Category Archives: Medicine

Salt Intake in Chronic Kidney Diease

Tweet How much salt people should eat continues to be a murky issue. A paper in the February 2017 issue of the American Journal of Kidney Diseases examines the issue of salt (actually sodium) intake on the prevention of cardiovascular disease in patients with chronic kidney diseases (CKD) stages 2-4. It is a commentary on…


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Thoughts on The Affordable Care Act

Tweet As everybody above ambient temperature knows, the US Congress is about to repeal and replace the Affordable Care Act. The repeal part is easy. What to replace it with is much harder. As someone who’s spent more than half a century taking care of patients and teaching others how to do the same, I’d…


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Celecoxib and Cardiovascular Disease

Tweet The New England Journal of Medicine has a paper in its current issue (Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis) that examines the safety of the COX-2 inhibitor celecoxib, best known under its brand name Celebrex, though now available in a generic formulation. This drug is the only COX-2 inhibitor available in…


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Life Expectancy in the Elderly

Tweet Americans have a lower life expectancy than people in other developed countries. This lower longevity has been often used to disparage medical care in this country as being inferior to that of other similarly advanced nations.  Such an accusation is made acute by the high cost of American medical care – the highest in the…


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Statins For the Primary Prevention of Cardiovascular Disease

Tweet The use of statins (drugs which lower blood cholesterol) for the primary prevention of CV disease has been controversial since the drugs became available almost 30 years ago. Primary prevention is the prevention of a disease which the patient does not have, eg a stroke or a heart attack. Secondary prevention is the prevention…


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AAA Screening

Tweet About 4% of men and 1% of women over the age of 65 have an abdominal aortic aneurysm (AAA). When this aneurysm ruptures the mortality rate is about 80%. Thus it is not surprising that screening for this condition in patients (mostly men) with abdominal ultrasound has become prevalent over the last decade or…


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In Outer Space

Tweet The popular press has picked up on a story about cosmic rays and cardiovascular disease in astronauts who landed on the moon. The Voice of America has a particularly breathless account of a study, Apollo Lunar Astronauts Show Higher Cardiovascular Disease Mortality: Possible Deep Space Radiation Effects on the Vascular Endothelium, published in the…


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Salt, Science, and Politics

Tweet Salt is in the news again. Thomas Frieden the head of the CDC published an article in the JAMA innocuously titled Sodium Reduction—Saving Lives by Putting Choice Into Consumers’ Hands. It more closely resembles propaganda than science. It argues that reducing dietary sodium intake to 1200 mg/day or less will lower the incidence of…


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96-year-old Dr Henry Heimlich Does His Eponymous Maneuver For the First Time

Tweet This one is too good to pass on. Retired surgeon Henry Heimlich performed for the first  time the maneuver he invented at the retirement center in Cincinnati that his home. “When he heard that a resident was choking, Perry Gaines, maître d’ for the Deupree House dining room, ran toward the table. Gaines has been…


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When to Start Dialysis in Patients with Acute Kidney Injury

Tweet When to start renal replacement therapy in patients with AKI has been a serious and incompletely answered question for as long as dialysis has been available to treat it. The seriousness of this disorder derives from its frequency, associated mortality, and cost. The JAMA contains a new study, Effect of Early vs Delayed Initiation of…


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