The incidence of atrial fibrillation (AF) and congestive heart failure is rising rapidly in the U.S., because the population is growing older. The birth rate in the U.S. is declining, making the average age rise. The most devastating complication of AF is cerebral artery embolism (blood clot) with resultant stroke. Severe disability often results in this setting. Anticoagulation therapy has been shown to markedly reduce the incidence of stroke from AF, and direct oral anticoagulants (DOACs), some of which have been approved only recently, have replaced warfarin (Coumadin) as the drug of choice for stroke prevention in AF. DOACs are as effective or more effective than warfarin in this setting and bleeding events are significantly less
Powder On
Women have used powders for genital hygiene for decades to absorb odors and moisture. While rates of powder use in the genital area have declined over the past 50 years, it remains a routine practice for some women. Commonly used products typically include talc, cornstarch, or a combination of both. Investigations into an association between the use of talc-containing powders for genital hygiene and ovarian cancer have revealed mixed results. Recent high-profile litigation and media coverage of
Broken
Last month, my column was based on one of a series of articles written by Dr. Edward Hoffer, concerning America’s broken health care system. Today I would like to continue that by looking at other broken areas. For example, our current malpractice system does not well serve doctors or patients. Medical malpractice insurance is a substantial cost of operating a medical practice. A standard $1.3/3.9 million policy can run $30-40,000 a year for a family practitioner with no surgery to well over
Norovirus
Foodborne illness is common in the U.S. The Centers for Disease Control, or CDC, estimates that there are 48 million cases of foodborne illness each year in the U.S., with 128,000 hospitalizations and 3,000 deaths. The five most common causes of foodborne illness are norovirus, salmonella, clostridium perfringens, campylobacter, and staphylococcus aureus. All are caused by contact with an infected person, an infected food or surface, or consumption of infected food or liquid. Together, these
Escape The Vape
Over the past decade, cigarette smoking has continued to decline, but the use of electronic cigarettes (ECs) is rising. Current estimates are that about 4% of the U.S. population uses ECs, or vapes, as it is commonly termed. While ECs come in all shapes and sizes, they all use the same technology, as seen in the illustration. When turned on, a battery heats up a heating element which causes the liquid in the vaporizer chamber to aerosolize. The resulting aerosol is commonly and incorrectly
Measles By Twain
“Then came the measles” from The Adventures of Tom Sawyer, Chapter XXII by Mark Twain (Samuel Langhorne Clemens, 1835-1910). In 2019, there were more than 1,300 cases of measles reported in the U.S., more than any year since 2000 when measles was declared eliminated in the U.S. The 2019 outbreak was linked to unvaccinated travelers who brought the disease here from other countries, with subsequent transmission to pockets of unvaccinated individuals. Most readers have never suffered from measles
Screening Limited
Screening asymptomatic patients for cancer is based on a simple premise: cancers that are detected early before they produce symptoms should be easier to cure than those that progress to become clinically detectable. Yet, this seemingly simple idea is fraught with problems. There are several factors that contribute to the difficulty of proving the value of cancer screening. First of all, any test will have false negatives, in which case a patient’s cancer goes undetected. Secondly, tests for
