It's cold out! People have heart attacks when it's cold out! You can avoid the cold weather heart attack! But how?

Studies have shown that Christmas, New Year's Eve, and winter months in general have the highest rates of heart attacks of all the days and months of the year. Why? Even in warmer climates, people have more heart attacks during the winter. Why? More...

Anytime you plan on making a significant lifestyle change, it helps if you have a social support structure around you to help you make that change. It's very difficult to quit smoking when everyone in your house smokes. You can't lose weight if the rest of your family keeps eating unhealthy food. One way to incorprate weightloss and a social support structure is through social applications. Smartphones are great becasue they have great apps! And some of them can help you lose weight.

One of the best apps for this is Calorie Conter by MyFitnessPal.com. You can search for it on your phone and download it. It is completely free.

You enter your sex, age, height, and weight, Then you give it a goal weight. It calculates your daily caloric intake allowance. For example, it may say, you may eat 1500 calories per day, and in 5 weeks, you will weigh 160 (assuming that's your goal).

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Although this isn't new information, a new article was published linking alcohol consumption to higher and higher incidence of breast cancer. We've know for years that alcohol is one of the few modifiable risk factors for breast cancer. Breast cancer kills 1 in every 36 women. Heart Disease kills 1 in every 3 women. What's new? Even very small amounts of alcohol increased risk of breast cancer.

The article in this weeks Journal of the American Medical Association is below: 

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A website from Stanford University Medical school teaching faculty in an attempt to revive the art of physical exam. Great site check it out!

http://stanford25.wordpress.com/

This is a lecture I give to all the medical students at the end of their third year clinical rotations to help them prepare for Step 2 boards. I also give this lecture in small parts throughout the year to the various internal medicine residents that rotate with us. It's a great introduction and intermediate course in EKG interpretation. After a brief introduction, we go through about 60 ECGs together and discuss them.

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Apixaban prevents embolic stroke, improves mortality, and reduces bleeding when compared to warfarin. Now we have many options for preventing thromboembolic events in atrial fibrillation; warfarin, dabigatran (pradaxa), rivoroxaban, apixaban.

The growing list of oral anticoagulant drugs jockeying to replace warfarin as the go-to agent for stroke prevention in patients with atrial fibrillation added a new candidate, apixaban, that appeared to immediately take the lead on the strength of strikingly impressive results in an 18,000-patient trial.

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Eplerenone has been found to be superior than spironolactone for all stages of heart failure, including a mortality benefit, less reshospitalization, as well as not raising HgbA1c levels.

The aldosterone antagonist eplerenone cut cardiovascular events and the need for hospitalization significantly across all risk levels in patients with mild heart failure, according to a subanalysis of the EMPHASIS-HF trial.

Read the full report below More...

A very thorough evaluation of diabetes and guidelines on how diabetes should be managed during Ramdan. This group of physicians wrote an excellent group of guidelines on the management of diabetic patients in Ramdan. They just updated their guidelines this year. This is a must read for every physician with diabetic patients who want to fast in Ramadan.

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A study of some families in Saudi demonstrates that some Muslims gain weight during Ramadan. While most Muslims improve their metbolic profile, improve their insulin resistance, improve their lipid panel and reduce inflammation, and lose weight. It turns out some do the opposite.

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The USDA has moved away from the Food Pyramid and is now going with the Food Plate. This is obviously easier to understand. They also stress portion size. 

This should make it a lot easier for people to visualize and understand the amount of each food category that should be eaten.

In 2005, the USDA used a new pyramid with a person running up the side to emphasize activity as well as diet. That pyramid was complicated and hard to understand. It also over emphasized grains.

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A question that we get asked all the time, "Can you still have a heart attack if your stress test was negative?" Or sometimes people want to know what kind of warranty they have if they just had a negatve stress test. "So does this mean I can't have a heart attack?"

Any one at any time can have a heart attack! More...

Interventional cardiologists in some countries have embraced radial-artery access for placing catheters aimed at the coronaries into patients. Dr. Jolly, a cardiologist at McMaster University in Hamilton, Canada, cited a greater than 90% rate among French interventionalists and a greater than 95% rate in Canada. But as recently as last summer, U.S. cardiologists used radial access for a mere 4% of their coronary catheterizations, based on data collected by the National Cardiovascular Data Registry, said Dr. Edward J. McNulty, an interventional cardiologist at Kaiser Permanente San Francisco.

From: Internal Medicine News

All the drink manufcturers have decided to show the full calorie count per bottle on their labels in an easy to read format. So instead of reading that each surving in a 12oz Coke contains 45 calories (each can is 3 servings), it will just say 135 on the can.

This should help people quickly identify the "calorie burden" of each product they consume.

If only people knew what calories meant and how much they need per day. People severly underestimate how many calories they consume and severly overestimate how much they burn.

Read more on the Alo Diet section on caloric needs!

My lecture titled Emergency EKGs for Emergency Phsyicians is now available online for your viewing and listening pleasure. It was a hit and some people missed it. So now you can download it and read it and listen to the audio on your own time.