Vitamin C and Vitamin E Do Not Prevent Eclampsia

A friend of mine recently asked me “Is regular soda or diet soda better for you?” I tried to probe for details.  “Are you talking about calories?  Obviously, if you’re watching your weight or restricting carbohydrates, you should have the diet soda.” “No, I don’t mean the calories.” “Oh, you mean the concern that the citric acid might leach calcium out of your body?” “No.  I just mean overall,...
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Pitfalls in Prostate Cancer Prevention

My regular readers know the controversies and challenges posed by prostate cancer.  It is very common.  Over half the men who die at advanced age of other causes will have prostate cancer on autopsy.  It is very slow.  From the time that prostate cancer is detectable on biopsy to the time that it causes symptoms or shortens life can be as long as a decade.  It is not very lethal.  Because it tends...
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Erroneous Evidence about Enough Exercise

This week, a study in the Journal of the American Medical Association received a lot of undeserved media attention.  The study wanted to examine the relationship between exercise and long-term weight changes among women who were eating a normal diet (i.e. not dieting).  It followed for over a decade 34,000 women who were 45 years old or older and correlated their self-reported physical act...
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More Match Day Misery

… or, If We Beg, Will You Go Into Primary Care? What if tomorrow 30% of the nation’s plumbers disappeared?  Perhaps they vanish due some fantastic science fiction experiment gone horribly wrong.  What would happen?  Would a national plumber group call for making plumbing a more attractive profession?  Would there be a cry for greater federal plumbing subsidies to draw more people from other field...
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Are Bisphosphonates to Blame for Baffling Bone Breaks?

This week ABC World News aired a story about a possible side effect of osteoporosis medications.  The family of medications involved in this story is called bisphosphonates and includes Fosamax, Actonel and Boniva.  These medications have been proven to prevent fractures in patients with osteoporosis (very low bone density).  Apparently, some doctors had noticed the occurrence of an unusual kind o...
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American Cancer Society Revises its Guidelines for Prostate Cancer Screening

About a year ago I reviewed the controversies of prostate cancer screening, especially the conundrum that we still don’t know whether finding prostate cancer early saves any lives.  I concluded by citing the US Preventive Services Task Force (USPSTF) recommendations that the evidence is insufficient to recommend for or against screening for prostate cancer in men age 50 to 75.  The USPSTF ...
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Carotid Stenting Still Controversial

Almost 800,000 Americans suffer a stroke every year.  Strokes are the third most common cause of death in the US, and are frequently disabling to those who survive.  These sobering numbers are despite the substantial improvement in recent decades in stroke prevention through the use of medications that lower blood pressure and cholesterol. This week’s hubbub relates to carotid arteries, the large...
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Alarms about Asthma Agents

(or, LABAs Relabeled) Long acting beta agonists (LABAs) are a family of inhaled medicines used to control asthma symptoms. LABAs include the medicines in Serevent and Foradil. LABAs are also available in combination inhalers, Advair and Symbicort, which combine a LABA with an inhaled steroid. Though LABAs dilate airways and improve airflow, they have long been associated with an increased risk...
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Gastric Banding is an Effective Option for Obese Teens

What’s my advice to my overweight patients?  Eat less and exercise more.  I give this advice every day, but following this advice is much harder than giving it.  Overweight people frequently struggle with diet and exercise for years, sometimes successfully, sometimes regaining their previously lost weight. And as we become more overweight as a nation, obesity is no longer just a problem for adult...
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Twelve Years Later, the Truth about Vaccines and Autism

Ideas have consequences.  False ideas, especially popular false ideas, can cause harm.  For example, the very popular false idea “corduroy pants and wide lapels are far out, man” made an entire nation ugly for about a decade.  And some false ideas do even more harm than that. In 1998 the British medical journal The Lancet published a paper authored by Dr. Andrew Wakefield that claimed to link aut...
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