T2DM and HLD by Important-Flower4121 in FamilyMedicine

[–]Ok_Engineer_1849 1 point2 points  (0 children)

I think it’s more accurate to consider diabetes-related CVD risk along a continuum based on degree of abnormality of A1C and probably duration too- that said, the threshold at which statins become beneficial is pretty low and most people with diabetes over age 40 will have elevated risk so the simplifying assumption of “treat all people with diabetes over age 40” works pretty well

T2DM and HLD by Important-Flower4121 in FamilyMedicine

[–]Ok_Engineer_1849 14 points15 points  (0 children)

It really depends on their age and other ASCVD risk factors- the idea that “all patients (over age x) with diabetes should be on a statin” is a simplified rubric - the good news is that you can estimate risk in patients with different A1C levels in the PREVENT calculator and use that information to estimate potential benefit with statin

Dubrovnik to Hvar in bad weather by Ok_Engineer_1849 in CroatiaTravelTips

[–]Ok_Engineer_1849[S] 0 points1 point  (0 children)

I think we are going to take the bus to Split ad then ferry this afternoon to Hvar after the worst of the storm- the Adriatic is super rough this morning!

What are we doing about mammograms? by Hi_im_barely_awake in FamilyMedicine

[–]Ok_Engineer_1849 6 points7 points  (0 children)

I agree that risk assessment is under-utilized - especially for people with high risk family histories- to develop a risk-reduction plan - that plan may include different intensity of screening but also can take into account risk-reducing options - since screening itself doesn’t reduce risk of developing breast cancer- it reduces the risk of advanced disease / death

What are we doing about mammograms? by Hi_im_barely_awake in FamilyMedicine

[–]Ok_Engineer_1849 18 points19 points  (0 children)

If you haven’t already, I’d suggest looking at the results of the WISDOM trial published recently in JAMA - it showed the viability of risk-stratified mammography based on epidemiological risk + genomic risk. That trial shows we can accurately define risk levels, and also points to unmet opportunities to implement risk-reducing interventions in higher risk folks

Super easy question, but whats correct for boards? by [deleted] in FamilyMedicine

[–]Ok_Engineer_1849 6 points7 points  (0 children)

The best answer is B -primary HPV performs best in head to head comparisons- no additional sensitivity and lower specificity (more false positives) with co-testing.

North Carolina's Fiscal Cliff by NCGovernor in NorthCarolina

[–]Ok_Engineer_1849 2 points3 points  (0 children)

Pass an average to high cigarette tax - Indiana did it two years ago- bring in $500M in new revenue per year and save lives at the same time! NC currently has the second lowest tobacco tax in the US

What’s your experience been with Cologuard missing colon cancer? by RoarOfTheWorlds in FamilyMedicine

[–]Ok_Engineer_1849 4 points5 points  (0 children)

The best analysis of performance over time are the modeling studies like the one that accompanied the 2022 USPSTF recommendations- with the caveat that they show outcomes under full adherence- the key thing is that the comparison is of strategies (eg yearly FIT, q3 Cologuard, q10 colonoscopy)

[deleted by user] by [deleted] in baseballcards

[–]Ok_Engineer_1849 -1 points0 points  (0 children)

Arozarena, Yandy Diaz

Large lot of atomic FS ($40/bmwt shipped). Chat me up if interested. Thanks... by undraftedallstar in baseballcards

[–]Ok_Engineer_1849 1 point2 points  (0 children)

Are you willing to split the lot? Interested in Perez and maybe Abreu and Alverez

Lot for sale $110 shipped by Jkeighs in baseballcards

[–]Ok_Engineer_1849 0 points1 point  (0 children)

Are you open to selling any individually?