Posted in Access to healthcare, CDC, Disease Prevention, Education, Evidence-based Medicine, FDA, News From Washington, outcomes, outcomes measurement, Patient Choice, Patient Safety, Uncategorized, Unsettled Science

FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

The drug is currently approved for malaria and also for rheumatoid arthritis and systemic lupus erythematosus, which is its main use in the U.S. It’s therefore available to be prescribed off-label, and some clinicians have already said they’re using it on COVID-19 patients. But neither Hahn nor other task force members addressed whether enough hydroxychloroquine is on hand to treat large numbers of coronavirus cases. Convalescent plasma is another treatment the FDA is considering for COVID-19, said FDA Commissioner Stephen Hahn, MD.

Convalescent plasma and the immune globulin that it contains is another possible treatment the agency is considering, Hahn added. “FDA’s been working for some time on this,” he said. “If you’ve been exposed to coronavirus and you’re better — you don’t have the virus in your blood — we could collect the blood, concentrate that and have the ability, once it’s pathogen-free, to give that to other patients, and the immune response could potentially provide a benefit to patients. That’s another thing we’re looking at; over the next couple of weeks, we’ll have information and we’re really pushing hard to try to accelerate that.” Such treatments have been effective in Ebola, for example.

Source: FDA to Study Hydroxychloroquine for COVID-19 | MedPage Today

Posted in Disease Prevention, Nutrition, outcomes, outcomes measurement, Prevention, Uncategorized, Unsettled Science

Filter Coffee Tied to Lower Diabetes Risk in Metabolomics Study

Adults who drank two to three cups of filtered coffee a day (the highest quartile of filtered coffee–metabolite score) had a 58% lower risk of developing type 2 diabetes within 10 years than those who drank fewer than one cup of filtered coffee a day (lowest quartile) after adjusting for multiple confounders (odds ratio, 0.42; 95% confidence interval, 0.23 – 0.75).

The protective effect of drinking this high amount on the risk of developing type 2 diabetes was not seen with boiled coffee.

https://www.medscape.com/viewarticle/923238

Posted in British National Health Service, Disease Prevention, Doctor-Patient Relations, Education, Evidence-based Medicine, Medical conditions and illness, outcomes, outcomes measurement, Patient Compliance, Patient Safety, Patient-centered Care, Prevention, Protocols, Quality, Uncategorized, Unsettled Science

Watch “Evidence Based Medicine Has Been Hijacked by Dr Aseem Malhotra | PHC Conference 2019” on YouTube

Insightful and fascinating glimpse into how medical science has been, and continues to be, distorted by special interests and ideological cabals to the detriment of patients.

Posted in Disease Prevention, Education, outcomes measurement, Patient Safety, Policy Issues, Uncategorized, Unsettled Science

All Young Cannabis Users Face Psychosis Risk

mscp-logo6910823767906072364RI-CLPMs use a multilevel approach to test for within-person differences that inform on the extent to which an individual’s increase in cannabis use precedes an increase in that individual’s psychosis symptoms, and vice versa.

The approach provides the most rigorous test of causal predominance between two outcomes, said Conrod.

“One of the problems in trying to assess a causal relationship between cannabis and mental health outcomes is the chicken or egg issue. Is it that people who are prone to mental health problems are more attracted to cannabis, or is it something about the onset of cannabis use that influences the acceleration of psychosis symptoms?” she said.

The study revealed statistically significant positive cross-lagged associations, at every time point, from cannabis use to psychosis symptoms reported 12 months later, over and above the random intercepts of cannabis use and psychosis symptoms (between-person differences). The statistical significances varied from P < .001 to P < .05.

Cannabis use, in any given year, predicted an increase in psychosis symptoms a year later, said Conrod.

A limitation of the study was that cannabis use and psychosis symptoms were self-reported and were not confirmed by clinicians. However, as the authors note, previous work has shown positive predictive values for such self-reports of up to 80%.

Commenting on the findings for Medscape Medical News, Robert Milin, MD, child and adolescent psychiatrist, addiction psychiatrist, and associate professor of psychiatry, University of Ottawa, said…”The study is at the forefront because it is specifically looking to measure psychosis symptoms and cannabis use in adolescents, and the model they are using strengthens the study,”

That model uses “refined measures or improved measures to look at causality, vs what we call temporal associations,” he said.

Posted in Disease Prevention, FDA, Government Regulations, outcomes, Patient Safety, Policy Issues, Uncategorized, Unsettled Science

Is the Sunscreen Scare Legitimate?

But just because something gets into your body doesn’t mean it’s bad for you. I know these compounds have chemical names, but the assumption that artificial compounds are worse for you than all of the other stuff we put in our bodies is known as the “naturalistic fallacy.” By way of comparison, the average blood level of caffeine after a cup of coffee is 50 times higher than the peak concentration of oxybenzone seen in this study. But that oxybenzone level is about seven times higher than the blood nicotine level seen after smoking a cigarette.

In other words, the fact that you can measure something in the blood doesn’t tell you anything about whether it is bad for you. We simply don’t know what the risk is. And we need to find out.

Personally, I wouldn’t call for a freeze on chemical sunscreens. These drugs have been used for decades and there have been no strong epidemiologic signals of harm. Quite the opposite, they have probably prevented uncounted cases of skin cancer.

The problem with studies like these is that the fear they engender may do more harm than the good science that results from them. Nothing has changed about the harm of UV rays since the publication of this study in JAMA; you still don’t want your skin exposed to them.

https://www.medscape.com/viewarticle/913130

Posted in Education, emotional intelligence, Free Society, Philosophy, Stress, Technology, Uncategorized, Unsettled Science

How Would Dostoevsky Have Responded to the Smartphone? | Intellectual Takeout

“The proliferation of digital technology has created an interesting paradox: devices that were designed to connect people have coincided with increasing rates of isolation, with nearly half of Americans reporting feelings of loneliness. Gen Z, the generation that has grown up immersed in a culture of communication technology, has fared the worst.

It turns out that this paradox of isolation and connection is nothing new. Fyodor Dostoevsky observed a similar trend in his own day. In Dostoevsky’s work, Brothers Karamazov, Father Zosima describes the isolation of Russian society in the late 1800s: “We are assured that the world is becoming more and more united, is formed into brotherly communion, by the shortening of distances, by transmitting of thoughts through air.”

Do not believe them, he tells us. According to Dostoevsky, the seeming connectedness of Russia at the time was only a thin veneer covering the reality of a deeply isolated and lonely society. Another character in the book explains:”

[Isolation is] that which is now reigning everywhere, especially in our age… For everyone now strives most of all to separate his person, wishing to experience the fullness of life within himself, and yet what comes of all his efforts is not the fullness of life but full suicide, for instead of the fullness of self-definition, they fall into complete isolation. For all men in our age are separated into units, each seeks seclusion in his own hole, each withdraws from the others, hides himself, and hides what he has, and ends by pushing himself away from people and pushing people away from himself….

Source: How Would Dostoevsky Have Responded to the Smartphone? | Intellectual Takeout

Posted in outcomes, Uncategorized, Unsettled Science

Probiotics Work for Kids With AGE, Right? Not so Fast!

There was little difference in the numbers of children in each group who developed moderate to severe AGE by day 14 (11.8% of the treatment group vs 12.6% of the placebo group). Differences in the secondary outcomes were also minimal. For example, the duration of diarrhea was 54.3 hours (medium) in the treatment group vs 52.4 hours in the placebo group. The duration of vomiting was essentially 27 hours in both groups. A total of 4.8% of the treatment group vs 4.5% of the placebo group required hospitalization for their illness, and 59.2% of both groups were febrile.

Source: Probiotics Work for Kids With AGE, Right? Not so Fast!

Posted in American Presidents, Education, Evidence-based Medicine, Free Society, Government Regulations, Medical conditions and illness, outcomes measurement, Pain, Patient Choice, Patient Safety, Policy Issues, Prevention, Quality, Rule of Law, State Medical Boards, Unsettled Science

Opioid Policy: The Devil and the Deep Blue Sea | Medpage Today

Great insight and perspective by Heath McAnally, MD, MSPH, regarding the sometimes reactive, albeit good intentioned, response of gov’t and private entities to the opioid crisis.  Worth the read for sure.

Pendulum swings in medicine aren’t new, but damping the oscillation rarely bears such urgency. To paraphrase the original document, we call on our leaders to:

  • Recognize that opioid tapering requires evidence-based careful selection, patient-centered methods, realistic goals, and close monitoring for adverse events.

  • Include the expertise of pain management subspecialists at every level of decision-making about future opioid policies and guidelines.

  • Put a halt to policies forcing opioid tapering/cessation outside the contexts of diversion or unequivocal, documented harm: benefit ratio imbalance

Dr. McAnally is a board-certified anesthesiologist, pain physician, and addictionologist practicing in Alaska (the military sent him there and he decided to stay). If he wasn’t trying to guide people in improving their own lives, teaching medical students to do the same, or writing about it, he’d probably be outdoors right now slogging up a mountain with a good friend or two.

Source: Opioid Policy: The Devil and the Deep Blue Sea | Medpage Today