Thursday, August 18, 2005

MARCO Grand Rounds, August 14, 2005

From Warren, KD4GUA:

Last week we discussed the importance of vitamin B-12....we ran short of time so will continue that discussion this Sunday.

The reason B-12 is important is the body needs 9 essential amino acids which it does not produce. From these 9 the body adds 11 more with the aid of B-12. For example, Methionine is a necessary amino acid ...from this it is converted to homocysteine and then to cystine another essential amino acid. If there is a deficiency of B-12 there will be an elevation of the homocysteine level in the blood and we know that is NOT good. Increased risk of CV disease.

There is an excellent
article in JAMA Aug. 10, 2005, Page 716, "Guidelines and Quality of Care for Older Patients." It basically says guidelines (cookbook medicine) may be ok when the patient has ONE disease, but most older people have comorbid pathology--more than one disease and then when you introduce two guidelines you start getting into trouble. Plan on discussing this week from Sunday unless someone has something else to bring up.

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