May 5, 2018

NYTimes: The Best Medicine = Meaningful to Our Patients

Another sensitive medical piece in the newspaper, this one about grasping our patients’ goals for their treatment and their lives. Living your own life well can teach you that:

“I can’t imagine a better reason to be treated as an outpatient than a daddy-daughter dance,” I told them. “Whatever it takes, we’ll find a way to make it happen.”

As we get older and spend more years practicing medicine, doctors and nurses tend to get better at identifying the subtleties of illness, and our decisions and recommendations become more accurate. But more important than that, because we’ve lived more of our own lives, I hope we also recognize when what’s meaningful to our patients trumps anything medical that we can offer.

https://www.nytimes.com/2018/05/03/well/live/doctor-patient-medicine-cancer-treatment-leukemia-meaning.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

May 1, 2018

More Bad News About Carbohydrates

A diet high in refined carbohydrates is associated with earlier menopause, whereas one high in good fats like omega-3 is linked to much later menopause than an average diet.

How your diet could influence the age of your menopause_101103529_pasta_gettyimages-945098118.jpgA study finds a diet rich in oily fish may help to delay natural menopause, while carbs hasten it.
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.

April 30, 2018

Cold Showers: From Hippocrates to Neurobiology

The Father of medicine prescribed cold baths for many of his sick patients. The Romans and Turks built bath houses, where health seeking citizens would go from a hot sauna-like room to a tempered room where they gradually finished sweating and finally climb or dive into an ice cold swimming pool. Modern Scandinavians, presumably following Viking traditions, cut holes in the ice and more or less briefly immerse themselves in frigid midwinter waters, with or even without a preceding sauna.

I read an interesting interview in the Harvard Buisnesss Review in the seat behind the copilot of a very small Cessna on my way back to Bar Harbor from the #HarvardWriters2018 workshop.

Dutch researcher Dr. Geert A Buijze and colleagues demonstrated that a daily cold shower, even 30 seconds of ice cold water at the end of a more typically soothing warm one, decreased workers’ sick time by 29%.

The explanation, he speculates, could be that cold water induces shivering and raises cortisol levels, which in turn increases energy and stamina. It could also have something to do with activating brown fat, or maybe it’s even a placebo effect, but, as we now know, even the placebo effect is reasonably well explained by modern neurobiology.

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April 28, 2018

BBC News: Five things you might be surprised affect weight

The BBC posted a nice review of some of the reasons behind rising obesity rates in our cultures: From gut microbes to the real reason eating dinner late causes weight gain.

Five things you might be surprised affect weight_100945010_twinsfacing.pngWhy do some struggle more to lose weight than others?
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.

March 9, 2018

Food Preservative for Schizophrenia? | Psychiatric Times

http://www.psychiatrictimes.com/schizophrenia/food-preservative-schizophrenia/?rememberme=1&elq_mid=512&elq_cid=1758157&GUID=2364CC00-4E85-4481-8890-98987D3FED4E

March 8, 2018

Hundreds of Canadian doctors demand lower salaries — Health — Bangor Daily News — BDN Maine

http://bangordailynews.com/2018/03/08/health/hundreds-of-canadian-doctors-demand-lower-salaries/

March 4, 2018

Pumping Steroids Reduces Asthma Attacks

We know that doubling inhaled steroids early in asthma deteriorations doesn’t ward off severe attacks. Quadrupling the dose reduces the attacks by 19%.

http://www.nejm.org/doi/full/10.1056/NEJMoa1714257?query=featured_home

March 2, 2018

BBC News: Diabetes is actually five separate diseases, research suggests

Diabetes is actually five separate diseases, research suggests_100238003_gettyimages-538364990.jpgScandinavian researchers say a new classification would mean better treatment for patients.

February 25, 2018

NYTimes: Doctors, Revolt!

When Dr. Bernard Lown, author of “The Lost Art of Healing” is the patient.

“What I learned when a famous 96-year-old physician became my patient.”

Read More…

February 24, 2018

Celiac Disease and the Gut-Brain Axis

Gluten free diets have become somewhat of a fad lately, and many people say that they are not offering any health benefits for most people. But, given the wide range of symptoms and conditions that seem to be associated with celiac disease, it makes you wonder.

I had been aware of the physical symptoms claimed to be triggered by gluten sensitivity, but an article in The New York Times by Moises Velasquez-Manoff describes several cases of neurological symptoms – “seizures, hallucinations, psychotic breaks and even, in one published case, what looked like regressive autism, all ultimately associated with celiac disease.”

The mechanism is at least partly understood:

“Scientists at the Royal Hallamshire Hospital in Sheffield, Britain, have identified an antibody that binds to a version of transglutaminase, called TG6, which occurs primarily in the brain. This antibody, they argue, may identify celiac patients at risk for neurological complications. When celiac patients with ataxia adopt a gluten-free diet.”

“Celiac disease differs from most other autoimmune diseases in one critical respect: The trigger, gluten, is known. And in most cases, removing gluten will turn off the autoimmune destruction in the gut. Around 10 percent of people with celiac disease, and possibly more, are thought to suffer neurological symptoms, ranging from headache and nerve pain, to ataxia and to epilepsy.”

Some researchers even claim that 25% of schizophrenics have anti-gliadin antibodies, compared to only 3% of the general public, but not all patients whither neurological symptoms associated with gluten intake carry this marker.

Certainly, food for thought…