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Zulfiqar Rana, MD, MPH, FACP
Board Certified in Internal Medicine
Category Archives: Cardiology
Edema
Posted by on October 3, 2022
Edema evaluation
Attendance requirements:
Please see the “Guidelines” section.
Objectives:
- Know the differential for this condition
- Know how to approach a patient with this condition.
- Know basic signs, symptoms, and treatment of other medical conditions in the differential.
Required reading:
- Harrison’s chapter on Edema.
- Also, review other “student slides” below. Know the differential and work-up algorithm!
Suggested reading:
Please use the text of your choice, e.g., UpToDate, Step-up to Medicine, Harrison’s, etc.
- Pathophysiology of Edema
Student Slides:
Prescribing of Fibrates
Posted by on April 1, 2011
Comment: In large trials published in 2005 and 2010, fenofibrate did not improve cardiovascular outcomes significantly in patients with type 2 diabetes (JW Cardiol Jan 5 2006 and Mar 14 2010). Although gemfibrozil lowered rates of cardiovascular endpoints in older trials involving high-risk nondiabetic patients conducted largely before the statin era — for example, the Helsinki Heart Study (JW Gen Med Nov 17 1987) and VA-HIT Trial (JAMA 2001; 285:1585) — most such patients would now receive statins as first-line therapy. Thus, the recent rapid expansion of fenofibrate prescribing is unwarranted. One reason for this phenomenon is aggressive marketing of fibrates; another is confusion among clinicians about the lack of hard evidence to support add-on triglyceride-lowering therapies in patients receiving statins.
Prescribing of Fibrates Is Booming in the U.S. – General Medicine.
Extracranial Carotid and Vertebral Artery Disease – Cardiology
Posted by on March 22, 2011
From J Watch: These recommendations concur with recently released guidelines on primary and secondary stroke prevention. The main message about revascularization for symptomatic carotid stenosis is that stenting should be avoided in older patients (e.g., aged 
70) but might be as safe as endarterectomy in younger patients. However, a more important question is how either revascularization technique compares with intensive contemporary medical therapy, particularly in asymptomatic patients. As evidenced by the number of recommendations that are based on consensus in the absence of definitive evidence, opportunities for further research abound (e.g., the “imperfect correlation” between severity of carotid stenosis and ischemic events, methods to improve diagnostic accuracy, the effectiveness of carotid surgery in women). Large gaps in knowledge about vertebral arterial disease will be difficult to fill because of its relative infrequency compared with carotid artery disease.
Guidelines: Extracranial Carotid and Vertebral Artery Disease – Cardiology.
Updated Guidelines on Secondary Stroke Prevention – Neurology
Posted by on March 13, 2011
About one in four strokes that occur annually are recurrent events. The American Heart Association/American Stroke Association has now updated its 2006 evidence-based recommendations for the prevention of stroke among survivors of ischemic stroke or transient ischemic attack (TIA). The guidelines include recommendations, rated by class (degree of treatment effect) and evidence level, for risk-factor control, antithrombotic therapies, interventional approaches for atherosclerotic disease, and treatment of unusual stroke mechanisms.
via Updated Guidelines on Secondary Stroke Prevention – Neurology.
Pacemaker, 1933
Posted by on February 16, 2011
FIRST MENTION: Pacemaker, 1933
The Times reported on a demonstration of the “artificial pacemaker,” but the device and various successors were not ready for prime time until decades later.
Diet News
- Take it from the rats: A junk food diet can cause long-term damage to adolescent brains
- Family and media pressure to lose weight in adolescence linked to how people value themselves almost two decades later
- Feeding the lonely brain
- Blended antioxidant supplement improves cognition and memory in aged mice
- Pilot study shows ketogenic diet improves severe mental illness
- Risk factors for faster aging in the brain revealed in new study
- Metformin during pregnancy affects the brain development in offspring mice, study finds
- Keto diet prevents early memory decline in mice
- Fatty food before surgery may impair memory in old, young adults
- A healthier diet is linked with a slower pace of aging, reduced dementia risk, study shows
Health News
- Supreme Court to consider when doctors can provide emergency abortions in states with bans
- Remnants of bird flu virus found in pasteurized milk, FDA says
- Mississippi lawmakers haggle over possible Medicaid expansion as their legislative session nears end
- US health officials warn of counterfeit Botox injections
- Ashley Judd and Aloe Blacc help the White House unveil its national suicide prevention strategy
- When can doctors provide emergency abortions in states with strict bans? Supreme Court to weigh in
- Transgender Louisianans lost their ally in the governor's seat. Now they're girding for a fight
- Get better sleep with these 5 tips from experts
- What's EMTALA, the patient protection law at the center of Supreme Court abortion arguments?
- UnitedHealth says wide swath of patient files may have been taken in Change cyberattack
Zulfiqar Rana, MD, MPH, FACP 