Medicine and Pharmaceuticals

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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Early and swift intervention with an automated external defibrillator (AED) amidst sudden out-of-hospital cardiac arrest (OHCA) during bystander cardiopulmonary resuscitation (CPR) saves lives—in fact, doubles the likelihood of survival. (1) We know this. There is data to support this. So, why is their usage so low?

The problems: Cost, Availability and High Variability of Place and Time of OHCA occurrence. 

A team of University of Toronto researchers critical of prior efforts to guide policy of public AED placement around too broadly defined location categories without consideration of accessibility decided to explore a way to rank specific businesses and municipal locales to maximize OHCA coverage with AEDs....

If you follow healthcare news, you know that millions of US pain patients are experiencing a world of troubles.  If their pain itself wasn’t enough, the US Centers for Disease Control and Prevention added to their agony in March 2016 by issuing a restrictive “Guideline” to primary care physicians on prescription of opioid medications to adults with long-lasting non-cancer pain. 

The Guideline was phrased as advisory rather than mandatory.  But that distinction quickly got lost as the US Drug Enforcement Administration ramped up disciplinary proceedings and prosecution of doctors for “over-prescribing” opioids like OxyContin and hydrocodone.  Even before final publication, Congress made the Guideline...

In science and medicine, much of the time there is no "right" answer. Different doctors will have different approaches to a given condition, a drug that may be great for one person may make another ill, and two surgeons—even in the same specialty—may have different opinions about what kind of surgery needs to be done, if any. Because of the differences in their training and experience, physicians will have a different interpretation of the risk and benefit of a therapy or procedure.

This type of uncertainty is one of the things that makes science and medicine fascinating, but also makes them overwhelming and confusing, even to the most knowledgeable laypeople. Few people have the ability to make an informed decision about what is best for them, so they turn to someone they trust...

A ten month-old baby girl – called Dominique – born with two spines and four legs traveled from the Ivory Coast to Chicago to cross paths with a team of care givers who would successfully operate on her in a six-hour surgery. The coordinated effort required five surgeons and fifty clinicians.

Concerned over lack of intervention leading to undesirable complications like paralysis, the medical crew reportedly removed the accessory appendages without event and the patient is thriving by all accounts. In this case, the anomaly is the consequence of a parasitic twin. "A parasitic twin is an identical twin that fails to fully separate in development," said...

Last January I wrote an article called "Kratom: The Supplement That Will Kill Godzilla," using hyperbole to point out that the supplement/drug (combination of drugs, really) was not a benign substance, nor a simple, risk-free herb. The increase in poison control center calls (see graph at bottom) was not without reason .

I used the table below to indicate some of the receptors that components of the drug were known to interact with. The key point was to demonstrate that mitragynine, the principal alkaloid (1) in kratom, which we call a "dirty drug"—one that acts at multiple receptors—is a psychotropic cocktail, which, like any other drug that alters brain function,...

The New England Journal of Medicine (NEJM) just published distressing accounts of three patients who endured irreparable damage to their vision after seeking treatment at the same unnamed “stem cell” clinic in Broward, Florida.

Shortly, we will address where things went very, very wrong and how such situations can be avoided. But, first, let’s discuss what happened.

The women aged 72-88 years old suffered blindness to near blindness as a direct result of untested “stem cell” therapies being injected into their eyes while being fleeced $5000 for the procedures. Promised “revolutionary” therapy, they were left with catastrophic reminders of the unfortunate and unnecessary ordeal.

Each patient had age-...