A Blunt Discussion About Marijuana: Drug Has Risks, Benefits

A family physician and a patient provided their perspectives on the risks and benefits of medical marijuana during the 2015 Family Medicine Experience in Denver.

Source: A Blunt Discussion About Marijuana: Drug Has Risks, Benefits

According to a 2013 survey(www.samhsa.gov) by the Substance Abuse and Mental Health Services Administration, 5.7 million Americans use marijuana daily, up from 3.1 million in 2006. Nineteen percent of Americans ages 18-25 indicated in the same poll that they had used marijuana in the past month. The drug is linked to nearly 500,000 ER visits annually.

Alternative Dementia Screening Tests | Physician’s Weekly

Alternative Dementia Screening Tests | News Brief

  

Chinese investigators suggest that there are multiples alternatives to the Mini-Mental State Examination that have comparable diagnostic capabilities for detecting dementia. The Mini-Cog test and the Addenbrooke’s Cognitive Examination-Revised were deemed the most effective alternative screening tests for dementia. The Montreal Cognitive Assessment was determined to be the optimal alternative for detecting mild cognitive impairment.

Source: JAMA Internal Medicine, September 2015.

Source: Alternative Dementia Screening Tests | Physician’s Weekly

Dig Deeper – PCSK9 Inhibitors

I’ve cut and pasted an email from Health After 50, a free newsletter from Scientific American.  My first thought was dig deeper.  The uninformed masses might take this information to their physician and start creating demand for these drugs.  Would you be surprised that the cost could be as high as $1000.00 per month?

In The Debate About Cost And Efficacy, PCSK9 Inhibitors May Be The Biggest Challenge Yet

PCSK9 Inhibitors: The Needle, the Cost, the Barriers | Medpage Today

There are still some highly effective generic statins where $10.00 buys you a 90 day supply.  There are OTC options to help with muscle pain and cramps.  You have to ask what good will these new drugs do if no one can afford them?

God Bless America.  We now have PCSK9 (proprotein convertase subtilisin/kexin 9) inhibitors.

The Promising Alternative to Statins

Every so often medication comes along that sends the world of medicine’s collective heart aflutter. Cholesterol-lowering newcomers alirocumab (Praluent) and evolocumab (Repatha) are the current favorites.

Both medications are part of a new class of drugs called PCSK9 inhibitors. As the “inhibitor” in the name implies, these drugs work by inhibiting proprotein convertase subtilisin/kexin 9, a protein that makes it more difficult for the liver to remove cholesterol. By blocking this substance, the medication is able to lower the LDL cholesterol circulating in the blood. In clinical trials, PCSK9 inhibitors have been shown to lower LDL levels significantly beyond what can be achieved with statin drugs, which have been the standard cholesterol-lowering therapy for more than two decades. And they did so without the most common side effect of statins: muscle pain.

Stroke Rounds: Long Work Hours, Stroke and CHD Risk Associated | Medpage Today

via Stroke Rounds: Long Work Hours, Stroke and CHD Risk Associated | Medpage Today.

“Working 55 hours or more a week was associated with significant 33% increase in stroke risk and a more modest 13% increase in risk of developing coronary heart disease, compared to working 35 to 40 hours weekly, in the analysis of published and previously unpublished prospective cohort studies from the U.S., Europe, and Australia.”

One could argue for causation given the strength of association identified by this study.  Common sense tells us that anyone working more than 60 hours a week is going to have considerably less time for other activities like exercise and time with family and friends.  Long hours working also can lead to neglect of one’s health.