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Showing posts from September, 2008

Horny Goat Weed – The Natural Viagra?

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An herbal remedy called “horny goat weed” has been studied by Dr. Mario Dell’Agli and his team at the University of Milan. The herb has long held a reputation in China as a natural aphrodisiac and now it looks like it could be a promising alternative to Viagra for impotent men. Dr. Dell’Agli calls it a “natural Viagra” because the compound targets the phosphodiesterase molecule (PDE-5) and it blocked the erection-inhibiting enzyme as well as Viagra.

Drugs like Viagra or Cialis or Levitra work by increasing blood flow to the genitals. The Italian researchers studied a number of plants and found that “horny goat weed” produces a compound called icariin, which blocks the enzyme and allows for increased blood flow to the penis. Also known as Epimedium or Yin Yang Huo, horny goat weed holds an important place in traditional Chinese medicine.

Erectile dysfunction affects an estimated 18 million men in the United States alone. The prescription drugs now available are effective, but can h…

Energy Drinks Need Warning Labels

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Experts from Johns Hopkins University School of Medicine are calling for health warning labels on "energy drinks" due to their high caffeine content that may pose a risk to adolescents and young adults. A single serving of some of these drinks can contain more than 500 mg of caffeine, an amount equal to 14 cans of Coca Cola.

Because the amount of caffeine is often not labeled, there is variability between the drinks and people don't know what to expect. In a 2007 survey of 496 college students, 51% reported consuming at least 1 energy drink during the past month. Of these energy-drink users, 29% reported "weekly jolt-and-crash" episodes and 19% reported heart palpitations from consuming these beverages.

It is common for young folks to combine energy drinks and alcohol and it is a common recreational practice. Bars stock "Red Bull" and other energy drinks and young adults pay for "Table Service" where they secure a party table at a club, st…

Medtronic Whistleblower Files Suit Against Physicians

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Medical device maker Medtronic settled a whistleblower lawsuit in 2006 by agreeing to pay $40 million while admitting no wrongdoing. In that complaint, Medtronic allegedly gave surgeons incentives to use its products, including entertainment at strip clubs and paying for lap dances.
That suit claimed that Medtronic, one of the largest medical device makers in the USA, made payments of $50 million in just four years to physicians doing implant surgery. One surgeon in Wisconsin was paid$400,000 for 8 days of "consulting" work. A surgeon in Virginia was compensated with nearly $700,000 in fees for nine months of work in 2005.


Now the same whistleblowers have filed against 100 spine physicians and the suit claims they received unwarranted Medicare money and kickbacks from Medtronic to use their devices. Plaintiffs and former employees, Jacqueline Kay Poteet and Bobbie Vaden, accused more than 130 orthopedic spine surgeons, neurosurgeons, medical practices and distributors o…

Barack Obama on Health Care

Universal coverage is the #1 most essential change needed. That means everyone.

John McCain on health care

Hmmmm. So the "change" is a tax credit and people can cross state lines to try and find better deals on insurance but insurers can deny if they have underlying conditions. Where's the "change?"

Health Insurance Costs Rise - And You Are Paying

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The cost of health insurance continues to rise and premiums far exceed the rate of wage increases and inflation in the United States. Insurance premiums are going up ten times faster than people’s incomes and the average dollar amount employees must pay per year for family health coverage increased by 30% from 2001-2005.

Federal employees premiums will climb an additional 13% next year for enrollees in the Blue Cross and Blue Shield Plans. The Office of Personnel Management (OPM) negotiates on behalf of the nations largest group of employees, more than eight million federal health workers, retirees and dependents. Despite this bargaining clout, they were unable to keep cost increases at a reasonable rate. On average, enrollees with family coverage will pay about 30% of the plan’s total cost with the government picking up the remaining 70%.

Blue Cross and Blue Shield, which covers the bulk of Federal employees, blames the cost increases on drug costs and the fact that few patients …

Transplant Surgeon Saves Child with $2 Ping Pong Ball

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Little Mackenzie Argaet from Australia was born with biliary atresia and underwent life-saving liver transplant earlier this year. But the transplanted liver was too big for her two year old body and was compressing vital blood vessels. Her surgeon, Dr. Albert Shun, was using a sponge to keep the vessels open but he couldn't close her up and he needed a solution and he needed it now! This quick thinking surgeon called his wife and said "Run to the store and get me a package of ping pong balls."

Using inovation and creativity, her surgeon placed a sterilized ping pong ball in her liver as a way to keep the liver off the arteries. The light, tough ping pong ball remains in place, doesn't deteriorate and the liver just grows around it without causing an infection.

What you see in the radiograph are the staples along the bottom, a nasogastric (or oxygen) tube in the middle and a round (think ping pong ball) in the right side with a drain tube coming from the area.

F…

UC Irvine in Trouble for Falsifying Patient Records

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UC Irvine (UCI) Medical Center is being placed under the oversight of the State Department of Public Health because federal inspectors found that doctors were filling out medical records in advance and even putting patient's outcomes in the record before the procedures were done.

A whistle blower complaint preceded an investigation and a 30-page inspection report that listed problems dating back at least three years. They included substandard equipment checks, inadequate record keeping and falsified records by doctors. Anesthesiologists were found to fill out operative reports a day before the surgery was even done.

The Department of Anesthesiology had problems dating back to 2003 when half of the 26 professors signed a letter alleging that "the direction of the department has been radically altered to achieve financial goals at the expense of academic goals." Many of the doctors resigned over the next few years.

After a lengthy search, UCI hired Dr. Zeev Kain, executiv…

How to Stay Healthy in Flu Season

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We are experiencing a glorious Indian Summer in Northern California, but Autumn is in the air and I can see some leaves starting to turn golden. When the weather changes, I know viral illnesses such as influenza and colds are also lurking and are just around the corner.

The most common reason for school and work absenteeism is a viral "cold". We call them "upper respiratory infections" and there are over a hundred different cold viruses. Influenza is also a virus and is passed from person to person in much the same way as a cold...via hands, touch, surfaces and droplets in the air from sneezing. Eighty percent of infectious illnesses are passed by touch.

One of the cheapest and most effective sanitizers for cleaning surfaces is bleach. Master chefs know this secret and use bleach to clean their cooking surfaces. Just mix a solution of 1 part bleach with 2 parts water in a spray bottle and you are ready to kill the cold virus and other bacteria.

Parents: Most …

Plastic Surgeons Come Out Against Unrealistic Big Breasts

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Kudos go out to the British Association of Aesthetic Plastic Surgeons (BAAPS) for speaking out against "unrealistic anatomically impossible" breasts that are being used in advertisements to seduce female patients. The Association, which represents about a third of cosmetic surgeons in the UK, launched its own advertising campaign against parts of the trade because of the ads some clinics had posted showing a woman with a body that was digitally enhanced.

Breast augmentation continues to be one of the fastest growing segments of cosmetic surgery. I've heard reports of young girls receiving breast implants as "sweet sixteen" birthday presents and high-school graduation presents from their parents. That is obscene and entirely too young to be making major decisions about serious and permanent body enhancement. TV and other ads are targeted at young, impressionable women and can make them think these types of artificial bodies are the norm. When they look i…

The Drugs Song - Amateur Transplants

How many of these names do you know? I'm an Internist...I know them all. Enjoy.

Senator Grassley Investigates Michelle Obama's Employer

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Senator Charles Grassley (R-Iowa) is investigating the University of Chicago Medical Center about the hospital's efforts to steer patients with non-urgent complaints away from the emergency room to local clinics. He is requesting financial records, board minutes, and other information related to hiring, job promotions, business contracting and care for the poor.


Michelle Obama, wife of presidential candidate, Barack Obama, is currently on leave from her position as the V.P. of community and external relations at the Hospital and she was a key person in the initiative to utilize community clinics.

I have news for Senator Grassley. Emergency departments across the country are in big trouble from over crowding and they are filled with patients who are using the hospital for primary care and non-emergent health issues. The New York State Health Commissioner has said that overcrowded emergency rooms are a sign of a health-care crisis for which there are few rapid, inexpensive or …

Eating Pistachios May Help Reduce Cardiovascular Events

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A new study reported in the American Journal of Clinical Nutrition says eating pistachio nuts decreased total cholesterol and LDL (bad) cholesterol compared with a control diet that had no nuts.

One of the control groups was fed a step 1 (low fat) diet without pistachios. Two other groups were fed the same diet with low doses of pistachios (32-63 gms/day) and high doses of pistachio nuts (63-126 gms/day). The pistachios were low salt and were fed as snacks and incorporated into recipes.

There was a significant lowering of total and LDL cholesterol in the pistachio diet groups and it was dose related with the higher pistachio intake having a greater effect. The authors concluded that the magnitude of reduction in LDL cholesterol for the high-dose pistachio eaters was equivalent to that of statins and would result in a 9-12% reduction in heart disease risk.

It should be noted that the study group was small (10 women and 18 men) and the study was sponsored by a grant from the Californ…

Why Do We Practice Medicine?

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Some blogs are so good and so perfectly written that they need to be widely read. This is one of them from M.D.O.D. and it is just great. Click here and enjoy

Waking Up Is Hard To Do

These doctors and nurses have a great sense of humor as well as cool vocals. I want them singing me to sleep and waking me up too.

Viagra vs Birth Control - McCain Squirms

Only 2% of Medical Students Going Into General Medicine

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With only 2% Medical Students planning careers in General Internal Medicine, we are in for a huge medical crisis. The USA will have 200,000 fewer doctors overall than it needs by 2020, yet the number of older Americans is expected to nearly double.

The reasons are clear and medical students are walking away from Primary Care specialties in droves.
High medical school debt (average >$150K)Lowest income of all specialtiesHighest hassles and horrible paper work of all specialtiesHigh cost of running an office (supplies, phones, billing, space needed, employees needed)Grueling crush of patients with no relief (no lunch, no break, no time for research or thinking about complex medical problems)High level of responsibility for "everything"Grueling call scheduleLack of respect from other physicians. Often dumped upon... "Call your primary"Requirements for best practice prevention and screening without systems to help manage it. Inability to combat low reimbursement and…

Screening for Colon Cancer - Just do it

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I have a patient who is absolutely phobic about getting a colonoscopy for colon cancer screening. She has a family history of colon cancer so the fear may be about what is "found" or it may just be the anxiety of going through the test. No amount of cajoling on my part or her husbands part has been successful for getting her tested. I've even offered valium to get her through it but she just won't take that next step!

I feel so strongly about this because colon cancer is one disease that is truly preventable if found early.

Here are some facts:
Colon cancer is the 2nd leading cause of death from cancerFewer than half of all men and women are up to date on their colon screeningsThe majority of colon cancer is diagnosed in people over 50Colorectal cancer often occurs with no symptomsMost colorectal cancer can be cured if diagnosed at an early stageRegular colonoscopy can prevent colorectal cancer all togetherYou can reduce the risk of colon cancer by maintaining ideal …

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Dentist Dumps Syringes - Contaminates Jersey Shore

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Can you believe it? A prominent dentist with homes in Pennsylvania and the Jersey Shore has been accused of "unlawfully discharging a pollutant and unlawful disposal of regulated medical waste." Lets say it in plain English...he dumped a bag of 300 used needles, 180 used cotton swabs and other materials from his medical office. He admitted to tossing the material from his boat a few miles offshore and, Surprise! The debris washed up on shore, closing down the beaches of Avalon, a resort town about 25 miles South of Atlantic City, throughout the Labor Day weekend.

I just don't get it. We have had years of "Earth First", "Earth Day", "Save the Earth", "Save the Ocean" and you would have to be in a coma not to know that dumping is illegal and immoral.

Thomas McFarland needs more than a fine for this ignorant and willful offense. He should get jail time and be forced to watch Jacque Cousteau documentaries and "Finding Nemo&q…

Tyson will Stop Saying Their Chickens are Antibiotic Free

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A federal judge issued a preliminary injunction against Tyson Foods last April and ordered them to withdraw advertisements claiming their chickens "are raised without antibiotics that impact antibiotic resistance in humans." Tyson said it would appeal that decision.

Tyson Foods now states it will "voluntarily' withdraw its labels for chickens raised without antibiotics because of what it called "uncertainty and controversy over product labeling regulations."

Tyson says its claims "raised without antibiotics" is true, even though they inject eggs with antibiotics and used antibiotic molecules in the chicken feed. Inspectors found they used Gentamycin, an antibiotic commonly used in humans, to inject eggs before they hatch.

Talk about deception! If I want antibiotic free poultry (AND I DO!), I want to know that the advertising really means ANTIBIOTIC FREE.

Lizard Man - Body Dysmorphic Disorder?

Extreme? Ya think?

New Screening Tool for Postpartum Depression

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Postpartum depression is more common than we thought and it is often missed by doctors and even families in the chaos and changes brought about by a new baby in the house. Postpartum depression can last for months and goes beyond the hormone fluxes that most new mothers experience with changing moods and fatigue. Postpartum depression is a serious disorder that requires identification and treatment.

A new study published in Pediatrics shows a simple questionnaire is a useful screening tool for postpartum depression. The sensitivity of the questionnaire was 95% and the beauty of it is how simple it is to administer by the doctor or nurse.

Women are asked to respond to these statements:
I have blamed myself unnecessarily when things went wrongI have felt scared or panicky for no very good reasonI have been anxious or worried for no good reason This brief and simple screening tool was effective at identifying new mothers that would need followup for depression.

(I've read some article…

Barack vs McCain - Health Care

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With the Democratic and Republican "Rah Rah" conventions over, it is time for Americans to do the hard work of really looking at the issues to decide the next president. It would be so refreshing if we actually voted based on policy and effectiveness...rather than hero status, race, sex, TV ads or sound bites.

I don't understand voters who zero in on a single issue and vote because of the candidate's stand on that issue. Whether it is gay marriage, guns, the war in Iraq, creationism, abortion, tax cuts, or Health Care, there are too many important factors that affect us all to choose because of one belief.

But speaking of Health Care...I found a bipartisan website that can help us all do our homework on a very complicated subject. Check out HealthDecision '08 to see Obama and McCain's health proposal summary side by side with both the advantages and the challenges.

It is a complicated subject and simplistic measures are a LIE. I see flaws with both pr…

Flame Retardant Chemicals Found in Children

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A new study shows polybrominated diphenylethers (PBDEs), flame retardant chemicals found in most household products, accumulate in children's blood and tissue at rates three times higher than their mothers in the same household..... to find out more go to EmaxHealth, where I have written a report about PBDEs and why we should care.

Medical Grand Rounds

The best of this weeks blogs is up at Chronic Dose. Check it out for a variety of good reading.