geoffrey modest medical blogs

  two recent articles just came out that further questioned the value of coronary artery calcium (CAC) scoring as an accurate indicator of clinically significant coronary artery disease. The first one assessed the accuracy of CAC and the important role of LDL cholesterol in cardiovascular risk in individuals without calcifications on CAC testing (see   cad coronary art calc high LDL poor correl with plaque EurHeartJ2025 in dropbox, or   doi.org/10.1093/eurheartj/ehaf497 ). these articles extend my concern about CAC as being a valuable intervention:   https://gmodestmedblogs.blogspot.com/2025/04/coronary-artery-calcium-dec-plaque.html   Details: -- patients were enrolled in the Western Denmark Heart Registry of symptomatic individuals for coronary artery disease who had had a coronary computed tomography angiography (CTA) , from 2008 to 2021     -- coronary CTA can accurately assess both calcified and noncalcified coronary artery plaques as we...

  Facial palsies are quite common and can be associated with Lyme disease or attributed to Bell’s palsy, however the treatments for these conditions are very different. This study developed a clinical risk tool to help differentiate the cause of the facial palsy (see   facial palsy bells vs lyme NeuroClinPrac2025  in dropbox or   doi.org/10.1212/CPJ.0000000000200476 )   Details: -- they accessed the records of 285 patients with facial palsies who were seen in the Massachusetts Eye and Ear Infirmary (MEEI) between October 18, 2005 and December 13, 2021, having first been seen in various primary care, acute care, and emergency care facilities throughout the US before being referred to this site -- inclusion criteria for the study included those with a rapid onset of unilateral flaccid facial paralysis, with full evolution of weakness over 72 hours and onset of recovery of facial tone and movement occurring within four months -- exclusion c...