With the launch of the ASCVD Calculator and the ASCVD algorithm we recently added to MDCalc (The difference? I’ll explain further down) we thought it might be nice to review the 2013 guideline. Let’s start at the beginning.
Before the ASCVD
A long time ago, in a galaxy far, far away, (2002) there were the ATP-III Guidelines — short for the “Adult Treatment Panel,” a group of cholesterol and lipid experts that attempted to figure out what the heck to do with patients with lipid issues. It really focused on LDL cholesterol and addressed trying to aggressively reduce it. Find high risk people with high LDL, and get that LDL down! Continue reading “About the ASCVD and ACC/AHA 2013 Calculators”
Suzanne Rosenfeld, MD, is co-founder of West End Pediatrics, a private practice in New York City. Formerly, she directed the Pediatric Emergency Room and also supervised in the Adolescent Medicine training of pediatric residents at The New York Hospital/Cornell Medical Center. Dr. Rosenfeld maintains an active teaching career at Cornell Medical Center and Columbia College of Physicians and Surgeons.
She sat down with us to give our users a some expert advice on the difficulties of vaccinations and some tips to use with patients.
MDCalc: What are some of the challenges you face when trying to vaccinate patients? How do you overcome these challenges?
Suzanne Rosefeld: The vast majority of my patients understand the importance of childhood vaccines. Before vaccinating each child I explain what the vaccine I am recommending is for. In the cases where there is hesitancy I make sure I answer every one of their questions. I listen to their concerns and address, using hard scientific evidence in terms of risk/benefit, each issue.
MDC: What are some of the most common cases in which you do not vaccinate patients?
SR: I do not vaccinate a child if they are at the beginning of an illness, even if its “just a cold”. Vaccines do not “make one sick” (with the exception of the live virus vaccines) but can “distract” the immune system. I am privileged by having a very responsible parent body and find that they 1) appreciate my considerations and, more importantly, 2) return at the recommended time to get the deferred vaccines. Continue reading “Dr. Suzanne Rosenfeld on the Dos and Don’ts of Vaccines”