food and nutrition

Vaccination and masks

The ongoing argument between two physicians, Senator Rand Paul and Anthony Fauci, illustrate the problem. Dr. Paul contends that if you have been vaccinated, you need not wear a mask. Dr. Fauci says we must continue to mask. First, let us look at the science we might consider and then at the messaging problem.

None of the vaccines are 100% effective in preventing COVID-19. None. The Pfizer and Moderna vaccines are both basically 95% effective “at preventing laboratory-confirmed COVID-19 illness in people.” 5% of people will still become infected, no one died. But that 5% could act as transmitters of the virus to others; they had undoubtedly developed enough viral multiplication to be identified. This...

The study involved asking 2,000 participants in RAND’s American Life Panel (ALP) their level of trust of the CDC, USPS, and FEMA in May and again in October. Here are the results weighted to reflect our nation’s population.

That decline for the CDC was statistically significant and more than likely was socially significant as well. As you might expect, there is a robust political component with the distrust growing more among, at the time, potential Trump voters, a 0.8 point decrease, than likely Biden voters at 0.3 point decrease. Skepticism did not change much in the Black community, dropping from 7.2 o 6.9. Still, distrust grew much more in the non-...

Urgent care centers (UCC) are increasingly common and maligned by some as “docs in a box.” They provide a range of acute care services that could be found in a primary care office but have better hours and shorter wait times – they are more convenient. A study reported in Health Affairs looks at how they have impacted Emergency Department (ED) use and cost by looking at insurance claims. 

Urgent care centers (UCC)

Commercial carriers have hoped that the lower price UCC services would be an acceptable substitute for the same, more expensive, service provided by the ED. There is no doubt that on a one-to-one replacement, the math is in their favor. As a result, UCCs have expanded rapidly, representing “the highest-volume alternative care site” to EDs as...

A bit of background - Why do some people choose to be vegetarians?

There appear to be two polar positions for health or because of an ethical imperative overexploiting and killing animals. Vegans make up the latter group and do not consume dairy products and eggs, or wear or use products made from animals, think leather, not just fur. Of course, there are many people in-between those poles whose reasons include health and a smattering of ethical concerns – think free-range chicken, grass-fed beef, or sustainably caught fish, the Whole Foods crowd. 

The study sought to understand the role of “moralization” in the transformation from omnivore to vegetarian or vegan. Moralization is a process where our preferences become our values. In the case of our diet,...

If you're lucky enough to have died at age 49, there is no need to read this. But if you reach 50, welcome to the beginning of old age, where icky things start to happen to you. One icky but hugely important thing will be a birthday gift called a colonoscopy, which people fear mightily. They shouldn't. Although the image of a bassoon being force-fed into your anus isn't especially comforting, a colonoscopy is nothing more than a really good nap, thanks to the wonder drug propofol, something I wrote about in 2020...

According to provisional 2020 year-end statistics, Alzheimer’s disease remained among the leading causes of death, increasing last year by almost 10%. Indeed, deaths from all types of dementia increased last year, accounting for many nursing home deaths and reflecting a lack of family visitation and stimulation.  Canada was especially hard hit. A report by the Canadian Institute for Health Information found that as of May 25, 2020, 80% of COVID-19 related deaths were people in long-term care facilities and retirement homes, many of which instituted lockdowns and restricted or...

Remember a few years ago Dr. Baselga and charges of conflicts of interest at Memorial Sloan Kettering? New York seems to have cleaned up its act, Boston not so much. 

As chief of Boston Children’s Hospital, one of the most esteemed pediatric hospitals in the world, Sandra Fenwick had outsized influence. After the pandemic struck last spring, she used that clout to lobby Massachusetts legislators for more money for telemedicine, a suddenly essential alternative to in-person visits.

She also spoke glowingly about remote care during an online forum last September, saying that satisfaction among patients and staff was hitting “eight, nine, and 10.’' The hospital, she told a Harvard public health professor, would objectively study the best...

Before jumping into the study, let’s take a moment to talk about R0, that standard measure of infectious transmission. I am sure you remember all the various values put forward for COVID-19’s R0 earlier in the pandemic – many took that as science’s flip-flopping, often with some hidden political intent. As it turns out, R0 is only a static number for those infections that have been around for a long time, like measles. For a novel disease, and that is COVID-19, the R0 will change over time as we reach equilibrium with our foe. 

An Rof less than 1 means the pandemic ends, greater than 1, and it continues, with the rapidity of spread related to increasing values over 1. We also know that the new variants seem to be more...

The same group of researchers that brought us the understanding of why our hair turns grey has released another study looking at a reason, beyond genetics, for hair loss. For those of you who missed my initial report, let’s get you up to speed.

Stem cells are responsible for hair growth and coloration, and the milieu of hormones and cell mediators controls where hair grows along with its texture. Hair follicles go through stages, of growth (anagen), rest (telogen), loss (catagen and exogen), as well as renewal (kenogen). The bulbous area at the bottom of the follicle contains those previously mentioned stem cells. Hair follicle stem cells (HFSC) derived embryologically from the same layer as our...

Background

Did the use of lead pipes for drinking water cause the collapse of the Roman Empire? Although historians no longer believe that lead poisoning caused the Roman Empire's collapse, the Romans did have an extensive plumbing system upgraded about 2,200 years ago to include lead pipes. In the U.S. in the 1800s, cast iron pipes were used, but with the growth of cities came the need for more flexible piping to connect buildings to water mains. Lead became the perfect material for this task, and by the 1900s, most of the largest cities in the U.S. installed lead piping. Amazingly, many of these pipes are still in use today.      

On March 31, President Biden released The American Jobs Plan, also known...