Quitting smoking is probably the hardest thing I ask my patients to do. Many patients try to quit multiple times before finally being able to quit permanently. Smoking is a frustrating and profound addiction.
A new medication has recently been approved for smoking cessation. The medication is varenicline and is being marketed under the brand name Chantix. Its efficacy was studied in three randomized blinded trials that were all published...
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Lipitor Helps Prevent a Second Stroke
An important study in this week's New England Journal of Medicine expands what we know about the benefits of cholesterol lowering medications. Statins, a family of cholesterol lowering medications which include Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Zocor (simvastatin), have already been proven to have many benefits. We al...
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The Surgeon General’s Report on Secondhand Smoke
U.S. Surgeon General Richard Carmona released today a major review of the scientific evidence on secondhand smoke: The Health Consequences of Involuntary Exposure to Tobacco Smoke. This subject was last reviewed by the Surgeon General's office twenty years ago, under Dr. C. Everett Koop.
The comprehensive study examined the link between secondhand smoke and a large number of diseases to determine if th...
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The Effects of Coffee and Napping on Nighttime Highway Driving
This issue of Annals of Internal Medicine has the most relevant medical study I've read in a long time. We've all been in the scary situation of driving late at night while sleepy and struggling to stay awake. This study asked the important question: Does drinking coffee or taking a nap improve driving late at night?
The study design involved having volunteer drivers each take 90 minute drives on differ...
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Homocysteine: A Risk Factor Worth Ignoring
Last month's New England Journal of Medicine has a great lesson about how we should think about risk factors.
It's been long known that homocysteine is a risk factor for heart disease. That means that, when looking at large numbers of people, those with high levels of homocysteine have more heart attacks on average than those with low levels. Too frequently, we confuse a risk factor with a cause, and we jump to the conclusion that homocysteine causes heart attack. A risk factor, howeve...
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Raloxifene (Evista) as Effective as Tamoxifen (Nolvadex) for Breast Cancer Prevention
The National Cancer Institute Study of Tamoxifen and Raloxifene (STAR) Trial has just concluded. It was one of the largest breast cancer prevention studies ever. It found that raloxifene, which is usually used for osteoporosis, is as effective as tamoxifen in preventing breast cancer in post-menopausal women who are at high risk of breast cancer. Raloxifene also had fewer side effects.
This study has generated much press attention and is sure to impact the lives of thousands of women who are cu...
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Mini-stroke is Dangerous If Ignored
Last week's Chicago Tribune featured an important article about transient ischemic attacks (TIAs), commonly known as mini-strokes. TIAs, just like strokes, occur when a part of the brain is cut off from its blood supply, causing that part of the brain to stop working. The only difference between a TIA and a stroke is that the sym...
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The Controversies of Prostate Cancer Screening
The March 21 issue of the Annals of Internal Medicine has a pair of excellent articles that highlight the unresolved questions in routinely testing men for prostate cancer: Viewpoint: Limiting Prostate Cancer Screening and Viewpoint: Expanding Prostate Cancer Screening. (The abstracts of the article are available by clic...
Calcium and Vitamin D Supplements: Still Modestly Beneficial
Last week's New England Journal of Medicine article publishing the results of a large National Institutes of Health (NIH) study on the effects of calcium and vitamin D supplements on risk of bone fracture and the risk of colon cancer has generated much media attention. The results were disappointing to some, but I believe that they help make our expectations of calcium and vitamin D more realistic.
You can review...
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Preventive Care — Separating Facts from Myth
This article published yesterday in the Los Angeles Times features a great summary of the current scientific evidence about preventive care. (Registration is required by the Times to read the article, but is free.) Some of what is known may surprise you. The annual physical examination -- for example listening to the heart and the lungs, feeling the ...
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