An Opinion On Single-Payer Healthcare Effects

 "Single-payer health care systems deliver better outcomes at much lower cost than those that rely primarily on private insurance, as we do in the United States."

Would a Single-Payer System Require Painful Sacrifices From Doctors?

A True Miracle Drug?

For decades, the political and legal establishments have suppressed growing evidence that cannabis (marijuana) has significant and wide application against many diseases.  Perhaps this one-hour documentary will prompt those in power who, for any reason, have not allowed appropriate research on cannabis and approval for its use as a legitimate form of medicine.

Dateline 5/2018: Growing Promise

 

Advice For People Considering Stem Cell Therapies

*Stem cell products have the potential to treat many medical conditions and diseases. But for almost all of these products, it is not yet known whether the product has any benefit—or if the product is safe to use.

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If you're considering treatment in the United States:

• Ask if the FDA has reviewed the treatment. Ask your health care provider to confirm this information. You also can ask the clinical investigator to give you the FDA-issued Investigational New Drug Application number and the chance to review the FDA communication acknowledging the IND. Ask for this information before getting treatment—even if the stem cells are your own.
• Request the facts and ask questions if you don’t understand. To participate in a clinical trial that requires an IND application, you must sign a consent form that explains the experimental procedure. The consent form also identifies the Institutional Review Board (IRB) that assures the protection of the rights and welfare of human subjects. Make sure you understand the entire process and known risks before you sign. You also can ask the study sponsor for the clinical investigator’s brochure, which includes a short description of the product and information about its safety and effectiveness.

* https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm286155.htm

(jSTEMCELL)

Fake News Effecting Medicine

Traditionally, the public puts great trust in medical physicians and assumes, when he or she is in contact with them, that they will be getting science-based medicine from them.  Following is an example of how even physicians can be influenced by fake news.

Alzheimer's Disease And The Nun Study

Alzheimer's Disease is something I am extremely interested in, as my mother died young (71) with it, and her mother and most of her 7 brothers and sisters also died of it.  Several years ago, there was a study of a Sister Mary and several other Nuns.  In the study, the Nuns agreed to donate their brains to science for analysis.  All has relatively long lives and had no signs of dementia at death.  Interestingly, many had advanced brain plaques as a marker for the disease.  As a science-based thinker, I have to take the results as an indication that much more needs to be known about the etiology of the disease.  THAT is the beauty of being a science-based thinker: go with the evidence, even if it does not comport with present expectations.

Aging and Alzheimer's Disease: Lessons From the Nun Study

Measles: What's The Harm?

"In the case of measles we have a highly contagious virus that is a leading cause of death and disability in young children. Fortunately, it is also completely preventable with a simple and effective vaccine. As the WHO points out – this is one of the most cost effective and highest benefit-to-risk ratio health interventions that humans have devised. The world-wide vaccine campaign has saved an estimated 17.1 million children deaths from measles in the last 14 years.

"Denial of these facts, and fear-mongering about vaccines, directly results in the death of children."

Measles More Deadly than Previously Thought

Placebo Effect Updates

"'Given the enormous societal toll of chronic pain, being able to predict placebo responders in a chronic pain population could both help the design of personalized medicine and enhance the success of clinical trials,' said Marwan Baliki, PhD,  a research scientist at RIC and an assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine."

Placebo Effect is All in Our Heads  

"In a sense both Pauletich and Mödl participated in a performance, one that we humans have been engaging in for thousands of years, every time we go to healers with the hope that they can make us feel better. And just as a good performance in a theater can draw us in until we feel we’re watching something real, the theater of healing is designed to draw us in by creating powerful expectations in our brains. These expectations drive the so-called placebo effect, which can affect what happens in our bodies as well. Scientists have known about the placebo effect for decades and have used it as a control in drug trials. Now they are seeing placebos as a window into the neurochemical mechanisms that connect the mind with the body, belief with experience."

Unlocking the Healing Power of You 

Why do Placebos Work?

A Legitimate Physician Answers A Question From A Patient In A Book

"By clinging to delusion, belief in alternative medicine denigrates the very wonder of science and medicine and the massive strides we as a species have made over the last century or so in understanding the world around us, and how our bodies work."

Dr. Richard Rawlins Reveals the Real Secrets of Alternative Medicine

Medical Screening And Overdiagnosis

"In the end, science can never really fully answer whether a woman should undergo mammography or whether mass screening programs are worthwhile, be they for breast cancer, prostate cancer, or other diseases. The reason is that, no matter how much science is brought to bear, there will be no escaping that the final decision will boil down to a value judgment informed by the science and that, because, contrary to what Dr. Kopans has suggested in the past, we can’t do a randomized clinical trial of mammography any more because there would not be clinical equipoise, In the US, we are very pro-screening, but that doesn’t necessarily mean that our care is better."

A lengthy article, but worth the read.  This topic does not have black and white answers.

Mammography and overdiagnosis, revisited

When is the Best Time to Get A Flu Shot?

"It has been said for years that the best time to get the flu shot is between Halloween and Thanksgiving. With the widespread timing of flu season and the unknown duration of antibodies, it's hard to say whether a few weeks will make a difference. But, if you are older (80% - 90% of flu-related deaths occur in people older than 65) it's probably best to stick to the standard recommendation of early November and have as many of those antibodies at the ready come February. But, if it the choice is getting the flu shot now or letting it drop down on your 'things to do' list until it falls below 'organize closet'.... go out and take care of it. Oh - and be sure to pick up a bottle of shampoo while you're there."

Link

Evidence, Clinical Expertise and Patient Preferences

"I could go on with multiple other examples, but the point remains. For the vast majority of cancers, intensive screening after curative treatment does not result in prolong survival, and, even when there is evidence that it does, such as in colorectal cancer, the survival benefit reported is variable and at best very modest. That means that the overall message to oncologists for most cancers is: Don’t be ordering CT scans every six months or following tumor markers every three months. It’s a viewpoint that oncologists have resisted but are finally coming around to. It’s also a viewpoint that is not popular with patients, as you will see."

 When science- and evidence-based guidelines conflict with patient wishes: What’s a doc to do?

Warning If You Have A Teething Baby

"Teething can bring sleepless nights full of non-stop crying. Although seeking out one of the teething products marketed to ease the baby's pain may be tempting - the U.S. Food and Drug Administration (FDA) is warning against it."

Stay Away From Homeopathic Teething Remedies Warns the FDA

A comment:  who would have thought that a homeopathic anything would be harmful?

Right To Try Movement Is Harmful

"Basically, the whole right-to-try movement is built on a delusion, namely that there is a river of cures to serious and fatal disease in the pipeline, but that the only reason they aren’t flowing to the people is because of the overly cautious bureaucracy and excessively burdensome regulations of the FDA. If the people could just get the FDA out of the way—or so the delusions go—cures would flow to the people, all courtesy of the magic of the free market, which will sort out problems with safety and efficacy."

The cruel sham that will not die: Right-to-try marches on in California and beyond

The Placebo Effect Gets More Scrutiny

"Hype about the 'amazing' placebo effect says more about the cultural appeal of the idea than it does about solid evidence supporting it. This is a troubling sign that an idea that resonates with experience and cultural meaning may be alluring enough to evade scrutiny, even among scientists. The best evidence indicates that the placebo effect is not a general phenomenon. But at some level it seems that evidence is beside the point; we simply want to believe. Perhaps belief in the placebo effect is itself the ultimate placebo effect."

The Myth of the Placebo Effect

How To Interpret The Results Of Animal Studies

“When people do studies in animals, you pay attention to them, but you don’t make any policy or any other conclusions related to that until you do good epidemiological observation in the human system.”

Don’t Make Policy Based on Animal Studies 

Low Back Pain Management

"Many people with lower back pain don’t manage it well because of wrong advice – and a lot of unhelpful myths about what back pain is and what you should do about it. Healthcare professionals all over the world speak to patients who think, for example, that back pain can damage their backs. This is not always the case. The weight of evidence shows that many assumptions made about lower back pain are wrong and, what’s more, could be harmful."

5 Myth About Lower Back Pain

Genetic Risk Testing

"This ties in with my recent article about prevention. It will be valuable to have more reliable estimates of risk. But it would be far more valuable to find effective ways of persuading all patients to take preventive action, not just the patients we think are at the highest risk."

Genetic Testing: Does Knowing Risk of Disease Make a Difference?

The Use Of The Hospital ICU And Its Value

"That greater utilization of ICU and invasive procedures increases cost without subsequent reductions in mortality is not an original conclusion, it’s really just a confirmation."

Why Use The ICU If It Doesn’t Improve Mortality?

HDL And Longevity

"A giant chunk of the public no longer trusts science, because scientists have not yet put epidemiology over with the social sciences and the humanities on the credibility scale. Using epidemiology, everything can both cause and prevent cancer."

I put medicine and health somewhere between the "Hard" sciences (i.e. physics, chemistry and biology) and the "Soft" sciences (i.e. social sciences, economics, politics and psychology).

High And Low Levels Of HDL Cholesterol Linked To Premature Death

The Problem With White Coats On Physicians

" - - - just like we don’t need a randomized trial to prove that parachutes save lives, we also don’t need a trial of white coats. The circumstantial evidence that many of them are covered in germs is sufficient."

Doctors, It’s Time to Hang Up the White Coats