Category Archives: Medicine

Nicola Fusati

Tweet Nicola Fusacchia (1876-1956) really deserves a spot on this site. After earning a medical degree from the University of Rome in 1901, he trained as a surgeon and became chief of surgery in Norcia Hospital in Perugia in 1904. Somehow he found time to study singing. He made his stage debut as Radames in…


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Systolic Blood Pressure Control and Dementia

Tweet Dementia increases with age. About 50% of the population 85 years or older will experience some degree of cognitive impairment. Obviously, this problem places an enormous burden on those charged with the care of these patients and an economic load on all of society.  There is no treatment currently available to retard cognitive decline…


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New (2019) Cholesterol Treatment Guidelines

Tweet The American Heart Association and the American College of Cardiology have released new guidelines for the management of elevated blood cholesterol levels. These guidelines focus on LDL-cholesterol. They are summarized in the figure below which can be enlarged by clicking on it. They were published in a short article in the JAMA which is…


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A Brief History of the Renin-Angiotensin System

Tweet If you’re here for the music you still might give this piece a glance. It’s on a subject of immense clinical importance that I’ve tried to present in a fashion accessible to layman while still having some content that might interest physicians. Some of the greatest work in medical pathophysiology has contributed to our…


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Inadequate Pain Management

Tweet It was inevitable. Everytime we get worked up about opioid abuse complaints about inadequate pain management are not far behind. Even though about two thirds of opioid abusers first get their drugs from illicit sources doctors are pressured to prescribe less opium derived pain medicine. I’ve seen this cycle at least three times since…


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Benzodiazepines, the Elderly, and Good Clinical Judgement

Tweet There has been a steady campaign to convince primary care physicians to stop prescribing long term benzodiazepine treatment to elderly patients. The intense declaratory nature of these admonitions suggests an almost emotional commitment to these recommendations.  The argument against their use includes a loss of effect after as brief a period as 4 weeks,…


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ACE Inhibitors and Lung Cancer

Tweet A recent paper in the British Medical Journal reported that treatment with angiotensin converting enzyme (ACE) inhibitors was associated with an increased incidence of lung cancer. As scores of millions of patients take these drugs for the treatment of hypertension and related disorders, the study naturally attracted a lot of attention from the lay…


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Addiction and Disease

Tweet Drug addiction has received extraordinary attention over recent years to the point where politicians have become interested in the problem. This is a sure sign that a real problem will be the subject of a lot of muddle headed thinking. For the past three decades or so addiction has been held to be a…


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Prophylactic Aspirin in Healthy Elderly Adults

Tweet Three studies, published online on Sept 16, 2018 by the New England Journal of Medicine, examine the effect  of prophylactic aspirin in healthy elderly patients. The subjects received 100 mg of aspirin daily or a placebo for five years. Trial participants were community-dwelling men and women from Australia and the United States who were 70 years…


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The Hard Bargain – Book Review

Tweet Richard Tucker (1913-75) was the greatest operatic tenor America has so far produced. He had three sons. David (b 1941) was the second child and the only one who aspired to take up his father’s profession. He ended up in medicine as an ophthalmologist. The Hard Bargain is his account of how he went…


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