Dietary Supplements: When Will They Ever Learn?

When we wrote about problems with dietary supplements in 2002, we concluded by saying that physicians should tell their patients that we really don’t know what’s in them. An article that recently appeared in JAMA Network Open1 tells us what’s in some of them, and it’s not good. The data in the new report comes […]

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 […]

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 […]

Treating Influenza

The CDC recently announced that the influenza vaccine has been 48% effective this year in preventing influenza illness. Presumably, it has been even less effective in subgroups like the elderly, the immunosuppressed, and those with chronic heart, kidney, or liver disease. The CDC recommends antiviral treatment for documented, or even suspected, influenza illness in these […]

Vaccine Resistance

The New York Times has reported that an antivaccine crusader may soon lead a government commission on vaccine safety. The commission is expected to focus particularly on the long discredited link between vaccines and autism, which originated in a study of 12 children that was published in The Lancet in 1998. The article was retracted […]

NSAIDS

Patients tend to underestimate both the effectiveness and the toxicity of nonsteroidal anti-inflammatory drugs (NSAIDs). For acute pain, single full doses of NSAIDs are more effective than acetaminophen, and some have shown an equal or greater analgesic effect compared to oral opioids combined with acetaminophen, or even injected opioids.  However, there is a price to […]