Tweet
Thursday, January 31, 2013
Q&A Session at HealthTap.com
I was having some kind of pain kind of sharp in my abdomen area, and boyfriend asked me if i think im prego, could i be ive bever been prego...
Follow @alvinblin
Tweet
Tweet
ED & Heart Disease: It's All in the Plumbing Part 2
It's deja vu all over again.
Yogi Berra
As I was reading a prospective population-based study published online 2 days ago in PLOS Medicine, I thought I was experiencing Yogi Berra's above noted quote, as the authors concluded that severity of erectile dysfunction (ED) was associated w/risk of cardiovascular disease & all-cause mortality. In fact, the authors followed for an average of 3yrs 95,038 Australians older than 45yo and took into the account the usual suspects such as age, tobacco use, alcohol consumption, education, income, physical activity, diabetes, high blood pressure, high cholesterol, and obesity (body mass index). And despite this, those men who reported severe ED had a greater risk of heart disease and of death from any cause compared to those who denied having any ED.
Well, after just a bit of digging around, I found the meta-analysis & review article referenced in my post from 2 weeks ago that arrived at the same conclusion: ED is linked to cardiovascular events & all-cause mortality. What this means for you and me is that we need to go beyond just writing a prescription for Viagra or Cialis. We need to consider ED the canary in the mine and look at the patient's risk factors for heart disease & death.
Follow @alvinblin
Tweet
Yogi Berra
And just how was ED assessed? By a single question! How often are you able to get and keep an erection that is firm enough for satisfactory sexual activity? The participants could respond with "always", "usually", "sometimes", "never", and "I would rather not answer this question" with the first 4 answers corresponding to no ED or mild, moderate & severe ED.
Tweet
Wednesday, January 30, 2013
PEDs: Is It OK Outside of Sports?
Back in the day, you competed w/your God-given talent(s). If you were blessed w/more muscle mass, greater cardiac output, or better lung capacity, you had an edge up on your fellow competitor. Of course, back then, you weren't under pressure to make tons of money either. Sure you got paid, but many also played for the sake of the game with honor, chief among them, the late Stan Musial.
Lance Armstrong recently came (kinda) clean after all these years of denial. Mark McGwire finally admitted to use of steroids while breaking records. Barry Bonds was convicted of obstruction of justice regarding his testimony in the BALCO trial. And as of yesterday, Alex Rodriguez joined that notorious list, as described in an expose published in the Miami New Times, having his name mentioned several times in a log kept by an anti-aging clinic.
Don't buy your medications & laboratory tests from your doctor. They don't need to profit as middlemen. Instead, get your legally prescribed testosterone and growth hormone (assuming your physician deems it warranted) from your local pharmacy. CVS, Walgreens, WalMart, etc all carry these medications. If you need to do so, go to a compounding pharmacy but there's no reason you need to buy it from your doctor!
And be careful if your doctor tells you that s/he doesn't need to examine you, that a phone call or online survey will suffice. In fact, federal regulations require that we meet with and physically examine you at least once a year if we're to provide ongoing care. Think about this before you veer away from traditional medicine.
Tweet
Migraines in Children: Time to Treat Like Little Adults?
So of course I read w/interest 2 studies published online earlier this week in JAMA Pediatrics in which the authors reviewed the literature looking at how to treat children & adolescents with headaches, especially migraines. In the first review, the authors concluded that only topirimate & trazodone might have limited evidence supporting its use in children & adolescents suffering from migraines. However, all other commonly used medications in adults lack any supportive data.
So while children & adolescents w/newly diagnosed diabetes may respond similarly to adult-based therapies, such is not the case in those w/migraines. Those children & adolescents suffering from headaches need to be treated as children & adolescents, not little adults. Much research needs to be performed in order to determine how best to help this population subset.
Tweet
Tuesday, January 29, 2013
Diabetes in Children: Time to Treat Like Little Adults?
In any case, I digress because just yesterday, the American Academy of Pediatrics released their Clinical Practice Guideline regarding the management of newly diagnosed diabetes type 2 in children & adolescents (a rarity back in the day). The full text of their new guideline is now available in their Pediatrics journal. What's different in this new guideline and sets it apart from previous guidelines is the willingness, nay, recommendation to offer the biguanide, metformin, to lifestyle modification after making an initial diagnosis of type 2 diabetes in children & adolescents. The irony is that we've been taking the same approach for adults for several years now, as updated in this month's Diabetes Care.
Follow @alvinblin
Tweet
Monday, January 28, 2013
Beta-Blockers: All-for-One or One-for-All?
Well, in a meta-analysis published online earlier this month in the American Journal of Cardiology, the authors compared carvedilol, a beta blocker, to other beta-1 selective beta blockers (atenolol, bisoprolol, metprolol & nebivolol) and concluded that carvedilol was better at lowering all-cause mortality in patients suffering from heart failure.
Will I change my prescribing habits based upon a single study, especially a meta-analysis? Probably not. At least not until we find more of a trend as opposed to a possible fluke. As always, discuss your concerns with your prescribing physician before stopping any medication.
Tweet
Sunday, January 27, 2013
Subscribe to:
Posts (Atom)