db's Medical Rants

The Case for Drinking (All Together Now: In Moderation!)

Thirty years of research has convinced many experts of the health benefits of moderate drinking for some people. A drink or two a day of wine, beer or liquor is, experts say, often the single best nonprescription way to prevent heart attacks ? better than a [...]

I personally find this story sad, but not surprising. Jeffco pulls plug on health plan for poor : Preference for ERs doomed project

A three-year test project trying to get uninsured patients out of emergency rooms and into primary, preventive health care has ended a year early because of lack of interest from [...]

This author thinks gluttony good! Gobble up: gluttony is the gift of civilisation

Gluttony is a gift of evolution. In the struggle for survival with other animals, human beings have always had two severe disadvantages: feeble bodies and simple digestions. These restrict our cycle of energy production by limiting the range of food sources [...]

Have you ever made a New Year’s Resolution? Did you honor your resolution?
Why are habits so difficult to change? Are there any tricks to help us succeed?
Retraining the brain for New Year?s: How to make sure you keep resolutions once and for all. Here is the punch line, read the article for the [...]

Disinfectant ‘could beat’ superbugs. A major health risk of hospitalization comes from highly resistant bacteria. This British news story reports on a new disinfectant that might decrease patient transmission of resistant bacteria.

An extra-strong disinfectant could help hospitals beat superbugs which affect thousands of patients each year. The sterilising liquid is strong enough [...]

Israel Will Expand Its Smallpox Vaccinations, but Not to Everyone

Israeli officials said today that they had decided against vaccinating the entire population against the smallpox virus. But they said they were expanding the number of soldiers and health care workers who would be vaccinated to 40,000 or more.
The officials said they made the [...]

May you and your family have a wonderful holiday season. Thanks for reading my blog. Writing this blog has helped me greatly. I have developed the discipline to think and write about medical issues daily. Thanks to the blog, I read the newspapers, review major journals, and peruse various web sites. [...]

Millions of U.S. Smokers Ignore Warnings: Millions of Americans Keep Smoking Despite Doctors’ Warnings, Illnesses The story is well known to physicians. I have patients sneak off the floor after a myocardial infarction – to smoke – even when the temperature is in the 30s. I have patients remove their oxygen to go [...]

Medical Milestones: Remembering the Top Stories of 2002. These are Dr. Tim Johnson’s top five – and he seems to have it right. Read and enjoy.
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Dutch Doctor Loses Euthanasia Appeal This short article makes my point precisely. So what point is that (the curious reader is asking)?
I am, have been, and will be against active euthanasia. I have read all the arguments in favor, and still believe that physicians should not engage in euthanasia. Here is my [...]

Small Amount of Fish in Diet Is Said to Yield Big Benefits

Men who eat seafood as seldom as once a month may cut their risk of the most common kind of stroke by more than 40 percent, a new study by the Harvard School of Public Health has found.
Many studies over the last [...]

We have used little spironalactone over the past 30 years. My only regular indication was ascites secondary to cirrhosis. While aldosterone blockade made sense as we learned about the renin angiotensin aldosterone system, the long side effects of gynecomastia and hirsutism (amongst other side effects) limited our enthusiasm. The RALES study – [...]

I tremble as I type this. Breast cancer screening may not work as well as we believe. Some experts have believed this since the 1950’s. Let me summarize their argument.
What if tumors, as they originally develop, have genetic features which predetermine their aggressiveness (and thus the patients probable outcome)? If [...]

Physicians know this, but sometimes forget. Acetaminophen can cause acute liver toxicity at high doses. The danger of acetaminophen.

It has long been known that too much acetaminophen can cause liver damage, but the alarming extent of the problem has just been documented. A new study has found that overdosing on acetaminophen, the [...]

I am a subscriber and intellectual supporter of the Medical Letter. This publication provides unbiased reviews of drugs; it is nonprofit; it accepts no advertisements. They have introduced a new product – Treatment Guidelines – which looks very interesting. I have printed out the free sample which gives Treatment Guidelines for Diabetes [...]

Study: Some Defibrillators May Be Riskier : More Sophisticated Heart Defibrillators May Have Increased Risks, Study Suggests

But most patients who need defibrillators are likely only to need less sophisticated devices equipped with a backup pacemaker, the research suggests. The backup pacemaker stimulates the lower heart chamber when the beat becomes too slow.
The researchers found [...]

Thyroid problems ‘missed by doctors’. This article, unfortunately, relies heavily on anecdote, but does not provide any data. I choose to link though to remind myself and readers that both hyperthyroidism and hypothyroidism present with non-specific complaints.

Eye problems, rapid weight loss and being unable to sit still are all symptoms of an [...]

We have spent more time discussing the smallpox vaccine, and not enough time getting educated about the disease. A prerelease NEJM article shows that the public (and probably many physicians) do not know the facts. This article provides a nice summary – With New Threat of Smallpox, a Reeducation. Take the 2-3 [...]

The Washington Post today has a very nice overview of Dr. Frist – The Doctor as Dealmaker? I am hopeful that he will bring a focus on health care issues that will help improve health care and delivery. We will all watch his performance carefully.
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I have written about this issue extensively. Medicare payments to physicians are a crisis. I hope the new Senate Majority Leader understands that this is his first health care priority! Medicare to Cut Payments to Doctors 4.4%

The Bush administration announced today that Medicare payments to doctors would be cut 4.4 percent [...]

The Lancet has prereleased an important article – Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial. This study shows that the combination of an ACE inhibitor and an ARB does a better job of delaying end stage renal disease than either alone.
They randomized [...]