Category Archives: Medicine

More Uncertainty about Cholesterol and Cardiovascular Disease

Tweet Cholesterol and lipid metabolism used to simple. There was good (HDL) cholesterol and bad (LDL) cholesterol. Eat a diet low in cholesterol and fat and your blood vessels will be as open as a new straw. On the basis of very little solid scientific information a litany of assumptions was issued by both the…


Read the full entry

Statin Therapy in the Elderly and Quality vs Cost

Tweet The JAMA published a study online which examines the Effect of Statin Treatment vs Usual Care on Primary CV Prevention Among Older Adults. The full paper is below as a pdf file. I’ve written about the overuse of this type of cholesterol lowering drugs in the primary prevention of cardiovascular disease several  times. Primary…


Read the full entry

Gene Therapy for Sickle Cell Disease

Tweet Sickle Cell Disease is a disorder of hemoglobin production secondary to an alteration in the hemoglobin gene on chromosome 11.  Specifically, there is a single amino acid substitution in “adult” β A -globin (Glu6Val) stemming from a single base substitution (A→T) in the first exon of the human β A -globin gene. The abnormal…


Read the full entry

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…


Read the full entry

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…


Read the full entry

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…


Read the full entry

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…


Read the full entry

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…


Read the full entry

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…


Read the full entry

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…


Read the full entry

Categories