Medicine and Pharmaceuticals

Dr. Cox: Did you actually just page me to find out how much Tylenol to give to Mrs. Lendsner?

J.D.: I was worried that it could exacerbate the patient's... 

Dr. Cox: It's regular strength Tylenol. Here's what-chya do: Get her to open her mouth, take a handful, and throw it at her. Whatever sticks, that's the correct dosage.

Of Dr. Cox's many rants on the comedy show Scrubs, this is definitely one of the funnier and more memorable1. However, it isn't quite accurate.

Tylenol (a.k.a. acetaminophen or paracetamol2), unbeknownst to many, is actually a fairly toxic drug. Its ubiquity has lulled us into a false sense of security about its safety. But as our resident chemist Dr. Josh Bloom...

A number of recent headlines imply a case study just published in the New England Journal of Medicine proves that gene therapy has cured sickle cell disease—a genetic disorder that incurs tremendous pain, suffering and diminished life expectancy. Here, we will unpack the significance of the researchers’ findings.

First, let’s address why this news could be so groundbreaking to those afflicted and their loved ones.

Sickle Cell Disease is an inherited condition that causes a mutated hemoglobin—the protein within red blood cells (RBCs) that carries oxygen for delivery to vital tissues. Oxygen feeds our organs so they can stay healthy and perform their respective jobs. This Hemoglobin S (aka Sickle...

For the millions of Americans who have interrupted sleep because of frequent trips to the bathroom, a new drug may provide some relief.

The U.S. Food and Drug Administration recently approved Noctiva (desmopressin acetate) - the first treatment for the condition nocturnal polyuria - the overproduction of urine during the night. Although making a bathroom break at night may not seem on the front lines of medical concerns, roughly 80 - 90% of octogenarians report it as a problem. The disrupted sleep has downstream effects - an increase in daytime sleepiness, depressive symptoms, cognitive dysfunction, and a general decrease in the quality of life. 

There are two broad reasons why people end up needing to use the bathroom at night. First, their bladder may not empty properly...

In Did Pompe Disease Get a New Champion in President Trump?, I discussed the significance such a spotlight as a presidential address in front of Congress and the world can have on so rare a disease. Despite the fact these types of “Orphan Diseases” individually impact small populations, collectively they affect 25 million Americans. 

Now, we will dive into why they are so important to understand, raise awareness about and divest resources for in order to advance therapeutic and potentially curative research.

Inborn Errors of Metabolism reflect a host of rare, genetic disorders that can be devastating, fatal and, in certain instances, if not swiftly detected in...

The squeaky wheel often gets the grease but sometimes wheels get an impassioned champion - and that is just as good. That may have happened with Pompe disease when President Trump, addressing a joint session of Congress, highlighted the presence of 20-year old Notre Dame sophomore Megan Crowley, who is afflicted with it.

Pompe disease results from mutations in the GAA gene which result in the inability of the body to break down the complex sugar called glycogen. That resulting buildup, especially in muscles, prevents them from functioning normally.

It's an inherited disease and relatively rare. According to the National Institutes of Health, Pompe disease affects about 1 in 40,000...

Just in time for the President's Address To Congress (a State of the Union, but since he has only been in office a few weeks, a new president doesn't use that term) the Every Child By Two health advocacy group has released a new "State of the ImmUnion" report, to remind people of the importance of immunization.

It's easy to take it for granted now, because a lot of communicable diseases are relatively rare, but among Baby Boomers almost everyone knows of someone with polio. And measles kills far fewer than ever, thanks to vaccines. But anti-vaccine beliefs, which were for most of this century just the domain of fringe kooks on one side and a lot of wealthy...

Two studies on surgeons published in the last month may be instructive on how patients find physicians. First, a report in JAMA Surgery from January by Ziemba et. al Consumers Preferences and Online Comparison tools used for selecting surgeons. The study looked at 25,000 households using a net based survey, with a median age of 50 and predominantly white (73%), female (63%) and 70% had at least one health issue. Let's start with some bad news, how often did they use a search tool to seek a physician? For a primary care physician, 21% of the time; for a surgeon, 7% of the time - that makes sense because we rarely seek surgery as our primary approach to a problem. But to put it into perspective these households searched for...

Sadly, the news outlets just reported the seemingly untimely passing of actor, Bill Paxton, at the age of 61. Losing a loved one is a devastating event and we wish his family peace during this especially difficult time.   

In a family statement, it was revealed he suffered surgical complications. 

Thankfully, with modern medical advances so many procedures that once carried great risk can be performed today with minimally invasive techniques that are safer and prompt speedier recoveries. And, most of the time, people —especially when otherwise healthy— do quite well.

Unfortunately, for all of us no matter our health status, there can still be a consequence or adverse event whenever surgery and anesthesia are involved. Even in the hands of the best surgeon, staff...

In 1965, when Medicare made its appearance, physicians would send bills for their "usual and customary charges” and it quickly became apparent that usual and customary allowed a far greater range of charges than President Johnson and his team had anticipated – there was significant variation in ‘fees’ and they were unrelated to quality, effort, specialty or geography.

To standardize doctor’s fees and their costs, Medicare commissioned a study by Harvard who got assistance from the American Medical Association (AMA.) They came up with the resource-based relative value scale (RSRVS) which defined the work effort and expenses in, at that point, well over 7,000 physician services. For any given service, a doctor’s...

Right now, 300 Austrian ticks are part of an interesting experiment. They are biting through a skin-like membrane for science, because they secrete a cement-like substance with excellent adhesive properties.

The sticking power of ticks is well known, but most people believe it's just mechanical. This is the belief because you turn a tick counter-clockwise to remove it, the opposite of the rotation that drilled in, but prior to that they produce a "tick cement" that anchors them. Lots of organisms, from bacteria to fungi to large animals to plants use chemical and mechanical ways to attach themselves to surfaces. But for human use they would have to function over a temperature range, in wet environments, and to challenging surfaces. And then there is the cultural issue. We can't...