Lewis Clarke M.D., Ph.D.’s Post

Dr. McCullough responds to the WHO's MPOX emergency declaration Peter McCullough, MD, MPH with Mike Vera #MFEducation

Atypical femur fracture (from bisphosphonte use) These need to be correctly diagnosed, and properly fixed. This is an 80 year old with a proximal femur fracture. You can see that it's a classic atypical fracture: cortical thickening at the fracture site, cortical beaking, short transverse nature of the fracture. It's a bit lower than the usual subtorch location, but they can occur lower. These are important to diagnose, which changes management. So get a good history. If you ask the patient, they typically have symptoms for months before the fracture. They also usually say they felt their femur break (usually from twisting or minimal trauma), and then they fell down. That's a very common story: "I was in the kitchen, turned around, felt my leg snap and fell down". Always ask about bisphosphonate use. Even if they deny it, if you see this xray they are likely taking the medication and don't know about it (I've had that many times). Important things about these atypical fractures: 1) They take a long time to heal, since the both is pathologic, and have a high rate of delayed union and nonunion. 2) Given the high risk of delayed/nonunion you need to get a good reduction (as anatomic as you can). So open them if you have to, and no varus. See below for reduction info. 3) Always ask the patient about symptoms on the other side, and x-ray the other femur. This lady had some symptoms on the other femur, and xrays showed cortical beaking. She had the other side fixed prophylactically a few days later (same hospital stay) 4) Bisphosphonates need to be stopped, and refer the patient to a bone health specialist. How do you reduce them? This was done on a fracture table. (My personal preference is supine on fracture table, but some people go lateral or supine with no traction, either is fine). You can see that traction helps, but it's still malreduced. I usually push on the fracture with my fist to see how that helps to get an idea of how easy it will be to reduce. I thought this may go closed, but we were prepared to open. Once draped I tried to reduce it closed with pushing on it with a mallet, but it was completely displaced laterally. You can try to play around with it to get it closed, but I just made a small incision to open and clamp it. It makes it much easier and quicker to get the reduction that way. Remember you need to reduce these as perfect as you can! #orthotrauma #femur #fracture #orthopaedics #bisphosphonates

These are seven of the kids that were m*rdered today by Hezbollah, in Druze village Majdal Shams in Israel. Overall victims toll from this massacre rose to 14. Kids were just playing football. The shelter was very close to the football field, but the kids didn't have time to enter it 😨 Hezbollah, proxy army of Islamic Republic of Iran, targets children. Photos from Amir Tsarfati TG

Statins. #Lipitor /atorvistatin is the blockbuster #Crestor #2 22% of us are on them most over 50. Tripled the past 10 years. This study below says they’re overprescribed. Truth is worse than this new study. 30 year olds are recommended statins if 190 ldl or higher or you have been 1 risk factor for CVD. Statins a massive prescription class. $15 of a 20b global spend on statins happens here in good old USA. Here are 2 views through the looking glass. ▪️Do they work? ▪️What is the harm? Statins are utter nonsense if judged on these 2 metrics. Let’s look at do they work? Here’s how. How many benefit from reliably taking statins 5 years without missing a day? (Who does that?)But stay with me. This data is from their own schedule H: If you have cardiovascular disease -CVD risk —#statins will benefit under 5 in 100. Said another way 🔻So 30 treated over 5 yrs to prevent 1 in stroke or heart attack 🔻80 have to take them 5 years straight to prevent 1 death Some would call that a low value drug. What if you’re low risk? If you have low CVD risk 100-120 have to be treated to prevent one CVD event. 🔻Under 1.5 in 100 benefit. 🔻Zero effect on death. Some call that a junk drug in the formulary. Even if you get it as cheaply as possible. Better to play it on black. At least that 47% odds vs under 1%. Yet every med student is taught these meds are no brainers. Take baby aspirin and statins. They sure are good and do no harm. But that’s not true either. The Harm ▪️Statins block pathways for two key nutrients -coQ10 and vit k - which opens the door for muscular dystrophy thx to mitochondrial disfunction in up to 30% last study I saw. Is it a coincidence the rise of statin use neatly matches Parkinson’s rise? Check that one out yourself. I’m just a common sense observer. You can’t supplement enough when a pathway is blocked. So I’m told. That kinda yanks statins out of the baby aspirin safety deal doesn’t It?

#EMRs Are a Mess!! A University of Pennsylvania study found that 50% of EMR text is #copied and #pasted. In order to #bill for patient visits, doctors must document specific phrases related to the patient's history and physical exam. There are a lot of billing codes and a lot of #documentation rules for each billing code. As a result, doctors copy and paste their own notes and other doctors' notes over and over again to fill the electronic medical record with #junk information. As a result, the EMR is filled with so much redundant, repetitive information that the average patient record is 56% the length of Shakespeare's '#Hamlet.' Just reading the records for 10 patients is the equivalent of reading an 85 page #book... and most physicians see more than twice as many patients each day. The Result: Doctors #skim medical records and miss the important information that is buried amongst the copied note text. #Errors occur and patients are hurt Sources at AHealthcareZ YouTube Channel.

NEW ARTICLE - ForbesWomen 🧠💫 A recent Forbes article by Jessica Cording, MS, RD, CDN, INHC highlights the importance of using objective brain data for clinicians in women's health. Featuring Angela DeRosa, DO, MBA, CPE (board certified internist), Dr. Julie McCallen , MD, and Barbie Boules, RDN, LDN, CHWC (registered dietician), the article describes WAVi's clinical utility to measure brain function and provide insights that are easy to track and understand. By leveraging WAVi's brain assessment capabilities, healthcare providers can objectively measure brain performance and detect changes over time, facilitating more tailored and effective treatment plans for aging women. This approach, discussed in the article by clinical wellness experts, underscores the critical role of brain data in improving patient outcomes and enhancing the quality of patient care. Click the link below to read the full article!  https://lnkd.in/g4xHBREE #BrainHealth #WAVi #EEG #ForbesWomen #ForbesFeature #Empowerment #AdvocateForYourself #AgingWomen

President Biden and his administration should take a page out of France's PM Gabriel Attal's book. This is how you stand with your friends and allies. Not by threatening them and by rewarding terror. Its rare to see such moral clarity among world leaders these days - thank you for telling it like it is PM Attal and for your #standwithIsrael.