Disease

In the last week, the media has extensively covered the increased prevalence of head and neck cancers caused by the human papillomavirus (HPV), in men.  This issue garnered extensive media coverage when Michael Douglas revealed his diagnosis of stage four throat cancer was caused by HPV.

A recent study published in the Annals of Internal Medicine discussed the disproportionately high rates of oral HPV-positive squamous cell carcinoma in men.  The authors of the study sought to determine just how prevalent oral and genital HPV...

Isn't it odd that Florida has so many people living with Alzheimer's Disease? If Erin Brockovich was investigating the case, she probably would conclude that it's something in the water.

The rest of us, however, know that there's nothing especially dangerous about Florida.* Old people all across America move to Florida for retirement, and Alzheimer's is a disease associated with aging. Ergo, Florida is not causing Alzheimer's; aging is.

Using the vernacular of epidemiology, aging in this example is known as a confounding variable. The apparent association between living in Florida and having Alzheimer's is confounded by age. If a researcher did not take age into consideration, he would draw incorrect conclusions about a link between geography and Alzheimer's....

The latest outbreak of the plague in Madagascar is worrisome. Since late August, the World Health Organization (WHO) has reported 501 cases of plague on the island. Even more concerning is the 11% death rate of those cases. 

The plague, also known as the Black Death for history buffs, is caused by the bacteriumYersinia pestis. Y. pestis lives in small animals (rats, primarily) and is present in many areas of the world.

One form of the disease, known as the bubonic plague, is an infection that occurs when people live in close proximity with rats. I don't mean seeing them in the subways of NYC, either. Rather, co-habitating with rats. When people live with rats, the fleas that feed on the rats occasionally jump to the humans and bite them, transmitting the...

People swear that popping a few vitamin C tablets when their throat starts to feel sore is a surefire method to prevent a cold.

Unfortunately, evidence doesn't support that. At the very best, daily supplementation with vitamin C (i.e., every single day, not just the day before you feel sick) may reduce the duration of a cold. A Cochrane review found that adults experienced 8% and children 14% fewer sick days when they took vitamin C every day. In other words, if the average adult is sick 10 days per year, supplementing with vitamin C would reduce it to 9 days. The review further concluded that "routine mega-dose prophylaxis is not rationally justified."

Echinacea doesn't work, either. Can...

A recent study published in the British Medical Journal, regarding approved cancer drugs in the European Medicines Agency from 2009-2013 has found that most of them did not significantly lengthen survival time nor did they improve quality of life. 

Two important outcomes of cancer treatment are the quantity and quality of life.  Most clinical trials, however, do not measure these outcomes directly, rather they look at "surrogate" measures of drug efficacy.  The study end-points are not a reflection, or are a poor reflection of, valuable patient-centered outcomes.  The authors continue to state that based on their findings from two separate systematic reviews, what had been touted as "breakthrough" treatment, really...

Proper functioning of the human body relies on microbial partners. The sum total of these partners, called the microbiome, plays a myriad of important roles in maintaining human health -- from facilitating digestion to developing the immune response.

Each person's microbiome may be unique. However, research has linked certain microbial compositions to good health and other compositions to bad health. This shift in the contents of the microbiome, known as dysbiosis, has been linked to a variety of disease states, such as periodontitis (gum disease), otitis media (middle...

Scientists in China have just provided one major piece that is the Zika puzzle.  Proponents of the "all natural" movement ought to look at this virus and recognize that nature can be a bitch.  What I mean by that is that nature is scary and it can take a single stupid mutation to wreak havoc on humanity. I will elaborate. 

Zika has been around for some time – first identified in 1947 in Uganda -  but it was never really given much thought.  It was around in Africa and Southeast Asia and those who were infected experienced vague, non-specific or mild symptoms.  There were some outbreaks identified in Micronesia and French Polynesia but not until it reached the Americas did the poop hit the fan.  The virus went from causing low-grade fevers and joint pain to shrinking the heads of...

Ever since the Women’s Health Initiative (WHI) trials of hormone replacement therapy (HRT) for post-menopausal women was halted early because of an observed increased risk of breast cancer, there has been confusion about the positive and negative effects of this treatment, as we discussed here. Early on, it was thought that HRT would reduce a woman’s chance of cardiovascular disease — but the results didn’t show that. Now, HRT is primarily suggested for women who suffer from extreme menopause-related symptoms such as hot flashes. A new analysis of the long-term results of the WHI should provide some additional guidance to women and their physicians.

To review: the WHI was a randomized, double-blind trial...

It's pretty common knowledge that obesity increases the chance that a woman will develop breast cancer, and how her excess adiposity is distributed on her body can be a clue to her risk. A new study from China increases our understanding of one possible mechanism by which this can occur.

First, some words about body shapes. Most men tend to be "apples" in that they carry most of their weight above the waist. Most women, on the other hand, are "pears", carrying more of their weight in the hips and thighs, as shown in the figure above. However, some women are more like apples, and their weight is distributed more like that of men. And if apples and pears become obese, these differences are accentuated. An apple will have a higher ratio of waist to hip circumference than will a...

Fifty or so years ago a woman diagnosed with breast cancer was almost sure to be treated aggressively — with a radical mastectomy. That surgery involved removing, not only the affected breast tissue, but also the underlying muscle and many if not all of the nearby lymph nodes. Not only was that surgery disfiguring, it also caused various morbidities such as lymphedema (1) and difficulty in using the arm. More recently, of course, we have moved on and no longer need to take such draconian measures as often as before — we have a larger armamentarium of systemic treatments (e.g. chemotherapy) and more targeted radiation treatments.

Today, a woman presenting with an early stage breast lesion which has spread to some degree to nearby (sentinel) lymph nodes, could be treated with...