I have a 5% chance of having a heart attack in the next 10 years. That’s not so high, but it’s higher than I want it. Most of that risk is due to my cholesterol and my age. I can’t do anything about the latter, but the former is under my complete control. Cholesterol medications can improve my cholesterol significantly. So can proper diet and exercise. That’s not true of ...
PalMD
HIV is devastating poor and minority communities
The HIV pandemic in the US has developed a stable appearance over the last few years, and that appearance is notably non-white and non-wealthy. When the pandemic was discovered nearly thirty years ago, it was---in the US---primarily a disease of gay men. In Africa, the disease is everyone's. Women make up significantly more than half of HIV cases in Africa, and tens of thousands of children are infected during ...
Omega 3 fatty acids and the prevention of heart disease
Omega-3 fatty acids (more properly called “n-3 fatty acids”) are a group of naturally occurring fat molecules.They are found mainly in fish and other marine-derived oils, but some can also be extracted from plants. Omega-3′s are currently very popular, but the evidence for their usefulness isn’t so clear. A recent study failed to show any benefit in preventing dementia. A new study out ...
Prevention of disease and monitoring of chronic diseases in a yearly physical
When I go to the doctor for my yearly physical (OK, not quite yearly, but…) he puts me through the ringer. He asks me dozens of questions, follows up with more questions, and does a (thorough!) physical exam. Then he takes some blood, and sometimes runs some other tests. The big question is "why"? What are ...
Disconnect between knowledge of STIs and behaviors to reduce risk
In my opinion, people are often too embarrassed to see their doctor about sexually transmitted infections (STIs)—in my opinion.“In my opinion” is one of the most dangerous phrases in science. But when in comes to attitudes toward STIs, the data are scarce. STI’s are very much a “behavior”-based disease, so knowing what attitudes prevail can help us design effective prevention strategies. Attitudes toward HIV have been ...
Making the decision to go to medical school
First, this piece is not a how-to guide for getting into medical school.But I use this ploy for good, and not for evil. Through conversations with a number of non-medical colleagues, I’ve been forced to think a bit more about premedical and medical education. A letter from a reader (which is presented in a highly altered version below) made me decide to more thoroughly and ...
The story of vitamin D and its association with other diseases
Vitamin D is a fascinating molecule with a fascinating story.Historically, “vitamins” were defined as chemicals that humans required from their environment that were “vital” to human health. These chemicals were needed only in very small amounts to prevent disease; an absence of a particular vitamin in the diet led to a specific deficiency disease: vitamin C, scurvy; thiamine, beri beri. Other vitamin deficiencies were found ...
Is placebo a therapy, like surgery or medication?
The New England Journal of Medicine recently published a troubling article on acupuncture, which was ably deconstructed by Dr. Mark Crislip. This incident has reignited a discussion of what, exactly, “placebo” is.A common argument is that placebo is like any other intervention, something that can be intentionally harnessed for the benefit of patients. This is both true and overly simplistic.First, we must review what “placebo” is. ...
