Medicine and Pharmaceuticals

Sadly, the news outlets just reported the seemingly untimely passing of actor, Bill Paxton, at the age of 61. Losing a loved one is a devastating event and we wish his family peace during this especially difficult time.   

In a family statement, it was revealed he suffered surgical complications. 

Thankfully, with modern medical advances so many procedures that once carried great risk can be performed today with minimally invasive techniques that are safer and prompt speedier recoveries. And, most of the time, people —especially when otherwise healthy— do quite well.

Unfortunately, for all of us no matter our health status, there can still be a consequence or adverse event whenever surgery and anesthesia are involved. Even in the hands of the best surgeon, staff...

In 1965, when Medicare made its appearance, physicians would send bills for their "usual and customary charges” and it quickly became apparent that usual and customary allowed a far greater range of charges than President Johnson and his team had anticipated – there was significant variation in ‘fees’ and they were unrelated to quality, effort, specialty or geography.

To standardize doctor’s fees and their costs, Medicare commissioned a study by Harvard who got assistance from the American Medical Association (AMA.) They came up with the resource-based relative value scale (RSRVS) which defined the work effort and expenses in, at that point, well over 7,000 physician services. For any given service, a doctor’s...

Right now, 300 Austrian ticks are part of an interesting experiment. They are biting through a skin-like membrane for science, because they secrete a cement-like substance with excellent adhesive properties.

The sticking power of ticks is well known, but most people believe it's just mechanical. This is the belief because you turn a tick counter-clockwise to remove it, the opposite of the rotation that drilled in, but prior to that they produce a "tick cement" that anchors them. Lots of organisms, from bacteria to fungi to large animals to plants use chemical and mechanical ways to attach themselves to surfaces. But for human use they would have to function over a temperature range, in wet environments, and to challenging surfaces. And then there is the cultural issue. We can't...

America leads the world in pharmaceutical discovery, and in all scientific and medical discovery really, so we accept that we pay higher prices here and then over time poorer countries will pay less, no differently than if you want to buy a phone the day of launch rather than on sale after the new one comes out.

Given that, why would American companies need any protectionism or preferential treatment? And if we know that's the case, is it always better to buy American?

Before you answer that question, let me provide you with an unsettling statistic. The prevalence in young males of Duchenne’s or Becker’s Muscular Dystrophy in the United States is 1.38/10,000. Based on the 2010 census that is about 3,657 patients....

Since “fake news” seems to be the catch all buzz worthy expression of the moment, we also don’t need to look very far to find common medical falsehoods that tend to originate from the Hollywood stratosphere. Whether it is a press statement about a celebrity or a concept in a film, the nugget for fodder gets picked up by all media forms and insidiously spread.

Especially in the realm of celebrity—a category many politicians tend to fall into these days, there is what gets publicized and the truth. Being a physician who still believes in the right to privacy and is bound by certain codes of ethics and regulations, the standard for the release of health information is pretty clear and reflects the fact that the public is not entitled to know the details of another person’s health...

Last week, the global news outlets reported a case of a baby boy born in India with two penises and four legs. The patient was successfully operated on to remove the anomalous duplications (aka polymelia, extra limbs) and is doing well by all accounts.

Fortunately, these types of abnormal or accessory appendages are a rarity. But, they occur more often than you would imagine. Fetal and embryologic development is a dynamic process with cells migrating in multiple directions along innumerable planes to form organ systems, in particular, in early pregnancy. As a result, varying influences can alter their trajectory albeit of chromosomal, genetic or environmental (e.g. medications,...

With the current wave of states legalizing marijuana, advocates championing the cause and the presence of greater societal acceptance, there is a growing perception that dispensary-supplied “medical marijuana”—not distinct from “recreational marijuana”— is as safe as any medical product obtained at a pharmacy. This is not so as there are no quality control measures or thorough federally-regulated vetting procedures in place to ensure safety.

It seems the medical and health research aspects of the issue are many steps behind the legal and political advances contributing to a false sense of security. The reality is much is not known about the science—good, bad or indifferent. Partly to blame is public universities’ very restricted ability to study the substance in the first place...

Ask yourself how often you ever think about your ability to hear? How much you value it? How much you—and your loved ones—would be impacted if it were gone or profoundly diminished?

How much you would intervene early and often if you knew it would best protect this precious sense? 

Well, the Centers for Disease Control and Prevention (CDC) recognizes our natural tendency not to appreciate things as much as we should until we don’t have them any more, so they recently studied the extent of adult hearing loss and modifiable ways to prevent it. The most significant finding was that much hearing damage and loss is occurring from loud sounds experienced in our daily lives, homes and community environments. (1) 

These noise-induced deficits are permanent and appear with...

 

 

Just another day at the office.

1. Go to Long Island off the coast of the Bahamas. Coordinates (23°41.12′ N, 75°22.18′ W) are included, in case you happen to be still using Apple Maps, because you are just as likely to end up here:

 

 

 

 

 

 

 

Apple Maps: Still not all that reliable

 

 

 

2. Get into one of these things.

...

This story has it all. Donald Trump's hair, drug prices, enlarged prostates, and a way for you follically-challenged guys to save a ton of money by sticking it to Merck.

Last week, there were a number of stories about some of President Trump's medications. Nothing all that captivating. But, if you scratch the surface, there's some interesting biochemistry going on with one of them—Propecia, the drug that keeps men from losing their hair. 

There are a total of two approved hair loss drugs available for men (1). One of them doesn't suck. Let's look:

The generic name for Propecia is finasteride. It works rather well....