Medical devices Archive

A study in JAMA Internal Medicine may help to explain the controversial connection between cholesterol-lowering medications and memory loss. Researchers scrutinized health records of more than 11 million people who saw their primary care doctors from 1987 to 2013. They compared reports of memory problems by three groups of people:

• 483,000 who were prescribed a statin to lower their cholesterol

• 26,000 who were given another type of cholesterol-lowering drug (not a statin) to lower cholesterol, such as a fibrate or niacin

• 483,000 who didn't take any cholesterol drug.

People who took any kind of cholesterol drug—a statin or some other type—were nearly four times more likely to report memory loss right after starting on the drug, compared with people who didn't take any kind of cholesterol drug.

Alternating two types of over-the-counter drugs can relieve pain while reducing the risk of serious side effects.

If you're in a drugstore trying to decide which over-the-counter pain reliever to buy, there are scores of products from which to choose. But there really are only two basic types: nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve, Naprosyn); or acetaminophen (Tylenol). If you want to maximize pain relief and minimize side effects, you might want to stock up on both types.

Ask the Doctor

Q. I've had a pacemaker for several years. Does it make sense to replace it with a newer model that is safe during an MRI scan?

A. Your concern is valid, given some estimates that many people who currently have an implanted cardiac electronic device will need magnetic resonance imaging (MRI) during their lifetime. Sometimes, computed tomography (CT) scans can be used instead. But MRI is the gold standard for diagnosing certain diseases of the brain and spinal cord.

A novel class of drugs has the potential to pick up the slack where other cholesterol medications leave off.

Q . Can you explain exactly what "ejection fraction" means? And is there any way to increase it?

A. Ejection fraction refers to the volume of blood that's pumped out of the heart's left ventricle each time it contracts. Contrary to what many people believe, a normal ejection fraction is not 100%. Even a healthy heart pumps out only about half to two-thirds of the volume of blood in the chamber in one heartbeat. So a normal ejection fraction lies somewhere in the range of 55% to 65%.

Q. My cardiologist told me to take clopidogrel for a year after I received a stent. Now the year is up. I haven't had any bleeding problems. Should I keep taking it?

A. In addition to aspirin, doctors routinely prescribe clopidogrel (Plavix) for people who receive stents, the tiny metal mesh tubes placed in clogged blood vessels to improve blood flow. This medication stops blood components called platelets from clumping together and forming clots. The current guidelines generally recommend that people take the drug for a year. This advice assumes they don't have any side effects such as unusual bleeding, which can show up as severe nosebleeds or blood in the urine or stools. However, these guidelines are still evolving. Experts are currently reviewing new findings from large studies on the benefits and risks of taking clopidogrel and similar drugs for extended periods of time.

Cardiopulmonary resuscitation (CPR) not only saves lives, it may also help survivors of cardiac arrest recover well enough to return to work, according to a study in the May 12, 2015, issue of Circulation.

Researchers studied more than 4,300 people in Denmark who were employed before they suffered a cardiac arrest. In cardiac arrest, the heart suddenly stops working. More than 75% of survivors who had a cardiac arrest outside a hospital were able to return to work in a median time of four months. Those who received CPR from a bystander were nearly 40% more likely go back to work compared with those who didn't get CPR. The chest compressions given during CPR keep blood circulating to the brain, minimizing brain damage caused by a lack of oxygen.

Physical therapy is helpful for wear-and-tear knee osteoarthritis, especially if you start doing it early. But injecting a painful knee with an anti-inflammatory steroid medication before starting physical therapy offers no additional benefit, according to a clinical trial in JAMA Internal Medicine.

Studies have shown that physical therapy modestly reduces pain and improves daily functioning in people with knee osteoarthritis. That could mean being able to walk farther with less pain or to continue leisure activities such as gardening. Before you start physical therapy, your doctor may offer to inject the knee with a cocktail of anti-inflammatory steroid medication and an anesthetic. Hypothetically, this could make it easier for you to stick with exercise and therefore lead to better results.

Wear sunscreen, and avoid direct exposure to the sun.

Fatty plaque in the arteries that feed the kidneys poses a danger to the heart and brain.