Gaetano Scuderi, MD

Full read review of the benefits & impact of hydroxychloroquine in #SLE. Benefits on: - T cells, cytokines, TLR signaling - VTE prevention - Decr CV risks - Glucose & lipid benefits - Pregnancy

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Value Based Care (VBC) has a left brain problem. When you strip away the flowery adjectives in VBC definitions, you are left with its real intention, which is that value-based health care is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. Who defines value? VBC protagonists, using the imagery of Dr. Ian McGilchrist, cede this responsibility to the Emissary (the left brain). VBC antagonists, on the other hand, prefer the Master (right brain) maintain authority over this definition. Who is right? Who is wrong? The answer = both. The reality is in order to achieve maximum balance between costs and outcomes, both the Master and the Emissary must play central roles in defining value and creating proper balance between costs and outcomes. Tom Morgan brilliantly captures the essence of all of this in this short video discussing the work of Dr. McGilchrist and the importance of ensuring the Master remain in full control, less we burn down the village to save it. Scroll to 24:35 in the video to watch Tom's 5-minute talk. https://lnkd.in/gSDcqPdz Enjoy.

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How Ozempic ™️and Botox ™️ are Alike™️: 🤷‍♂️ Botox, the first aesthetic product to spark a generational shift, launched a revolutionary movement in medicine. Now enter the GLP-1 agonists—a drug class with 20X the appeal of anything similar, transforming the landscape. These drugs are poised to have a tremendous health, cultural, and economic impact for years to come. As a researcher, clinician, and professor on the cutting edge, I see similarities: 1. Widely Popular and Beneficial 🌍 - Botox: Over 10 million treatments per year. - GLP-1s (Ozempic, Wegovy, Mounjaro): With over 70% of the US population overweight or obese, already 1 in 8 Americans have tried it. Newer indications for heart disease and adolescent use could make it the first $100 billion drug. 2. Incredibly Effective 💯 - Patient satisfaction is in the 93% to 95% range for both.* 3. Low Side Effect Profile 🚫 - When used as indicated, both are safe and effective with few serious side effects. 4. Unexpected Benefits 😲 - Botox: From migraines to excessive sweating and urinary incontinence. - GLP-1s: Emerging benefits for cardiovascular, renal, and brain health. 5. Maintenance Required 🔄 - Continued benefits with regular treatment. 6. Success Breeds Adversaries 🤺 • The “vanity police” criticize, while the food, alcohol, and diet industries face challenges from reduced overindulgence. 7. Fear-Mongering on Social Media 📲 - Profiteers amplify rare, minimal side effects, claiming they have a better solution. 8. Highlights Societal Ills 🔦 - Raises awareness on the issues with processed foods and exposes beauty products making exaggerated claims. 9. Mood-Boosting Effects 😊 - Published data shows both help with major mood disorders.** 10. Big Bang! 💥 - Both launched a new discipline in health and wellness. But beware: Many “fly-by-night” providers and online pharmacies claim to be your supplier. Only seek reputable specialists; treatments can pose risks if not prescribed by experienced professionals. Matza LS et al., Patient. 2022 May;15(3):367-377* **The Antidepressant Effects of GLP-1 Receptor Agonists. The American Journal of Geriatric Psychiatry, Volume 32, Issue 1, 117–127 #ozempic #botox #botoxfacial #botoxday #botoxinjections #botoxfiller #botoxcosmetic #ozempicface #ozempicjourney #glp #glp1weightloss #glp1weightloss #glp1community

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Adolescent diabetes care: the power of GLP-1 medications What I envision is for physicians to embrace a comprehensive approach to metabolic health, especially when treating adolescents. It is crucial to be open to all available treatments and to initiate conversations about GLP-1 receptor agonists. By doing so, we can begin to address insulin resistance and type 2 diabetes more effectively in this young population. Physicians need to expand their knowledge about these medications and consider their potential benefits. For instance, the TODAY2 study provides valuable insights into type 2 diabetes in adolescents and highlights the efficacy of these treatments. It’s important for us as medical professionals to stay informed and proactive, given that our training may not have covered these newer developments extensively. Furthermore, assessing your patients thoroughly is essential. Obtain their lab results and avoid assumptions that they will simply outgrow their conditions. Don't shy away from discussions about potential treatments out of fear of causing harm. Many teens are struggling significantly with metabolic health issues, and their parents often feel lost in how to support them. As physicians, we must take the lead in ordering labs, discussing insulin resistance, exploring medication options, and considering prescriptions when appropriate. Karla Lester, M.D., FAAP is a pediatrician, certified life and weight coach, and diplomate, American Board of Obesity Medicine. Link in bio or visit https://lnkd.in/eEgKJj_6 #TeenHealth #MetabolicHealth #GLP1Medications #InsulinResistance #AdolescentDiabetes #DiabetesCare #TODAY2Study #PhysicianTips #TeenDiabetes #HolisticHealth

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"What is a C-Arm machine, and what does it do?" 👇️⁠ ⁠ A C-Arm machine is an advanced medical imaging 📸 device based on X-ray technology. ⁠ ⁠ They are primarily used for fluoroscopy capabilities (real-life moving images) but have radiography (viewing the internal form of an object) capabilities too. ⁠ ⁠ Its name comes from its C-shaped arm, which connects the X-ray source on one end and the detector on the other.⁠ ⁠ Have more questions? Drop them below ⬇️. ⁠

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Clinical Reminder 👀 SSRIs and Hyponatremia –💧 Selective serotonin reuptake inhibitors (SSRIs) like sertraline and citalopram can cause hyponatremia, especially in older adults or those taking diuretics. Symptoms can include confusion, fatigue, headaches, or even seizures in severe cases. This is often due to syndrome of inappropriate antidiuretic hormone (SIADH). Monitor sodium levels, particularly in the first few weeks of treatment, and educate patients on reporting unusual symptoms early. #Pharmacy #PharmX #SSRIs

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Apremilast Benefits and Risks in PsA Dr. Akhil Sood discusses abstracts 1466, 2583, 0598 and 2640 discussing the use of apremilast in PsA, presented at #ACR24. https://buff.ly/491Nc4b

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Would somebody please, please explain to me why these most tachyphylactic drugs in history (more than heroin) the glp1 class, can possibly be the answer to the over-fat epidemic. I never use the ridiculous nonsensical word obesity or BMI as the problem is not weight, it’s fat. So doses have to bump every month for 16 months (STEP-1 extension trial) and then at some arbitrary dose you stop going up and stay there and somehow magically it will keep working. Or if you stop them you gain back on average 2/3s of the lost weight in a year. WTF about year 2? Year3, etc. why wasn’t Novo or Lilly forced to extend it out 3 or 4 years. Duh!? Big Pharma owns the FDA. Where is your common sense people? We will look back years from now and see all these drugs did is drop LBM and SM and metabolism to make people lighter (maybe) but certainly fatter. Modern medicine is devoid of common sense. I’m so glad I retired from practice 20 years ago to develop a nutrional fat loss -muscle maintenance Cornerstone WellnessMD. Lifetime maintenance of healthy body composition.

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I came across this article today . The rising cost of GLP-1 weight loss drugs is pushing insurers and employers to tighten coverage in 2025! What a surprise!😐 As an Orthopedic surgeon, I see how transformative weight loss can be—it improves quality of life, reduces joint pain, and lowers the risk of chronic diseases like diabetes. Even modest weight loss can exponentially improve surgical outcomes and overall health. While I am all for a natural remedy with daily exercise and a healthy lifestyle, I understand that some patients need Extrahelp. Limiting access to these medications ignores their long-term benefits. Weight loss isn’t just personal and “aesthetic”—it’s preventive care that reduces healthcare costs, reduces surgical complications, and improves quality of life. I think the bigger picture is we really need Insurance Reform in this country.

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Data, data, data. Actionable data managed by a patient activation process is critical to VBC success.

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The difference between #climate #doom and #urgency is to provide a roadmap and practical steps for rapid #urban #decarbonization since #cities emit 70% of #carbon, as I do with my "#Gaiapolis #Strategy" book, which also identifies new #green #jobs in emerging #bionic (healthy and smart) cities. #C40 #mayors are already moving fast, but need to engage #businesses and billions of #citizens. www.dreamscapeglobal.om

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The Sequence for the week of 4/29-5/5 talks about a previously unreported repeat expansion founder mutation causing Spinocerebellar ataxia type 4 (SCA4). SCA4 is a rare subtype of SCA characterized by ataxia and nerve pain and numbness that has never before been associated with repeat expansions. This could mean an entirely new way to utilize testing and treatments for SCA4! #genetics, #publicpolicy, #geneticcounseling, #precisionmedicine, #translationalmedicine, #genetictesting, #geneticresearch, #genomesequencing, #spinocerebellarataxia, #SCA, #SCA4

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Delayed gastric emptying and pulmonary aspiration following induction of anesthesia in patients using GLP-1 drugs was evaluated across over 23,000 patients by Dixit et al. in JAMA. Just about three and half thousand were on GLP-1 medications, and there was no significant difference in the incidence of postoperative respiratory complications between those on a GLP-1 drug versus those not on the drug. The authors suggest ‘…liberalizing the withholding guidelines for GLP-1 RAs preoperatively should be considered.’ Whilst a small study, I do think that anyone on a GLP-1 medication should inform their clinician, especially if they are to undergo a procedure under sedation or general anesthesia. https://lnkd.in/eF6w5M-F

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Combining treat-to-target principles and shared decision-making: International expert consensus-based recommendations with a novel concept for minimal disease activity criteria in atopic dermatitis. https://lnkd.in/diEmrs9b

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Despite diligent efforts, CDI programs, in my view, not infrequently generate clinical validation denials while performing “appropriate review” activities: · 1) The most frequent example is the “late” query such that a DX is established in the D/C Summary only. This is particularly an issue when DX is a high-severity medical condition like sepsis, acute-on-chronic respiratory failure, acute-on-chronic CHF, severe protein-calorie malnutrition, etc. 2) Failing to ensure that a clinically cogent clinical story is reflected in the medical record (i.e. a complete and accurate interdisciplinary clinical communication tool) 3) Issuing high numbers of queries such that the attending physician becomes inured to the query process and less likely to respond in a meaningful fashion 4) Failing to truly partner with the attending physician as a documentation partner (i.e. missing the opportunity to “shepherd” the clinical documentation process via brief mentoring in-person interactions). Solution- Restructure, rebrand, refocus, reinvent, and redesign CDI processes to facilitate opportunities to partner with attending physicians and drive better communication of patient care through physician documentation training that focuses upon strong fundamentals and principles of documentation. Educate physicians vs "Queryrating" & annoying physicians with repetitive rapid-fire queries. Stop relying on KPIs that fail to correlate with documentation improvement. Contact me for a list of valid reliable KPIs for CDI performance measurement. I am honored to work with Open Source MD, Inc. hospitalists and David Rosen, providing group & one-on-one physician documentation training in a meaningful way with the achievement of sustainable improvement & denials reduction.

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The role of AI and new technology to aid cardiology “As cardiology starts to face staffing shortages and continued decreases in CMS payments, Biga believes technology advances need to be leveraged in cardiology to help improve outcomes, make workflows more efficient to do more with less, and to help cut costs.” “Many of the solutions that can help were displayed on the expo floor, including telehealth and real-time remote monitoring systems. "I think this area will experience an explosion in use," Biga said. Another major area that will likely see an explosion of use is artificial intelligence (AI). She said AI will begin playing a rapidly growing role in cardiology in the coming years to augment cardiologists and other clinical staff. And not just on the front lines of patient care, but also in the back offices where AI will play a growing role in IT systems, smoothing workflow, analytics, automated quality metrics capture and many other areas. "We must use AI to reduce administrative burdens and improve patient outcomes," Biga explained. “

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