This week I discovered how painful it can be to change a habit. Not because it means admitting I was doing the wrong thing, but because it means analyzing how feeble my reasons were for the habit in the first place.
Ever since I started practice I’ve been recommending calcium supplements to post-menopausal women. Why? Mostly out of habit. There’s not a shred of evidence that calcium supplements prevent fractures, but some suggestion that they may help bone density. But what’s the harm? Ca...
More
More Support for Hands-Only CPR
My regular readers are a sharp bunch, so you probably already know that cardiac arrest – the cessation of a pulse and of blood circulation – is very very bad for you. Most doctors don’t recommend it. Nevertheless, hundreds of thousands in the U.S. every year suffer cardiac arrest outside of a hospital, frequently due to a heart attack. Cardiopulmonary resuscitation (CPR) was developed 50 years ago for just such situations. Decades of data strongly support that the following two factors are k...
More
Progress in Type 1 Diabetes: Insulin Pumps with Continuous Glucose Monitoring
Before I review this week’s study, bear with me while I clear up some terms.
Type 1 diabetes mellitus and type 2 diabetes mellitus are completely different diseases. That they have such similar names and are differentiated only by a “type” promotes the common misunderstanding that they are subtypes of the same disease. They should just have different names to keep things clear. (I suggest “George” and “Bob”.) They have entirely different causes and treatments. Type 1 diabetes is caused by ...
More
A New Medication for Weight Loss
Obesity is an increasingly prevalent problem in developed countries, and a safe and effective medication for weight loss is eagerly sought. Most weight loss medications have been plagued by serious side effects.
Fenfluramine, a medication used with phentermine in the popular “fen-phen” combination in the 1990s, was found to cause serious heart valve abnormalities and was withdrawn from the market. The two prescription medications currently available are only modestly effective and each suffer...
More
Fewer Americans Dying of Cancer
This week the American Cancer Society published its annual review of cancer statistics and trends. This year the big picture was overwhelmingly positive.
The three most frequently diagnosed cancers in men are prostate cancer, lung cancer, and colorectal cancer (in that order). For women the top three are breast, lung and colorectal cancer. (See the link below to Figure 1 in the study for details.) The incidences (the numbers of new diagnoses every year) of all of these cancers have decrease...
More
New Evidence Supports Prostate Cancer Screening
My regular readers know that prostate cancer screening has been an active research topic recently. (My not-so-regular readers who are interested are invited to catch up on the topic by reading my most recent post on the subject. See the link below.) Whether testing men for prostate cancer saves lives is still an open question. Large trials are currently underway that should provide a definitive answer in the next few years.
In the meantime, preliminary results from a Swedish trial give pros...
More
Doctors to Deal with Distracted Drivers
Doctors are expected not just to diagnose and treat diseases but to prevent disease by counseling patients about behaviors that expose them to risk. We are expected to ask patients about smoking, alcohol use, high-risk sexual behavior, failure to use seatbelts and dancing on windowsills. We are expected to counsel our patients to refrain from behaviors that may lead to injury or disease.
“Mrs. Jones, I’m very worried about the fact that you grease your stairs with motor oil. I advise that yo...
More
Heavy Coffee Drinkers May not be Getting any Boost from their Caffeine Fix
Everyone knows that caffeine is useful on occasion if we need to stay alert, especially when we’re sleepy. Is there any college graduate who hasn’t had a caffeine-fueled all-night study session before an exam? I certainly remember several nights in which I drank coffee to the point of inability to blink, much less sleep.
But for those who drink a lot of coffee daily, how much of a boost in alertness are they getting? A study in this issue of Neuropsychopharmacology offers an interesting insi...
More
Carotid Artery Stenting Almost Ready for Prime Time
Three months ago I wrote about carotid artery narrowing, which is one of a number of causes of stroke. There are currently two alternative treatments for severe carotid artery narrowing: surgery, called endarterectomy, to open the artery, and a newer procedure called carotid artery stenting. (Read my previous post, link below, for some background about these procedures and their role in stroke prevention.)
Thus far, carotid artery stenting has not been shown to be as safe as endarterectomy. ...
More
A Brief History of Unnatural Selection
Indulge me as I digress from writing about health this week to write about an important scientific breakthrough.
People have been altering the living things around us as long as we have been around. We domesticated wild wolves into tame dogs and kept them for protection and as pets. Eventually humans began to farm, and raise livestock. We then began selecting the best animals to breed for the next generation, and we selected seeds from the best plants to sow. Generation after generation, we...
More