale of 2 FDAs
By ANISH KOKA
Frances Oldham Kelsey by all accounts was not mean to have a consequential life. She was born in Canada in 1914, at a time women were meant to be seen and not heard. Nonetheless, an affinity for science eventually lead to a masters in pharmacology from the prestigious McGill University. Her first real break came after she was accepted for PhD level work in the pharmacology lab of a professor at the University of Chicago. An esteemed professor was starting a pharmacology lab and needed assistants, and the man from Canada seemed to have a perfect resume to fit. That’s right, I said man. France...
Source: The Health Care Blog - June 4, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
Antiphospholipid Syndrome
Antiphospholipid Syndrome (APS) important in vascular medicine as well as obstetrics. In obstetrics, it is important because it can cause fetal loss, intrauterine growth retardation and severe preeclampsia. In vascular medicine it is important because it can cause thrombotic events which could be arterial, venous or microvascular [1]. It can also be accompanied by moderate thrombocytopenia [2]. Thrombotic events involving multiple organs may be termed catastrophic Antiphospholipid Syndrome [3].
APS is an autoimmune disease with antibodies directed against beta2 glycoprotein I. This leads to suppression of tissue factor p...
Source: Cardiophile MD - May 27, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology anti beta2 glycoprotein I antibodies anti cardiolipin antibodies lupus anticoagulant Source Type: blogs
Prosthetic valve thrombosis with stroke – Cardiology MCQ
Treatment for prosthetic valve thrombosis presenting with stroke:
a) Intravenous heparin
b) Thrombolysis
c) Surgery
d) Warfarin
Please post your answer as a comment below. Correct answer will be published on: May 25, 2018 @ 07:40
The post Prosthetic valve thrombosis with stroke – Cardiology MCQ appeared first on Cardiophile MD.
Source: Cardiophile MD - May 23, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Interview with Tal Golesworthy, Inventor of the ExoVasc Aortic Root Support
Tal Golesworthy is the inventor of the ExoVasc, a bespoke implant that supports the aortic root when it has becomes weak and dilated. Tal’s invention was born out of his personal need for the device to support his aorta that was expanding dangerous...
Source: Medgadget - April 10, 2018 Category: Medical Devices Authors: Tom Peach Tags: Cardiac Surgery Cardiology Exclusive Source Type: blogs
MKSAP: 26-year-old woman with a mechanical mitral valve prosthesis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 26-year-old woman with a mechanical mitral valve prosthesis visits to discuss anticoagulation management during pregnancy. Her last menstrual period was 6 weeks ago and her pregnancy was confirmed by laboratory testing in the office. Her mitral valve was replaced 5 years ago. Her medications are low-dose aspirin, metoprolol, and warfarin (4 mg/d).
On physical examination, vital signs are normal. Cardiac auscultation demonstrates a normal mechanical S1. There are no murmurs or added sounds. Her INR is 2.6.
Whic...
Source: Kevin, M.D. - Medical Weblog - February 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Cardiology OB/GYN Source Type: blogs
Taking an anticlotting drug? If you need a procedure, be prepared
Millions of people with cardiovascular disease take drugs that help prevent blood clots, which can lodge in a vessel and choke off the blood supply to part of a leg, lung, or the brain. These potentially lifesaving medications include warfarin (Coumadin) and a class of drugs called non-vitamin K antagonist oral anticoagulants or NOACs. Examples include dabigatran (Pradaxa) and rivaroxaban (Xarelto).
However, if you’re taking one of these drugs and need an invasive procedure — anything from a tooth extraction to a hip replacement — managing the risks can be tricky, says cardiologist Dr. Gregory Piazza, assistant profe...
Source: Harvard Health Blog - November 1, 2017 Category: Consumer Health News Authors: Julie Corliss Tags: Drugs and Supplements Health Heart Health Surgery anticlotting drug anticlotting drugs Source Type: blogs
Cardiology MCQ Test 5
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This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - October 22, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Cardiology MCQ Test 3
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This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - October 20, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Left Atrial Appendage Closure Does Not Prevent Strokes
Our cautionary left atrial appendage occlusion (Watchman) editorial is now published in a prominent medical journal, called Heart Rhythm. My co-authors are Drs. Andrew Foy and Gerald Naccarelli from Penn State. It was a peer-reviewed version of my previous theheart.org | Medscape Cardiology column.
Watchman and other similar devices are plugs that occlude the left atrial appendage in an attempt to reduce the odds of stroke in patients with atrial fibrillation. It was a nice idea but it did NOT work.
The link is here> Percutaneous Left Atrial Appendage Closure is Not Ready for Routine Clinical Use
In the allotted 2500 ...
Source: Dr John M - October 12, 2017 Category: Cardiology Authors: Dr John Source Type: blogs
Young people, stroke and a hole in the heart (PFO)
(This post introduces my latest column on TheHeart.org | Medscape Cardiology. It’s about stroke in young people.)
***
We define stroke as the death of brain cells. The typical cause is a blocked blood vessel in the brain. Stroke usually occurs in older people who have established blood vessel disease. Stroke is bad; it may be the worst outcome in all of medicine. That’s because stroke can permanently remove basic functions of being human, things such as speech, thought, personality, movement, swallowing, and many others.
Stroke is not supposed to happen in young people. But sometimes it does. And in some of t...
Source: Dr John M - September 28, 2017 Category: Cardiology Authors: Dr John Source Type: blogs
Here ’s what it looks like when our health system actually works
The other day, rather than being at the office, I was sitting in the waiting room of our favorite gastroenterologist’s endoscopy suite. I had dutifully accompanied my wife, who was getting her colonoscopy. My cell phone buzzed. It was my nurse calling from the office. I had seen a patient late the previous day who was complaining of right leg pain.
I had ordered a D-dimer, hoping the test would be negative, ruling out a blood clot. But the test had been positive. The patient was still experiencing pain, and now wanted further instructions. I asked my nurse to order an ultrasound of the patient’s leg, which she was able...
Source: Kevin, M.D. - Medical Weblog - September 2, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/matthew-hahn" rel="tag" > Matthew Hahn, MD < /a > Tags: Physician Cardiology Emergency Medicine Facebook Infectious Disease Source Type: blogs
How important are short AF episodes?
A study presented at the recent Heart Rhythm Society meeting in Chicago has added more uncertainty about the significance of short-duration AF episodes.
Before I tell you about the study, I need to clarify what I mean by short-duration AF episodes, sometimes called subclinical AF (SCAF).
SCAF is AF on a monitor that is often not felt by the patient. Doctors are seeing more of this because patients are increasingly being monitored–with pacemakers, ICDs, long-term event recorders and implantable cardiac monitors. These devices can pick up minute-long or hour-long AF episodes.
In the past, AF could only be picked up whe...
Source: Dr John M - May 25, 2017 Category: Cardiology Authors: Dr John Source Type: blogs
