Harm Reduction

A recent study suggests that vaping is much less harmful than smoking. The authors and the journal that published the paper tried to minimize this result. Do they have an anti-vaping bias?
Remember the 1983 movie, War Games, in which a teen played by Matthew Broderick hacked into a military computer system? He was asked, “Shall we play a game?” and he responded, “Sure, how about thermonuclear war.” Well, Twitter has gamified conversation and turned discourse into a different kind of “thermonuclear” war, without the missiles.
Once pretty, vivacious young women in their late teens and early twenties awaiting marriage and children, one by one, they sickened. On X-ray, their bones looked moth-eaten; their teeth fell out, leaving pockets of pus– every dental effort to treat them caused more tooth loss. Eventually, their jawbones broke or splintered in their mouths, or they suffered cancerous sarcomas of their limbs, requiring amputation. Their spines crumbled, their legs shortened, so they painfully limped. For years no one could determine what ailed them. They were the “Radium Girls.”
Seemingly everywhere you look there are articles on the dangers of PFAS. Federal and state governments, environmental groups, and the media have declared that dangerous PFAS chemicals are everywhere and present a widespread problem across the U.S. The condemnation and fearmongering are so widespread that you’d be forgiven if you question why we would even bother to write about such a black-and-white subject in the first place. But we must.   
A surprisingly large percentage of physicians have recommended vaping as a safer alternative to their smoking patients, a new study shows. The results suggest that many doctors have parted ways with the abstinence-only approach to smoking cessation championed by tobacco-control activists.
Epidemiological studies have reported statistically significant relationships between long-term air pollution and mortality over the past 50 years, frequently without controlling for smoking. Smoking is perhaps the strongest actionable risk factor in our longevity, and despite dramatic declines, it remains so in modern society. Smoking more than one pack per day can double the risk of all-cause mortality and increase lung cancer risk at least 10-fold.
The debate over when to lift mask mandates continues. The CDC extended mask guidance on airplanes, among other forms of mass transit, for an additional two weeks. The war over masks in elementary school continues to be waged. A new model attempts to provide more data on the interaction of the three horsemen of non-pharmaceutical intervention, face masks, room ventilation, and distance in short and long-range airborne transmission.
In Vitro Fertilization (IVF) has produced some eight million children since its inception in 1978 with the birth of Louise Brown. But, like many novel technologies, problems abound - including errors and malfeasance on the part of the very lucrative IVF industry, which in the US is virtually unregulated. The novel technology, its problems, related lawsuits, and lack of legal redress in some cases raise essential questions about the value of a human life.
Every day of the week, surgeons stand before their peers to discuss and explain the most recent bad outcomes. It is part of our training and our work. As we continue to discuss and explain the public health, behavioral, and political choices during the pandemic, those weekly surgical conversations about morbidity and mortality can give us some insight into how we respond to what went right and what went wrong.
COVID-19 may remain in our communities for the foreseeable future, and we are told to live with as yet to be defined “new normal.” By and large, this pandemic has been fought on an individual level, one case, mask, and vaccination at a time. Alternatively, environmental risk analysis involves three levels of specificity: community, local, and individual, comprising a “3-legged stool”. Understanding the first two legs is required to benefit the third.
Access to health care and having health insurance are two easily recognizable “social determinants” of health. But is having access to the Internet another social determinant? A new study and the media suggest that the answer is yes. Let’s see what the paper actually said and what it might mean.
Pneumonia is a relatively common problem resulting in antibiotics and the need, in some cases, for hospitalization or intensive care. Can physicians follow guidelines that deliver optimal care and reduce cost? Intermountain Healthcare offers a "yes."