Angst about Acetaminophen

When many of us get a headache, a fever, or just suffer the aches and pains of physical exertion we don’t think twice about reaching for an over-the-counter pain reliever.  Acetaminophen, which is the medicine in the well-known brand Tylenol, has long been considered the safest pain medication.  Non-steroidal anti-inflammatory medications (NSAIDs) can cause stomach irritation and ulcers and can decrease kidney function.  Opiates (morphine and its relatives) can cause drowsiness, constipation and...
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Torpedoing Primary Care

For the last few years the future of primary care has been looking bleak.  Fewer and fewer medical students are choosing primary care careers, just as baby-boomers retire and will need more care.  Primary care physicians meanwhile are retiring early or cutting back their practices at record numbers, worsening the coming shortage. The current issue of the Annals of Internal Medicine publishes a perspective article by Dr. David Norenberg that heaps on the gloom.  Describing himself as cl...
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Folic Acid: Fabulous for Fertile Females, Feckless for Fellows

Folic acid, a vitamin found naturally in green leafy vegetables and legumes, is essential for making the building blocks of DNA.  And since copying DNA is an important part of what cells do before they divide, it’s critical for cell division.  Developing fetuses have very rapidly dividing cells, so it’s not surprising that folic acid deficiency has been linked to birth defects, specifically brain and spinal cord abnormalities. To prevent these birth defects, physicians for many...
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Vaccine Refusal: Turning Back Two Centuries of Progress

Vaccines have become a victim of their own success.  In 1809 Massachusetts became the first state to pass a law requiring a vaccination – of smallpox – ushering a series of public health victories over a number of serious diseases.  In the past 200 years smallpox has been eradicated, and measles, polio, rubella and tetanus have become so rare that they have disappeared from public consciousness. The number of children who contract vaccine-preventable diseases today is tiny compared to the numbe...
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