This week a study published in the Journal of the American Medical Association revealed new results about estrogen use and generated major media hubbub. (See the links below for some of the media coverage, the article and an accompanying editorial.) To understand the kerfuffle it helps to review how our understanding of estrogen replacement therapy has evolved.
A generation ago, based largely on intuition and on epidemiologic studies, we were convinced that long term estrogen replacement therap...
More
News Nincompoops Narrate Nuclear Nonsense
Images from Japan continue to sadden and shock us. Over 12,000 are confirmed dead or missing due to the earthquake and tsunami, and that number will likely rise. Hundreds of thousands have been displaced from their homes. I’m having a hard time finding recent numbers on those without water and electricity, but all the stories state that this continues to be a major problem. The magnitude of what has already been lost, not to mention the serious challenges that remain to get food and water to eve...
More
Disaster Preparedness
I was going to post about a different topic today, but I could not ignore the devastation that befell Japan. The powerful earthquake and subsequent tsunami have caused destruction that is difficult to grasp. (See links below for two news articles.) The magnitude of the disaster is even more sobering when you realize that Japan is a developed modern high-tech country. Japan is extremely aware of earthquake risks and has modern building codes and frequent earthquake drills. Despite these efforts i...
More
This Isn’t Your Father’s Heart Disease
What’s the most common cause of death among American women? Breast cancer? Accidents? Suicide after watching too many Lifetime Channel specials? Nope. Heart attacks kill more women than any other cause—same as men. A generation ago heart disease was mistakenly thought of as an exclusively male disease, but patients and physicians have learned that preventing and treating heart disease is critical in women too.
This week the American Heart Association published their updated recommendations for ...
More
Rattled by Rickets Resurgence
Rickets is a childhood bone disease caused by severe vitamin D deficiency. It causes bone pain, weak bones and bone deformities in growing children. In the 1920s the link between rickets and vitamin D was discovered and within a couple of decades rickets largely disappeared from the developed world.
Until now.
A flurry of articles in the media this week (links below) reports a resurgence of rickets in England, Scotland and Ireland. One hospital in Southampton is reported to have treated 40 chi...
More
Flu Incidence on the Rise
(Please excuse this short post during this short week. If you feel deprived of health education, I’ve listed some educational links for you below.)
You better watch out. The flu is coming to town, and it doesn’t care if you’ve been naughty or nice. It looks like flu season is starting later this year than usual, but both the CDC data and Google Flu Trends suggest that illnesses due to the flu are increasing nationwide.
The best way to protect yourself is with a flu shot. And if you do get ...
More
Animated about Aspirin
Aspirin was hailed as a wonder-drug in the 1800s when it was first purified – the first anti-inflammatory medication that did not have the severe side effects of steroids. More recently aspirin’s benefits in stroke and heart attack prevention have been proven. This week another possible benefit of aspirin has been uncovered.
An important study published in The Lancet attempted to find any effect of aspirin on cancer prevention. I’ve written frequently about the myriad substances that are fal...
More
The Most Recent Celebrity Vitamin: D
Every now and then some vitamin or dietary supplement becomes all the rage. A couple of generations ago vitamin C was the miracle drug that could prevent all diseases, despite lots of evidence to the contrary. Lots of my patients still take it for colds, demonstrating its persistent mythology. Vitamin B12 became the wonder-drug a few decades ago, leading to a whole generation of patients getting monthly injections for reasons that remain scientifically mysterious. And many lesser stars can b...
More
Safety: It’s not Just for Airlines Anymore
Preventing medical errors is a subject that is belatedly attracting a lot of attention. The way in which hospitals prevent errors and manage them after they happen is undergoing a major transformation. (See the links below to my prior posts on medial errors.)
The traditional plan for error prevention in medicine can be summarized as “we should all be more careful”. Physician autonomy and diversity of practice styles were thought to be sacrosanct and it was thought that errors could be minimi...
More
A Screening Test for Lung Cancer
This week brings very exciting news, but everybody seems worried that we’ll misunderstand and read too much into it.
There are very few cancers for which we have a good screening test. A good screening test is a test that is done on people without any signs or symptoms of cancer and that diagnoses the cancer accurately enough at an early enough stage so that lives are saved. Mammograms save lives from breast cancer. Pap smears save lives from cervical cancer. Screening for colon cancer save...
More