Scientists are genetically modifying dairy cows to reduce the production of allergens. Sorry for the bad pun.
Allergy shots remain the most effective treatment for allergic rhinitis and allergic asthma. Nothing else gives the same magnitude of benefit or promise of prevention
In a placebo controlled study, probiotics given to infants did not result in fewer allergic complications at age 5. The non-statistically significant trend was actually for more eczema in the probiotics group. Oops. There’s now a pretty good body of literature on probiotics and allergies, and the weigh of it supports a lack of effectiveness for probiotics. I still like peach yogurt for breakfast, though.
Four types of drugs are responsible for 70% of hospitalizations due to adverse drug reactions.They are: warfarin(a blood thinner), insulins, oral diabetic medications, and anti-platelet blood thinners. Scary number, but a very good and reasoned analysis in the linked article.
Antibiotic use is highest in the South. Not coincidentally, we also have the highest rates of antibiotic resistance. I wrote a blog post about this four years ago. Apparently things haven’t changed that much. Patients expect doctors to do something for them and doctors are afraid to make patients angry. If we both don’t start changing our behavior, bad things are going to happen.
An astonishing 20% of antibiotic prescriptions are written to treat sinusitis, and they probably don’t even work. As an allergist, I can tell you, dear reader, that much of what is diagnosed as sinusitis is actually allergies. If more people had their allergies properly diagnosed and managed, then the rate of unnecessary antibiotic prescribing would plummet. As a specialty, allergists and our governing bodies need to do a better job educating the public on this issue.
Spirometry on your iPhone? Researchers at UW have created an app that measures tracheal sound wave resonance (I’m not even pretending to know what that means) to determine air flow. They claim it is accurate to within 5% of existing devices. If that’s true it would be an amazing advance in treating asthma. Having had lots of experience with Siri and autocorrect, I’m still a bit skeptical.
Do mild asthmatics do just as well on intermittent steroids? This is an article that kind of scares me. The headlines and first few paragraphs talk about fewer medications, billions in cost savings, and adults being “freed” from daily dosing, which is all great, but the details of this study are very important.
The researchers divided 340 patients into three groups: daily inhaled corticosteroid (ICS) therapy, ICS dose adjustment based on nitric oxide, and ICS treatment only when symptomatic. All the groups had similar outcomes. One of the study authors goes on to suggest that the asthma guidelines should be changed to allow for intermittent ICS treatment in mild asthmatics.
Not so fast my friend. Your study has some serious limitations.
First, this is a really small study. Each arm had only ~110 patients. Second, the study only ran for nine months. That too short an amount of time to capture exacerbations in a mild asthma population.
Editorial commentary on the study had much more tempered enthusiasm, stating “There is no compelling rationale to alter the current approach to inhaled corticosteroid dosing for mild or mild to moderate persistent asthma.” I agree. It is an interesting approach, but it needs to be studied in more patients for longer periods before recommending it as routine therapy. Stay tuned.
Taking NSAIDs after a heart attack will increase your risk of death from all causes and from heart disease specifically. I always thought that the Vioxx debacle would turn out to be a class effect and it looks like that might be the case. They throw around some big numbers (30% increased risk!) which I assume are relative risks, not absolute risks, which is a big difference. Cardiology studies are often like this. They have to power them with huge numbers, in this case 100,000 people, to find a statistical difference which, in absolute terms, is often quite small. The difference is this: 20% chance of heart attack to 50% is a 30% change in absolute risk. 1% chance of a heart attack to 1.3% is a 30% relative risk change. Ah, statistics.
Acupuncture works to control pain in some conditions. In other news, it feels really good when you stop banging your head against a wall. Notice that allergies and asthma are not among the conditions for which acupuncture might be effective. I’ve actually had acupuncture for back pain so I found this rather interesting.
I had an alternate tagline for this, but it was too inappropriate. Pot might increase your risk of testicular cancer.
Britain’s new health minister is a homeopathy advocate, among other things. Some of the royalty are into this sort of thing, so I guess this is politically expedient for him, but it’s still the quackiest of quackery.
Ultra-progressive Portland, Oregon still hasn’t fluoridated their water. Really? Is this 1955? I think the Communist Menace is long gone by now. Looks like the Portland city council is finally getting word of this.
Stanford organic food study is controversial. Said people who make money off organic food. And Consumer Reports, too, to be fair.
Hantavirus has killed two travelers in Yosemite National Park and sickened several others. Hantavirus is a relatively rare but nasty viral illness spread by rodents. It occurs largely in Western states. The World Health Organization is all over this and has advised travelers to “avoid exposure to rodents and their excreta.” Thanks for the tip, WHO.
U.S. healthcare system wastes $750 billion per year. That’s a staggering number. There’s no easy answer to this problem, but from a physician perspective I’d recommend a couple of things. Unnecessary services- $210 billion/year First, a universal health care database. Some folks will bristle at having the government store health information on them, but until this happens it will be very hard to reduce duplication. Second, give physicians “safe harbor” practice guidelines for areas of practice that are particularly litigious where defensive medicine drives up cost. If you are within these guidelines, then you cannot be sued for malpractice. As it stands now, a doctor doesn’t have to do anything wrong to get sued. This would eliminate many frivolous lawsuits and significantly lower cost without the need for Tort reform. Inefficient delivery of care ($130 billion); Excess administrative costs ($190 billion) Third, simplify medical billing and reimbursement. One of the reasons doctors have less time for patient interaction, is that we’re so consumed will filling out the chart properly, checking the appropriate number of boxes, and signing 6 pieces of paper for every patient. All this stuff is mandated for us to do by the insurance carriers who will deny payment if documentation is not perfect. If I could cut out “billing and coding specialists” and the insurance companies didn’t have armies of employees and even entire outsourced companies dedicated to trying to deny claims on the basis of documentation, then insurance costs would fall dramatically. It would also allow doctors to spend more time on patient care and less time being box-checking bean counters. Inflated prices ($105 billion) Fourth, limit “me too” drugs. Do we really need 12 different ACE inhibitors or 7 different nasal steroid sprays? Limiting the number of redundant medications would drive drug companies to truly innovate and lower prices on existing drugs.
It’s a start.
Inhaled steroids reduce final adult height. This study is consistent with prior studies showing that ICS can reduce height. Adults who received ICS therapy as kids were 1.2cm shorter on average. That’s about half an inch for the metrically challenged or about the length of a finger nail. Not much cause for alarm.
Organic food is not any healthier for you than non-organic. OH it’s about to get REAL in the Whole Foods parking lot. I do think many organics are tastier, especially meats and eggs, but the super high prices for organic foods may not be justified on the basis of health alone. As the grandson of a farmer, I still think buying local is good when you can.
Bronchial thermoplasty is a novel treatment for severe asthma. It can cost as much as $20000 (!), but in selected patients, that might be a long term cost savings, not to mention improving their health. It uses a heat probe to shrink the muscles surrounding the airways. You’ll hear more about this.
Moar evidence that LABA/ICS therapy is safe. Hello? FDA? I’ll keep banging this gong until they change the ridiculous labeling on LABA containing inhalers. Fortunately, it seems that physicians are continuing to do the right thing.
Americans agree with Paul Ryan on Medicare. Americans don’t agree with Paul Ryan on Medicare Is this the longest election ever?
Fitness is good for you.
Smoking pot can lower IQ. This is going to get a ton of play in the media. These Kiwis took IQ tests at 13 and again at 38. Those who smoked marijuana at least 4 times a week in adolescence and continued to smoke throughout their life saw an 8 point drop in IQ. I think that the conclusion that 25 years of hardcore pot smoking beginning in early adolescence is not good for you is reasonable. Either that or years of chronic Pink Floyd listening is harmful. This study will be (mis)quoted for years to come.