John Digman
@jdigman.bsky.social
Clinical Pharmacist working in Primary Care, Husband, Father, Disciple of Jesus Christ. Interested in Clinical Pharmacy, General Practice, Politics, Christianity.
Reposted by John Digman
Fascinating paper suggesting the assumption that there is a sigmoid dose response relationship and threshold effect ( "all-or-nothing") for loop diuretics rests on repeated misinterpretation of original studies from the 70s and 80s. #nephsky #cardiosky #emimcc academic.oup.com/ehjcvp/artic...
What are the pharmacodynamics of loop diuretics?
A recent editorial was entitled ‘Loop diuretics in heart failure: few facts and lots of prejudice’.1 I would argue that we have forgotten or distorted some
academic.oup.com
November 9, 2025 at 6:40 PM
Fascinating paper suggesting the assumption that there is a sigmoid dose response relationship and threshold effect ( "all-or-nothing") for loop diuretics rests on repeated misinterpretation of original studies from the 70s and 80s. #nephsky #cardiosky #emimcc academic.oup.com/ehjcvp/artic...
Reposted by John Digman
At 23 years of follow-up, population-based PSA screening of asymptomatic men led to a sustained reduction in prostate cancer mortality, although overdiagnosis remains a concern. Full ERSPC study results and Research Summary: nej.md/42YYsg7
#MedSky #Oncology
#MedSky #Oncology
November 2, 2025 at 2:01 PM
At 23 years of follow-up, population-based PSA screening of asymptomatic men led to a sustained reduction in prostate cancer mortality, although overdiagnosis remains a concern. Full ERSPC study results and Research Summary: nej.md/42YYsg7
#MedSky #Oncology
#MedSky #Oncology
Reposted by John Digman
Among patients with atherosclerosis or diabetes but no previous myocardial infarction or stroke, evolocumab led to a lower risk of major adverse cardiovascular events than placebo. Full VESALIUS-CV trial results: nej.md/4oWrIN6
#AHA25
#AHA25
November 8, 2025 at 3:36 PM
Among patients with atherosclerosis or diabetes but no previous myocardial infarction or stroke, evolocumab led to a lower risk of major adverse cardiovascular events than placebo. Full VESALIUS-CV trial results: nej.md/4oWrIN6
#AHA25
#AHA25
Reposted by John Digman
In a meta-analysis of 17,801 patients with myocardial infarction and preserved LVEF (≥50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up. Full results: nej.md/43U5Ppo
#AHA25
#AHA25
November 9, 2025 at 4:14 PM
In a meta-analysis of 17,801 patients with myocardial infarction and preserved LVEF (≥50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up. Full results: nej.md/43U5Ppo
#AHA25
#AHA25
Reposted by John Digman
New living clinical practice guideline: Cardiovascular, kidney related, and weight loss effects of therapeutics for type 2 diabetes
See our #BMJInfographic for a visual summary of the recommendations
www.bmj.com/content/390/...
See our #BMJInfographic for a visual summary of the recommendations
www.bmj.com/content/390/...
August 26, 2025 at 9:04 AM
New living clinical practice guideline: Cardiovascular, kidney related, and weight loss effects of therapeutics for type 2 diabetes
See our #BMJInfographic for a visual summary of the recommendations
www.bmj.com/content/390/...
See our #BMJInfographic for a visual summary of the recommendations
www.bmj.com/content/390/...
Reposted by John Digman
Happy 276th birthday Edward Jenner! What a time for vaccination: 154 million lives saved in the last 50 years, tempered with an increase in vaccine preventable diseases across the world, vaccine sceptics in charge in the US, and cuts to overseas aid threatening global immunisation programmes.
May 17, 2025 at 7:41 AM
Happy 276th birthday Edward Jenner! What a time for vaccination: 154 million lives saved in the last 50 years, tempered with an increase in vaccine preventable diseases across the world, vaccine sceptics in charge in the US, and cuts to overseas aid threatening global immunisation programmes.
Exceptionally clear and informative resource.
🚦Latest @medscape.com Primary Care #hack is live!
🔥Paired #hacks covering the diagnosis & management of #HFrEF & #HFpEF in primary care
PDF download link in comments 👇🏾
@pharmrj.pharmsky.app @goggledocs.bsky.social @hpillminster.pharmsky.app
🔥Paired #hacks covering the diagnosis & management of #HFrEF & #HFpEF in primary care
PDF download link in comments 👇🏾
@pharmrj.pharmsky.app @goggledocs.bsky.social @hpillminster.pharmsky.app
May 2, 2025 at 8:58 PM
Exceptionally clear and informative resource.
Reposted by John Digman
The risk of venous thromboembolism (VTE) varies across contemporary hormonal contraceptives, with the highest risk associated with combined pills.
#MedSky https://ja.ma/3Y5WQPf
#MedSky https://ja.ma/3Y5WQPf
Contemporary Hormonal Contraception and Risk of Venous Thromboembolism
This study assesses the risk of venous thromboembolism of different forms of hormonal contraception, including pills with estrogen and progestin, vaginal rings, patches, progestin-only pills, intrauterine devices, implants, and injections.
ja.ma
April 18, 2025 at 6:00 PM
The risk of venous thromboembolism (VTE) varies across contemporary hormonal contraceptives, with the highest risk associated with combined pills.
#MedSky https://ja.ma/3Y5WQPf
#MedSky https://ja.ma/3Y5WQPf
Reposted by John Digman
Terminally Ill Adults (End of Life) Bill: call for evidence
here's mine
margaretmccartney.substack.com/p/terminally...
www.parliament.uk/business/new...
here's mine
margaretmccartney.substack.com/p/terminally...
www.parliament.uk/business/new...
Terminally Ill Adults (End of Life) Bill: call for evidence
Terminally Ill Adults (End of Life) Bill: call for evidence
www.parliament.uk
January 28, 2025 at 11:04 PM
Terminally Ill Adults (End of Life) Bill: call for evidence
here's mine
margaretmccartney.substack.com/p/terminally...
www.parliament.uk/business/new...
here's mine
margaretmccartney.substack.com/p/terminally...
www.parliament.uk/business/new...
Reposted by John Digman
Paper in this week's NEJM shows that in patients with atrial fibrillation and stable coronary artery disease, edoxaban monotherapy is superior to the combination of edoxaban plus an antiplatelet drug. Major difference was in bleeding rather than reduction in ischaemic events.
December 4, 2024 at 11:25 PM
Paper in this week's NEJM shows that in patients with atrial fibrillation and stable coronary artery disease, edoxaban monotherapy is superior to the combination of edoxaban plus an antiplatelet drug. Major difference was in bleeding rather than reduction in ischaemic events.
Reposted by John Digman
Oral HRT increases venous thrombotic risk (VTE). Tibolone increases arterial but not VTE risk. Topical HRT showed no increase in either. Huge prospective Swedish study: 919,614 women of whom 77,512 started HRT. tinyurl.com/85jxatux #HRT
December 8, 2024 at 9:34 PM
Oral HRT increases venous thrombotic risk (VTE). Tibolone increases arterial but not VTE risk. Topical HRT showed no increase in either. Huge prospective Swedish study: 919,614 women of whom 77,512 started HRT. tinyurl.com/85jxatux #HRT
Reposted by John Digman
Disagree. It’s not the NICE decision that’s disappointing , it’s the drug
https://www.ft.com/content/7762094c-a86d-43ac-9ed7-fc74ead4c5c5
https://www.ft.com/content/7762094c-a86d-43ac-9ed7-fc74ead4c5c5
The disappointing Alzheimer’s decision is part of a bigge...
Nice’s ruling on lecanemab demonstrates the lack of readi...
www.ft.com
November 23, 2024 at 8:38 AM
Disagree. It’s not the NICE decision that’s disappointing , it’s the drug
https://www.ft.com/content/7762094c-a86d-43ac-9ed7-fc74ead4c5c5
https://www.ft.com/content/7762094c-a86d-43ac-9ed7-fc74ead4c5c5
Excellently articulated opinion piece from former PM Gordon Brown.
“The experience of sitting with a fatally ill baby girl did not convince me of the case for assisted dying; it convinced me of the value and imperative of good end-of-life care.”
This is such a complex and emotional issue.
www.theguardian.com/commentisfre...
This is such a complex and emotional issue.
www.theguardian.com/commentisfre...
Spending time with people in their final days showed me that we need not assisted dying, but better end-of-life care | Gordon Brown
We can and must improve on our current end-of-life options – ‘Switzerland, suicide or suffering’, says former UK prime minister Gordon Brown
www.theguardian.com
November 22, 2024 at 11:24 PM
Excellently articulated opinion piece from former PM Gordon Brown.
Reposted by John Digman
MEGA PDF on Incretin therapies by the one and only @drkevinfernando.bsky.social
Very topical at the moment for CRM world
#PharmSky #Medsky #GPsky #CRM #CardioSky
img.medscapestatic.com/vim/live/pro...
Very topical at the moment for CRM world
#PharmSky #Medsky #GPsky #CRM #CardioSky
img.medscapestatic.com/vim/live/pro...
November 19, 2024 at 7:03 PM
MEGA PDF on Incretin therapies by the one and only @drkevinfernando.bsky.social
Very topical at the moment for CRM world
#PharmSky #Medsky #GPsky #CRM #CardioSky
img.medscapestatic.com/vim/live/pro...
Very topical at the moment for CRM world
#PharmSky #Medsky #GPsky #CRM #CardioSky
img.medscapestatic.com/vim/live/pro...
Reposted by John Digman
Excited to share our recent publication exploring a path forward to retire Cockroft Gault and move towards universal eGFR-based medication dosing decisions, a monumental effort led by Wendy St. Peter and the @nkf-professionals.bsky.social
doi.org/10.1093/ajhp...
doi.org/10.1093/ajhp...
November 18, 2024 at 8:26 PM
Excited to share our recent publication exploring a path forward to retire Cockroft Gault and move towards universal eGFR-based medication dosing decisions, a monumental effort led by Wendy St. Peter and the @nkf-professionals.bsky.social
doi.org/10.1093/ajhp...
doi.org/10.1093/ajhp...
Reposted by John Digman
CLEAR trial: Should we routinely use Spironolactone after Acute Myocardial Infarction?
No!
#AHA2024
www.nejm.org/doi/full/10....
No!
#AHA2024
www.nejm.org/doi/full/10....
Routine Spironolactone in Acute Myocardial Infarction | NEJM
Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial...
www.nejm.org
November 17, 2024 at 4:19 PM
CLEAR trial: Should we routinely use Spironolactone after Acute Myocardial Infarction?
No!
#AHA2024
www.nejm.org/doi/full/10....
No!
#AHA2024
www.nejm.org/doi/full/10....
GOLD 2025 guidance now available.
No dramatic changes to pharmacological management of COPD from my reading.
#PharmSky #COPD
goldcopd.org/2025-gold-re...
No dramatic changes to pharmacological management of COPD from my reading.
#PharmSky #COPD
goldcopd.org/2025-gold-re...
2025 GOLD Report - Global Initiative for Chronic Obstructive Lung Disease - GOLD
GLOBAL STRATEGY FOR PREVENTION, DIAGNOSIS AND MANAGEMENT OF COPD: 2025 Report Evidence-based strategy document for COPD diagnosis, management, and prevention, with citations from the scientific litera...
goldcopd.org
November 16, 2024 at 10:19 PM
GOLD 2025 guidance now available.
No dramatic changes to pharmacological management of COPD from my reading.
#PharmSky #COPD
goldcopd.org/2025-gold-re...
No dramatic changes to pharmacological management of COPD from my reading.
#PharmSky #COPD
goldcopd.org/2025-gold-re...
Interesting conclusion from Cochrane. Are we currently over treating BP in this cohort?
Thoughts?
#PharmSky #Pharmacy
Thoughts?
#PharmSky #Pharmacy
🎺 For people with high #bloodpressure (BP) & chronic renal disease, evidence does NOT support lower than standard BP targets 🎯
Our #Cochrane systematic review looks at evidence from 6 trials involving 7,348 participants: tinyurl.com/BP-targets-r...
#SystematicReview #hypertension
Our #Cochrane systematic review looks at evidence from 6 trials involving 7,348 participants: tinyurl.com/BP-targets-r...
#SystematicReview #hypertension
November 16, 2024 at 9:44 PM
Reposted by John Digman
SUMMIT trial: “Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with heart failure with preserved ejection fraction and obesity”
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity | NEJM
Obesity increases the risk of heart failure with preserved ejection fraction. Tirzepatide, a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor...
www.nejm.org
November 16, 2024 at 3:33 PM
SUMMIT trial: “Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with heart failure with preserved ejection fraction and obesity”
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Reposted by John Digman
BPROAD trial: “Among patients with T2 diabetes, the incidence of major CVD events was significantly lower with intensive treatment targeting a systolic blood pressure of <120 mm Hg than with standard treatment targeting a systolic blood pressure of <140 mm Hg”
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Intensive Blood-Pressure Control in Patients with Type 2 Diabetes | NEJM
Effective targets for systolic blood-pressure control in patients with type 2 diabetes are unclear. We enrolled patients 50 years of age or older with type 2 diabetes, elevated systolic blood press...
www.nejm.org
November 16, 2024 at 3:41 PM
BPROAD trial: “Among patients with T2 diabetes, the incidence of major CVD events was significantly lower with intensive treatment targeting a systolic blood pressure of <120 mm Hg than with standard treatment targeting a systolic blood pressure of <140 mm Hg”
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Reposted by John Digman
Good piece on the problems around drug choice in assisted suicide unherd.com/2024/11/the-...
The painful truth about assisted suicide
unherd.com
November 13, 2024 at 8:28 AM
Good piece on the problems around drug choice in assisted suicide unherd.com/2024/11/the-...
Reposted by John Digman
Partisan prophecy: God warning powerless people of their fate if they do not support and defend the cause of the right people in power.
Biblical prophecy: God warning those in power of their fate if they do not support and defend the cause of powerless people.
Biblical prophecy: God warning those in power of their fate if they do not support and defend the cause of powerless people.
November 12, 2024 at 4:34 AM
Partisan prophecy: God warning powerless people of their fate if they do not support and defend the cause of the right people in power.
Biblical prophecy: God warning those in power of their fate if they do not support and defend the cause of powerless people.
Biblical prophecy: God warning those in power of their fate if they do not support and defend the cause of powerless people.
I understood that BlueSky was supposed to be a 'safer' space than X... On browsing feeds on Christianity/religion, perhaps this is not a safe space after all!
Is there space for people of faith to encourage each other here, or should we move elsewhere?!
#christianity #religion #christian
Is there space for people of faith to encourage each other here, or should we move elsewhere?!
#christianity #religion #christian
November 14, 2024 at 10:36 PM
I understood that BlueSky was supposed to be a 'safer' space than X... On browsing feeds on Christianity/religion, perhaps this is not a safe space after all!
Is there space for people of faith to encourage each other here, or should we move elsewhere?!
#christianity #religion #christian
Is there space for people of faith to encourage each other here, or should we move elsewhere?!
#christianity #religion #christian