geoffrey modest medical blogs

  A recent meta-analysis assessed the time to show benefit of bisphosphonate therapy in preventing fractures in postmenopausal women with osteoporosis, which is  helpful in determining for which women these meds are not indicated (see   o steoporosis bisphosph time to benefit jamaintmed2021  I n dr opbox, or doi:10.1001/jamainternmed.2021.6745 ) Details: --10 high quality RCTs were identified that involved  postmenopausal women with osteoporosis based on existing vertebral fractures or bone mineral density (BMD) of -2.5 or lower; the studies each ranged from 994 to 7765 women involved --23,384 women identified and followed --age range 63-74, follow-up duration 12-48 months --doses of meds: alendronate 5-20 mg/d, risedronate 2.5-5 mg/d, zoledronic acid 5 mg/d --main outcomes: time to 3 different absolute risk reductions (ARRs) with differing thresholds (0.002, 0.005, and 0.010 ) for the first nonvertebral fracture (these ARRs reflects  1 event per 500, 1 per...

The CDC just published their 2017 report on the health status for the United States, with a special feature on mortality (see  https://www.cdc.gov/nchs/data/hus/hus17.pdf  ,  for highlights see page 16) --U.S. life expectancy at birth has declined for the second year in a row, to 78.6 years in 2016     -- life expectancy decreased 0.2 years between 2014 and 2015 and another 0.1 years between 2015 and 2016. [these are really significant: heart disease, a huge killer, continues to decrease, so the fact that there is an increase overall (especially in certain age groups and with certain diseases) means that the actual absolute increase in noncardiac deaths is even more extreme than the 0.1 or 0.2 per year might suggest] -- Life expectancy at birth was 76.1 years for males and 81.1 years for females in 2016 -- of note, the gap between the life expectancy between the non-Hispanic black population and the non-Hispanic wh...

The CDC just released the  life   expectancy  statistics for the US from 2015, finding a decrease of 0.1 years from the 2014 numbers (see  http://www.cdc.gov/nchs/ products/databriefs/db267.htm   ). Details: --in 2015, there were 2,712,630 deaths, an increase in 86,212 --in 2015,  life   expectancy  was 78.8 years, with 0.1 year decrease from 2014    --for males, the decrease was 0.2 years from 76.5 to 76.3 in 2015    --for females, the decrease was 0.1 years from 81.3 to 81.2 in 2015    --for both, the change was only in  life   expectancy  from birth, with no change in the group who made it to 65 yo [ life   expectancy  for males aged 65 was 18.0 years, females 20.6 years: no change from 2014 to 2015. But no indication in their data as to why.  ??from more opiate deaths??] --the age-adjusted death rate increased 1.2% from 724.6 deaths/100,000 to 733.1 in 2015  ...