Harm Reduction

A new study estimates that adding an MRI test - a short-term cost in increasingly stretched government health care budgets - would yield savings because 27 percent of men could avoid an unnecessary biopsy and also reduce over-diagnosis by 5 percent. An over-diagnosis is when a patient is diagnosed with a cancer that does not go on to cause any harm during their lifetime.

Currently, over a million prostate biopsies are performed in both the US and Europe each year. They are scheduled when men experience symptoms of prostate cancer or have a prostate specific antigen (PSA) test showing high levels of the PSA protein in their blood. Yet prostate cancer can be aggressive or harmless and tissue samples taken at random cannot confirm whether a cancer is aggressive and may even miss...

Doctor checking BP

When we check our blood pressure, we usually do it in one arm or the other. But there is a good reason to check our blood pressure in both arms. A large difference in systolic blood pressure between arms – defined as ≥ 10 mm Hg - may be a sign of increased cardiovascular disease – and even the threat of death.

That is because when blood pressure is higher in one arm, it may be because of  narrowing in a blood vessel, called “artery”, in that arm.  The most common cause of blood vessel narrowing in the body is atherosclerosis (buildup of cholesterol); and, since atherosclerosis tends to affect blood vessels throughout the body, it can impede blood flow to vital organs like the heart and the brain, causing a heart attack or stroke. 

Mild Inter-arm systolic blood pressure...

Smoking is bad.  Bad for mom.  Bad for unborn and born baby.  Now, yet another study reveals its adverse effect on the developing child.  

This time the focus is the kidney and the resultant damage.  

Researchers from Kyoto University in Japan set out to clarify the association between smoking during and after pregnancy in the home with the risk of proteinuria at age 3 years old of the child.  

Proteinuria refers to the spilling of protein into the urine.  This can occur in a benign fashion when it is in trace amounts and due to orthostatic proteinuria (aka protein appearing in the urine upon standing due to a positional or postural shift).  When it is sustained and present in the urine in increasingly significant amounts, it can reflect underlying disease or...

 

“An aspirin a day keeps the doctor away” has been the mantra for prevention of cardiovascular disease (CVD) since the early 2000s, but that seems to be changing in some cases.

It is well documented that taking aspirin helps prevent the recurrence of heart attack, stroke, and other vascular events after they have already occurred - known as “secondary prevention”.  But there is debate over the benefits of taking aspirin in people without a history of prior cardiovascular disease - primary prevention.  The current consensus advocates using low-dose aspirin, for primary prevention, in certain high risk groups: those with advanced age, diabetes, high cholesterol, high blood pressure, smoking etc.  Not so, says a new ...

The United States Food and Drug Administration has informed Swedish Match, the makers of the snus tobacco product, that the product will not be designated as a Modified Risk Tobacco Product - MRTP. Last year, the FDA Center for Tobacco Products reviewed the "pre-market tobacco application" for snus and approved its continued sale in the U.S because the company showed it contains lower levels of harmful constituents than other smokeless products on sale in the United States. Had the MRTP application been successful, it would have allowed the Swedish...

A dangerous practice

It's now almost one year to the day that the Food and Drug Administration publicly recommended that teenagers be prevented from using tanning beds. It was a compelling and worthwhile statement based on science that would save thousands of young lives.

"Indoor tanning is a known contributor to skin cancer, including melanoma (its most deadly form), and other skin damage. Yet, 1.6 million minors indoor tan each year, increasing their risk of skin cancer and other damage," the agency stated on Dec. 18, 2015. "According to the American Academy of Dermatology, those who have been exposed to radiation from indoor tanning are 59 percent more likely to develop melanoma than those who have never tanned...

One of my extended family members is a former smoker. Nagging him to stop did little good. Warning him against its health dangers produced similarly poor results. He was addicted, and he appeared to like smoking, anyway. 

Then e-cigarettes came along. After giving them a try, he quit cigarettes for good. No nagging was necessary. He received the same kick from vaping minus all the nasty smoke that makes cigarettes so dangerous. His blunted sense of smell and taste returned to normal and breathing became easier. 

His story is not unique. Many former smokers credit e-cigarettes with changing their lives for the better. A study in the journal Tobacco Control concluded that...

If you are over the age of 50, your doctor has most likely advised you to get a colonoscopy- the gold standard procedure for early detection and removal of growths called polyps, that can potentially turn into deadly colorectal cancer (CRC).  But despite its proven effectiveness, the idea of getting a colonoscopy invokes dread and apprehension in many people.  Understandably, no one looks forward at the thought of drinking a gallon of gag-inducing bowel-prep and spending hours running to the bathroom, which is a prelude to having a tube inserted through the rectum and snaked through the entire intestinal tract, while a camera looks for suspicious growths.  It is actually not as terrible as it sounds.  In fact, the preparation is more unpleasant than the actual procedure which is done...

A new paper seeks to inform concerns about e-cigarettes, purportedly used as harm reduction and smoking cessation techniques, being a gateway to smoking.

The conclusion by Hongying Dai and Jianqiang Hao is that e-cigarettes, and especially flavors, do lead to both cigarette smoking and an unwillingness to quit. There is just one problem - there is no data showing that. (1)

Pediatrics is a good journal to be addressing this issue. The American Council on Science and Health has long shown that smoking is a pediatric disease. Like many other habits, if we prevent them in youth, we can prevent them throughout life. But we also...

"Merciless In Seattle: Untreated Pain, Misery, And Suicide" (November 2nd) examined the tragic suicide of Seattle resident Denny Peck, who had the misfortune of being dependent upon opioid drugs to manage his intractable pain that resulted from an accident that crushed part of his spine in 1990. When the pain clinic that had been treating Peck abruptly closed, he could not find a doctor who was willing to prescribe the drugs that made his life bearable. Two days following Peck's desperate, but futile call to 911, during which he maintained that he couldn't bear the pain anymore, Peck committed suicide by shooting himself in both side of his head. What happened to Peck is...