Questioning Medicine

Dr sprouse-- Endo saying that Vit D below 30 leads to 2nd hyperparathyroidism due to calcium absorption deficiency and downstream consequences of that condition leads to poor bone health. He agreed all the other outcomes don’t have good evidence. I think 30 is the recommendation from the endo society. MY RESPONSE Well just to be clear they are right and they are wrong Yes it MAY, key word is MAY (...

NEW covid19 vaccine I am sure many of you have heard it is the first of its kind. It uses mRNA technology. I am not going to discuss what that means ebcasue so many people already have on other podcasts and publications but the question is should you get the vaccine. I have read many opinons on this from experts for example Dr. Michal Elovitz, a preterm labor researcher and obstetrician at the Uni...

What you see is what you get- no more clearly seen then in This paper titled Nutritional Analysis of Foods and Beverages Depicted in Top-Grossing US Movies, 1994-2018 In JAMA internal medicine which looked at the nutritional quality of foods and beverages depicted in the 250 top-grossing US movies from 1994 to 2018 these 250 movies sold 10 billion box office tickets and grossed $164 billion in the...

Get the best evidence because you want to know what they are looking at and occasionally people send me articles I was not aware of. Plus I ate spending my time sending them all the information then people say well ya but you are looking at the wrong evidence just right off the bat say “I will explain but tell me the evidence you are looking at” So he sent me 5 articles and I going to break them d...

2020 Update to The Top Articles of 2019

Alzheimers disease—doesn’t say what you think it says https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2020.6432?guestAccessKey=807ca0d3-63aa-48f9-8a1d-16df0d828d42&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=113020 Conclusions and Relevance Alzheimer disease and related...

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771041#:~:text=Conclusions%20and%20Relevance%20Initiation%20of,effective%20as%20brand%2Dname%20levothyroxine. Comparative Effectiveness of Generic vs Brand-Name Levothyroxine in Achieving Normal Thyrotropin Levels JAMA Netw Open. 2020;3(9):e2017645. doi:10.1001/jamanetworkopen.2020.17645 Quick history lesson- levothyroxine was cleared a...

www.bmj.com/content/368/bmj.m149 No one wants to get pregnant two minutes after having a baby. And also agrees that an IUD is most effective form of conception. However placing IUD after delivering a child seems to be a point of debate as the risk of expulsion seems to be significantly higher immediately post pregnancy In this study titled Averbach SH, Ermias Y, Jeng G, et al. Expulsion of intraut...

Questioning medicine daily https://www.acpjournals.org/doi/10.7326/M20-7448 https://www.acpjournals.org/doi/10.7326/M20-6817 Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers FREE A Randomized Controlled Trial Masks!!!! Do they prevent COVID19 transmission by preventing spread from infected people to others OR do th...

https://www.clinicalkey.com/#!/content/journal/1-s2.0-S0140673620322339?scrollTo=%23hl0000424 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32233-9/fulltext do statins work in old people?? This study in the lancet says- “In a contemporary primary prevention cohort, people aged 70–100 years with elevated LDL cholesterol had the highest absolute risk of myocardial infarction and...

https://www.acpjournals.org/doi/10.7326/M20-2470 Pharmacologic Approaches to Glycemic Treatment of Type 2 Diabetes: Synopsis of the 2020 American Diabetes Association's Standards of Medical Care in Diabetes Clinical Guideline FREE Which is as the artciel suggest in a sypnopsis of the 2020 ADA guidelines metformin is still universal fist line but now the guideline says The choice of agent to add to...

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771093 meta-analysis of 78 original studies, looking to find the accuracy of ECG interpretation. In this analysis they looked at studies with med students, physiciansm even cardiologist and found on average we got the right diagnosis only 55% of the time. Obviously education goes up with more education 42.0% for medical students, 5...

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771670 trials are not real life. We know that. Realistically if your drug just barely hits 0.05 in a clinical trial then in the imperfect setting of the clinic of every day life the drug likely wont work. In this next study, in jama internal medicine titled Concordance Between Blood Pressure in the Systolic Blood Pressure Intervent...

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 SO HOW DO YOU LOSE WEIGHT!! FASTING DOESN’T WORK or so says this study titled- Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and ObesityThe TREAT Randomized Clinical Trial 100 overweight or obese adults were randomized to regular eating or to a restricted eat...

Doc my heart is racing— Stop drinking—or so says this article in NEJM that found when they took 140 pts who severed from paroxysmal afib and who drank 17 drinks a week that when randomized to complete alcohol abstinence for 6 months there was significant reduction in afib recurrence.. how much of a difference?? 20% ABSOLUTE DIFFERENCE….. I have a rule of thumb that anytime someone says the improve...

Rapid fire articles- no deep dive. Just good a lot of questioning, questioning medicine. If you want any of the articles for your own review or have any questions you can always reach me at andrewbuelt@gmail.com

We stuck purely to the evidence. There was no evidence panel or committee to vote on the evidence like is often done by the American college of rheumatology and no expert opinion statements where their only citation is themselves like can be seen with the ACC. This was purely 100% evidence recommendations. So lets start try to make it quick because guidelines on a podcast a boring, I want to hit t...

athlete heart covid https://www.the-scientist.com/news-opinion/college-athletes-experienced-heart-damage-after-covid-19-study-67929 titiles like- “Images of the players’ hearts showed signs of inflammation consistent with myocarditis, a rare but potentially fatal condition.” “two dozen of Ohio State University players using cardiac magnetic resonance (CMR), they found evidence of myocarditis in 15...

the thing about RCT is they are random and everything is equal. its why in table one of an RCT you should never see a pvalue because they are random and should be equal but in observational studies you see pvalues because it is not equal, it can’t be, its not random. In observational studies you try to account for all the confounders but you just cant ever make it equal to an RCT but lets look a l...

Finance ethics committee, big pharma with deep pockets, mafia like arrangements, and a patient with a 40% increase risk of ischemia myocardial events have in common? I will say todays podcast was inspired by a tweet, yes a tweet from Dr. john Mandrola and he said “I am embarrassed to have not (really) known the details of the rosiglitazone affair. Teaching this to learners has to be 10x more valua...

In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions, this was a freak out statement if I have ever heard of one I mean Covid is doing something directly to the heart? and this thing it is doing to the heart is ind...

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768888 Serial Bone Density Measurement and Incident Fracture Risk Discrimination in Postmenopausal Women Carolyn J. Crandall, MD, MS1; Joseph Larson, MS2; Nicole C. Wright, PhD3; et al OBJECTIVE To assess whether a second BMD measurement approximately 3 years after the initial assessment is associated with improved ability to estim...

Sometime I wonder how the world will change post covid- or how the board questions will change? And that is clearly seen in this article titled- Yip L et al. Serious adverse health events, including death, associated with ingesting alcohol-based hand sanitizers containing methanol — Arizona and New Mexico, May–June 2020. MMWR Morb Mortal Wkly Rep 2020 Aug 14; 69:1070. hand sanitizing gels and foam...

henry ford once said “failure is simply the opportunity to begin again, this time more intelligently” Designed to Fail? the Future of Primary Care Journal of General Internal Medicine (2020) Access to primary care has been shown to improve patient outcomes and lower cost although outcomes are debated the cost is not- its because we can be the jack of all or the referral of all. neither is wrong th...

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