Thank you for all the feedback you’ve given me about my posts.  You let me know that I’m not just writing to myself. Thank you for all the links to interesting articles you send me.  You help keep me informed and give me great ideas for posts. Thank you for praising Jaymes, our receptionist, Nancy, our medical assistant, and Angela, our biller, when they help you.  They’re very good at what they...

The new cholesterol medication generating hubbub this week is anacetrapib. Why is the world holding its breath for another cholesterol medicine in an already crowded field?  Well, the most successful family of cholesterol medications is statins.  Statins have solid evidence for stroke and heart attack prevention.  Statins lower LDL, the “bad cholesterol” that you hear about whenever your doctor d...

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 diver...

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 liv...

“I hope I die before I get old” -- The Who My Generation Composed in 1965 by Pete Townshend, currently 65 years old

The good news is that people are living longer all the time.  This trend has been happening as long as records have been kept and shows no sign of stopping.  Better hygiene and sanitation, safer living environments, and antib...

… or, How to Love the Null Hypothesis First, bear with me for an important definition.  “Meta” used as a prefix, has come to mean self-reference, or “an X about X”.  For example, meta-analysis is an analysis of other analyses.  If you are arguing with your boyfriend about how unfairly he argues, you’re having a meta-argument, an argument about other arguments.  You with me? I usually write about...

… or, So Long Sibutramine Over two thirds of Americans are overweight.  A safe and effective medication that helps people lose weight would be a boon for the health of millions who are struggling to take off the pounds.  Unfortunately, this has been an extremely tough nut to crack for the pharmaceutical industry. The existing medications for weight loss have been only modestly effective, and las...

The correlation between obesity and inadequate sleep has been known for some time.  But does one cause the other or are they coincidental?  It’s also known that inadequate sleep increases hunger, an effect I can attest to from my memories of medical training.  I always ate more than usual on the days following nights spent in the hospital. So people who don’t sleep enough feel hungrier and presum...

Patients whose asthma symptoms are only mild and intermittent usually don’t need daily asthma medications.  They just use a rescue inhaler, like albuterol, whenever symptoms come up. Patients with daily or almost daily symptoms, on the other hand, need daily preventive medications to control their asthma.  The first choice for a preventive asthma medicine is a low dose of an inhaled steroid.  If ...

Pertussis or whooping cough is a bacterial respiratory disease marked by a runny nose for a week or two followed by a severe persistent cough.  In adults it rarely causes severe illness, and usually resolves even without treatment, but in infants the disease can be life-threatening. California is currently experiencing a whooping cough epidemic.  Over 4,000 cases have been reported this year, the...