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COMMENTARY: COVID-19 Diary Day 2: Insomnia -- The Mark of Medical Practice  - web md

COMMENTARY: COVID-19 Diary Day 2: Insomnia -- The Mark of Medical Practice

Don Dizon shares how he is dealing with the pandemic, knowing that despite COVID-19, people still need care, chemotherapy needs to be administered, and new patients are still coming in for evaluation.
web md - 14 hours ago
COVID-19 Hitting Some African American Communities Harder  - web md

COVID-19 Hitting Some African American Communities Harder

In states such as Michigan and Louisiana, as well as in cities like Chicago and Milwaukee, African American people are making up a disproportionately large number of COVID-19 cases and deaths, officials say.
web md - 14 hours ago
What’s it like to be a healthcare worker in a pandemic? - harvard

What’s it like to be a healthcare worker in a pandemic?

Millions of healthcare workers on the front lines of the fight against the coronavirus have a much higher risk of becoming infected, and are being put in further danger due to shortages of protective equipment, but they continue to do their jobs while adapting to current conditions. The post What’s it like to be a healthcare worker in a pandemic? appeared first on Harvard Health Blog.
harvard - 15 hours ago
No School Forces Many Medical Workers to Stay Home  - web md

No School Forces Many Medical Workers to Stay Home

About 29% of U.S. health care workers have children between 3 and 12 years of age, the analysis showed. In households without a non-working adult or a sibling age 13 or older to care for them, 15% of health care workers will require child care if schools close.
web md - 2 days ago
Mysterious Heart Damage Hitting COVID-19 Patients  - web md

Mysterious Heart Damage Hitting COVID-19 Patients

Most of the attention in the COVID-19 pandemic has been on how the virus affects the lungs. But evidence shows that up to 1 in 5 infected patients have signs of heart damage and many are dying due to heart problems.
web md - 2 days ago
Patients on Steroids With COVID-19 Might Need Rescue Steroids  - web md

Patients on Steroids With COVID-19 Might Need Rescue Steroids

Those on steroids because of known adrenal disease, and for more common ailments, may need additional 'stress' doses of IV corticosteroids in the case of severe infection with COVID-19, endocrinologists urge.
web md - 2 days ago
Lifestyle changes are important even if you take medications - harvard

Lifestyle changes are important even if you take medications

People who are prescribed medication for high cholesterol or high blood pressure may be more likely to gain weight and less likely to exercise, but for those who are on such medications, it's even more important to commit to making healthier lifestyle choices. The post Lifestyle changes are important even if you take medications appeared first on Harvard Health Blog.
harvard - 2 days ago
Test for Coronavirus Antibodies Approved by FDA  - web md

Test for Coronavirus Antibodies Approved by FDA

The test checks for protective antibodies in a finger prick of blood, revealing whether a patient has ever been exposed to the coronavirus and now may have some immunity, The New York Times reported.
web md - 5 days ago
COMMENTARY: NYU Med Student Joins COVID Fight:

COMMENTARY: NYU Med Student Joins COVID Fight: 'Time to Step Up'

New York med schools asked fourth-year students to graduate early and volunteer to help battle COVID. One student discusses how he weighed the potential life-or-death decision to join the front lines.
web md - 5 days ago
Coronavirus Hangs Around After Symptoms Subside  - web md

Coronavirus Hangs Around After Symptoms Subside

It took about five days from the time patients were infected until symptoms appeared, and about eight days before they disappeared. Patients were contagious for one to eight days, the researchers said in a news release from the American Thoracic Society.
web md - 5 days ago
WalMart Will Check All Workers

WalMart Will Check All Workers' Temperatures

Employees with a temperature of over 100 degrees Fahrenheit will be sent home for at least three days and may be advised to seek medical treatment. The workers will be paid for showing up for work, CBS News reported.
web md - 6 days ago
In Some Cases, COVID-19 May Harm the Brain  - web md

In Some Cases, COVID-19 May Harm the Brain

It's believed the brain can be damaged by viral infection whenever a patient's immune system overreacts to the virus. This immune system hyperactivity triggers a "cytokine storm" -- an overproduction of immune cells and their activating compounds, known as cytokines.
web md - 6 days ago
How does cardiovascular disease increase the risk of severe illness and death from COVID-19? - harvard

How does cardiovascular disease increase the risk of severe illness and death from COVID-19?

Initial investigation into COVID-19 focused on its respiratory effects, but a more recent report describes serious cardiovascular complications in people with pre-existing heart disease. How does this underlying condition increase risk for these people? The post How does cardiovascular disease increase the risk of severe illness and death from COVID-19? appeared first on Harvard Health Blog.
harvard - 6 days ago
Top 10 Must-Dos in ICU in COVID-19 Include Prone Ventilation  - web md

Top 10 Must-Dos in ICU in COVID-19 Include Prone Ventilation

With new European Society of Intensive Care Medicine guidelines on caring for critically ill COVID-19 patients covering more than 50 recommendations, Medscape asked one author for his essential top 10.
web md - 6 days ago
Top 10 Tips for Diabetes Telehealth Prophetic in Face of COVID-19  - web md

Top 10 Tips for Diabetes Telehealth Prophetic in Face of COVID-19

A new article sets the stage for routine virtual diabetes visits, offering 10 top tips that will undoubtedly be of use for transforming care during the COVID-19 pandemic, and likely for long afterwards.
web md - 6 days ago
Abortion Access Shifting in Some States Amid COVID-19  - web md

Abortion Access Shifting in Some States Amid COVID-19

In addition to challenges the coronavirus pandemic already poses to women seeking healthcare, several states have included surgical abortions as restricted procedures in executive orders related to COVID-19.
web md - 6 days ago
Ranitidine (Zantac) recall expanded, many questions remain - harvard

Ranitidine (Zantac) recall expanded, many questions remain

The FDA has not yet released the results of its testing of the heartburn medication ranitidine. The testing method used by the online pharmacy that originally alerted the FDA may have affected their results. The post Ranitidine (Zantac) recall expanded, many questions remain appeared first on Harvard Health Blog.
harvard - 6 days ago
Taking Stock - positively positive

Taking Stock

My intention is to walk this part of my life’s journey with a tremendous amount of compassion for myself and others. To navigate with as much positivity as I can muster, to set the intention to come out the other side knowing myself more, connecting a bit more deeply with the world outside my door even if it is over Zoom, and realizing that when push comes to shove, we sure as hell do know how to come together when faced with a difficult time. The post Taking Stock appeared first on Positively Positive.
positively positive - 1 week ago
FDA Requests Zantac Be Pulled From the Market  - web md

FDA Requests Zantac Be Pulled From the Market

Six months after independent testing first raised the possibility that popular heartburn drug ranitidine (Zantac) might break down into the powerful carcinogen n-nitrosodimethylamine (NDMA), the FDA has asked for the removal of all ranitidine products from the market.
web md - 1 week ago
EPA Didn’t Tell Residents About Gas Risks: Report  - web md

EPA Didn’t Tell Residents About Gas Risks: Report

A new government report has rebuked the U.S. Environmental Protection Agency for failing to tell residents about the health risks they face by living near facilities that release cancer-causing ethylene oxide gas.
web md - 1 week ago
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harvard
LDL cholesterol: How low can you (safely) go?

LDL cholesterol: How low can you (safely) go?

harvard - 2 months ago

Elevated low-density lipoprotein (LDL, or bad) cholesterol is a clearly established risk factor for the development of cardiovascular disease (CVD). Lowering LDL with medications and/or lifestyle changes has been shown to lower CVD risk. Just how far to lower LDL, however, has remained controversial.

Current guidelines developed by the American Heart Association, American College of Cardiology, and several other professional organizations recommend lowering elevated LDL levels to 70 milligrams per deciliter (mg/dL) in people with high-risk CVD. However, recent studies have suggested that CVD risk may continue to drop as LDL is lowered beyond these targets, leading some cardiologists to believe that our current guidelines are not aggressive enough. Others are concerned that lowering LDL too much may lead to harm.

No apparent danger of very low LDL cholesterol

LDL is a key component of many hormones and all cell membranes, which allow cells to communicate with each other. Earlier studies had raised concerns that lowering LDL too far might interfere with normal cellular functions, especially in organs that have higher lipid concentrations, such as the brain and reproductive organs. And there have been reports of a slightly increased risk of osteoporosis and brain bleeding in patients treated with high doses of statin medications.

Well-known side effects in people who use statin medications include muscle aches and a slightly increased risk of diabetes, especially when high doses of medication are used. Whether these risks are due to the statin medications themselves or the lowering of LDL is not entirely clear.

However, people with rare inherited disorders in which LDL levels are extremely low (often less than 30 mg/dL) from birth appear to have normal fertility and no major organ dysfunction. Therefore, an extremely low LDL by itself does not appear to be dangerous in these unusual cases.

Study suggests lower LDL cholesterol is better

A recent meta-analysis published in JAMA Cardiology suggests that it is both safe and effective to lower LDL below 70 mg/dL. The authors reviewed a large database of CVD patients with LDL levels averaging 70 mg/dL or less at the start of the studies. On average, there was a 20% drop in CVD risk seen for every 39 mg/dL drop in LDL cholesterol. In other words, a drop in LDL from 70 mg/dL down to 31 mg/dL was associated with 20% fewer CVD events such as heart attack or stroke.

The benefit was consistent regardless of the medications used to lower cholesterol. The JAMA Cardiology meta-analysis looked at studies in which LDL was lowered with a statin drug, which works by lowering LDL production in the liver, or with a different type of medication, including ezetimibe (Zetia), which interferes with absorption of LDL from the intestine, or PCSK9 inhibitors, newer injectable medicines that increase uptake of LDL from the bloodstream into the liver. The drop in CVD risk was in line with previous studies of patients who started with LDL levels around 130 mg/dL, and saw a drop in CVD events of about 22% for every 39 mg/dL drop in LDL.

In this study, there was no increased risk of adverse outcomes (including muscle aches, liver dysfunction, new onset of diabetes, cancer, and bleeding strokes), even when LDL was lowered to as low as 20 mg/dL. Although statin medications themselves have been linked to side effects, especially at high doses, it appears that extremely low LDL concentrations are not responsible for side effects.

In other words, lowering LDL beyond our previous target of 70 mg/dL appears to be not only safe but beneficial, in patients with CVD.

The post LDL cholesterol: How low can you (safely) go? appeared first on Harvard Health Blog.

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