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Showing posts from June, 2010

Doctor Fakes Research and Goes to Jail

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A prominent 51 year old anesthesiologist pled guilty to falsifying research on the analgesic medications Celebrex and Vioxx for post-op pain managment.  He was sentenced in Massachusetts federal court to 6 months in prison and given hefty fines to be paid to the pharmaceutical companies who financed his research and paid him to promote their drugs.

Dr. Scott Reuben just plain faked the results.  He reported in two published articles that he had treated 200 patients in a trial - 100 with placebo and 100 with celecoxib (Celebrex).  He simply made up the findings and never enrolled any patients at all.  Multiple medical journals have retracted more than 20 articles by Dr. Reuben containing faked data on a number of pharmaceutical drugs.

Besides the faked research he spoke frequently at medical conferences and continuing medical education events about using Celebrex and Vioxx in combination with other analgesics to reduce postoperative pain.  The pharmaceutical companies reimburse their e…

6 Ways To Help Simplify Your Life

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I like to pass on good tips and these six ways to simplify your life make a lot of sense.  The constant stress we feel because life is so complicated is not good for our health.  Here are six ways you can have a simpler lifestyle:

1. De-Clutter Your Home

Look around.  If you have piles of paper, too many "things" and nic-nacs laying around it is hard to think clearly and function. An open, clear space allows our minds to feel open and more peaceful.  Tackle one room at a time. Be ruthless and donate or toss everything that isn't useful, beautiful or has special memories.


2. Limit Family Activities


Try to force family members to choose only those activities that are most important.  Many of us are over-scheduled and have no time to just see "where the day will take us".   30 years ago no stores were open on Sunday and there wasn't much to do except go on picnics or just hang out with friends and family.  It is OK to "vege" and may even be good for y…

Good Lessons Come from McChrystal Debacle

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General Stanley McChrystal's loose lips and ultimate downfall can teach us all some valuable lessons.  He was a career military man (West Point Graduate) who rose to the top of the heap as Commander of the International Security Assistance Force and Commander of U.S. Forces in Afghanistan.  People are scratching their heads about how a man who was in such an esteemed position could be so stupid as to publicly criticize the only three people who had the power to sack him!

First, he was on thin ice in 2009 when he publicly suggested that 30 to 40 thousand more troops were needed to "win in Afghanistan".  At that time many people thought he should be fired for insubordination for disclosing information that should have been said in private to the President.  Flash forward to the June article in Rolling Stone  where he mocked civilian government officials (including V.P. Joe "Bite-me" Biden), the Ambassador to Afghanistan and the National Securing Advisor and final…

Omega 3 FFA for Depression

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A study published in the Journal of Clinical Psychiatry has shown that supplementing Omega-3 fatty acids (FFA) can significantly reduce symptoms for patients with major depression.  This study looked at 432 adult patients (mean age 46 years, 68.5% female) and randomized them to receive either 8 weeks of omega 3 FFA or placebo.  40% of the patients were also taking antidepressants when they started the study.

The results strongly showed that the patients who got the Omega 3 FFas had significantly reduced symptoms of depression compared to the placebo group.  Of interest is that patients with anxiety and depression did not improve with the Omega 3 supplements, only the patients with depression and no anxiety.

I have extolled the benefits of Omega 3 FFA supplements many times on EverythingHealth for treatment of hypertriglyceridemia and cardiovascular protection and I mentioned it for depressive symptoms also.  These essential fatty acids are not made in the body but must be consumed fro…

Black Spot Poison Ivy

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I love learning something new in medicine and this was a new one for me...black spot poison ivy.   Poison ivy (also known as rhus dermatitis) is a common contact allergic dermatitis.  Like poison oak and poison sumac, the chemical that causes a reaction is called urushiol.  When this plant sap touches the skin a pruritic (itchy) red rash appears with little blisters that are often in a line.

Black spot poison ivy is the same urushiol but in humid, warm conditions it is oxidized by lactase from the skin and turns into a dark black lacquer color.  It is an uncommon presentation because usually the sap is diluted by perspiration and never turns black.

Poison ivy/oak is more common in the summer and I treat lots of cases in Northern California because it grows like a weed.  The worst cases are when someone tries to burn the plant and inhales the resin.  Treatment of black spot poison ivy is the same as regular poison ivy.  Washing the skin, clothes, and all contacts area immediately is cri…

Weight Loss from Activity Only Works in Thin Middle Age Women

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Talk about a cruel trick of nature!  A study funded by the National Institutes of Health (NIH) and published in JAMA shows that physical activity prevents weight gain in middle-aged and older women ONLY IF THEY ARE ALREADY AT IDEAL WEIGHT.  Did you read that?  It means that the recommended guidelines advocating 150 minutes of exercise a week isn't sufficient to prevent weight gain in most middle age women.

The Harvard associated researchers assessed weight changes associated with various levels of physical activity on 34,079 women who had been followed since 1992 in the Women's Health Study.  They stratified women as inactive (less than 150 minutes a week of moderate level physical activity), intermediately active or highly active if they performed a high, strenuous level of activity.  All three groups showed similar weight gain over a mean 13 years of follow up.

Despite exercise, there was no correlation between activity level and weight gain except in the subgroup of women w…

SpaghettiOs Recalled

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I know the readers of EverythingHealth would never eat Campbells SpaghettiOs but in case you know someone who does, you should know that the USDA has recalled 15,000,000 pounds of SpaghettiOs because of under processing. The recall includes 14.75-ounce cans with a use-by date between June 2010 and December 2011 of three varieties of the product: "SpaghettiOs with Meatballs," "SpaghettiOs A to Z with Meatballs" and "SpaghettiOs Fun Shapes with Meatballs (Cars)."


Consumers who have purchased those products with a plant code of "EST4K" should not eat them and should return them to the store where they were purchased for an exchange or full refund, Campbell Soup said.

More than 150 million cans of spaghettiOs are sold each year.

Being curious, I wondered what is in this American brand that was introduced in 1965?  Here is what I found:

Water, Tomato purée (Water, Tomato Paste), Enriched Macaroni Product (Wheat Flour, Niacin, Ferrous Sulfate, Th…

Email Alerts by Popular Demand

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Dear EverythingHealth readers,
Many of you have requested an email alert when new blogs are posted.  It took me awhile, but now it is easy to sign up on the right hand side of the blog.  Check it out and never miss a fascinating topic.
Thanks for visiting and reading.

Senate Approves Last-Minute Delay for Medicare Physician Cuts

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Yesterday's Medicare pay cuts for physicians have been delayed in a last-minute compromise deal today by the U.S. Senate.  The agreement was passed by "unanimous consent" without a roll call vote.  (I need to go back to 8th grade Government 101 to figure out how that is done!)

The last minute agreement means that the pay cuts will be reversed.  The House of Representatives will (hopefully) pass the measure on Monday.  In the meantime, Medicare is still holding on to June claims and will pay them when everything gets approved.  These "fixes" will only last 6 months and then we will go through this again.

The Doctor is Out for Medicare Patients

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Breaking news tonight that in a last minute shocker, the Senate voted today against postponing a scheduled 21% cut in Medicare reimbursement to physicians and other health providers.  60 senators were needed to end filibuster debate and stop the cuts under Senate rules.  Fifty-six voted in favor, with 40 opposed. There was no Republican support. (And, of course, no support from Senator Lieberman, who is a Republican in disguise).   Another consequence of the vote is that tens of thousands of Americans who have exhausted their jobless benefits would not be eligible for more.  In addition, new taxes on wealthy investment managers would not be imposed, along with an increase in liability taxes on oil companies, leading Democrats to contend that Republicans were protecting Wall Street and the oil industry, according to the New York Times.

“We’re not going to give up,” said Senator Harry Reid, the Nevada Democrat and majority leader. “We know the American people only have us to depen…

Surgery and Radiation Therapy for Prostate Cancer Cause Lack of Ejaculation

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The American Urological Association 2010 Annual Scientific Meeting was held in San Francisco.  One of the reports at the meeting dealt with the fact that nearly 90% of men who undergo radiation therapy for prostate cancer will eventually develop anejaculation (inability to ejaculate).  Additionally radical prostatectomy (surgery) is almost always associated with loss of ability to ejaculate.  It is an inevitable and well-recognized result of surgery but anejaculation after radiation treatment is less discussed.

A  study of 252 men who were treated for prostate cancer showed that 72% of men lost their ability to ejaculate after radiation treatment.  After 5 years, 89% had anejaculation.  The mean study age was 65 years.

Since both surgery and radiation therapy are likely to cause anejaculation, it is important that men know about it as they are making decisions on treatment.

Addiction to Tanning

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According to the Archives of Dermatology, there are people who are addicted to indoor tanning.  That journalreported on a study of 421 University students in the northeastern United States.  Using self-reported questionnaires, they screened for alcoholism and substance use as well as anxiety and depression.  They also had a questionnaire about addiction to indoor tanning. 
If you are scratching your head (as I was) please know there is a medically accepted criteria known as CAGE (cut down, annoyed, guilty, eye-opener) that correlates with addiction so they used this for "addiction" to indoor tanning also.  They found that more of the kids who met the criteria for addiction to indoor tanning also had greater anxiety, greater use of alcohol, marijuana and other substances.  Depression didn't seem to go with the tanners or the non-tanners.

The researchers concluded that students who are addicted to indoor tanning may also have other addictions and psychologic disturbances.

Doctors Offices Not Keeping Up with Online Demand from Patients

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At a time when more and more patients are using the internet to research doctors, hospitals and medical conditions, there are still few physicians who utilize on-line services for patient care.  Thirty eight percent of  US adults have researched a medical problem online in the past 12 months, according to a Forrester Research Study.  The survey also showed that 26% of adults researched a specific drug and 7% looked up the quality or reputation of a doctor.  Despite this activity, few physicians interact with patients online.

In another poll reported in Modern Healthcare, 50% of patients say they would like to communicate online with their doctor or his office about clinical or administrative services.  They would like to use web-based tools to schedule appointments, access immunization records or schedules, complete screening forms or refill prescriptions.

How many physician offices offer any one of these?  Less than 15%.

It isn't a surprise to me that Doctors are so behind on imp…

Eight Secrets You Should Tell Your Doctor

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It is important to have an open relationship with your primary care physician because the more she knows about your health and lifestyle, the better able she is to diagnose illnesses as they come up.  You wouldn't take your car to a mechanic and not tell him that the brake is sticking.  And a human organism is thousands of times more complicated than a car.  But patients are shy. They are embarrassed. They don't want you to think badly about them.  So they often leave out important information that is critical for the physician to know.  Here are eight secrets you should tell your doctor:


All of the medicines you take, including herbs and over the counter:It is amazing to me how many times I review a med list and  even when I prompt "is that all?", I find out much later that the patient left out the birth control pill or the herb for prostate.  Everything is important.   Smoking, drinking, drugs: All doctors know to triple the amount a person says they drink.  If you …

Are We Overmedicating Our Kids?

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One of the blogs I read by Maggie Mahar, pointed out that a new study found that 26% of kids under age 19 are now taking prescription drugs for a chronic condition. The drugs include asthma medication, anti-psychotics, diabetes, anti-hypertensives and heartburn medications.  According to the Medco study (the largest pharmacy benefit manager), the incidence of type 2 diabetes increased over 150% in children between 2001 and 2009.  Readers, that is staggering!  Children are supposed to be healthy and active and not tied to a regimen of pills.

What is our nation doing to care for our most precious citizens?  Why are 17% of adolescents (ages 10-19) now classified as obese?  Why have medications used to treat high blood pressure, high cholesterol and diabetes increased 15.2% in children?  And why are children being treated for heartburn, a condition that is associated with obesity and should never be part of childhood?

I ask these questions rhetorically.  We know the answers.  The increas…

Keratosis Pilaris

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This photo of the arm of a 17 year old girl showing tiny red rough bumps that were not painful or itchy.  She had similar bumps on her thighs.  This common condition is called Keratosis Pilaris and it peaks during adolescence in all races.  It goes away by itself as a person ages.

We don't know the cause of this strange phenomenon.  Since it is mainly seen in puberty there may be a hormonal effect.

 There are no special tests to diagnose Keratosis Pilaris and there is no specific treatment.  Moisturizing the skin is important to soften the dryness and reduce roughness.   Topical retinoids (Retin A, Tazorac) can help to promote cell turnover and prevent plugging of hair follicles.




Image and case from Consultant Live

Extra Fees Help Physicians Stay in Practice

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I was interested in an article in USA Today about the growing number of physicians, especially primary care doctors, who are boosting their revenues by requiring patients to pay new fees for services that insurance doesn't cover.  No longer is your insurance payment "all-inclusive". These fees can include annual administration fees, no-show fees, medical report fees, and extra fees for email or phone consultations.  If private practice medicine is going to survive, these fees are a necessity.

An article in the NEJM in April, showed how much time physicians spend on activities that receive no compensation at all.  It is not unusual for an Internal Medicine physician to spend an extra 3 hours a day filling out forms, refilling prescriptions, making phone calls on patient's behalf, answering questions from patients and dealing with a myriad of patient related requests.  With overhead running at 65% or above, more and more doctors are leaving practice or burning out.  Th…

Start Talking - a book for Teens and Moms

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Raising kids gets really challenging when they hit the pre-teen age and there are few books that really help moms understand how maintain closeness with their teen daughters.   Authors Mary Jo Rapini and Janine Sherman offer a helpful book for young girls and their moms to read individually and together.  "Start Talking - A girls guide for you and your mom about health, sex or whatever" is a welcome coaching guide for moms who really want to open the door to great communication.

In my day there was one book that every girl read called "Growing up and Liking it".  With anatomical drawings that were hard to understand and the biologic facts about your body "changing", it didn't create much of a discussion platform.  It also didn't deal with any of the real issues young girls want to hear about.  Boring!  Rapini and Sherman have exponentially raised the bar with "Start Talking".

"Start Talking" offers straight and complete answers…

More Medication Errors in July

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We medical folks have always known that July is the worst time for a patient to be admitted to the hospital.  It has nothing to do with nice summer weather or staff vacations.  Although it cannot be proven, we think the answer to the mystery of July hospital errors is human...yes it's the new interns.

A new study published in the June issue of the Journal of General Internal Medicine looked at all U.S. death certificates from 1979 to 2006.  They found that in teaching hospitals, on average deadly medication mistakes surged by 10% each July.  The good news is they did not find a surge in other medical errors, including surgery or in non-teaching hospitals.

So lets break this down.  Every July a new crop of medical interns hit the wards.  Eager, motivated, and anxious to do well in their new white coats and carrying smart phones, they start seeing hospitalized patients.  Each intern is paired with a Medical Resident...a young doctor a little further along in training.  Some Resid…

Chin Slimmer

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After yesterday's eyebrow post, I am on a cosmetic run. Here is a gimmick, "As seen on TV" , on which you should save your hard earned money.  The neckline slimmer claims to reverse the effects of aging without cosmetic surgery.  Simply hold this gadget to the chin area and it will exercise your neck muscles to reduce those jowls or sagging fat under your chin.  Just two minutes a day should do the trick, according to the commercial.

Unfortunately the effects of aging and loose skin cannot be reversed by jiggling the head or pressing the fat upward.  Weight loss can slim the face but sagging jowls probably needs cosmetic surgery.
Personally, I prefer candle lighting and light dimmers.

Desired Shape of the Eyebrow

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While my Internal Medicine Journals are filled with long studies about breast cancer, diabetes and optimal doses of Vitamin D, the Archives of Facial Plastic Surgery reports on the aesthetically desired position of eyebrows and the range of eyebrow motility.  Please understand, dear reader that  I am not poo-pooing the importance of eyebrows.  We all have two and I am sure how they sit on our foreheads is of utmost importance so here are the results of the clinical trial.
The researchers took photos of 40 adult subjects in 5 poses: eyes open and eyes closed, brows elevated and brows contracted and brow positioned optimally by the subject.  (I have never thought about optimal eyebrow positioning.  My eyebrows just seem to happen.)
They found that women desired the lower border of the brow to fall just below the orbital rim at the medial canthus (the inside corner of they eye).  They liked the rim of the eyebrow at the mid-pupil area.  The men desired a lower brow with a lower tail and a …

What You Should Know About Prostate Cancer

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When Dennis Hopper died of prostate cancer at age 74, my husband asked me "Hey, I thought prostate cancer didn't kill men and it is slow growing".  Well, he is right  about it usually being slow growing, but prostate cancer is still the 2nd leading cause of cancer death in men.  His question made me realize that there are some facts that everyone should know about prostate cancer.

Prostate Cancer is very rare in men under age 40 and the incidence increases with age.  African-American men are at higher risk and Asian and Latin men are less likely that white guys to get it.  We do not know why these ethnic differences occur.  Family history is important and men with an affected brother or father are twice as likely to get prostate cancer.  Although genes are undoubtedly responsible, there are no genetic tests that can predict it.  Some studies show obese men and men who eat large quantities of red meat and dairy products are more at risk.  A vasectomy doesn't seem to m…