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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
Feedback
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
therapy.
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 " ..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".
2015-08-30A 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.