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Showing posts with label Cardiovascular Disorders. Show all posts
Showing posts with label Cardiovascular Disorders. Show all posts

Wednesday, October 23, 2013

Questioning Statins for Older Patients

Limiting medication can reduce overall patient care costs. The efficacy of controlling cholesterol in the "very old" population is now being discussed. Today's post was shared from the NYTimes.com.

Should older adults take statins if they have elevated cholesterol but no evidence of heart disease? It’s a surprisingly controversial question, given the number of seniors taking statins.

Recently AMDA, a professional group representing physicians working in nursing homes, highlighted the issue in a list of five questionable medical tests and treatments. The list was drawn up as part of the national “Choosing Wisely” campaign, which alerts consumers to inappropriate or overused medical interventions, an effort that caregivers would do well to follow.

The standout item on the AMDA list: “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.” That means anyone older than 70, according to the medical society.

Dr. Hosam Kamel, an Arkansas geriatrician who is vice chair of AMDA’s clinical practice committee, said that there is scarce scientific evidence supporting the use of statins by 70- or 80-year-olds without pre-existing cardiovascular disease. Only a handful of studies have focused on outcomes (heart attacks, strokes, premature death) in this older population.

Most of the data on the benefits of statin use come from larger studies that looked at adults of varying ages. The results...
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Saturday, October 23, 2010

Working Overtime Results in Compensation Heart Attack

Working overtime that resulted in a heart attack was deemed to be a compensable dependency claim.

"The compensation judge held that Anthony's overtime work contributed in a material way to his heart attack. In reaching that conclusion, the judge found that the work effort was more intense than the normal wear and tear of Anthony's daily living."

"The parties agree that the overtime work was more strenuous for Anthony than daily living tasks. Glen Gery required Anthony to change heavy paddles or blades that churned the water and shale. To access the blades, he was required to use a jackhammer to remove hardened material, each chunk weighing between thirty and forty pounds. Once the hardened material was removed, certain blades had to be replaced. To replace the blades, a shaft weighing approximately 200 pounds had to be lifted off the ground by at least two workers who were required to push, lift and pull until each new blade was secured. Anthony worked that day performing intense manual labor in a hot and dusty environment."

"Dr. Malcolm Hermele, petitioner's expert, opined that the heart attack occurred on the day Anthony worked overtime, and that his work effort contributed materially to it. Hermele pointed to the results of tests performed the day after Anthony worked overtime to prove when the heart attack occurred. A creatine kinase (CK) enzyme test showed a reading of 1453. A normal reading would be zero. He explained that the CK enzyme is released into the blood stream when there is damage to the heart. Anthony's troponim levels and the result of his brain natriuretic peptide test show that he was experiencing a heart attack. Hermele concluded that a 1453 reading was evidence that Anthony's heart attack occurred within a day or two of the test, during which Anthony performed the overtime maintenance work."

Reading v. Glen Gery Shale and Brick Company, Not Reported in A.3d, 2010 WL 4137298 (N.J.Super.A.D.)Decided October 21, 2010

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For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900jon@gelmans.com have been representing injured workers and their families who have suffered work related accident and injuries.