Questioning Medicine Questioning Medicine

Bottom line-Elevated cholesterol as a child into an adult is bad but we still don’t know if treating children with medication improves this badness but we can say if you have elevated cholesterol as a child and it resolves as an adult then that is a good sign and puts you at equal risk to someone who never had dyslipidemiahttps://jamanetwork.com/journals/jama/article-abstract/2817700

Weight gain 5 kg was not associated with risk for the composite outcome among women with class 1 and 2 obesity (BMIs, ≥30–39.9 kg/m2).Weight gain 5 kg and weight loss were associated with lower risk for the composite outcome, compared with recommended weight gain, in women with class 3 obesity (BMIs, ≥40 kg/m2; rate ratio, 0.81)As the authors suggest—my take away bottom lineThese findings suggest that a low amount of weight gain or weight loss is safe in pregnant women with obesity, and might even be beneficial for those with class 3 obesity.https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0140673624002551?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0140673624002551%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.jwatch.org%2F

Chair placement was not associated with a difference in patients’ ability to name their physician (P=1.0), ability to successfully identify their reason for hospital admission (P=0.82), or perceptions of time (P=0.2) (see supplemental table 5).  Overall if you put a chair at bedside and have medstudents following then yes a provider is more likely to sit down. However- this only minimally changes patient satisfaction score 3.9% on a 100 point scale. This would take hospital change. And set up change. This although touted as positive is a negative trial for those in HR and adminhttps://www.bmj.com/content/383/bmj-2023-076309

primary outcome was Duration of the first stage of labor was the primary outcome. AND It was 179 minutes shorter (95% CI 146 - 213) in the intervention group than in the control group (392 minutes; standard deviation [SD] 122 vs 571 minutes; SD 188). Intensity of pain, was reported on a visual analog scale of 0 to 10 at several points in time, was on average 2.0 to 2.7 points lower in the intervention group. The absolute rate of cesarean delivery was reduced by 14 percentage points in the intervention group (26 vs 12; absolute risk reduction = 14; 3 - 25; number needed to treat = 7).Main limitation here was that those in the intervention group were trained and had a professional physiotherapist with them at all times. This is not reasonable. https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1836955323001212?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1836955323001212%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F

In older adults, mildly elevated TSH levels normalized in about 50% of cases during 1 to 2 years of observation.https://academic.oup.com/jcem/article/109/3/e1167/7325863?login=true

A study that was done before the widespread use of troponin only measurements for ACS (and certainly before high sensitively trop  EVER EXISTED), a trial that took place before the first statin was even FDA approved,  a trial that had no idea what DAPT was and took place PRIOR to the publication of the trial that would ultimately make aspirin post MI a standard of care, a trial that existed before a standard 90 minute door to balloon time. As a reminder this trial (ISIS) didn’t demonstrate a huge mortality benefit despite all of the things that were missing from it that are now considered standard of care. The mortality number needed to treat was 143 (13.3% vs 14.0%) https://www.nejm.org/doi/abs/10.1056/NEJMoa2401479