Archive for ‘Uncategorized’

February 15, 2018

Anticoagulants may increase risk of stroke for CKD patients, study warns | News Article | Pulse Today

http://www.pulsetoday.co.uk/clinical/cardiovascular/anticoagulants-may-increase-risk-of-stroke-for-ckd-patients-study-warns/20036169.article

February 15, 2018

Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort | The BMJ

http://www.bmj.com/content/360/bmj.k322

January 7, 2018

Medicines are Bad for You

Every day, as I print the mandated medication information about a new prescription from my EMR, I end up saying something like:

“When you go to the health food store, all their pills and supplements are good for you, but everything I prescribe has side effects. It’s an uneven playing field.”

Some patients squirm uncomfortably as I continue.

“FDA regulated medications have to list known side effects, even if only one percent of people get them. Would you buy a car if you got a piece of paper that said you could burn to a crisp of the gas tank exploded in a rear end collision or get crushed if you got T-boned by a logging truck or suffocate if he car slid down an embankment and into the Atlantic?”

Usually that gets some recognition.

“It’s just so the pharmaceutical companies can’t get sued if someone comes to harm, because they have been warned. It’s like the man who successfully sued a lawn mower manufacturer for not warning against using it at eye level as a hedge trimmer – a twig flew in his eye that way and he lost his vision.”

Then I get nods and mumbles, but how much nocebo or placebo effect am I getting when I have to present my remedies in his fashion?

I read an article today about how pseudoscience is presenting itself with greater conviction than real science, how alternative practitioners seem unfettered by the doubts of real scholars (the Dunning-Kruger effect), and how now the alternative practitioners are immensely more dogmatic and authoritarian than science based medical professionals.

“One traditional view of the medical profession is that doctors are commanding and authoritarian, even arrogant. Though some individuals fit that description, in fact, the profession is built on doubt.

Most doctors, especially the good ones, are acutely aware of the limits of their knowledge. I have learned from those much more experienced and qualified than me that humility is something to be cultivated over time, not lost.

Our field is built around trying to prove ourselves wrong. In hospitals we hold morbidity and mortality meetings trying to show where we have failed, what we need to change, how we can do better. Our hospital work is audited to identify where we fell short of our ideals. Through scientific research we try to disprove the effectiveness of treatments. Our failings are exposed from the inside.”

December 19, 2017

Odor can diagnose and even predict Parkinson’s disease

A retired nurse first smelled it in her then 35 year old husband. Scientists have now isolated the molecules.

Scientists sniff out Parkinson’s disease smellp05rcrcq.jpgThe breakthrough, inspired by Joy Milne’s sense of smell, could lead to the first diagnostic test.
Disclaimer: The BBC is not responsible for the content of this email, and anything written in this email does not necessarily reflect the BBC’s views or opinions. Please note that neither the email address nor name of the sender have been verified.

December 12, 2017

Spinal drug injection arrests Huntington’s Disease

The defect that causes the neurodegenerative disease Huntington’s has been corrected in patients for the first time, the BBC has learned.

Huntington’s breakthrough may stop disease_99155050_img_2496.jpgScientists say it could be the biggest breakthrough in neurodegenerative diseases for 50 years.
Disclaimer: The BBC is not responsible for the content of this email, and anything written in this email does not necessarily reflect the BBC’s views or opinions. Please note that neither the email address nor name of the sender have been verified.

September 15, 2017

Life is the best education for a GP

PULSE, the British General Practitioner website has an amusing article by Dr. Zoe Norris, titled “Life is the best education for a GP”. I agree wholeheartedly.

Some examples:

1) Sit up all night with a child who has acute otitis media until their ear drum perforates.

2) Have at least two acute admissions: one that turns out to be nothing (trapped wind is a good one), and one that results in a hospital stay of at least 48 hours.

3) Try one dose of everything you prescribe.

4) Have at least one unpleasant examination.

5) Breastfeed. And bottle feed. Preferably with a normal baby who doesn’t know how to do either, while you are horribly sleep deprived.

6) Take a course of antibiotics without missing a dose. You can’t, can you?

7) Have headlice. And scabies. Then try to treat them.

8) Have constipation. And piles. Check what you are prescribing actually works – your patients will love you forever.

http://www.pulsetoday.co.uk/views/dr-zoe-norris/life-is-the-best-education-for-a-gp/20035263.article

September 9, 2017

Drug Patents Safer with Tribes than Offshore

Allergan’s Restasis eye drop patent has been sold to a Native American tribe. Generic drug makers therefore cannot challenge Allergan, because the patent now belongs to an entity that is very difficult to sue – Tribes are sovereign and US law doesn’t apply. Allergan will now be leasing the rights from the Tribe and paying handsome royalties. Almost like moving the rights offshore, but easier…

https://www.bloomberg.com/news/articles/2017-09-08/allergan-makes-deal-with-native-american-tribe-over-drug-patents

June 25, 2017

Could an Alzheimer’s gene make you smarter, and a sickle cell gene make you healthier?

I just read a fascinating article in The New York Times about how genes we think of as bad sometimes do good things too:

“Consider the border between Finland and Russia, where there’s a sharp gradient in the prevalence of autoimmune disorders like celiac disease and Type 1 diabetes. As I’ve pointed out before, these conditions have become worrisomely common in Finland in recent decades, but are between one-fifth and one-sixth as common on the Russian side, despite the fact that the Russians are just as genetically predisposed to developing them.

What protects the Russians from their own genetic inheritance? Or better phrased, what makes the Finns vulnerable?

Finnish scientists think that exposure to a particular community of microbes — one that more resembles the microbiota of our less hygienic past — prevents the diseases from emerging in Russia. That’s important because at least some of the gene variants associated with autoimmune disease are probably useful; they most likely helped us battle infections in the past.

So instead of rewriting our genetic code, a better approach might be to change the interplay between our genes and environment — in this case by altering the microbes we encounter.”

https://www.nytimes.com/2017/06/17/opinion/sunday/crispr-upside-of-bad-genes.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

May 8, 2017

Salt Isn’t Doing What We Thought

An entertaining article in The New York Times explains that, according to studies on Russian Cosmonauts, a high salt diet makes us hungry, not thirsty. Salt also helps us burn fat and produce our own water, thereby also increasing urine output, just like camels in the desert.

https://www.nytimes.com/2017/05/08/health/salt-health-effects.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

April 26, 2017

And How Long Will You Be Staying, Doctor?

A family physician writes in The New England Journal of Medicine about being asked, again and again, “And how long will you be staying, Doctor?”

“Caring for entire families helps me understand my community. I know that a patient is stressed because her son struggles with alcoholism: I’ve admitted him several times with pancreatitis. I know another patient can’t focus on her diabetes because she is still grieving her mother’s death: for years she wheeled her mother into my clinic for monthly appointments. When a teenager returns from a first year at college and asks for birth control, I remember her mother crying in my office months earlier, overwhelmed with pride and worry at having her first baby move so far away.
The patients weary of explaining all this — their tragedies, triumphs, and transformations — to a new face every few years, no matter how bright or kind that new face is. Seven years in, I understand why my patients would be disappointed if I left. As their doctor, I would be, too.”

http://www.nejm.org/doi/full/10.1056/NEJMp1613899