Episodes
Friday Apr 08, 2016
Drug Treatment for Agitation in Alzheimer’s Disease: A Conundrum
Friday Apr 08, 2016
Friday Apr 08, 2016
Managing behavioral health in persons withdementia is an enormous and growing problem. Most patients with Alzheimer's disease (AD) have challengingneuropsychiatric symptoms such as agitation. These symptoms are distressing andoften overwhelming for caregivers often resulting in institutionalization andincreased healthcare utilization. Several medications are used off-labelto treat these symptoms including antidepressants, antipsychotics,anticonvulsants, anxiolytics and cholinesterase inhibitors. But manyregulatory bodies, professional associations, and patient advocacy groups havepromoted initiatives to decrease the inappropriate use of medications andencourage the use of alternatives, particularly behavioral interventions. The combination of dextromethorphan hydrobromideand quinidine sulfate (Nuedexta) has been recently studied for the off-labeltreatment of agitation in Alzheimer’s disease. A patient-centered, systematic, andevidence-based approach should be considered when addressing the behavioral and psychological symptoms of dementia.
Friday Mar 25, 2016
Crossing the Periprocedural Bridge in Patients with Atrial Fibrillation
Friday Mar 25, 2016
Friday Mar 25, 2016
For over two decades LMWHs have been routinely used to provide therapeutic coverage in patients who must temporarily stop warfarin. Current guidelines suggest using injectable anticoagulants during warfarin interruption (aka bridging) in patients with atrial fibrillation based on patients’ risk of arterial thrombosis. Using the CHADS2 score to assess risk, the guidelines recommend (grade 2C) bridge therapy if the CHADS2 score is 5 or higher and not bridging if the CHADS2 score is 2 or lower. But what about patients with a CHADS2 score of 3 or 4?
Friday Mar 11, 2016
Reconsidering Strategies for Insulin Intensification
Friday Mar 11, 2016
Friday Mar 11, 2016
Basal, prandial, NPH, ultra-long, inhaled, 70/30, 75/25, 50/50, U-100, U-200, U-300, and U-500 insulin … the list of options for patients with diabetes requiring insulin continues to expand. Current guidelines for glycemic management of patients with type 2 diabetes provide specific recommendations for the initiation of insulin therapy, but not insulin intensification. The recently published LanScape study provides a foundation for making evidence-based clinical decisions.
Friday Feb 26, 2016
TEXT ME — Text Messaging to Promote Behavior Change
Friday Feb 26, 2016
Friday Feb 26, 2016
Wednesday Feb 10, 2016
Pulling Ahead After a SPRINT – Evidence for Lower Blood Pressure Goals
Wednesday Feb 10, 2016
Wednesday Feb 10, 2016
The debate over the intensity of blood pressure (BP) lowering for patients with hypertension has been going on for decades. Additional fuel to the fire was recently added with the early halt and publication of the Systolic Blood Pressure Intervention Trial (SPRINT). So “how low should you go” for patients with high BP? Do lower BP goals reduce CV outcomes and death, particularly in patients at high risk? Do they cause greater adverse effects? Or perhaps even worsen CV outcomes? These questions were examined in SPRINT.
Tuesday Jan 26, 2016
Televised Medical Talk Shows – Is There Truth in Edutainment?
Tuesday Jan 26, 2016
Tuesday Jan 26, 2016
Televised medical talk shows have become a daily viewing ritual for millions around the world. The Dr Oz Show is so popular that it earned him the title “America’s Doctor”, attracting massive numbers of followers as did the show The Doctors. To what extent are the recommendations and claims made by medical shows supported by evidence?
Friday Jan 08, 2016
Preventing Gestational Diabetes with Myo-Inositol: Ready for Prime Time?
Friday Jan 08, 2016
Friday Jan 08, 2016
With increased emphasis on disease prevention, gestational diabetes (GDM) is worthy of more attention. The incidence is on the rise not only in the United States (U.S.) but worldwide. Complications of GDM such as preeclampsia, cesarean delivery, neonatal hypoglycemia, macrosomia, and birth trauma negatively impact maternal and fetal health. Is a readily available, non-prescription dietary supplement the answer? Recent investigations have examined the use of myo-inositol for GDM prevention, with positive results.
Tuesday Dec 22, 2015
An Aspirin a Day to Prevent Colon CA
Tuesday Dec 22, 2015
Tuesday Dec 22, 2015
Several studies have evaluated the correlation between low-dose aspirin and NSAID use and the development of colorectal cancer. In 2007, the U.S. Preventive Services Task Force (USPSTF) recommended against the use aspirin for the prevention of colorectal cancer in most adults. However, there is mounting evidence that daily, long-term aspirin use may prevent colorectal cancer in patients aged 50-69. Could something as simple as an aspirin a day prevent colon CA?
Thursday Nov 19, 2015
The Heart of the Matter – Is EMPA-REG a Game Changer for Diabetes Management?
Thursday Nov 19, 2015
Thursday Nov 19, 2015
The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) study sought to determine the effects of empagliflozin on cardiovascular morbidity and mortality in patients with type 2 diabetes at high risk for CVD. Does the evidence from the EMPA-REG OUTCOME study coupled with the other benefits of SGLT2 inhibitors (reduction in weight and blood pressure, mild adverse effects) make empagliflozin the preferred second-line agent from the treatment of type 2 diabetes?
Friday Oct 30, 2015
Taking a CHANCE on Clopidogrel Plus Aspirin to Prevent Stroke Recurrence
Friday Oct 30, 2015
Friday Oct 30, 2015
The CHANCE (Clopidogrel in High risk patients with Acute Non-disabling Cerebrovascular Events) trial investigators examine whether patients who have a TIA or mini-stroke should receive aspirin AND clopidogrel to reduce the risk of recurrent stroke.