Alexander Mazziotti MD,PA - The Art of Healing www.mdmazz.com copyright
BLOGS

Date	Comment
2023-07-15	Climate change has been highlighted recently with the wildfires which have arisen in Canada and are polluting our air in the United States. It is easy to see the pollution and to recognize even the immediate damage that can occur. We need to have the same mindset of pollution to understand that climate change is about pollution ofCo2 in the air. Even though it is not visible Co2 can build up in the atmosphere from our use of fossil fuels and from the chemistry of Co2 we know that it traps heat from escaping the earth. Climate change theory has multiple factors involved, for example that both the ocean and vegetation can absorb some of the CO2. Despite the complexity of modeling all the many factors involved we can not deny that man-made climate change theory, supported by extensive scientific research, has provided valuable insights into climate changes over the past 20 years. Climate models based on this theory have been successful in predicting several important climate phenomena, such as the overall increase in global temperatures, changes in precipitation patterns, the melting of polar ice and increases in violent weather events. If Co2 released in higher concentrations than normally in the air was visible as say a slightly black color then with every breath and every motor exhaust we would be easily convinced that we are polluting our world and need to act now. While computer models are providing valuable projections there are uncertainties associated with long-term predictions and it may be worse than our current gloomy predictions. Just think of the visibility of concentrated Co2 and recognize that yes this is a man made byproduct of energy usage and we need to control it before it is too late.
2023-07-08	Nicotinamide, a form of vitamin B3, has been studied for its potential role in preventing skin cancer. It is believed to work through multiple mechanisms: 1. DNA repair: Nicotinamide enhances the repair of DNA damage caused by UV radiation, which is a major contributor to skin cancer development. 2. Anti-inflammatory properties: It helps reduce inflammation in the skin, which can be a contributing factor to skin cancer. 3. Immune system support: Nicotinamide strengthens the immune system, potentially aiding in the detection and elimination of cancerous cells. 4. Energy metabolism: Nicotinamide is involved in cellular energy production, and optimizing energy metabolism may help maintain healthy skin cells and prevent abnormal growth. It's important to note that while some studies have shown promising results, further research is still needed to fully understand the effectiveness of nicotinamide in preventing skin cancer. It's always advisable to consult with a healthcare professional for personalized advice.
2023-06-02	Recent advances in the understanding and treatment of gastric and duodenal ulcers have significantly impacted patient outcomes and management strategies. Here are some key developments in this field: 1. Helicobacter pylori eradication: Helicobacter pylori (H. pylori) infection is a major cause of gastric and duodenal ulcers. Advancements in diagnostic techniques, such as non-invasive tests and endoscopic methods, have improved the detection and accurate diagnosis of H. pylori. Additionally, the development of effective antibiotic regimens has revolutionized the treatment of these ulcers. Combining antibiotics with acid-suppressing medications has shown high success rates in eradicating H. pylori and promoting ulcer healing. 2. Proton Pump Inhibitors (PPIs): PPIs are potent acid-suppressing medications commonly used in the treatment of gastric and duodenal ulcers. Recent advances have led to the introduction of more potent and long-acting PPIs, enhancing their effectiveness in reducing gastric acid production and promoting ulcer healing. Furthermore, there has been progress in personalized dosing strategies based on individual patient factors, optimizing treatment outcomes while minimizing side effects. 3. Endoscopic interventions: Endoscopy plays a crucial role in the diagnosis and management of gastric and duodenal ulcers. Recent advances in endoscopic techniques have enabled precise identification and treatment of ulcers, reducing the need for surgery in many cases. Advanced endoscopic modalities, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), allow for minimally invasive removal of large or high-risk ulcers, leading to improved patient outcomes and reduced morbidity.
2023-04-21	I asked Google?s AI program Bart about the current state of this years influenza severity. Here is the response: The 2022-2023 influenza season in the United States was a relatively mild season compared to previous seasons. The overall burden of influenza was estimated to be 26 million illnesses, 290,000 hospitalizations, and 19,000 deaths. This is significantly lower than the estimated burden of 62 million illnesses, 610,000 hospitalizations, and 61,000 deaths during the 2017-2018 season, which was a severe season. There are a number of factors that may have contributed to the mildness of the 2022-2023 season. One factor is that the influenza vaccine was more effective this season than in previous seasons. The vaccine was estimated to be 40% effective at preventing laboratory-confirmed influenza illness, 44% effective at preventing influenza-related hospitalizations, and 48% effective at preventing influenza-related deaths. Another factor that may have contributed to the mildness of the season is that the COVID-19 pandemic may have had a suppressing effect on influenza transmission. It is possible that people were taking more precautions to avoid getting sick, such as wearing masks and social distancing, which may have helped to reduce the spread of influenza. Finally, it is also possible that the circulating influenza viruses were not as severe as in previous seasons. The predominant influenza virus this season was an influenza A(H3N2) virus, which is typically associated with more severe illness than influenza B viruses. However, this particular influenza A(H3N2) virus was not as severe as some other influenza A(H3N2) viruses that have circulated in recent years. Overall, the 2022-2023 influenza season is mild.
2023-04-20	I asked Google?s AI program Bart about the current state Covid-19. Here is the response: As of April 20, 2023, the global COVID-19 pandemic is still ongoing. There have been over 685 million cases and 6.8 million deaths worldwide. The number of new cases and deaths has been declining in recent months, but the virus is still a major threat to public health. The COVID-19 pandemic has had a significant impact on the world. It has caused widespread economic disruption, social isolation, and mental health problems. The pandemic has also exacerbated existing inequalities, such as those between rich and poor countries. There is no one-size-fits-all answer to the question of where we are now with COVID-19. The situation varies from country to country, and even within countries, there can be significant differences between regions. However, there are some general trends that can be observed. First, the pandemic is becoming more manageable in many parts of the world. This is due to a number of factors, including the development of effective vaccines and treatments, as well as the increasing immunity of the population. Second, the pandemic is becoming less deadly. This is because the virus is mutating to become less severe. However, it is important to note that the virus is still capable of causing serious illness, hospitalization, and death. Third, the pandemic is becoming more endemic. This means that it is likely to continue to circulate in the population, even after the pandemic is declared over. This means that we will need to continue to take measures to protect ourselves from the virus, such as getting vaccinated and boosted, wearing masks, and social distancing. The COVID-19 pandemic is a complex and evolving situation.
2022-07-02	A 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.
2022-01-27	Our 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.
2021-10-16	Our 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.
2021-10-16	Our 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.
2021-06-17	Six 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.
2021-01-16	The 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.
2021-01-16	The 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.
2020-10-30	For 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.
2020-09-30	For 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.
2020-08-30	Last 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!
2020-07-28	Last 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.
2020-06-29	This 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!
2020-05-28	Last 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.
2020-04-29	On 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.
2020-03-28	A 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 suffering.
2020-01-22	Power without a nation's confidence is nothing. Quoting Catherine the Great and it still true today!
2019-11-09	In 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.
2019-07-21	Medicare 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.
2018-11-17	The 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.
2018-06-17	Happy 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.
2018-06-05	Bobby 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.
2018-04-28	A 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 knowledge.'
2018-02-16	Lori 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.
2018-01-26	Rapid 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.
2018-01-06	A 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
2017-12-22	Merry 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.
2017-10-24	Sen. 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 legislation. "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 interviews. "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.
2017-09-05	Immigration 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.
2017-07-15	I 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
2017-06-10	In 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.
2017-04-01	Roger 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."
2017-02-02	An 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.
2016-12-31	Happy 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"
2016-11-13	Now 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?
2016-10-14	Blowin' 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 Feedback
2016-08-16	Better 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."
2016-07-22	Does 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
2016-07-01	When 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?
2016-06-12	A 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.
2016-05-15	Today'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 therapy.
2016-04-22	Zika 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.
2016-03-20	It 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.
2016-03-04	A 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.
2016-02-14	Over 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.
2016-01-21	According 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?
2016-01-17	One 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.
2015-12-27	A 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.
2015-12-13	A 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.
2015-12-05	A 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.
2015-11-27	The 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.
2015-11-08	Hypertension 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.
2015-10-23	Second 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.
2015-10-04	The 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."
2015-09-26	One 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".
2015-09-13	Video on computers that learn and their effects on the future of medicine has been added to the site.
2015-09-13	It 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.
2015-09-07	About 100 years ago President Taft's wife was quoted about Washington as the capital of the country " ..in 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".
2015-08-30	A 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.
2015-08-28	Alexander Mazziotti MD, PA The Art of Healing Website: Blog Posts see also Twitter feed
2015-08-28	It 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.