Episode 200: 200. COVID 4th Vaccine, Vitamin D, Statin

Episode 200: 200. COVID 4th Vaccine, Vitamin D, Statin

Association of Receipt of the Fourth BNT162b2 Dose With Omicron Infection and COVID-19 Hospitalizations Among Residents of Long-term Care Facilities | Geriatrics | JAMA Internal Medicine | JAMA Network


careful what you believe and always question medicine- even if it is about covid vaccine

Use and Cost of Low-Value Health Services Delivered or Paid for by the Veterans Health Administration | Cancer Screening, Prevention, Control | JAMA Internal Medicine | JAMA Network

low value care exist in the VA but also in the community-- you need a comparative arm to figure out how bad you are doing or good you are doing.

Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults | NEJM

You can also check a level if you are trying to make the diagnosis of rickets. ELSE no need to check anyone, if you really believe in it or your patient really believes in in then just start 2000IU and continue to take as long as they feel indicated because it likely is not doing any benefit but realistically it is not doing any harm at that dose either (there has been harm seen at super high doses 50,000IU)


listener question---- My question is what is the smallest doses statin I need to convince patient to take to benefit.

For me the answer is that yes high dose is better than moderate dose for those needing secondary prevention, but any dose is better than no dose for both primary and secondary prevention. If the patient isn’t taking the medication it doesn’t matter how good the drug is so ultimately if they are very serious about their risk reduction then go ahead and try and push higher dose statin else just take any dose the patient is willing to take and be happy they are you getting some sort of risk reduction that drastically beat ‘nothing’/placebo.


Jaksot(385)

15. Clinical Testing

15. Clinical Testing

An overview of a few studies and information regarding inpatient and outpatient testing. "The first principle of solid wisdom is discretion.." --Norman MacDonald. A little discussion on understanding ...

21 Loka 201432min

14. IV Fluids part 2

14. IV Fluids part 2

Bottoms up on the last discussion on fluids and a review of a few of the trials that contribute to the current mindset in EBM. Andrew creates his own "Mike Tyson Theory of fluids" and Joe subscribes t...

3 Loka 201424min

13. IV Fluids part 1

13. IV Fluids part 1

A quick discussion one the topic of which patient to give which fluid. Review of studies from the 90s to 2014 with demographics including pre/post Operative, Septic patient and even Rattus Rattus. (th...

25 Syys 201423min

12. Dexa Scan Part 2

12. Dexa Scan Part 2

Hard topic and difficult discussion continues about reasonable intervention and evaluation of therapy for osteoporosis. Andrew starts right off with his personal recommendation on the screening of low...

10 Syys 20147min

11. The Dexa Scam

11. The Dexa Scam

Hard hitting discussion on the evidence on soft bones and the best screening and treatment options. This episode was broken into two parts because Joe needed to run a full NIH Stroke Scale on Andrew m...

1 Syys 201429min

10. Vitamin D Part 2

10. Vitamin D Part 2

Who and when to test. Dose and frequency along with route of administration of Vitamin D are discussed along with 12 studies of outcomes and complications/benefits of each. Joe discovers Andrew is bel...

13 Elo 201431min

8. Watch Were You Are Putting Your Hands...

8. Watch Were You Are Putting Your Hands...

You might be outside the guidelines soon. Joe and Andrew discuss the newest recommendations from ACP regarding bimanual/pelvic exams. Andrew can't hold it any longer and breaks into song for the first...

6 Heinä 201434min

7. Diabetes. It's Not Over Until the Intervals Are Over.

7. Diabetes. It's Not Over Until the Intervals Are Over.

Don't celebrate just yet, the confidence intervals aren't all the way over the line. Andrew gives yet another history lesson on the improvements in Diabetes and runs over some of the recent talk abou...

23 Kesä 201430min

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