Monday, September 26, 2016

KARMEL mneumonic for high anion gap acidosis

The mnemonic MUDPILES is pretty long, so I like this one that I just came across on Wikipedia. Easy to remember!


    K — Ketoacidosis
    A — aspirin
    R — Renal failure
    M — Methanol
    E — Ethylene glycol
    L — Lactic acidosis

Dual aspirin and anticoagulant therapy in patients with atrial fibrillation.

In patients with non-valvular atrial fibrillation, there appears to be no or little benefit of aspirin therapy in addition to coumadin therapy. Dual antiplatelet and anticoagulant therapy increases major bleeding risk. J Thromb Thrombolysis. 2016 Sep 24;

Comment: There may be a role for dual antiplatelet / anticoagulant therapy in patients with non-valvular atrial fibrillation who are within 12 months of acute coronary syndrome or revascularization. However, with these exclusions in place, the researchers still found that 45% of the patients in their retrospective review were receiving both an anticoagulant and aspirin.

Sunday, September 25, 2016

Using the Blockchain for Medical Record Privacy

Blockchain technology has proven its worth in financial markets; another use may be for patients to securely own, control, and share their own healthcare data. J Med Syst. 2016 Oct;40(10):218

Comment: Instead of patient data stored on different electronic medical records, an alternative would be for clinics and hospitals to have blockchain data readers which (with patient permission) will allow them to temporarily access an individuals medical data. Once the patient left the clinic and/or hospital, access to the private data would be revoked.

Friday, September 23, 2016

Combination pain medication therapy in acute postoperative pain

The combination pain medication containing dexketoprofen 25 mg with tramadol 75 mg was effective, and more effective than either alone, in the treatment of acute post-op pain. Cochrane Database Syst Rev. 2016 Sep 22;9:CD012232.

Comment: To decrease opiod use, we are going to have to come up with other safe and effective pain medications. Using a combination of an NSAID with tramadol appears to work well, and is associated with a low rate of side-effects.

Tuesday, September 20, 2016

Strategies to Improve Exercise Adherence and Enhance Physical Activity.

This review article discusses how to change your health behaviors: motivational interviewing and the transtheoretical model of behavior change. Prog Cardiovasc Dis. 2016 Sep 14. pii: S0033-0620(16)30105-0.

Comment: Some of the greatest advances in modern medicine this century likely will come from the discovery of improved ways to get people to change their habits for the better. Habit change, specifically in the area of diet and exercise, is a critical component of health and longevity.

Friday, September 16, 2016

B-Group Vitamins: Chemoprevention?

The author of this article hypothesizes that folic acid, vitamins B2, B6 and B12 may have an important role in the prevention of serious diseases, including cancer. Adv Clin Exp Med. 2016 May-Jun;25(3):561-568.

Comment: This is a theoretical hypothesis only, so individuals must weight hypothetical benefits vs known risks. I generally take a well rounded multivitamin daily which includes these B vitamins without megadosing.

Friday, September 9, 2016

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care.

Behavioral modification techniques and strategies are rarely incorporated into neurologic rehabilitation programs. Curr Opin Neurol. 2016 Sep 6.

Comment: It is critical that we teach people how to successfully adopt new habits when they are undergoing rehabilitation. As Aristotle said: "We are what we repeatedly do. Excellence, then, is not an act, but a habit."