geoffrey modest medical blogs

  A recent study reaffirmed a relationship between H Pylori infection in the development of Type II diabetes (see  H pylori and development of diabetes BMCendo2024  in dropbox, or  https://doi.org/10.1186/s12902-024-01694-2 )   Details : -- 4406 participants attending their annual health checkups at a single Chinese hospital were included in this study to assess the correlation between the incidence of Type II diabetes and H. pylori infection.     -- 2053 participants were H. pylori positive as detected by breath test, 2353 were H. pylori negative -- Mean age 48, 37% female -- BMI 24, fasting blood glucose 95 mg/dL, total cholesterol 174/HDL 52/LDL 108 mg/dL -- exclusion criteria included patients with severe hepatic, renal, cardiovascular or cerebrovascular diseases; those with malignant tumors or autoimmune diseases; and those with other endocrine disorders   -- main outcomes: assess the correlation between the incidence of Type II diabetes...

  A recent VA study found that the vast majority of vete rans with resistant hypertension did not have a workup for primary hyperaldosteronism (see   htn hyperaldo workup AIM2020  in dropbox, or  doi.org/10.7326/M20-4873  )   Details:   -- retrospective cohort study of veterans, via the US VA system  -- 269,010 patients from 2000-2017 had apparent treatment-resistant hypertension, with 2 blood pressures of at least 140/90 mmHg and at least one month apart       -- treatment-resistant hypertension was defined as inadequate control with at least 3 antihypertensive meds including a diuretic, or requiring at least 4 antihypertensives -- Median age 65, 96% men, 50% obese, median blood pressure 140/79, hypokalemia 3%, diabetes 40%, OSA 11%, heart failure 14%, arrhythmias 25%, atherosclerotic cardiovascular disease 24%  -- meds: ACE/ARB 81%, dihydropyridine CCB 39%, thiazide 59%, beta blocker 64%, other 66% -- Primary endpoi...