A child develops a fever of 104 ⁰F, cough, runny nose and red eyes. A few days later she develops a red bumpy itchy rash as in this photo. Any guesses as to the diagnosis? Many of us would be stumped, having never seen this disease. This is the classic presentation of measles, which prior to the development of the measles vaccine in the 1960s affected hundreds of thousands of U.S. children annually. There is no treatment. Complications from measles caused 3 fatalities for every one thousand ca...
More
Linaclotide is Safe and Effective for Chronic Constipation
Chronic constipation affects about one in six people in the U.S. and is a problem that primary care doctors hear about very frequently. Symptoms include infrequent bowel movements, hard stools, straining, abdominal bloating and discomfort, and a sense of incomplete evacuation. It’s not a dangerous problem, but it causes plenty of misery for lots of people. Though doctors have a few remedies for chronic constipation (which I’ll list at the end of this post) they are only temporarily and modestly ...
More
A New Species of Tick-Borne Bacteria Identified in Minnesota and Wisconsin
[Lunch warning: Parts of this post are kind of gross. If you’re reading this over a meal, you have been warned.]
What a depressing week. The debt ceiling debate postponed all difficult decisions, second quarter economic growth was revised so low that you need to squint to see it, and yesterday the stock market jumped off the balcony, losing all the gains it’s made over the year.
We need some happy news to...
More
Mammogram Reading Not Better With Computer Assistance
… or “Read this mammogram, HAL.” “I'm sorry, Dave. I'm afraid I can't do that.”
I went to college in the late 1980s, at perhaps the peak of optimism about computer intelligence. Personal computers had just become available and there was a general expectation that computers would soon be driving our cars, accepting our commands in spoken English, and generally doing everything better than humans could.
The reality has been much less consistent. There have been impressive gains in computer intel...
More
The Power of Placebo
We’ve all heard of the power of the placebo effect – the benefit from receiving an inactive medication or a phony simulated treatment. But how do placebos work? Do they improve objective measures of disease? Do they improve the patient’s subjective symptoms? Do they do both? A cleverly designed study in last week’s New England Journal of Medicine (link 1 below) answers that question.
The investigators chose asthma as the disease in which to study the effect of placebo because asthma can cause u...
More
Spiral CT Scans Save Lives from Lung Cancer
In November I wrote about preliminary data from the National Lung Screening Trial, a large study funded by the National Cancer Institute that attempted to find out if catching lung cancer early with spiral CT scans made a difference. (See link 1 below for my November post.) Last week, the New England Journal of Medicine published the trial results (2) and an accompanying editorial (3).
The study randomized over 50,000 people who were
More
- aged 55 to 74,
- were either current smoker...
When the Stool Hits the Sprouts
... or Technology Phobia Can Be Fatal
[This post is perfectly safe for work, but may not be safe for lunch, as it mentions poop more frequently than you may find appetizing.]
This post is an update about the E. coli food poisoning outbreak in Germany that I posted about two weeks ago (link 1 below). If you didn’t read that post, please do, as it explains some important terms like hemolytic uremic syndrome (HUS) and shiga toxin-producing E. coli (STEC). Using these phrases at ...
More
Niacin Does Not Prevent Strokes or Heart Attacks
In the last decades we’ve made major strides in heart attack prevention through the use of blood pressure medications, smoking cessation, and statins – a family of cholesterol-lowering medications that have been proven to prevent heart attacks and strokes. Despite these advances, heart attacks remain the leading cause of death in the US. New medications to further decrease heart attack risk are being eagerly sought.
Allow me a brief digression to explain three important fat molecules in your bl...
More
Chronic Fatigue Syndrome Study Criticized by Patients
“Everyone is entitled to his own opinion, but not his own facts.” –attributed to Daniel Patrick Moynihan, among others
Chronic fatigue syndrome (CFS) is an illness marked by chronic disabling fatigue that is not explained by another diagnosis. Other symptoms such as non-refreshing sleep, subjective memory impairment, tender lymph nodes, and joint or muscle pain may be present. The cause of CFS remains unknown, and no consistently eff...
Sitting Won’t Kill You, Except on Train Tracks
In the last couple of weeks the media has published stories making it sound like your Ikea chair is a death trap waiting to assist your suicide through the dangerous activity of sitting down. Stories with sensational titles like “Is Sitting a Lethal Activity?” (see link below) make you think that you’re better off walking outside for a smoke. Let’s spend a few minutes sifting the solid science from the wacky conjecture. You might as well sit down for this.
The media interest in the idea that si...
More