Harm Reduction

President Trump’s former National Security Advisor, General H.R. McMaster, lost his father recently to a death being investigated as “suspicious.” Though published accounts indicate the tragic event was deemed by the Department of Health to be due to “blunt impact head trauma” and “ruled an accident,” Philadelphia police in cooperation with the Pennsylvania attorney general’s office are, for not entirely known reasons, in the beginning phases of scrutinizing the incident.

H.R. McMaster Sr. was a resident of a senior living facility in Philadelphia that provides a host of supportive services – it has been reported that he was receiving care there after enduring a stroke. According to...

Fractures due to the declining health of our bones places a substantial burden on patients, at one year 60% require assistance with daily living, 40% are unable to walk independently, and 20-30% are dead. It is a big deal and the only treatable risk factors for reducing the number of falls and improving bone mass. That is the idea behind Calcium and Vitamin D supplements. And there continues to be increasing evidence that these supplements are just not effective. 

The US Preventative Services Task Force is an independent voluntary group who develop evidence-based guidelines for preventative care. This week they updated their previous recommendations regarding the use of Calcium and Vitamin D supplements for patients who have no evidence of bone loss, osteoporosis. The latest...

It's one thing to be on the wrong side of a health issue as important as concussion-caused brain damage. It's quite another to go on the largest sports-talk radio station in the country and be incorrect and misleading about the underlying science.

Yet, that's what Gary Bettman, Commissioner of the National Hockey League, did recently when he was guest on WFAN in New York discussing the topic of head trauma and its link to CTE, or Chronic Traumatic Encephalopathy, an extremely debilitating degenerative brain disease.

During his April 10 discussion not only did Bettman deny that there was a link between head trauma in hockey and CTE, but the league's chief executive also falsely claimed that top researchers at Boston University's Concussion Legacy Foundation haven't yet...

Has an aspirin replaced the apple? Is it true that an aspirin a day keeps the doctor away? The short answer is perhaps; the long answer is complicated. Physicians straddle that divide by simplifying, creating what I refer to as “indication creep” – prescribing medications that afford more psychic than physical benefit. 

The benefit of a daily aspirin for individuals that have already had a heart attack or stroke is well documented, reducing the chance of a second heart attack, stroke or death. But therapeutically, there is no free lunch. Aspirin can cause bleeding, often from a pre-existing ulcer or a tumor, but that isn’t always the case. Higher aspirin dosages increase the bleeding risk; a low dose aspirin (75-162mg) strikes the right balance, with the lowest risk of bleeding...

It should come as no surprise that drug traffickers are quite creative about distributing their du jour illicit product. Most recently, multiple agencies including the U.S. Drug Enforcement Agency (DEA) and Homeland Security, intercepted an operation using legitimate Disney Donald Ducks and Winnie The Poohs as a cover for their imposter shipments of non-ceramic wax figurines replete with 500 lbs. of meth (estimated to be worth $2 million).

Drugs notoriously have been transferred for distribution using all sorts of vehicles intended to bypass discovery radars. The human body has been among the most dangerous ones. When a person swallows a bag of...

In a rapid series of progressively escalating press releases by the Illinois Department of Public Health, it appears that a dangerous synthetic cannabinoid product called K2, spice, synthetic marijuana, legal weed or fake weed has now claimed its latest victim in an outbreak currently totaling 38 people whose severe bleeding is linked to exposure of this substance. The state division just announced the first death in this cluster. Over recent days, the toll of those harmed continues to increase with all being hospitalized for spontaneous excessive bleeding, including but not limited to coughing up blood, urinating blood, bloody stools, bleeding from the eyes, ears,...

Climate change has been with us forever. Leave aside the current rancorous “debate” about the causes of our current climate, is there anything history can teach us about how human society copes when the weather around them change? John Haldon, a historian, and his colleagues mash up history, archeology and palaeoenvironmental [1] science to provide some clues. Society is a complex structure, and the ability to respond to environmental changes has varied over time. By combining information from archeologic findings, sampling our ecological history through techniques like core samples and tree rings (admittedly a simplification) as well as our historical record they believe a more layered understanding of the interaction of society and the environment can be achieved.

The point of...

I had the distinct pleasure of being a reviewer for the 2018-2019 Community Grants program for Komen this Fall. The experience gave me a fresh perspective on the process and affirmed the organization’s dedication to getting it right with respect to women’s health, optimizing breast cancer understanding as well as facilitating early diagnosis, screening, monitoring and treatment. Fulfilling a core commitment to reducing barriers and expanding access, especially for those most challenged and underserved, this funding is particularly important to curtail late stage diagnosis which can adversely impact survival.(1)

Here are some pearls of wisdom I can now pass along.

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The media and Twittersphere are full of articles and comments on the recent fatal crash involving an Uber vehicle and pedestrian in Arizona. I will leave the National Highway, and Transportation Safety Administration and the National Highway and Transportation Safety Board investigate the accident and publish their findings. But I feel compelled to point out a few salient points about autonomous technologies.

The Society of Automotive Engineers has published a classification of autonomous vehicles. Most cars currently on the road are at level 2, e.g., lane and cruise control – to be used in conjunction with an active driver, supervising and monitoring the environment. At the next level, the level of aircraft automation the pilot or drive cedes “full control of all safety-...

Six years after the last update, a national panel of health experts focusing on disease prevention just determined that revised skin cancer guidelines were warranted.

The most significant change extends its recommendations on sun protection to young children for two reasons: (1) Because being badly sunburned at an early age increases the chances of developing skin cancer later, and (2) kids are more likely to incorporate sun-safe precautions into their lives the earlier they are exposed to them.

The U.S. Preventive Services Task Force this week recommended that all light-skinned children beginning at the age of six months receive skin-cancer prevention guidance, which is a stark shift from its 2012 recommendations when the panel advised this training start at age 10....