I was on call this past weekend, rounding at about 8am on the cardiology floors, and a woman I didn't recognize approached me.  She asked if I remembered who she was, and was quick to tell me that if I didn't it was ok.   She had had bariatric surgery about 6 months previously, and I had seen her in the office for a pre-surgical consultation. She went on to tell ...

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I just returned from the annual American Heart Association meeting where I heard distinguished cardiologists and researchers from around the world present the latest in cardiovascular disease. Yet, amidst all the late-breaking clinical trial presentations and ask-the-expert sessions, what I didn't hear were the speakers' financial conflicts of interest. Don't get me wrong -- the AHA mandates that all speakers present a disclosure slide at the beginning of every talk, and this rule was ...

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There has been much discussion recently, by journalists and health professionals, on the new guidelines for the treatment of blood cholesterol put forward by the American Heart Association (AHA) and the American College of Cardiology (ACC).    Critics have raised concerns the revised guidelines will increase the number of healthy people who take statin drugs by 70 percent, that treatment thresholds are too low and that some guideline writers have links ...

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This past spring, I went to Dar es Salaam, Tanzania to do an internal medicine elective at Muhimbili University of Health and Allied Sciences. I rotated through two sub-divisions of internal medicine while I was there: infectious disease and cardiology. The medicine When I initially stepped onto the infectious disease ward, I saw the janitors mopping the cement floors with soap and water. The ward was crowded and the patients lying on ...

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Sometimes I feel as if my entire emergency medicine career is dedicated to one patient complaint.  And that one complaint is chest pain.  It may be that the incidence and prevalence of chest pain was the same during my medical school and residency training as it is now.   But I doubt  it. I recall how I struggled to learn the salient questions.  ‘Where is your chest pain?  Is it heavy, dull, ...

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From MedPage Today:

  1. Medicare P4P to Affect More Docs in 2014. Next year will bring a number of changes to one of Medicare's pay-for-performance programs, the physician value-based payment modifier (VPM) -- changes that will show up in physicians' paychecks a few years hence.
  2. Ecstasy Use Doubles Over 6 Years. The number of emergency department visits involving the drug ecstasy more than doubled from ...

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From MedPage Today:

  1. HealthCare.gov Works for 'Vast Majority,' White House Says. The Obama administration met its self-imposed deadline to have most of the issues with the HealthCare.gov web portal through which consumers can sign up for health insurance under the Affordable Care Act working ironed out by Nov. 30, officials with the Centers for Medicare and Medicaid Services (CMS) said.
  2. Death Risk Lower With ...

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I know what you're thinking, punk. You're thinking "did he fire six shots or only five?" Now to tell you the truth I forgot myself in all this excitement. But being this is a .44 Magnum, the most powerful handgun in the world and will blow you head clean off, you've gotta ask yourself a question: "Do I feel lucky?" Well, do ya, punk? - Harry Callahan (played by Clint ...

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The American Heart Association and American College of Cardiology recently published new guidelines for screening and treating cholesterol. In some ways these guidelines are more like the British guidelines. Instead of setting up doctors and patients to fail by calling for certain cholesterol number targets as in the old U.S. guidelines (i.e. LDL level below 100), they instead focus on putting higher risk patients on drugs called statins and then ...

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The American Heart Association, in collaboration with the American College of Cardiology, recently released recommendations that should change the way we prescribe medications called statins, including drugs like Lipitor and Crestor and their generics, atorvastatin and rosuvastatin. The headlines say stuff like, "More Americans may be Eligible to Receive Cholesterol Lowering Drugs!" I am a bit skeptical of news about statin therapy because Lipitor, before it went generic, was responsible for over ...

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