Medicine and Pharmaceuticals

The U.S. Preventive Services Task Force (USPSTF) recently released a 2017 draft recommendation statement on screening for prostate cancer which is based on systematic evidence review and assessment— updated from their prior 2012 version. As indicated by the authors’ viewpoint published in JAMA, the goal of this release is to raise awareness of newly acquired data on the topic while inviting review and commentary before the report is officially finalized. (1)

Because there was concern that universal PSA (aka prostate-specific antigen, a blood test) population screening often...

President Trump has convened a panel to address America's opioid epidemic. Its first mission should be to find convincing data to identify the actual cause(s) of the problem. That will be much harder than it sounds, since ideologues are always in plentiful supply.

Indeed, many influential people already seem to have a strong opinion about who is to blame. Claire McCaskill, a Senator from Missouri, points her finger at pharmaceutical companies. She is launching an investigation, but there is little need for one, given that she has already told us what its conclusions are ahead of time: 

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Every now and then, people screw up. Who amongst us has never made a mistake? Even the American Council gets it wrong now and then. Yet, we are nothing if not humble. Since it's World Homeopathy Week, this provides the prefect opportunity for some self reflection and humility. Is it possible that we have been unfairly criticizing homeopathy and homeopaths all this time? 

In the interest of keeping an open mind, I decided to search for evidence that might indicate that I may have been wrong all along. It was a humbling experience, but I'm glad I did it. I feel so...... cleansed. I was dumbfounded by what has been in front of my face all this time that I failed to see. Clearly, I was so arrogant and unshakeable in my belief system of traditional science that I did not give...

When I received my official summons for jury duty the other day, the form guided me to complete a juror qualification questionnaire. In so doing, I came upon my state’s list of acceptable excuses which included, among others, an automatic exemption for those 75 years or older if so inclined—no infirmity required.  

When I delved further, it appears not all states comply with the same age guidelines. Some allow self recusal over 65 or 70, others warrant proof of distance to courthouse or doctor’s written verification. Pennsylvania permits those 75 or older and breastfeeding women to be exempt if so desire. Each state supports its own policies, as expected, with some more...

Vitamin D status and supplements seem to have become a societal preoccupation. Encouraging the latter’s use as a cure-all, the “magic bullet” commercialization of vitamins and supplements has created a multi-billion dollar industry. One that is often unchecked due to absent regulation and universally promotes these items whose mechanisms of action are poorly understood and of questionable value—let’s not forget that they also have the capacity to do harm. (1,2)

Hence, why it is important to write about a new study published in the Journal of the American Medical Association (JAMA) that set out to determine if vitamin D3 and Calcium supplementation in older women would reduce their...

A paper in the Journal of Infectious Disease provides clinical data for Genocea's genital herpes vaccine GEN-003. The good news is that infected patients did respond to the vaccine. The not-so-good news is that the response was not as impressive as patients would hope. Here is a summary:

In Phase Ia/II trials (1), a total of 134 participants who were infected with HSV-2 were given a total of three injections of 003 three weeks apart. Three different doses of the vaccine were given, and the enrollees received genital swabs for four weeks before administration of the vaccine, and four more weeks after they got the last injection.

Summary of the results:

  • The vaccine was safe
  • The rate of viral shedding (2) for...

How would you feel about unlicensed pilots flying commercial airliners? Or consider if we allowed every driver to determine which side of the street to drive on. Irrespective of your political leanings, there are times when federal regulations might be reassuring, and a loss of these regulations might give one pause.

While we’re at it, how would you feel about the federal government striking down all regulations that require that drugs are safe, contain what they claim, and actually work before going to market? This, and worse, is what happened in 1994, when the Dietary Supplement Health and Education Act was enacted.

“But wait,” you say, “dietary supplements are not drugs. They are just supplements. They are natural nutrients that are good for you. Aren’t they?” A bit of...

Given the popularity of marathons and participation in the United States exceeding half a million annually, a Yale-led team of researchers sought to explore the relationship between strenuous exercise and kidney function. (1)

Not much has been done on the topic, so they sought to investigate adverse effects that such vigorous activity compounded by the heat stress experienced could have on the kidney. Their findings were just published in the American Journal of Kidney Diseases.

Appreciating that the blood flow to the kidneys can diminish as much as 25% under intense activity compared to when a person is at rest, they hypothesized that ischemic tubular damage could be a consequence. (2) When a body...

People who have an allergic parent are pretty likely also to be allergic. But those of us with two allergic parents (yours truly) are really hosed. We are much more liable to have atopic dermatitis, (aka AD, eczema) (1) and that isn't much fun.

The name is a bit misleading (2) because atopy is not just itchy skin. Atopics are genetically predisposed (3) to also suffer from allergic rhinitis (hay fever, allergies to animals,) have allergies to certain foods and asthma. When these three occur together (which is not uncommon) is it called an "atopic triad." I can personally tell you that it just plain sucks.

Until now, standard treatments for severe eczema have been topical steroids and UV light therapy. Each carries its own...

To be honest, spiders — fascinating as they may be to some — are not my favorite critters. That's likely because having suffered some pretty painful spider bites, I connect them with unfortunate consequences. Yet, as we've discussed in the past, components of spider venom can be a good thing, helping actually to decrease pain in some circumstances. And recent work published in the Proceedings of the National Academy of Sciences indicates that other ingredients in at least one spider's venom could help mitigate the effects of a stroke on the brain.

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