Category Archives: Medicine

Life Expectancy in the Elderly

Tweet Americans have a lower life expectancy than people in other developed countries. This lower longevity has been often used to disparage medical care in this country as being inferior to that of other similarly advanced nations.  Such an accusation is made acute by the high cost of American medical care – the highest in the…


Read the full entry

Statins For the Primary Prevention of Cardiovascular Disease

Tweet The use of statins (drugs which lower blood cholesterol) for the primary prevention of CV disease has been controversial since the drugs became available almost 30 years ago. Primary prevention is the prevention of a disease which the patient does not have, eg a stroke or a heart attack. Secondary prevention is the prevention…


Read the full entry

AAA Screening

Tweet About 4% of men and 1% of women over the age of 65 have an abdominal aortic aneurysm (AAA). When this aneurysm ruptures the mortality rate is about 80%. Thus it is not surprising that screening for this condition in patients (mostly men) with abdominal ultrasound has become prevalent over the last decade or…


Read the full entry

In Outer Space

Tweet The popular press has picked up on a story about cosmic rays and cardiovascular disease in astronauts who landed on the moon. The Voice of America has a particularly breathless account of a study, Apollo Lunar Astronauts Show Higher Cardiovascular Disease Mortality: Possible Deep Space Radiation Effects on the Vascular Endothelium, published in the…


Read the full entry

Salt, Science, and Politics

Tweet Salt is in the news again. Thomas Frieden the head of the CDC published an article in the JAMA innocuously titled Sodium Reduction—Saving Lives by Putting Choice Into Consumers’ Hands. It more closely resembles propaganda than science. It argues that reducing dietary sodium intake to 1200 mg/day or less will lower the incidence of…


Read the full entry

96-year-old Dr Henry Heimlich Does His Eponymous Maneuver For the First Time

Tweet This one is too good to pass on. Retired surgeon Henry Heimlich performed for the first  time the maneuver he invented at the retirement center in Cincinnati that his home. “When he heard that a resident was choking, Perry Gaines, maître d’ for the Deupree House dining room, ran toward the table. Gaines has been…


Read the full entry

When to Start Dialysis in Patients with Acute Kidney Injury

Tweet When to start renal replacement therapy in patients with AKI has been a serious and incompletely answered question for as long as dialysis has been available to treat it. The seriousness of this disorder derives from its frequency, associated mortality, and cost. The JAMA contains a new study, Effect of Early vs Delayed Initiation of…


Read the full entry

End Stage Kidney Disease: Costs and Treatment

Tweet About 1 million people  in the US have End Stage Renal Disease (ESRD). Treatment is divided roughly 70/30 between dialysis and kidney transplantation. The annual cost of the ESRD program, almost all of which is funded by Medicare, is more than $48 billion. It costs about $89,000 a year to care for a dialysis patient….


Read the full entry

Alcohol and Pregnancy

Tweet The CDC issued  a recommendation today that “Women of childbearing age should avoid alcohol unless they’re using contraception, federal health officials said Tuesday, in a move to reduce the number of babies born with fetal alcohol syndrome.” From a USA Today story which reported the advice as a new study. The CDC did not…


Read the full entry

British National Health Service Faces Financial Crisis

Tweet NHS faces biggest financial crisis ‘in a generation’ is the headline of an article published in The Telegraph. The NHS has a deficit of about £1 billion in just the first three months of its fiscal year. You can read the linked article to see the usual excuses offered when a government health program exceeds…


Read the full entry

Categories