Category Archives: Medicine

No Time For Patients – ICD 11 and the Banality of Evil

Tweet Talk to your doctor and ask about how much time is spent on the 21st century’s version of paperwork. Also ask about the sense of satisfaction he gets from spending more time in front of a computer than he does interacting with his patients. Having just been confronted with with ICD 10, which contained…


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The First Medical Harvey Award

Tweet The MHA is named for Harvey Kurtzman (no relation) the  founder and first editor of Mad magazine. This award is not to be confused with the Harvey Awards for achievements in comic books. It (the MHA) is given to the authors of any paper in the scientific literature (not including the Journal of Irreproducible…


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CMS – Proposed New Physician Fee Schedule

Tweet If you think health care is expensive now, wait until you see what it costs when it’s free PJ O’Rourke CMS (the federal agency that runs Medicare and Medicaid) is proposing a new physician fee schedule. The three page article that summarizes the proposed changes is hard for my ossified brain to decode, so…


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Type 1 Diabetes Mellitus and an Artificial Pancreas

Tweet Clinical endocrinology can be defined in one sentence. It is the study of diseases that are characterized by too much or too little of a hormone or by over or under responsiveness to a hormone. That’s it. The rest is detail. Type 1 diabetes is due to the lack of insulin secondary to autoimmune…


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Folic Acid and Psychosis

Tweet The Journal of the American Medical Association has a paper thus far only published online – Association of Prenatal Exposure to Population-Wide Folic Acid Fortification With Altered Cerebral Cortex Maturation in Youths – that is both interesting and a big stretch. Government mandated folic acid fortification of enriched grain products has been in force…


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Materia Medica

Tweet Two new studies that reinforce old points. The first is from the JAMA (Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality ): Question  What is the effect of an invitation to a single prostate-specific antigen (PSA) screening on prostate cancer detection and median 10-year prostate cancer mortality? Findings  In this randomized clinical trial comparing men…


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World Health Organization to Issue New Dietary Recommendations

Tweet The WHO has issued draft recommendations that advise less consumption of saturated fats and trans fats. “Dietary saturated fatty acids and trans-fatty acids are of particular concern because high levels of intake are correlated with increased risk of cardiovascular diseases,” Dr. Francesco Branca, Director of WHO’s Department of Nutrition for Health and Development, told…


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Dr. Donald W. Seldin, ‘intellectual father’ of UT Southwestern, dies at 97

Tweet Dr Seldin died April 25, 2018 at the age of 97. I was one of thousands of physicians whose life and career was shaped by this great man. The article below is the tribute to him that was published by Southwestern Medical Center, the institution that he devoted his life to and which was…


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Lies, Damn Lies, and Statistics

Tweet An understanding of statistics is essential if a physician, or any interested party, is to understand the medical literature. Alas asking a typical doctor to evaluate statistical data is like giving a scalpel to an accountant and asking him to perform a coronary bypass. My last post on sodium intake gave an example of…


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The Salinity Obsession

Tweet Many physicians and those charged with regulating the nation’s health have been obsessed with salt since Lot’s wife was transformed into a pillar of the stuff. On March 7, 2018  the JAMA published online a well performed study of sodium intake, the investigators used 24 hour urinary sodium excretion as a marker of intake, which…


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