The Aspirin Controversy, Part II

My post last week created much confusion and worry.  I received many emails asking “What about me?  Should I keep taking aspirin or not?” Let me clarify the issue by explaining what we already knew before last week’s study in the British Medical Journal.  We knew that aspirin is valuable in:
  • patients who have had a stroke
  • patients who have had a heart attack
  • patients who have had bypass surgery or angioplasty
  • patients with angina (chest pain or d...
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Aspirin Doesn’t Prevent Heart Attacks in Patients with Diabetes

Aspirin has been a mainstay in the treatment and prevention of cardiovascular disease for decades. We know that in patients who have had a heart attack in the past aspirin prevents a second heart attack, and during a heart attack aspirin is life-saving.  We also know that in patients with a prior stroke aspirin prevents further strokes.  And in patients with symptomatic narrowing of the arteries, that is chest pressure with exertion (angina) or calf pain with walking (claudication), aspirin pre...
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Medications for Osteoporosis

The current issue of the Annals of Internal Medicine published a clinical practice guideline from the American College of Physician on drug treatment for low bone density.  It contains a valuable review of the known benefits and risks of the medications used for osteoporosis which I summarize below. Bisphosphonates This family of medicines includes Fosamax, Didronel, Boniva and Actonel.  Fosamax, Didronel, Boniva and Actonel have been proven to prevent vertebral fract...
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Get Your Flu Shots

The first day of fall is three days away.  The kids are back in school, temperatures are dipping lower and the leaves on the trees in LA are doing nothing.  In this magical season a doctor’s thoughts turn to flu shots. The flu shot is recommended for the following groups:
  • Children aged 6 months until their 5th birthday,
  • Pregnant women,
  • People 50 years of age and older,
  • People of any age with certain chronic health conditions (such as asthma, diabetes, or ...
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Gamma Rays are Good for Your Veggies

Last month the Food and Drug Administration allowed food manufacturers to irradiate fresh lettuce and spinach to kill bacteria.  The decision resulted in some controversy and much press coverage.  (See link to LA Times article, below.)  The process involves shooting gamma rays through the produce in an amount enough to kill most bacteria but not enough to wilt the leaves or affect the taste. Though food safety advocates have been recommending food irradiation for many ...
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Micardis does not Prevent Strokes Better than Other Blood Pressure Medicines

Do you remember when we talked last year about the purpose of preventive medicine?  Then you remember that the point of blood pressure medicine isn't to lower blood pressure, it's to prevent strokes and heart attacks. There are now many blood pressure medicines that have been proven to prevent strokes and heart attacks and have track records of safety lasting decades.  These older medicines are also available generically and so ar...
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Summer Swimming Safety

"Summertime, And the livin' is easy" -- George Gershwin

Summer is here, and especially in Southern California, that means opportunities to enjoy lots of outdoor activities including fun days at the beach and in the pool.  Unfortunately that also means more accidental drowning.  In 2005 there were 3,582 drowning fatalities in the United States, a quarter of them in kids 14 and under. So this is a good time to remind ourselves never to leave children unattended in or near a p...
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Osteoporosis Screening: Not Just for Women Anymore

Osteoporosis, which means very low bone density, is a major risk factor for fractures.  Fractures can be catastrophic for older people, and effective medicines exist to treat osteoporosis and prevent fractures, so detecting osteoporosis before a fracture happens is very important in older patients.  Since osteoporosis is very common in postmenopausal women, screening them for osteoporosis is a well-established part of preventive care. Though men are less likely then women to have osteoporosis, ...
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U.S. Measles Cases at Highest Numbers Since 2001

I almost never write about children's health.  I'm not a pediatrician, and most of what I know about kids' health I learned as a dad, not in training.  This topic, however, is important enough to concern all of us. Measles is a very contagious viral illness that causes high fever, a rash, cough and a runny nose.  Complications can include pneumonia, brain inflammation and death.  In 1958 there were 763,094 cases of measles reported in the US.  The measles vaccine was introduced in 1963, and wid...
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It’s Never Too Late to Treat High Blood Pressure

New Feature Ask the Doctor

I've read a lot in the news in the last two weeks scary stuff about Singulair.  Should I stop taking it? -- Jeff K.

About two weeks ago the FDA released a communication that it was investigating the incidence of suicidal thinking and mood changes in patients taking Singulair, a medication used to treat asthma and nasal allergies.  No connection between Singulair and these symptoms has been est...
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