Medicine and Pharmaceuticals

I hope you enjoyed Part I of the "Brain Tumors: Fact vs. Fiction" series.  

Welcome to the concluding piece where I continue to enlist Dr. Gregory Riggins, Professor of Neurosurgery and Oncology and Director of the Brain Cancer Biology and Therapy Research Laboratory at Johns Hopkins, to help clarify myth from reality:

 

Why is location so critical to a patient's success?  

Dr. Riggins:  Location is critical and the location – along with the neurosurgeon’s skill - dictates how much can be removed, and whether removal will on average...

In this week's Annals of Internal Medicine, doctors Peter A. Ubeland and Peter B. Bach have written an opinion piece entitled Co-pay Assistance for Expensive Drugs: A Helping Hand That Raises Costs. You may remember Dr. Bach from his previous attempts to draw attention to this issue last year. I have written previously about the reality underlying co-payments for both drugs and other therapies. The authors make the following points:

Drug costs are one of the fastest growth components of health care and out of pocket drug costs have kept...

Beau Biden, son of Vice President Joe Biden, died from brain cancer.  As did Senator Edward “Ted” Kennedy.  Brittany Maynard - suffering from a terminal type - became widely known for fighting for her right-to-die.  

Aside from the occasional high profile cases and Hollywood movies, brain tumors rarely make center stage.  And, when they do, it tends to be the most ominous story that gets told.  

Fortunately, there is variability in diagnoses and early discovery can better your chances with certain forms.  Benign (aka not cancerous) masses are common.  As I have previously emphasized, however, location is crucial to many disease states.  When it comes to the brain and tumors, prime real estate exerts tremendous influence on operability, survival, and impairments.  So does...

Algorithms are a set of rules or calculations that computers use in making decisions. Unlike neural network programs, which often are too complex for its programmers to understand (implicit), explicit algorithms are code that can be understood. Algorithms are everywhere and have become the topic of an on-going series by Pro Publica. Pro Publica series began by concentrating on a program written to advise courts on recidivism. But given the ubiquitous nature of algorithms, they have moved on to look at what big data and it's algorithms know about you from...

Don't worry. You'll feel better soon.

By any measure, the opioid addiction epidemic was (and still is) a huge mess. For years, doctors and dentists were too lax in prescribing narcotics, paper prescriptions permitted drug seekers to "doctor shop," and quite a few people got addicted. Many of them died. Clearly, something had to be done.

"Done" turned very quickly into "overdone." It is now increasingly difficult to get strong pain medications when you really need them—even for short-term use. Some oral surgeons are even considering giving their patients Advil (ibuprofen) rather than Vicodin following a surgical procedure. This is especially barbaric since oral surgery is notoriously painful. Perhaps an oral surgeon or two with this mindset should get a bone graft or have an impacted wisdom tooth removed and be sent...

When some of the public hears about vaccines today, they may think of Andrew Wakefield's fraudulent links to autism or Jenny McCarthy’s use of her Hollywood megaphone to polarize the issue as well as encourage the spread of an anti-vaccine movement.  

Truth be told, for a time public opinion did shift and philosophical exemptions boomed, primarily in states like California, Washington, and Oregon. Preventable diseases blossomed. 

As science stood largely silent, Dr. Paul Offit - Chief of Infectious Diseases and the Director of the Vaccine Education Center at Children’s Hospital of Philadelphia (CHOP) and long-time trustee and supporter of the American Council on Science and Health - took to the helm to fight the noble battle on behalf of children’s health and safety.  He...

What goes up must come down.  There is no top without a bottom.  Two sides to every coin.  No front without a back.  A lid without a pot.  My cliche list is endless.  So, I will stop torturing you.

Just know, most arise from kernels of truth.

Alcohol is good and bad.  Makes some happy.  Others sad.  Amplifies joy.  Or, exacerbates decline.  It alienates.  It coalesces.  De-stresses and stresses.  It calms.  It kills.

You are the variable.  As is the dose.

Is ‘Moderation’ sexy? 

For those whose health benefits from moderate drinking exceed their drawbacks, it is.  Like most things, there are no absolutes or guarantees. No one size-fits-all.

According to the...

Enthusiasts of the supplement kratom, derived from the leaves of the Mitragyna Speciosa tree, have been giving the DEA, the FDA and us a hard time lately, in the case of the government because they want to ban it  due to a huge surge in poisonings and in our case since we called for the substance to be regulated just like any other drug. Some supporters don't even believe that it is a drug, but it certainly is. Here's why.

First, the definition from the FDA website (emphasis mine):

"A drug is defined as: A substance recognized by an official pharmacopoeia or formulary. A substance intended for use in the diagnosis, cure, mitigation...

Pharmaceutical companies, never America's darlings even on a good day, have been hammered mercilessly over the past few months, starting with the vile Martin Shkreli, followed by the scoundrels at Valeant, who objected rather vehemently when I referred to them as being one step below head lice on the food chain of life

Then it was generic giant Mylan's turn in the bulls-eye for their infamous $600 EpiPen. But, should all of the blame fall on Mylan, or is there something else going on? 

It turns out that there is quite a bit going on, it's just behind the scenes. And it isn't the...

As we enter the final stretch of so vitriolic a Presidential campaign, it is not a surprise that scandalous accusations are being thrown in all directions by both sides.  Center stage yesterday was the possibility of a Bill Clinton ‘love child.’  

The issue of paternity (aka fatherhood) predates this election throughout history.

When I toured Versailles in France, I was taken to the bedroom where Marie Antoinette gave birth.  The guide conveyed there was a ‘court’ (aka an audience of people) at the bedside that observed the actual event so proof of maternity (aka motherhood) could be established.  This always interested me since the process says nothing of paternity.

Systems have evolved since the 1700s in terms of reliability.

When I entered the field of...