Episode 64: More listener questions with answers leaving more questions - Part II

Submitted by admin on Wed, 2009-08-19 17:03

In episode 64, we finish off the listener questions and comments and clarify the murkiness, or murkify the clariness, around a number of cardiovascular issues. By the end of the podcast, both Mike and James are heavier because they eat up all the "sweet" comments made by their listeners.

Show Notes

1) BMJ hypertension meta-analysis

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Comments

Hi, thank you very much for a

Submitted by dr_fab (not verified) on Wed, 2009-08-26 20:19.

Hi,
thank you very much for a wonderful podcast - I'm listening to you since the first episode.
So here's my little wish list of topics you could cover in future - just in case you run out of ideas...
- pharmacokinetics: who doesnt't hate it? e.g. half-life of drugs & when does make it sense (if at all) to check the serum level 0f a medication, bio-availability: when is starting a therapy orally as good as iv?
- anticoagulation, e.g. how to start and control heparine therapy (sounds easy, but I assume you can find a lot of "myths" here), low-molecular heparines, warfarin; are coagulation tests only surrogates (e.g. "correcting" PT with vitamine K in warfarin-overdoses patients, thrombosis risk in patients with severe liver cirrhosis and so on) ??
- proteinuria (you promised!) - really just a surrogate, or may there be a difference in heart failure patients vs. patients with nephrotic syndrome (as my colleague from nephrology department points out) ?
- biostatistics (oh you'll never do this one, will you?) - e.g. can you extrapolate somehow a NNT say from a five year lasting study to ten oder twenty years - if not, couldn't that mean that a pill with a "unfavorable" NNT for a chronic disease pays off in the long run?

greetings from freiburg (germany)
-fab.

ps. one more silly question: why the hell do we use phrenprocoumon in germany instead of warfarin as the rest of the world?

Hi fab - thanks so much for

Submitted by JPM on Wed, 2009-09-09 04:31.

Hi fab - thanks so much for your kind words about our podcast and sorry for the delay in my response - great ideas for topics and some good questions - we'll get to a number of them with the next question and answer podcast. No idea why you use phrenprocoumon instead of warfarin. Thanks again.

Three podcast suggestions: 1.

Submitted by Natup (not verified) on Wed, 2009-10-07 14:20.

Three podcast suggestions:

1. Insulin glargine (Lantus) cancer risk
2. Best evidence - and the screening physical exam (likelihood ratios, etc). Or dare to tackle more specifics of various complaint oriented exams.
3. Influenza vaccination - overview the evidence and ask Mike to pick which flu he'd rather have: H3N2 or H1N2.

Thanks again

Hal Huff

Thanks for continuing to

Submitted by conniedavis (not verified) on Thu, 2009-10-08 20:49.

Thanks for continuing to discuss risk and benefit. You might want to check out this website:

www.decisionsinthegrey.org which is a way for patients to prepare for a shared decision making discussion with their provider. It is developed by the people who do howsyourhealth.org, a very cool tool to help providers with risk appraisal, chronic disease management, quality improvement, etc. Sorry to sound a bit like a marketer, but it is nice to have this kind of thing available.

Another plea to occasionally mention if any of the evidence fits for a frail elderly population. I think a mandatory sentence in every podcast should be: "and this hasn't been studied in very frail or very old patients."

Thanks!

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