geoffrey modest medical blogs

  in the spirit of the upcoming holiday season, there was a recent article finding that even moderate alcohol consumption was associated with atrial fibrillation (“holiday heart”) , in a dose-dependent manner (see: alcohol and atrial fib AIM2021 in dropbox, or doi:10.7326/M21-0228)                   Details:  -- 100 consecutive patients at least 21 years old with a history of documented paroxysmal atrial fibrillation (AF) who consumed on average at least one standard alcohol drink per month, recruited from cardiology clinics at UCSF -- they excluded patients with documented substance use disorder (alcohol or other) -- mean age 64, 79% male, 85% white/9% Asian/3% Black, smoking: 1% current/23% former/25% never -- median alcohol drinks: median of 19 drinks (IQR 10-38 drinks) on a median 12 different days (IQR 7-21 days); IQR = intraquartile range, which compares the distance between...

  A study of mental stress-induced myocardial ischemia in patients with coronary heart disease (CHD) found it to be associated with increased cardiovascular events (see   cad mental stress jama2021  in dropbox, or  doi:10.1001/jama.2021.17649 )   Details:  -- 2 prospective cohort studies in patients with stable coronary heart disease from Emory University in Georgia, between June 2011 and March 2016, with follow-up until February 2020      -- Mental Stress Ischemia Prognosis Study (MIPS), 618 participants who were 30-79 years of age and had documented CHD      -- Myocardial Infarction and Mental Stress Study 2 (MIMS2), 300 participants who were hospitalized for a verified MI in the past eight months and were 18-60 years old at the time of the MI;    50% were women by study design -- 918 total patients in the total sample -- mean age 60, 34% women in combined study, 40% Black/55% white -- hyperlipidemia in 80...

  This is the second blog on vaccine effectiveness, this one assessing the Pfizer vaccine in a US study, finding  that the Pfizer vaccine provided continued high effectiveness against severe covid-19 infections: see  covid pfizer inc infections but no change hosps Lancet2021 in dropbox, or doi.org/10.1016/ S0140-6736(21)02183-8     Details:  --retrospective cohort study from Kaiser Permanente Southern California assessed the Pfizer vaccine effectiveness against SARS-CoV-2 infection and Covid-related hospital admission for up to 6 months, in individuals at least 12yo  -- 3,436,957 individuals’ data, from Dec 14, 2020 until Aug 8, 2021 --median age 45 (44% 16-44yo, 31% 45-64yo, 20% >64yo); 52% female; BMI 18.5-25 in 27%, 25-30 in 30%, 30-35 in 19% ; 41% Latinx/32% white/8% Black/12% Asian/10% Pacific Islander  --comorbidities:  21% hypertension/11% diabetes/9% COPD/8% peripheral vascular dz/rest <5%   ...