Category Archives: Medicine

New Blood Pressure Guidelines – Think First

Tweet The press with an assist from the American College of Cardiology is trying to drive the American public crazier than it usually is. Here’s a quotation typical of those floating around the media: “Nearly half of Americans have high blood pressure under the new guidelines issued Monday by heart organizations and the medical community….


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The Gene – Book Review

Tweet That children share traits with their parents, grandparents, and siblings has been recognized since antiquity. How these traits were transmitted remained a mystery for more than two millennia. Unmasking this process has been the greatest scientific discovery since man discovered fire. Siddhartha Mukherjee has written a history of this entire process – The Gene:…


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Medical Rationing in the UK

Tweet A sizable, but likely still a minority, of the population seems to think that the federal government should have sole responsibility for the funding and delivery of medical care in the US – ie, a single payer system. Many, if not, most people make up their minds about the provision of both medical care…


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Random Thoughts on Addiction, the Stock Market, and Gerbils on a Wheel

Tweet Having changed the definition of sex, gender, marriage, pronouns, speech, health, victory, defeat, money, bullying, poverty, success, dress, fake news, children, and height, I thought a few ruminations on smoking, addiction, and whatever free association could bring to mind might fill a few paragraphs. On Friday July 28 the FDA announced a comprehensive regulatory…


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Don’t Look Back

Tweet The most poorly managed institution in modern western society is the hospital. I say this after half a century of steady exposure to hospitals of all sorts. I was a student, resident, fellow, staff member, section chief, department chair, chief of staff, and even a patient. Inertia at all levels was unconquerable. Newton’s first…


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The Charlie Gard Case

Tweet By now almost everyone has heard of the the Charlie Gard case. The issue at its core is much simpler than any of the accounts that I have read of the plight of this child and his family. Medically the case is straightforward. The child suffers from a rare metabolic defect that has destroyed…


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The Opioid Epidemic

Tweet There seems to be no end of mischief that the government can do when it plunges into the quicksand of American medicine. Let’s consider the opioid epidemic. It appears that deaths from opioid overdose have sharply increased in this country.  Let’s also grant that this surge in deaths is exactly the way it’s portrayed…


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More Uncertainty about Cholesterol and Cardiovascular Disease

Tweet Cholesterol and lipid metabolism used to simple. There was good (HDL) cholesterol and bad (LDL) cholesterol. Eat a diet low in cholesterol and fat and your blood vessels will be as open as a new straw. On the basis of very little solid scientific information a litany of assumptions was issued by both the…


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Statin Therapy in the Elderly and Quality vs Cost

Tweet The JAMA published a study online which examines the Effect of Statin Treatment vs Usual Care on Primary CV Prevention Among Older Adults. The full paper is below as a pdf file. I’ve written about the overuse of this type of cholesterol lowering drugs in the primary prevention of cardiovascular disease several  times. Primary…


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Gene Therapy for Sickle Cell Disease

Tweet Sickle Cell Disease is a disorder of hemoglobin production secondary to an alteration in the hemoglobin gene on chromosome 11.  Specifically, there is a single amino acid substitution in “adult” β A -globin (Glu6Val) stemming from a single base substitution (A→T) in the first exon of the human β A -globin gene. The abnormal…


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