If you drink coffee, I have some bad news and some good news. The bad news is that the more cups of coffee you drink, the higher your risk of dying early. The good news is that if you “risk adjust,” then the more cups of coffee you drink, the lower your risk of dying early. Let me explain.
According to a Read more…
Can coffee help you live longer?
After a terribly painful and debilitating illness, Steve died. He had been treated for Stage 2 Hodgkin’s Disease with a series of intense therapies including German enzymes, American antineoplastins, Mexican naturopathy and Chinese herbs, complemented by focused meditation, innumerable vitamins, extreme diet modification and acupuncture for severe pain. He fought the cancer with every ounce of his being, doing everything to survive, except the one thing that had an 85% …
When alternative cancer therapy harms patients
Wemberly worried about everything. Big things. Little things. And things in between.
–Wemberly Worried, Kevin Kenkes
The bottom line: you can add arsenic in rice to your long list of health risks you don’t need to worry about. And you can add Consumer Reports to your long list of media outlets that you can’t depend on for reliable health advice. Inaccuracy and breathless scaremongering …
Should you worry about arsenic in rice?
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause …
Azithromycin and long QT syndrome: Facts from a cardiologist
An article from Sweden was recently published showing that in a very large group of women, over 60,000 of them, followed for 19 years as part of an also very interesting study of the effectiveness of mammograms, women who get more calcium, in their diet or as supplements, had a higher risk of dying of anything, but especially of heart attacks. It is …
A high calcium diet and calcium supplementation: Is it bad for you?
Where did the medical community get the idea that Vioxx, Trovan and Baycol were safe and the benefits of Prempro, Neurontin and bisphosphonates outweighed their risks? From research published in medical journals written by drug companies or drug-company funded authors.
Scratch the surface of many blockbuster drugs that went on to be discredited, or even withdrawn as risks emerged, and an elaborate “publication plan” emerges, developed by …
Planting drug industry-funded papers in medical journals
As an addiction psychiatrist, I have seen marijuana do far more harm than good. So with the medical use of marijuana in Massachusetts now legal under state law, what should physicians do?
Recently, I attended a chilling presentation from Dr. Kevin Hill, an addiction psychiatrist at McLean Hospital, at a meeting of the Massachusetts chapter of the American Society of Addiction Medicine on the topic “Medical Marijuana: What is the Proper …
Against the medicalization of marijuana
Hi. I’m a 44-year old emergency physician. And I’m an addict.
My addiction came to light when my Press Ganey scores plummeted after I started to stand up to the chronic pain and frequent ER patients.
The fact that I have an addiction was reaffirmed when I went to my state’s Prescription Drug Abuse Summit. When I saw so many professionals from varying fields (medicine, law enforcement, pharmacy, education) assembled, I realized …
I’m addicted to prescribing pain medications
Two of the biggest -selling prescriptions of all time, Plavix, an anti-platelet medication, and Lipitor, a cholesterol lowering medicine, have been available in generic form since May 2012 and November 2011, respectively. However, most retail pharmacies are still charging patients $100-$200 monthly for these medications. Why? And what does this market oddity say about our chances of lowering healthcare costs in the United States?
Patients are used to paying a high …
Why are some generic drugs so expensive?
A version of this column was published in USA Today on April 1, 2013.
Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year. And for every death, significantly …
Curb prescription drug abuse by following Mayor Bloomberg
It’s a nightmare that doesn’t end for the family of 24-year-old Marek Lapinski, who suffered cardiac arrest recently during the removal of two wisdom teeth in a southern California oral surgery clinic. The former college football player had no known health problems prior to the surgery, but died three days later in a hospital intensive care unit.
While the circumstances of Mr. Lapinski’s death are still being investigated, the case highlights …
There is no such thing as minor anesthesia
The FDA issued a warning about the antibiotic azithromycin (Zithromax). The media stories have some patients terrified and some of them are calling me convinced that azithromycin is poison, a reliable agent for suicide.
What’s the hubbub about?
Azithromycin is in a family of antibiotics called macrolides, which also includes erythromycin and clarithromycin (Biaxin). Erythromycin and clarithromycin have long been known to very rarely cause fatal abnormal heart rhythms. It …
The real reason to be cautious about Z-Paks and azithromycin
According to a new report from Cegedim Strategic Data, DTC promotional spending declined 22% versus last year. In fact they reported that “spending in nearly every channel saw decline year over year in 2012, the only exception being direct mail, which continued an upward trend. Here are the reasons why I expect DTC marketing to continue to decline in 2013.
1. Most big brands …
7 reasons why DTC drug marketing will decline in 2013
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I just finished reading Neil Gaiman’s fascinating novel, Gods of America. I first learned about his work by watching the movie Stardust, then reading the novel.
One of the themes of Gods of America is that the deities of the old world came to America in the hearts of their followers, but over time lose their followers and thus their power. A war is arranged between the …
We worship at the feet of pain and pills
A recent meta-analysis published in the American Journal of Clinical Nutrition suggests that coenzyme Q10 is of benefit in congestive heart failure. For those who like the idea that food and nutrients can be excellent medicine, this paper is interesting at the very least. But there is a case to be made that it is far more than that. There is a case to be made …
The resurrection of coenzyme Q10: It’s all about the money
Think you know something about oncology? Ok then, pop quiz: If you are giving chemotherapy to a patient who does not have cancer, how can you tell if it works? Ridiculous question? Not at all. The answer to that question is; “hopefully, we will never know,” and it is at the core of modern cancer care.
In the 1960s, breast cancer surgeons had a serious problem. They were doing large complex …
How can you tell if adjuvant chemotherapy works?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 64-year-old woman is hospitalized for a 2-day history of fever and chills and a 1-day history of hypotension and dyspnea. Medical history is significant for adenocarcinoma of the colon diagnosed 3 weeks ago for which she had a partial colectomy. Her course was complicated by the development of a polymicrobial intra-abdominal abscess. After …
MKSAP: 64-year-old woman with fever and chills
My perspective on scientific publications has been greatly affected by my experience with this blog and social media in particular. The ability to serve as author, reviewer, advertiser and marketer can be easily achieved in this space thanks to the power of self-publishing. But with this new platform comes new responsibilities and for those of us who chose to work with people daily, perhaps none is as great as maintaining …
Cost is a gaping hole in scientific discourse
Quick! Can you name the leading cause of accidental death in the United States now? It is prescription drug overdose. Since 2009 death from legally prescribed narcotics has led auto accident deaths as the number one cause of accidental death in the United States. More than 15000 die now annually.
On October 5, 2012 the Wall Street Journal on its front page published …
Explaining the rise in legal narcotic misuse and addiction
I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.
Hey Dr. Young, I’m looking for some basic mentoring advice. I’ve been moonlighting at ZZZ Urgent Care for about a year. Not my favorite work, but oh well. I don’t routinely prescribe antibiotics …
Working in an urgent care center: An assault on the soul
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