Category Archives: Medicine

Thrombotic Thrombocytopenia Associated With the AstraZeneca Vaccine

The COVID-19 vaccine developed by AstraZeneca (AZ) has been widely used in Europe, but not in the US. Its technical nomenclature is a recombinant adenoviral vector encoding the spike protein antigen of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (ChAdOx1 nCov-19. Not long after the introduction of this vaccine cases of clots associated with low…


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One Flu Over the Cuckoo’s Nest

There are books abut white fragility which get a lot of attention, both pro and con. Someone needs to write a tome entitled Fragility without any modifier. The pandemic now stalking the world is not the one caused by a newish virus, it’s the one due to a fervid worldwide outbreak of the woollies and…


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Brief Medical Updates

Three recent medical reports. The first is from Science. A conference held by Biogen in February of this year was a superspreader event. Phylogenetic analysis of SARS-CoV-2 in Boston highlights the impact of superspreading events reports the spread of SARS-CoV-2 following an international business conference in at the Marriott Long Wharf on Feb 26-27. By…


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Asymptomatic Subjects Do Not Transmit the Coronavirus

Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China is the title of a paper published in Nature Communications. First, a few caveats. The article is from China and its content was obviously scrutinized by a repressive regime before it was allowed publication in a western journal. Second, Nature Communications is…


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Effectiveness of Masks

Those who advise, sometime with the threat of jail time, that everyone use masks as a palliative against the coronavirus are usually the same who proclaim that we should follow the science. Well, when it comes to masks and the current pandemic there isn’t much science. The Annals of Internal Medicine has just published Effectiveness…


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Why Nothing is Hardest

Nothing is harder than doing nothing, especially when it’s the best alternative among a pack of difficult choices. Medicine’s prime commandment – Primum non nocere – often requires that the physician refrain from treatment when the remedy is worse than the malady. While the maxim is endlessly preached, it is rarely observed. The urge to…


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Diet and Physical Activity

The American Cancer Society recently released its guidelines for diet and physical activity. As is typical for these sorts of dicta, there are multiple authors (more than 20) not one of whom is a physician. The guidelines can be shortened to if it tastes good, don’t eat it. If it has any amount of alcohol…


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The Stethoscope

A reader suggested that I write about the stethoscope. At first, I wondered if such an article would have much interest to a general audience; but then I realized that there was a lot to say about this instrument that might have wide appeal. The stethoscope was invented by one of the epochal figures of…


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Thoughts on the 1918 Flu and COVID-19

A little over a century ago the most lethal epidemic in human history began. It was caused by a virulent form of the H1N1 influenza-A virus. It’s origin is uncertain. Originally thought to have first appeared in Kansas, it may even have originated in China. Regardless of where it started it rapidly spread throughout the…


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NSAIDs and Pregnancy

Non-steroidal anti inflammatory drugs (NSAIDs) are used by millions of patients. They act by inhibiting the enzyme cyclooxygenase (COX) which facilitates the formation of prostaglandins and thromboxane. The enzyme has two forms: COX-1 and COX-2. They mediate inflammation and pain by simulating prostaglandin synthesis. All the NSAIDs available in the US save one inhibit both…


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