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 The article was retracted […]


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 […]

The Right Antibiotic

A letter from the CDC and others published online October 24 in JAMA Internal Medicine presents evidence that about half of patients thought to have bacterial otitis media, sinusitis, or pharyngitis are treated with the wrong antibiotic. First-line (correct) antibiotic therapy, according to the letter, would be amoxicillin or amoxicillin/clavulanate for otitis media or sinusitis […]

Weight Loss

The AspireAssist weight loss device, which was the subject of an article in our August 29 issue, provoked a flurry of articles and letters in the New York Times. The first of these, written by 2 directors of weight loss programs and published on September 10th, called the new device “the latest in a desperate […]

Put Statins in the Water?

An article later this year will update our 2014 article on Drugs for Lipids, and there is plenty of updating to do. Our 2014 article was published shortly after the American College of Cardiology and the American Heart Association recommended using risk factors rather than specific cholesterol targets as indications for statins. There is general […]