In concert with sanitation and clean water supplies, vaccination has been the most cost effective means of preventing infectious diseases. Most vaccines have been inexpensive, easy to administer (albeit objected to by the recipient’s arm!), safe and effective. From when I was a child until today the number of new vaccines has multiplied dramatically. This will only continue at an accelerated pace in the coming years. In the future many ...

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I had an interesting exchange with one of our nurses recently about a long-term patient of ours. The e-mails went something like this:

Got a fax from —-’s insurance that his Lipitor won’t be covered anymore.  They will cover simvastatin, lovastatin, and pravastatin.  Let me know what you want to do. Charlie
He’s on darunavir, and all three of those statins are contraindicated because of drug-drug interactions. Rosuvastatin? Paul
Checked with them — rosuvastatin needs ...

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All thoughtful physicians I know consider the historical theory and philosophy of homeopathy to be rubbish, balderdash, preposterous, BS, or, politely, NOT PLAUSIBLE; thus, not even worth testing for safety and efficacy. Then, why, when one asks Mr. Google by entering ... Homeopathy ... and clicking, does one receive 9.9 million results? And, why does the National Health Service of the U.K. continue to fund homeopathic hospitals, clinics, and treatments? And why are ...

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What a blessing and a curse it must have been to practice medicine fifty years ago. Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat many common ailments but somewhat of a blessing not to have the modern medical nightmare of having patients on 15-20 chronic medications with all the logistical problems of keeping track of ...

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by Jack Cain In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain.  Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances. Bias is ...

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It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer. Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached to a scaffolding-like contraption resting on her shoulders.  Vomiting while immobilized in a halo became a form of medieval torture.  During her third round of chemotherapy, her nausea was so ...

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Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic islet cells. It is important to understand just where these cells come from. Those used in science are ...

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The placebo effect is somewhat of a mystery in modern medicine. Wikipedia calls a placebo  "a sham or simulated medical intervention." Commonly, when we refer to a placebo we mean dummy-drugs, but the placebo effect has further applications in medicine, such as sham surgery or false information. Now, a great video produced by an Australian journalist from the ABC Science Show has compiled ...

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I should be hard at work right now seeing patients in the office, and I would be if it weren’t for one little pill. Have you ever been frustrated by a physician refusing to give you an antibiotic?  That very scenario occurs daily in primary care. "It is only a virus." The arguments against taking an antibiotic (cost, side effects, allergic reaction) can seem less ...

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Comparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as studies to support efforts to keep useful but expensive ...

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