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The year in Cardiology 2014 — a top-10 list
When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a bunch for a blogger. The link to the piece is at the end of this post. What follows is a regular-language breakdown of the ten topics. The first five deal with specifics; the second five touch on trends. Here we go: 1. Renal denervation is the medical name given to a procedure in which a doctor uses a catheter to ablate (burn) n...
Source: Dr John M - December 21, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

Sovaldi, Harvoni, And Why It’s Different This Time
With the Food and Drug Administration (FDA)’s approval of Harvoni, the successor to Gilead Science’s Sovaldi, the alarm bells have officially rung on breakthrough hepatitis C treatments. One can’t open a newspaper or scan a Twitter feed without stumbling on at least one reference to either of the these two drugs for hepatitis C — an often debilitating viral infection impacting the liver that affects somewhere between 3 to 5 million Americans and several hundred million people worldwide. Hepatitis C infection is often asymptomatic and can have long latency periods. In up to 20 percent of people, chronic infectio...
Source: Health Affairs Blog - November 21, 2014 Category: Health Management Authors: Laura Fegraus and Murray Ross Tags: Access All Categories Bioethics Biotech Business of Health Care Health Care Costs Pharma Spending Source Type: blogs

Top stories in health and medicine, November 6, 2014
From MedPage Today: Simple Tool May ID Dementia Risk in Seniors. A higher incidence of a pre-dementia condition called motoric cognitive risk syndrome (MCR) was seen with advancing age in older, healthy adults. Do Statins Up a Woman’s Risk for Thyroid Cancer? The regular use of statins, particularly among women, was associated with an increased risk of thyroid cancer. Three Wearables that Could Change Afib Screening. Atrial fibrillation is an increasingly prevalent arrhythmia; it currently affects 3 to 6 million of Americans and that number is expected to rise. And unlike many other medical conditions, it is often ...
Source: Kevin, M.D. - Medical Weblog - November 6, 2014 Category: Journals (General) Authors: Tags: News Endocrinology Geriatrics Heart Neurology Source Type: blogs

Writing about lifestyle modification — and blaming the patient
I was pleased when the editors of the TheHeart.org reposted my recent essay, Let’s Stop the Unnecessary Treatment of Heart Disease. As of this morning, there are 167 comments. The majority of them were positive, and supportive of lifestyle promotion. Negative comments represented a small minority, but were notable in their vigor, and occasionally reached the level of vitriol. (“A self-righteous sanctimonious SOB,” said one nurse of the author.) I’m glad the post touched a nerve. That was the aim. This beautiful comment, in particular, indicates the power of a physician’s voice and his or her deeds. My father&...
Source: Dr John M - October 9, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

Top stories in health and medicine, September 5, 2014
From MedPage Today: Potent Statin Offers No Help After Cardiac Surgery. The powerful lipid-lowering drug rosuvastatin (Crestor) — also purported to be an effective anti-inflammatory agent — was powerless to prevent postoperative cardiac surgery complications such as atrial fibrillation. Questioning Medicine: The Pain Management Fiasco. I spent my intern year at a community hospital that was equipped with an acute detoxification center. I was exposed to addiction routinely. PD-1 Blocker OK’d for Advanced Melanoma. Pembrolizumab (Keytruda) has won FDA approval for treating advanced or unresectable melanom...
Source: Kevin, M.D. - Medical Weblog - September 5, 2014 Category: Journals (General) Authors: Tags: News Cancer Heart Source Type: blogs

The Palbociclib Saga: Or Why We Need a Lot of Drug Companies
Science has an article by journalist Ken Garber on palbociclib, the Pfizer CDK4 compound that came up here the other day when we were discussing their oncology portfolio. You can read up on the details of how the compound was put in the fridge for several years, only to finally emerge as one of the company's better prospects. The roots of the project go back to about 1995 at Parke-Davis: Because the many CDK family members are almost identical, “creating a truly selective CDK4 inhibitor was very difficult,” says former Parke-Davis biochemist Dave Fry, who co-chaired the project with chemist Peter Toogood. “A lot of ...
Source: In the Pipeline - August 22, 2014 Category: Chemists Tags: Cancer Source Type: blogs

Obama’s Foreign Policy Is Linked to a Healthy, Restrained Immune System
With 58% of Americans disapproving of Obama’s foreign policy, mounting Ebola virus deaths, and flu season around the corner, I think it is important to synthesize an overlapping theme between how our country fights perceived threats, and how our bodies successfully or unsuccessfully fight disease. In short, I think Obama’s continued restraint and use of soft power is evidence of a good prognosis for the country. In this analogy, our bombs and military are the most caustic weapons of the country’s immune system, akin to a fever of 105 degrees and impending sepsis. Does “nuke them all” work? Diplomacy, espionage, s...
Source: The Examining Room of Dr. Charles - August 16, 2014 Category: Primary Care Authors: drcharles Tags: Uncategorized Source Type: blogs

A vacation book review…
The good thing about vacation is that time off is essential. The bad thing is the reentry, which, lately, is harried enough to induce arrhythmia. Almost. Thankfully, I made it through the reentry week and now sit in peace on Saturday morning with my MacBook. I thought I would tell you a little about my unplugged vacation—mostly the book reading. You have to understand that I am behind in my education. While many of you were reading classic books, writing papers, learning grammar and becoming educated, I was playing sports, memorizing science, excelling in math and then, later in life, learning only medicine. I kick mysel...
Source: Dr John M - August 2, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

The Antibiotic Gap: It's All of the Above
Here's a business-section column at the New York Times on the problem of antibiotic drug discovery. To those of us following the industry, the problems of antibiotic drug discovery are big pieces of furniture that we've lived with all our lives; we hardly even notice if we bump into them again. You'd think that readers of the Times or other such outlets would have come across the topic a few times before, too, but there must always be a group for which it's new, no matter how many books and newspaper articles and magazine covers and TV segments are done on it. It's certainly important enough - there's no doubt that we real...
Source: In the Pipeline - July 25, 2014 Category: Chemists Tags: Infectious Diseases Source Type: blogs

Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it. Recommended by: Anand Swaminathan Read More: Nausea? We’ve Got Placebo for That The Best of the Rest Emergency Medicine, Pulmonary 1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865567 This Cochr...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations resear Source Type: blogs

The “Cholesterol Con”–Eggs
In the past, I have written about the “cholesterol con” (part 1), the widespread  belief that high levels of “bad  (LDL)  cholesterol” can cause heart attacks. As I have explained (part 2), the myth has generated enormous profits for many commercial interests, including companies that peddle statins. (Please read both parts of the post.)   No surprise, manufacturers  have poured millions of dollars into perpetuating the myth, and  thus have succeed in convincing a great many Americans that they should avoid high-cholesterol foods–including eggs. According to Harvard University’s...
Source: Health Beat - June 15, 2014 Category: American Health Authors: Maggie Mahar Tags: cholesterol cholesterol con eggs heart attacks Carolyn Thomas Heart Sisters Source Type: blogs

Driving While Hypertensive
The Second Law of the Dinosaur states: It is impossible to make an asymptomatic patient feel better. So true. Chapter 2 of my book, Declarations of a Dinosaur, discusses how I handle a patient who may be asymptomatic at present but who will not remain so for long without taking my advice. Essentially, I explain in as much detail as necessary to create just enough anxiety, which can be relieved by doing what I say, be it taking pills, quitting smoking; whatever. Another way of looking at it is that although the patient may not feel there’s anything wrong with him, my anxiety spikes when I see things like a hemoglobin...
Source: Musings of a Dinosaur - June 12, 2014 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

Be courageous: help stop the pill madness
Medicine people give it a sterile-sounding name. Polypharmacy means giving too many drugs, usually to an elderly person. But this practice is worthy of clearer words: dumb, dreadful or doctoring at its worst. The idea to mention the growing problem of giving too many pills in combination came to me after reading this Medscape coverage of a trial of statin removal in patients nearing end of life. The randomized clinical trial was presented at the 2014 Annual Meeting of the American Society of Clinical Oncology. One group of patients had their statin stopped and the other group continued the drug as is the normal practi...
Source: Dr John M - June 6, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

Fierce Urgency of Now: Family Caregivers and the Future That Is Upon Us
Just before Mother’s Day, I was a guest on an Al-Jazeera news segment focused on the challenges of aging in America. It was my first-ever news appearance, and, later, I proudly showed a recording to my adult daughters when they came by to visit. The segment included a look at how elders are navigating the shoals of old age, sickness, and financial insecurity—a future millions of face, and all of us deny. One segment featured a mid-life African American woman who had abandoned her retirement dreams to care for her mother, who has Alzheimer’s. As the woman fixed her mother’s wisps of hair, both daughters turned to me...
Source: Disruptive Women in Health Care - May 29, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs