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2022-07-02A lot has changed with Covid since our last blog. The rise of Omicron and
its variants plus the major surge in cases last winter followed by a
relaxation of restrictions has led to a new view of the disease. Yet still
at this rate at least one hundred thousand people a year will still die of
Covid. The new drug Paxlovid has the potential to save many of these lives
if started soon enough. The elderly are most susceptible to severe disease
and death. Unfortunately many people remain under vaccinated. This winter
has the potential to have another major surge in illness and possibly
deaths. Test and have your doctor treat is necessary for those who are most
vulnerable. Don?t just say it is a cold rather test and consider treatment.
Also the new booster vaccines for the fall have the potential to mitigate
the surge so check with your doctor when these are available. We also hope
you will take a look at our new book as highlighted on the website. If you
like science and philosophy you should find it enjoyable reading.
2022-01-27Our last prediction of Covid 19 outcomes correctly predicted that a minimum
would occur in the middle of November at 70000 cases a day and would then
rise till the middle of January. Prediction of the number of deaths minimum
value and time was also correct with now rising values until February and a
peak not reached yet. What was not predicted was that Omicron would arise
and the huge numbers of cases associated. Now it is extremely difficult to
predict future cases so for now we hope this current recent decline
continues. Continue to mask up indoor public settings. Assess your risk and
those you contact. The elderly carry the biggest risk. Get vaccinated and
boosted if you have not already.
2021-10-16Our last prediction of potential Covid 19 outcomes in June, when many
people felt that the pandemic might be over, turned out to be quite
accurate. Now we face the hardest time to predict what will happen next.
Based on the cycles that occur worldwide and in US I predict that this
current cycle down will end in the first two weeks of November at 70000
cases a day and the subsequent rise in cases will peak at 190000 cases a
day in the middle of January. As to deaths, they would reach a low at end
of November at 800 a day and peak in February at 1500 a day. Here is hoping
that the unvaccinated will get vaccinated and people utilize the boosters.
I thus also hope that this prediction is a huge overestimate. Also mask up
and keep some reasonable social distancing for indoor groupings.
2021-10-16Our last prediction of potential Covid 19 outcomes in June, when many
people felt that the pandemic might be over, turned out to be quite
accurate. Now we face the hardest time to predict what will happen next.
Based on the cycles that occur worldwide and in US I predict that this
current cycle down will end in the first two weeks of November at 70000
cases a day and the subsequent rise in cases will peak at 190000 cases a
day in the middle of January. As to deaths, they would reach a low at end
of November at 800 a day and peak in February at 1500 a day. Here is hoping
that the unvaccinated will get vaccinated and people utilize the boosters.
I thus also hope that this prediction is a huge overestimate. Also mask up
and keep some reasonable social distancing for indoor groupings.
2021-06-17Six months ago as vaccines were just being deployed my extrapolated
prediction for July 1 2021 was 700 thousand deaths in the USA from
Covid-19. Now we just reached 600 thousand deaths. So the vaccinations
achieved so far may have saved 100 thousand lives. Unfortunately there are
those who will not get vaccinated and we still have cases and deaths
despite the markedly decreased rates. At the current rate we could lose
another 35 thousand people by Labor Day and if large portions of the
country stay with vaccination rates under 30% then a resurgence in the fall
could see 700 thousand deaths by Christmas. Add to that the waining
immunity of the administered vaccines, the delta or other new variants and
we have a recipe for a return to lockdowns. So consider your responsibility
to others and yourself if you have not received a vaccine.
2021-01-16The country as a whole has doubled the number of daily Covid19 cases and
the number of associated daily deaths in the last two months. Now with the
advent of new mutations to the virus we may find that the acceleration is
even greater. Hopefully a federal program to create and distribute the the
vaccine will help however at best the effect probably will not show results
until the summer. So again we need to keep social distance avoid crowds and
wear a mask when going shopping etc. Between now and July 15 another 300
thousand deaths could occur. Thus a total of almost 700 thousand deaths. Be
as wise and safe as you can and get your Doctors opinion on the vaccine and
if positive take the vaccine when available since evidence for now shows
that both Moderna and Pfizer vaccines are safe and effective.
2021-01-16The country as a whole has doubled the number of daily Covid19 cases and
the number of associated daily deaths in the last two months. Now with the
advent of new mutations to the virus we may find that the acceleration is
even greater. Hopefully a federal program to create and distribute the the
vaccine will help however at best the effect probably will not show results
until the summer. So again we need to keep social distance avoid crowds and
wear a mask when going shopping etc. Between now and July 15 another 300
thousand deaths could occur. Thus a total of almost 700 thousand deaths. Be
as wise and safe as you can and get your Doctors opinion on the vaccine and
if positive take the vaccine when available since evidence for now shows
that both Moderna and Pfizer vaccines are safe and effective.
2020-10-30For October I underestimated the number of new cases by half a million and
overestimated the deaths by about 7 thousand. So now we stand at 9 million
cases and 235 thousand deaths. For the end of November predictions we have
11.5 million cases and 275 thousand deaths. We are moving into an
exponential growth phase with great risk. Closures have started but too
slowly and rapid action is needed as contact rates soar. Curfews and
shutdowns may again be necessary if closers don?t work and if Americans
still fail to mask, social distance and have gatherings of only of six or
fewer people.
2020-09-30For the end of September I predicted a total of 7.2 million cases and
215000 total deaths which unfortunately as of today seems almost on target.
Again we need a clear national strategy based on individual county numbers.
Masks and social distancing should be required in crowds with rare
exceptions. For the end of October I predict a total of 8.5 million cases
and 242 thousand total deaths. Again masking and social distancing plus
adjustments to restrictions could reduce the change by one half.
2020-08-30Last month I wrote: By the end of August I expect 5.3 million cases and 175
thousand deaths. That is assuming the hot states act now! As of today
there are 5.9 million cases and 182000 deaths. Clearly the hot states did
not do what they were supposed to do. The rise in total deaths is
particularly disturbing. For the end of September I predict a total of 7.2
million cases and 215000 total deaths. Trump has succeeded in marginalizing
the scientists who understand epidemics and touted nonsense remedies.
National standards for what is open or not need to be set and enforced on a
county by county basis depending on the number of cases and positivity
rates. Testing should be maximized not minimized. Winter is coming, America
wake up!
2020-07-28Last month I wrote that: By the end of July I predict 4.1 million cases
total and 160 thousand deaths. Here we are now on the 28th and cases are
about 4.4 million and deaths about 151000. Unfortunately the guesses were
quite accurate especially remembering that we had only 2.6 million cases
at end of last month. Needless to say the states that closed down to late
and opened to soon have been punished. By the end of August I expect 5.3
million cases and 175 thousand deaths. That is assuming the hot states act
now! Our thoughts and prayers go out to those who died and to the families
who suffer. May wisdom come to all of America.
2020-06-29This month our prediction in terms of estimated cases vs actual cases by
the end of June was 2.25 million slightly lower compared to what looks like
about 2.6 million cases.This appears to be due to the southern surge from
opening up too rapidly. The number of deaths will be about 129 thousand and
we predicted 134 thousand. Slightly higher prediction because the younger
population was effected more and they have a lower mortality rate. By the
end of July I predict 4.1 million cases total and 160 thousand deaths. This
rise of 31 thousand new deaths is capable of being cut by 20000 if states
and or the federal government take strict measures to hunker down in hot
counties and seriously universally enforce social distancing and mask
usage. It?s up to us. We can make these predictions too high. Stay safe!
2020-05-28Last months predictions for cases and deaths from Covid-19 were
unfortunately quite correct with passing 100000 deaths and 1750000 cases.
The prediction for the end of June is much harder since one needs to take
into account the effect of opening up the economy and at the same time
accounting for a decreasing trend factor which seems partly seasonal. So I
expect that we will have had 134000 deaths by the end of June and 2250000
total cases. I hope I am in error with much fewer cases and deaths. We
need something like a Marshall Plan from the Federal government for all
nursing homes since they contribute to an large part of the mortality and
transmission from Covid-19. Workers are needed for testing, sanitation,
patient assessment and assistance. Also improved medical care at the homes
instead of total dependence on hospitals. This should go a long way to
reducing the cases and deaths for the country.
2020-04-29On March 28th with 125000 cases we wrote that all the estimates on future
Coronavirus cases and deaths seemed too low so we made an estimate of total
of 500000 cases and we hoped that with then 2750 deaths it would limit to
5000 as the mortality data decreased to 1 percent. The following day the
government shockingly projected 100000 to 200000 deaths before it was over.
Now a month later we are approaching 60000 deaths and have over a million
cases. This data is also off because of reporting and testing problems. So
I will try again by just looking at the graphs the USA will have in another
month 1.75 million cases and 100000 deaths. The case for more testing with
tracing and going easy on releasing restrictions seems clear. But as seen
predictions need to be constantly re-examined.
2020-03-28A century after the 1918 Flu pandemic the world again faces a silent sneaky
killer enemy in Covid-19. Trump?s lack of understanding of science led to
budget cuts in the CDC and impaired preparation for pandemics even after
the nation had to deal with SARS, MERS and an Ebola outbreak. Penny wise
and thousands of pounds foolish. The administration has failed to look at
the epidemic numbers and projections and at each step underestimating the
real problem. Looking at the data now even with the shutdowns in place it
looks as if the USA could have up to a half a million cases and 5 thousand
deaths before it fully diminishes. With a full nationwide enforced shutdown
for at least two months more we could limit it to 250 thousand cases and
2500 deaths or less. Hopefully these estimates are in error on the high
side but we need to be prepared. The economy will only recover when the
epidemic has a marked decrease in weekly cases. Having recently had one of
my long time patients die from this virus is painful and makes the epidemic
for me only too real. Some progress on the scientific front could mitigate
the damages. Drug testing of various drugs for early treatment could
discover a way to stop its early stages as Tamiflu does for influenza.
Vaccines are not fully testable until a year from now but shortcuts in the
process could find a safe effective one by winter time. Home testing as a
mail in should be approved in the near term and will help. One must also
factor in the mutations possible in the virus as well as the change in
seasons. The healthcare teams need protection and if the cases climb
ventilators and new hospital space are necessary. Only time will tell
whether we have the will to fight this war and save lives and prevent
2020-01-22Power without a nation's confidence is nothing. Quoting Catherine the
Great and it still true today!
2019-11-09In a recent article in the New England Journal of Medicine doctors Gardner
and Kleinman address the present state of psychiatry and their comments
reflect somewhat on the state of medicine in general as we finish out the
first fifth of this 21st century. They state that checklists have replaced
thoughtful diagnosis and a trial and change of medication type practice has
emerged. Practitioners see the severe limitations of psychiatric biologic
treatments in addition to the economic constraints of less time spent with
patients. The brain, body, mind and environment problem is seen as even
more complex today than 100 years ago. Psychiatry is often overprescribing
medications based on a digital checklist of diagnoses with major
overlapping symptoms while contact with patients is dwindling in all
specialties. The authors see the need for a restart of psychiatric
knowledge creation and training. Biologic knowledge is essential but one
must guard against corporate and administrative interests that benefit from
simplified notions of mental illness and treatment. The field needs to
change in order to address the needs of real people who suffer and not just
abstract notions. All of medicine can learn from their challenge.
2019-07-21Medicare rates hospitals based on several measures including the following
- Mortality which includes death rates over the past three years for heart
attacks, heart surgery, congestive heart failure, lung disease, strokes and
complications of surgery. Safety of care includes infections due to line
placements in the body and surgical site infections and rates of resistant
bacteria. Readmission rates consider rates after heart attacks, heart
surgery and for general procedures. Patient Experience reflects staff
treatment and the assessment of the overall environment. Effectiveness of
care includes vaccinations, not leaving ER before being seen, fast stroke
care, receiving needed meds on time, appropriate follow up instructions and
blood clot prevention. Timeliness of care includes length of time in ER
before admission or length of time it took to give lifesaving or pain
relieving treatments. Efficient use of Medical Imaging includes appropriate
usage of MRI in low back pain and Double CT scans where indicated. Check
out hospital ratings and the ratings for each category mentioned above.
Rating systems have their limitations however they can help you to better
assess your hospitals.
2019-02-17"Fools act on imagination without knowledge, pedants act on knowledge
without imagination." - Alfred North Whitehead Those who continue to bury
their heads on climate change may be imaginative in that they can imagine a
world where a slight possibility exists that the overwhelming majority of
those who study climate change are wrong but they are not knowledgeable
about the facts of climate change. With the rising global temperatures the
warmer air has more average energy and the range of potential temperatures
broaden. Also the warmer air holds more moisture and yet the ground
moisture and arctic ice decrease. Thus in addition to worsening tornadoes,
hurricanes, droughts, flooding and earthquakes food production will be
affected with areas of starvation increasing. New and deadly insect borne
viruses can emerge as well as increases in existing diseases like Lyme and
malaria. Worker production will decrease in certain areas. Shorelines will
recede with damage to major population areas. On the other hand moving to
reduce greenhouse gases would also decrease particulate particles in the
air and thus decrease the 6.5 million premature deaths which already exist.
It is time for the fools to wake up to the reality of the medical effects
arriving by their inaction.
2018-11-17The state teachers union is switching to Medicare Advantage over Medicare
and one has to opt out in order to get back to traditional. Below are some
excerpts as to problems with Medicare Advantage from a recent NEJM article:
Traditional Medicare also allows beneficiaries to get care without the
hassles and obstacles that can result from prior authorization and referral
requirements frequently used by Medicare Advantage plans. In addition, for
some beneficiaries with high health care spending, traditional Medicare
coupled with supplemental insurance has the potential to be a lower-cost
alternative to Medicare Advantage. For example, the most popular Medigap
plans fill in virtually all cost-sharing requirements for Medicare Parts A
and B services, limiting enrollees financial exposure to their monthly
Medigap premium, which is typically substantially less than the
out-of-pocket limit of Medicare Advantage plans. Medicare Advantage
enrollees are more likely than beneficiaries in traditional Medicare to be
discharged to poorly rated skilled nursing facilities. In addition
Physicians and patients have complained of the Advantage drug plans
restricting needed medications for serious illnesses which border on
unethical restrictions.
2018-06-17Happy Fathers Day Unfortunately for some fathers and mothers they cannot
see their children because of the Trump administration action on people
seeking asylum in our country. All major medical associations point out
that the damage to these children is irreversible. International agencies
have suggested that Trump and Sessions should be brought to the Hague to be
tried for human rights violation. This is not America. Call your
congressman and Senators and demand action from the Trump administration.
His holding these children hostage in order to pass legislation is
criminal. If he took hostage a Democratic Senator and held him in the
basement of the White House until Democrats voted for whatever he wanted
would not be nearly as bad as this.
2018-06-05Bobby Kennedy, now 50 years since his tragic death, had given a speech in
Apartheid South Africa two years before. The last part is inscribed on his
tombstone. For two centuries, my own country has struggled to overcome the
self-imposed handicap of prejudice and discrimination based on nationality,
social class, or race-discrimination profoundly repugnant to the theory and
command of our Constitution. Even as my father grew up in Boston, signs
told him that No Irish Need Apply. Two generations later President Kennedy
became the first Catholic to head the nation; but how many men of ability
had, before 1961, been denied the opportunity to contribute to the nation's
progress because they were Catholic, or of Irish extraction? How many sons
of Italian or Jewish or Polish parents slumbered in slums-untaught,
unlearned, their potential lost forever to the nation and human race? Even
today, what price will we pay before we have assured full opportunity to
millions of Negro Americans? .... We must recognize the full human
equality of all of our people before God, before the law, and in the
councils of government. We must do this, not because it is economically
advantageous, although it is; not because of the laws of God command it,
although they do; not because people in other lands wish it so. We must do
it for the single and fundamental reason that it is the right thing to do.
..... Each time a man stands up for an ideal, or acts to improve the lot
of others, or strikes out against injustice, he sends forth a tiny ripple
of hope, and crossing each other from a million different centers of energy
and daring those ripples build a current which can sweep down the mightiest
walls of oppression and resistance.
2018-04-28A confession of ignorance is essential in the process toward true
knowledge: 'And if anyone thinks that he knows anything, he knows nothing
yet as he ought to know' (1 Corinthian 8:2). The person who wants to learn
God's truth must be honest and humble. The philosopher Alfred North
Whitehead said: 'Not ignorance, but ignorance of ignorance, is the death of
2018-02-16Lori Alhadeff, whose daughter Alyssa, 14, was killed, made an emotional
plea for action. "President Trump, we need action, we need change," she
said, the urgency rising in her voice. "Get these guns out of the hands of
these young kids and get these guns off the streets." "If we're constantly
having our children worried about getting shot at, what are we telling our
future?" said David Hogg, 17, a senior, who said two of his 14-year-old
sister's friends were killed. "And that's what these people are killing,
our future." "My daughter is dead, but all these children out here have to
go to school. A shooter should not be able to just walk in," she said,
tears streaming down her face. "I hope she didn't die for nothing." Lori
Alhadeff Assault weapons need to be banned again or strictly controlled!
Background checking must deny anyone with any mental health issues.
2018-01-26Rapid flu test with a nasal swab which are common in offices and emergency
rooms have a sensitivity for flu of about 55% which means that 55 people
out of 100 people who actually have the flu will test positive and of
course 45 people who test negative actually have the disease. Meanwhile the
specificity is about 96% which means that out of 100 people who actually
are negative for the flu 96 of them will report negative test yet 4 will
test falsely positive. The success of this test also depends on how
prevalent the disease is at the time. Now while we are at the peak of flu
season about 20 percent of those appropriately tested will have the flu. It
then can be shown by Bayes Theorem that about 77 percent of the people who
actually have the flu will test positive while 90 percent of those who do
not have the flu will test negative. The important point to recognize is
that if you have the symptoms of the flu in the peak season if you test
negative you should still be treated whereas relying on a negative test
could lead to serious consequences.
2018-01-06A genuine revolution of values means in the final analysis that our
loyalties must become ecumenical rather than sectional. Every nation must
now develop an overriding loyalty to mankind as a whole in order to
preserve the best in their individual societies. Martin Luther King
Someday, after mastering the winds the waves the tides and gravity we shall
harness for God the energies of love and then for the second time in
history of the world man will discover fire. Teilhard De Chardin
2017-12-22Merry Christmas and a Happy New Year! Luke 1:46:56 He has mercy on those
who fear him in every generation. He has shown the strength of his arm, and
has scattered the proud in their conceit. He has cast down the mighty from
their thrones and has lifted up the lowly. He has filled the hungry with
good things, and the rich he has sent away empty.
2017-10-24Sen. Bob Corker (R-Tenn.) accused President Trump of "debasing" the country
with his "untruths," "name-calling"and "attempted bullying," escalating his
criticism of the president and further fueling their feud just as Trump
arrived on Capitol Hill to meet with GOP senators about tax
"For young people to be watching, not only here in our
country, but around the world, someone of this mentality as president of
the United States is something that is I think debasing to our country,"
said Corker, who spent the morning lambasting Trump in media
"You would think he would aspire to be the president of
the United States and act like a president of the United States. But that's
just not going to be the case, apparently," Corker said. This is a
republican who can speak the truth.
2017-09-05Immigration can be a controversial topic. We all want safe, secure borders
and a dynamic economy, and people of goodwill can have legitimate
disagreements about how to fix our immigration system so that everybody
plays by the rules. But that's not what the action that the White House
took today is about. This is about young people who grew up in America -
kids who study in our schools, young adults who are starting careers,
patriots who pledge allegiance to our flag. These Dreamers are Americans in
their hearts, in their minds, in every single way but one: on paper. They
were brought to this country by their parents, sometimes even as infants.
They may not know a country besides ours. They may not even know a language
besides English. They often have no idea they're undocumented until they
apply for a job, or college, or a driver's license. Over the years,
politicians of both parties have worked together to write legislation that
would have told these young people 'our young people' that if your parents
brought you here as a child, if you've been here a certain number of years,
and if you're willing to go to college or serve in our military, then
you'll get a chance to stay and earn your citizenship. And for years while
I was President, I asked Congress to send me such a bill. That bill never
came. And because it made no sense to expel talented, driven, patriotic
young people from the only country they know solely because of the actions
of their parents, my administration acted to lift the shadow of deportation
from these young people, so that they could continue to contribute to our
communities and our country. We did so based on the well-established legal
principle of prosecutorial discretion.....Barack Obama
2017-08-21"Now, after decades of preaching that what was good for General Motors is
good for America, corporate leaders have acknowledged that it might
actually be the other way around - that what's good for America is good for
General Motors", he concludes. "However belated the conversion, their
action this past week was courageous and impactful. We owe them our
gratitude." Steven Pearlstein Columnist - Washington, D.C.
2017-07-15I am not a Know-Nothing. That is certain. How could I be? How can any one
who abhors the oppression of negroes, be in favor of degrading classes of
white people? Our progress in degeneracy appears to me to be pretty rapid.
As a nation, we begin by declaring that "all men are created equal." We now
practically read it "all men are created equal, except negroes." When the
Know-Nothings get control, it will read "all men are created equal, except
negroes, and foreigners, and catholics." When it comes to this I should
prefer emigrating to some country where they make no pretence of loving
liberty-to Russia, for instance, where despotism can be taken pure, and
without the base alloy of hypocracy . Abraham Lincoln, letter to Joshua
Speed, August 24, 1855
2017-06-10In 1993 approximately 25 % of the population smoked and during the Clinton
years the rate dropped down to approximately 23%. After the tenure of
George W. Bush the rate was about 20%. Under Obama with his numerous
policies against smoking we see an even more dramatic drop with the
percentage of people who smoke down to 15.3% by the end of his term. In
March 2012 the CDC had a national campaign to end tobacco usage which
presented important stories of former smokers. It is estimated that the
campaign alone led about 400,000 smokers to quit smoking for good. It also
prevented at least 17,000 premature deaths. The FDA banned the manufacture
of fruit and candy flavored cigarettes and banned the use of advertisements
claiming low or light and mild and extended its regulations to E-
cigarettes cigars and pipes. These major changes under Obama are the kinds
of strategies that reduce overall healthcare costs and save lives. Now
under Trump we are in era of deregulation yet we hope that the trend in
tobacco cessation continues its steep decline.
2017-04-01Roger Cohen NYTimes - It might almost be funny. Almost. But the day will
come when the Dow plunges and what the former British Prime Minister Harold
Macmillan is said to have feared most in politics " "events, dear boy,
events" " occurs, perhaps in ghastly terrorist form, and an incoherent
administration will be confronted by its first crisis. All that can be said
for now is that, in such a moment, illiberalism and xenophobia in the hands
of a would-be autocrat will make for a dangerous brew. Already, in
countless small ways, America is narrowing in ways that hurt it. Foreign
applications to U.S. colleges have dropped. USA Today reports that"an
inhospitable political climate could punch an $18 billion hole in U.S.
tourism by international visitors over the next two years."
2017-02-02An excerpt from a letter signed by many Berkeley faculty yesterday: As you
may know, he has labeled Black Lives Matter a form of "black supremacism"
and argues that the protest movement should be labeled a "terrorist
organization"; he refers to principles of diversity at college campuses as
"anti-White racism." He has also denounced rape culture as a myth
propagated by feminists "aimed squarely at undermining masculinity." More
serious, however, was his reference to women as "cunts" at a recent event
at the University of West Virginia. He mocks campus cultures of
inclusiveness and invites his audiences to ridicule people with
disabilities. At a talk at the University of Delaware in October, he
referred to transgender people as "mentally ill," adding: "Never feel bad
for mocking a transgender person. It is our job to point out their
absurdity, to not make the problem worse by pretending they are normal." In
the same speech, he advocated "fat-shaming." Apart from holding such
noxious views, he actively incites his audiences to harass individuals. In
July of this year, Yiannopoulos was permanently banned from Twitter for
what the organization described as "participating in or inciting targeted
abuse of individuals" He incited his followers to barrage an
African-American actress with hate speech. We urge you to consider the
seriousness of this claim and what it forebodes for his visit to Berkeley.
Yiannopoulos's views pass from protected free speech to incitement,
harassment, and defamation once they publically target individuals in his
audience or on campus, creating conditions for concrete harm and actually
harming students through defamatory and harassing actions.
2016-12-31Happy new year! Here is an excerpt of today's editorial from the Washington
Post - "Are there loans or deals with Russian businesses or the state that
were concealed during the campaign? Are there hidden communications with
Mr. Putin or his representatives?" The newspaper speculated. "We would be
thrilled to see all the doubts dispelled, but Mr. Trump's odd behavior in
the face of a clear threat from Russia, matched by Mr. Putin's evident
enthusiasm for the president-elect, cannot be easily explained."
2016-12-13"The transition from democracy to tyranny, Plato says, is most easily
brought about by a popular leader who knows how to exploit the class
antagonism between the rich and the poor within the democratic state, and
who succeeds in building up a bodyguard or private army of his own. The
people who have held him first as a champion of freedom are soon enslaved
and then they must fight for him, in one war after another which he must
stir up ... because he must make people feel the need of a general." Karl
Popper "The Open Society and it's enemies"
2016-11-13Now that the Republicans are in charge in Washington what happens to the
Affordable Care Act? They have hinted at keeping some of the well liked
provisions. The first one would be the extension of insurance for dependent
coverage for up to the age of 26. This has 80% popularity it would be
easily incorporated into the new program. The next one is to close the
Medicare loophole in drug costs which is also highly popular and could be
incorporated easily. Another popular item presently existing is to
eliminate the out-of-pocket costs for preventive services which can be
continued. The next item allowing for pre-existing conditions is also
well-liked however it's correlated with the condition that insurance be
mandatory which is not liked it all. The net effect of eliminating the
latter would mean that those with pre-existing conditions would have to be
charged huge fees in order to have the insurance company survive. For some
items such as brain cancer the cost could be as high as $400,000 a year for
insurance. This is because those with pre-existing conditions are really
being paid for by the younger patients who signed up under the mandatory
clause and the higher tax paid by Medicare beneficiaries who earn more
money. Also correlated with the other points in the bill is the provision
that some people can receive the Medicaid expansion coverage. An estimated
22 million people now covered would lose their Medicaid insurance if
Congress implemented the changes outlined in the most recent reconciliation
bill of the republicans. This could lead to some 40,000 of the 22 million
people dying each year unnecessarily because they couldn't now afford
insurance. Is this making America great again? What will happen?
2016-10-14Blowin' in the Wind Bob Dylan Lyrics How many roads must a man walk down
Before you call him a man? How many seas must a white dove sail Before she
sleeps in the sand? Yes, and how many times must the cannon balls fly
Before they're forever banned? The answer, my friend, is blowin' in the
wind The answer is blowin' in the wind Yes, and how many years can a
mountain exist Before it's washed to the sea? Yes, and how many years can
some people exist Before they're allowed to be free? Yes, and how many
times can a man turn his head And pretend that he just doesn't see? The
answer, my friend, is blowin' in the wind The answer is blowin' in the wind
Yes, and how many times must a man look up Before he can see the sky? Yes,
and how many ears must one man have Before he can hear people cry? Yes, and
how many deaths will it take 'till he knows That too many people have died?
The answer, my friend, is blowin' in the wind The answer is blowin' in the
wind Songwriters: Bob Dylan Blowin' in the Wind lyrics ? Bob Dylan Music
2016-08-16Better is a poor man who walks in his integrity than a rich man who is
perverse in his ways" (Proverbs 28:6)
2016-08-01"Two things are absolutely necessary in any leader or any person that
aspires, wishes to be a leader. That is moral compass and, second, is
empathy. This candidate is void of both traits that are necessary for the
stewardship of this country," Khan said on CNN's "State of the Union."
2016-07-22Does Cranberry Juice prevent Urinary Infections? Commentary: Recurrent UTIs
are common, with a quarter of young women who have a first UTI experiencing
a recurrence within 6 months. Sexual intercourse, spermicide/diaphragm use,
and previous UTIs are the strongest risk factors for recurrent UTIs.
Various strategies have been used to decrease recurrence, ranging from
post-coital voiding, cranberry juice, probiotics, post-coital antibiotics,
and daily antibiotic prophylaxis.1 The results of the present study showing
that cranberry juice decreases recurrences of UTIs is consistent with the
results of a systematic review and meta-analysis that shows an approximate
40% decrease in the incidence of recurrent UTIs with the use of cranberry
containing products.2 This study lends further evidence to support using
daily cranberry juice for prophylaxis of UTIs in women with multiple UTI
recurrences, a simple approach that has the advantage of avoiding issues of
antimicrobial resistance associated with antibiotic prophylaxis. Neil
Skolnik, MD
2016-07-01When Abraham Lincoln was criticized for his courtesy and tolerance towards
his enemies during the American Civil War, he responded: "Do I not destroy
my enemies when I make them my friends?" How do you treat those who cross
you and cause you trouble? Do you seek their good rather than their harm?
2016-06-12A recent study from England published in the American College of Cardiology
this year showed that vitamin D supplementation improved patients with
congestive heart failure due to systolic dysfunction. These patients all
had low vitamin D levels at the start of the study. They can verify this
based on the echocardiograms before and after treatment which showed very
significant changes in the improvement of the heart structure and function.
At the end of the study an exercise test of walking for six minutes showed
that they did not improve in the statistically significant way compared to
the one at the beginning of the study. It is felt that the numbers of
patients were too small for that improvement to be observed statistically.
I have seen numerous studies showing the effects of vitamin D
supplementation on various cancers however all of the studies while
interesting are far from definitive. I believe this study since it's based
on the hard evidence of the echocardiogram results is also far from
definitive but extremely strong.
2016-05-15Today's New York Times science magazine has an article on the 20th century
German scientist Otto Warburg who believed that tumors could be treated by
disrupting their source of energy. The article states that his idea was
dismissed for decades - until now. The article discusses several new drugs
which hold some promise in this area and also discuss the diabetic drug
metformin. Several studies have shown that metformin can significantly
reduce the incidence of cancer. For example, a systematic review and
meta-analysis included 11 independent studies contributing 4042 cases of
cancer and 529 deaths in patients with diabetes showed that cancer
incidence and cancer mortality were reduced by 30 percent among users of
metformin. Significant reduction in the incidence of pancreatic and liver
cancer was noted; reductions for breast, colon and pancreas were observed,
though were not statistically significant. There was a trend toward a
dose-response relationship. Two subsequent meta-analyses in patients with
diabetes found an association between metformin use and a significant
decrease in colorectal cancer risk and a decrease in risk of colorectal,
liver, and lung cancers.(ref) In vitro colonies of malignant breast cells
have had growth inhibited by metformin. Full understanding of the metabolic
pathways in which this is occurs is far from fully appreciated. Metformin
like any other drug has potential side effects and for some individuals it
is contraindicated. It may very well be that Otto Warburg was onto
something and that the new understanding of the biochemical processes
beyond the Kreb cycle may in the future be a major contributor to cancer
2016-04-22Zika virus was first isolated in 1947 in the forest in Uganda. Minor
illness was described in the 50s however major outbreak did not occur until
it had spread to French Polynesia in 2013. Other islands in the Pacific
were also affected. The virus first arrived in the Americas in Brazil
(2015). It spread quickly to the point where there was believed to be
about 1.3 million suspected cases. It was in September 2015 that
investigators noted increased number of infants born with microcephaly in
the same areas in which the virus was first reported. The virus is carried
by mosquitoes through different species. The A. Aegypti being the most
common and can be found in the United States on the East Coast up through
the northern parts of New Jersey. It is also present in the south and
southwest. Non-mosquito transmission can occur during pregnancy and
transferred from the mother to the fetus. Sexual transmission can also
occur being given to a partner from someone who had traveled to endemic
area where the virus is present. RT-PCR can detect the virus in the blood
urine or saliva. IgM antibodies can also be detected. Symptoms include
fever, rash, muscle pain, arthritis conjunctivitis, headache and some G.I.
symptoms. Guillain-Barre syndrome can occur based on current knowledge.
2016-03-20It is well known that vascular dementia is a significant category of
dementia however an outstanding question that remains is how important is
the vascular system for dementia in general. A study by Dr. Kuller et al in
the March 8, 2016 issue of the Journal of the American College of
Cardiology takes a look at this issue. They measured the coronary artery
calcification score, measured by a CT scan, and showed for women mostly in
their 80s that those with a very low calcium score had significantly
decreased incidence of dementia. Also the calcium scores were found to be
directly related to age adjusted mortality. For example those with the
score of greater than 400 had about a 1.73 greater risk. Also for men with
maximal percent coronary stenosis they found an increased risk of dementia.
So it seems that if you are heart healthy you might also be potentially
brain healthy.
2016-03-04A recent review of two long-standing studies reaching over 32 years have
again shown that aspirin can prevent colon cancer. This one included
136,000 participants and it showed that even if you have just one to one
and one half of a standard aspirin tablets a week you reduce overall risk
of colon cancer by about 19% and any gastrointestinal malignancy by about
15%. The study's main author was a Dr. Chan of the Massachusetts General
Hospital in Boston. Even at such a low doses there are certain risks for
bleeding from the aspirin however it may be useful for people over 50 who
fail to follow the recommended colonoscopy requirements of screening. Check
with your personal physician before starting any aspirin regimen.
2016-02-14Over the last few weeks we have learned of two major discoveries one in
Medicine and one in Physics. The search for these discoveries has been
many years in the making. The medical condition is schizophrenia and the
physics research is in regard to gravitational wave detection. Over the
past several years the genetic database of diseases and especially on
schizophrenia has increased dramatically. Researchers have found more than
100 genetic locations for schizophrenia and this most recent study used the
fact that chromosome 6 had the highest number associated with risk for
schizophrenia. It turned out that the C4 area of the gene was the most
associated with the disease. C4 functions with the immune system and in
particular in this case it is what it is called pruning or removal of some
synapses. In the illness it may be that an over aggressive pruning occurs.
This is consistent with the fact that adolescents tend to have a high
pruning activity and also it is also in adolescents that schizophrenia
often first appears. So now it may be possible to find therapies that
target this genomic area and its associated proteins. Einstein postulated
gravitational waves just over 100 years ago and with this new actual
recording of what appears to be two black holes coalescing into each other
we now have have proof of their existence. It was based upon an
unbelievable engineering feat namely of obtaining such accurate
determinations of extremely small energies. The fact that the two
independent dual detectors miles and miles apart both recorded the same
activity makes it highly likely that they have finally been detected. Also
the shape of the contours are consistent with the theoretical expectations.
2016-01-21According to the January 20, 2016 Bergen Record the following is stated:
Governor Christie said no to a bill that would have barred convicted
carjackers, gang members and others from buying guns.....also Sen. Loretta
Weinberg, D-Teaneck, said she was 'not shocked' that Christie vetoed her
legislation to revise a 2002 bill she led requiring that smart guns be sold
in New Jersey. Current law requires the firearms, which use wireless
technology or fingerprints so that only one authorized person can fire it
be sold in place of traditional handguns after they hit the market. But
they never did, because opposition by the gun lobby stifled innovation.
Weinberg's latest bill would have required that the smart guns be sold by
all retailers alongside traditional handguns, with the goal of reducing
accidental child deaths and opening the market up to an alternative type of
firearm. Another chapter for Profiles In Courage or another chapter for
the Screwtape Letters?
2016-01-17One definition of political correctness is the avoidance, often considered
as taken to extremes, of forms of expression or action that are perceived
to exclude, marginalize, or insult groups of people who are socially
disadvantaged or discriminated against. The first known use of this term
goes back to the 1930s. It didn't become commonly used until after 1986. It
has been used by both the left and the right as a tool to castigate the
other side. Major scientific or medical theories which are in the majority
may have for those proponents who attack the minority opinion a tool to
keep the minority in line. Those who proposed originally that the earth
revolves around the sun had more than just castigation about their words
for some were put to death. The Medical establishment looked upon Sister
Kenny and her notion of using physical therapy for polio patients as
heresy. Despite many setbacks she continued on her pursuit and eventually
this became the mantra of established medicine as well as leading to the
giant field of physical therapy. History, politics, and philosophy are more
complicated than science and medicine. While we all need to have an open
mind we need to be vigilant in that each side does not present facts that
are totally false and then just resort to character assassination. Media
and the people need to criticize the speech of some of these people so that
they don't distort the true facts and at the same time keeping open to
possibilities of new ideas and new ways of thinking. Complicated problems
need to be presented as they are with many facets. If we throw away
rationality we are left with nothing.
2015-12-27A recent study published in JAMA a shows that supplementation with Folic
Acid for hypertensive patients also treated with hypertensive medications
significantly reduced the incidence of first stroke independent of the
hypertensive medication by a factor of about 21%. This Study randomized
just over 20,000 patients with clear controls even in the genetic subgroups
of folic acid metabolism. The study was carried out over a period of four
years. The average age of the patients was 60 years. Folic acid levels were
in the low normal range on average at the beginning of the study. Folic
acid is known to be important in vascular health however previous
randomized studies from several years ago showed no improvement in stroke
prevention however a more recent meta analysis prior to this study did show
improvement. This is a quite promising result and hopefully it will be
reaffirmed with other studies.
2015-12-13A recent New England Journal of Medicine article entitled "cardiac
complications in patients undergoing major noncardiac surgery" came to the
conclusion that one of the best ways of preoperatively monitoring the risk
of cardiac complications after noncardiac surgery would be to measure the
BNP level in the blood. BNP is a substance in the blood which elevates when
there is even a mild decrease in the ability of the heart to pump blood
appropriately. In patients with congestive heart failure the levels can
become markedly elevated. Thus of all the possibilities preoperatively
including stress testing and computer tomographic angiography they found
that the BNP was the best method. While mortality post operatively is quite
low, if one looks at 0 to 30 day limit after the surgery there's some
significant amount of cardiac disability and death which can occur. Many of
these situations have subclinical myocardial damage which could best be
assesed by measuring the Troponin level in the blood. The risk is elevated
if the troponin level is elevated. More than half of the cases can only be
determined with this test.
2015-12-05A profile in cowardice is one way one can describe the vote by the Senate
against a bill which would make people on the no-fly list unable to buy
guns in this country. The fear of the NRA is so great that they would not
even pass this bill. This is quite disgusting especially in the wake of the
recent tragedy. They argued that sometimes people are on the no-fly list
who shouldn't be on them and they gave an example of Edward Kennedy once
being on the list as the reason for not voting for the bill. The founding
fathers must be rolling over in their graves.
2015-11-27The power of positive thinking. How much of what we do in medicine is
related to the placebo effect? Recently there was a study which showed that
among a group of runners who were falsely told that they were getting an
injection of EPO, which is the substance which is known to increase the red
cell mass in the body, had substantially better running times in the 3 km
race then the group that did not receive the placebo. While study after
study keeps showing that the placebo effect is important we now have
grounds on the scientific basis to understand why this is the case.
Epigenetics is a still growing field but it does reveal how our minds can
trigger on and off certain protein productions.
2015-11-08Hypertension has many facets to it one of them being the ability of a
person to exercise. A recent study has shown that when people move into a
neighborhood which is considered a high walk ability neighborhood versus
those who move into a low walk ability neighborhood they find the incidence
of hypertension that develops over subsequent years is nearly half in the
in the high walk ability neighborhood. Most blood pressure medications that
we use reduce the blood pressure by just a few points and yet by getting
out and exercising, forgetting the car, and being able to walk to the store
for groceries or for paper or a nearby mall in a convenient neighborhood
can make all the difference. Well this won't work for everyone but if you
have the ability to get out there and increase your walking it could help
your hypertension.
2015-10-23Second hand smoke continues to be a major factor in heart disease and
cancer rates. Measurement of Cotinine levels in the urine or blood show
that exposure to secondhand smoke has steadily decreased in the United
States from 1988 at 90% down to about 25% today. However still some 58
million non-smokers in the United States continue to be exposed to
secondhand smoke. Children of non-smokers who live in multi unit housing
have 45% higher Cotinine levels then those who live in single-family homes.
Also 37% of nonsmokers now living in rental housing are exposed to
secondhand smoke.
2015-10-04The following is a quote from a NY Times letter regarding President Obama's
speech on gun safety: "No, Mr. President, we are not "numb" - we are
terrified. We are the human shields used by politicians too afraid to face
the National Rifle Association without cover. We are hostages caught in the
crossfire, helplessly watching our friends and family members mowed down
while they go to classes or the movies."
2015-09-26One line from the Pope's message to Congress was " if politics must truly
be at the service of the human person, it follows that it cannot be a slave
to the economy and finance". In his speech he also mentioned Thomas Merton
and gave a quote from him. Here's another abbreviated quote from Thomas
Merton's famous book, The Seven Storey Mountain. " consider how in spite of
centuries of sin and greed the human race can still recover each time."
And he goes on to say that "How could all this be possible without the
merciful love of God, pouring out his grace upon us".
2015-09-13Video on computers that learn and their effects on the future of medicine
has been added to the site.
2015-09-13It is probably premature to read too much into the new hypertension study
called Sprint. The media seems to be reporting it as the final word on the
need to bring systolic blood pressure down to the 120 range. Recently new
guidelines have been put in place to not treat systolic blood pressure
until it was over 150 for someone who had no other risk factors. This study
needs careful analysis before it can be accepted since it deals with people
with heart disease and renal failure.
2015-09-07About 100 years ago President Taft's wife was quoted about Washington as
the capital of the country " the capital she envisions a national
society comprised of the best people in the land, a society not founded on
the dollar, but on culture, art and statesmanship".
2015-08-30A new video was added on epigenetics the science of human empowerment by
Dr. Bruce Lipton. Epigenetics has transformed our notion of genetics and
allows us to better understand how our thought processes and our ideas
change our body chemistry and our lives. It also shows us how our
environment and stresses affect our newborn children.
2015-08-28Alexander Mazziotti MD, PA The Art of Healing Website: Blog Posts see also
Twitter feed
2015-08-28It is important for people to know that the Medicare Advantage Plans have
some major limitations. For example unlike regular Medicare they can deny
you a test that you may need and that your doctor who knows you best thinks
is important. For example if the insurance company denies you a stress test
it could cost you more than a few dollars.