Opioids Again and Again

The CDC reported today that the opioid crisis is only getting worse: more ED visits, more deaths. More than from car accidents, more than from guns. Unbelievable, but we believe it and we are doing what we can to help. In the June 5th, 2017 issue of The Medical Letter, we published an article on […]

Alternatives to Hormonal Contraceptives

The results of a large Danish prospective cohort study (1.8 million women followed for an average of 10.9 years) published recently in The New England Journal of Medicine indicate that even low-estrogen oral contraceptives and progestin-only intrauterine devices are associated with an increased risk of breast cancer.  The risk was 20% higher in current or […]

What a Sham: The Power of Placebo

The November 2, 2017 issue of The Lancet included an online first article (R. Al-Lamee et al) describing a sham-controlled trial of percutaneous coronary intervention (PCI) in the treatment of stable angina pectoris. Each year more than 500,000 PCI procedures are done for stable angina worldwide and unblinded randomized trials have shown significant relief of […]

ALL

I don’t remember her name anymore. She was 8 years old: blonde, pretty, smiling politely. I remember her parents, older than most, looking concerned. She looked too healthy to be the source of their concern, but as I moved close to her, I could see the petechiae on her cheeks. In three weeks, she was […]

One Drug Interaction

The unveiling of Drug Interactions from The Medical Letter® reminded me of the profound effects of a single drug interaction that occurred in the emergency room of New York Hospital in 1984. Libby Zion was an 18-year-old college student who came to the hospital seeking treatment for a flu-like illness. She had been taking the […]

O Canada!

The current issue of The Medical Letter (May 22, 2017) leads off with a contentious topic: drug prices. I could think of a lot of good reasons for not publishing an article on this subject: not our usual thing, more questions than answers, everyone in the world has already written about this, etc. But many […]

The USPSTF and Vision Screening in Older Adults

In 2009, the Affordable Care Act required Medicare and private insurance plans to cover, without a copay, preventive services given grades of A (high certainty of substantial net benefit) or B (high certainty of moderate net benefit, or moderate certainty of moderate to substantial net benefit) by the US Preventive Services Task Force (USPSTF). The […]