Episode 200: 200. COVID 4th Vaccine, Vitamin D, Statin
Questioning Medicine17 Elo 2022

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)

Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

https://jamanetwork.com/journals/jama/article-abstract/2822097Design, Setting, and Participants  Nested case-control study using population-based linked administrative datasets among adults aged 66 ye...

3 Tammi 20255min

Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

https://www.nejm.org/doi/full/10.1056/NEJMoa2407001ConclusionsNo participants receiving twice-yearly lenacapavir acquired HIV infection. HIV incidence with lenacapavir was significantly lower than bac...

30 Joulu 20246min

Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

Allaudeen N et al. Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study. J Hosp Med 2024 Dec; 19:1122. (https://doi.org/10.1002/jhm.1345...

27 Joulu 20245min

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Real‐world use of glucocorticoids and clinical outcomes in adults hospitalized with community‐acquired pneumonia on medical wards - Malecki - 2024 - Journal of Hospital Medicine - Wiley Online Library...

23 Joulu 20246min

Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

2024 ESC guidelines propose a simple new BP categorization: Non-elevated: less than 120/70 mm Hg in the office (pharmacological treatment is not recommended). Elevated: 120 to 139/70 to 89 mm Hg (phar...

20 Joulu 20248min

Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Question  Does adding centralized mailed fecal immunochemical testing and patient navigation to usual care improve colorectal cancer (CRC) screening in US federally qualified health centers? pragmatic...

18 Joulu 20247min

Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Packer M et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2024 Nov 16; [e-pub].https://doi.org/10.1056/NEJMoa2410027  In the industry-funded SUMMIT trial...

13 Joulu 202411min

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Wang Z et al. Safety of triptans in patients who have or are at high risk for cardiovascular disease: A target trial emulation. Mayo Clin Proc 2024 Nov; 99:1722. (https://doi.org/10.1016/j.mayocp.2024...

12 Joulu 20246min

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