Questioning Medicine

1) nurses commit more suicide and average population (doctors don't) 2) AK will turn in to SCC at a rate of about 2% per year 3) STOP SMOKING (even if you gain weight) 4) zofran is about equal to the rest for pregnant patients and the outcomes we care about 5) Tubes in the ear for children with acute otitis media?? It works about the same as medical management Association of US Nurse and Physician...

Donanemab doesn't work for alzheimers if you actually read the study. Mammograms should be done every other year and starting at age 50. Blue-blockers don't prevent eye strain on the computer and sleep varies but at this time the evidence doesnt suggest it causes obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2100708 new drug donanemab vs placebo = 257-patient double-blind randomised TRAILBLA...

Circulation Bariatric Surgery and Cardiovascular Outcomes in Patients With Obesity and Cardiovascular Disease: A Population-Based Retrospective Cohort Study Circulation 2021 Apr 13;143(15)1468-1480, AG Doumouras, JA Wong, JM Paterson, Y Lee, B Sivapathasundaram, JE Tarride, L Thabane, D Hong, S Yusuf, M Anvari Patients with CVD who underwent bariatric surgery were matched 1:1 with similar CVD pati...

Compression stocking to prevent cellulitis? NOT SO FAST! Vitamin D still doesn't work even for depression. Hip fractures are on teh decline and it is not because of drugs. A scribe cost money, but how much? What about doing an LP with anticoagulants, it is probably safer than you think. What do you do with kidney stones? Finally, there is a lot of medical waste, so stop ordering MRIs for low back...

1- make sure pts follow up on positive FIT test 2. symptom severity — driven particularly by catching/locking and clicking/popping — correlated significantly with the burden of cartilage damage. CARTILAGE DAMAGE!! 3. U.S. Food and Drug Administration announced it is allowing the use of the Binx Health Assay for point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae 4. In patient...

DOAC are just as safe if not safer for warfarin for valvular afib (NOT valve replacement but moderate to severe mitral stenosis). Please, just give normal lovenox for covid patients. Stop DM drugs in the elderly cause no-glycemia is more dangerous than hyperglycemia. semaglutide works as along as you keep taking it. gestational diabetes screening should be a two stop process. Effectiveness and Saf...

Uterine Fibroid and heavy bleeding might have a new drug if your normal drug was giving placebo. HPV Vaccine is still awesome and very very safe. Copper IUD has a new kid in town when it comes to emergency contraception and Colchicine should not be used for secondary prevention (at least not when I read the trial) HTTPS://WWW.NEJM.ORG/DOI/FULL/10.1056/NEJMOA2008283 Treatment of Uterine Fibroid Sym...

Part 2 of the top articles of 2020 1) statins and the nocebo effect 2) VA DOD Lipid guidelines- Don't check more than every 10 years! 3) blood in the urine and what to do about it per the newest guidelines. 4) SGLT2i, FLOZINS!!! The data and how to use it in practice with really really sick patients

A two part podcast on the top published articles of 2020

SGLT2 inhibitors and GLP1 agonists administered without metformin compared to other glucose‐lowering drugs in patients with type 2 diabetes mellitus to prevent cardiovascular events: A systematic review - Escobar - 2021 - Diabetic Medicine - Wiley Online Library Yes these fancy new drugs work with and without metformin but that does not mean these drugs should be first line!! Effect of a Single Hi...

Semaglutide works for weight loss but at what co$t? BOARD CHANGER- New gonorrhea guidelines Diabetes drugs are expensive for our patients and we can't forget that. Children find it hard to tell what facial expression you are giving when you have a mask on! https://www.nejm.org/doi/10.1056/NEJMoa2032183 industry-conducted trial published in the New England Journal of Medicine. Researchers randomize...

Also ask yourself, did this study compare their treatment to the 'gold standard' and if the answer is no they compared it to a straw man, then think big Pharma, or authors that needed publication for their job. We can't treat what we don't know exist and 30-50% of the time COVID19 is asymptomatic. Combined Oral Contraception DO NOT have an increase risk of DVT and long term the risk are very minim...

The Drug Addiction Treatment Act of Under the Act, physicians may apply for a waiver to prescribe buprenorphine for the treatment of opioid addiction or dependence outside of an opioid treatment program (OTP). The Drug Addiction Treatment Act of 2000 was authored by Senator Orrin Hatch (R-UT), Senator Joe Biden (D-DE), and Senator Carl Levin (D-MI). DATA 2000 waiver Why would biden reverse this—it...

Autoimmune mothers likely don't actually have more ADHD kids. If you patient is in the hospital we now have a RCT to answer the question about ACEI starting or stopping. Finally, there are problems around COVID we don't even know about and it has nothing to do with contracting COVID19. Association of Maternal Autoimmune Disease With Attention-Deficit/Hyperactivity Disorder in Children | Attention...

HHS Expands Access to Treatment for Opioid Use Disorder | HHS.gov U.S. Department of Health and Human Services Announcement of practice guidelines for the administration of Buprenorphine for treating opioid use disorders Jan 12- 20221 -physicians with a DEA license- only not all providers -you can only treat patients located in the state you have a medical license in (basically no tele) -Physician...

They say every dog has its day and IT think every drug has its place Anyone who says ‘that drug is bad’ or that test is bad or that anything is bad is just being closed minded or not aware of the evidence because evidence and medicine comes down to numbers. The real statement should be I don’t think that drug is beneficial enough for the harm. However that is an opinion statement, it is what you t...

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...