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First In-Vivo Gene Delivery Mastered?

While gene therapy has always seemed just on the verge of being right around the corner, the limitation has always been delivery of the gene. How do you get the new gene to the right cells and activated?

An in-vivo mice study in the Proceedings of the National Academy of Sciences (PNAS) may take us closer to a usable delivery system. Rui Maeda-Mamiya of the University of Tokyo and others were able to get diabetic mice to increase their insulin levels after delivery of a insulin 2 gene by a water-soluble fullerene. Read more »

*This blog post was originally published at Medgadget*

No End In Sight For Prostate Cancer Screening

Is the tide finally turning on PSA screening for prostate cancer? There’s no definitive data that PSA screening saves lives from prostate cancer, and it indeed can lead to further, invasive, tests that can cause men significant discomfort. Medical societies are divided on the issue. Primary care groups like the U.S. Preventive Services Task Force (USPSTF) recommend against it for older men, while the American Urological Association (AUA) continues to recommend screening.

In a strongly worded op-ed in the New York Times, Richard Ablin, also known as the founder of the PSA test, bemoans how our healthcare system has twisted its use. “The test’s popularity has led to a hugely expensive public health disaster,” he writes. Read more »

*This blog post was originally published at KevinMD.com*

Mainstream Media’s Sub-Par Health Coverage, Part 2

I recently wrote about an experience that I had with a reporter (Erica Mitrano) who interviewed me about energy healing at Calvert Memorial Hospital in southern Maryland. Erica was very friendly and inquisitive, and we had a nice conversation about the lack of scientific evidence supporting any energy healing modality. I thought it would be fun to post what we had discussed at SBM, and then wait to see what trickled down into the finished piece.

When the final article appeared I was very disappointed. Not only was I not quoted, but there was no skeptical counterpoint at all. The story read like an unquestioning endorsement of junk science, and I wondered if it was worth it to continue speaking to journalists to offer expert advice. It seemed to me that this experience was emblematic of all that’s wrong with health reporting these days. (Just ask Gary Schwitzer, who has recently given up on reviewing TV health stories in mainstream media since they are generally so inaccurate.) Read more »

*This blog post was originally published at Science-Based Medicine*

All About Skin Cancer

The entire March issue of Archives of Dermatology appears to be dedicated to skin cancer — melanoma and non-melanoma. 

Basal cell carcinoma (BCC) represents 65% to 75% of all skin cancers. Most occur on sun-exposed parts of the face, ears, scalp, shoulders, and back. Intense short-term UVB exposure is important in the formation of BCC. Clinical features include pearly translucent flesh-colored papules or nodules with superficial telangiectasias (broken blood vessels). More active lesions may have rolled edges or ulcerated centers.

Squamous cell carcinoma (SCC) represent 30% to 65% of all cutaneous malignancies.  SCCs are most attributable to UVB exposure, long-term or accumulative exposure over years. Clinical features include crusted papules and plaques that may become indurated, nodular, or ulcerated. SCC may arise in chronic wounds, scars, and leg ulcers. Recurrent SCC development within 3 years is 18%, a 10-fold higher incidence compared with initial SCC diagnosis in the general population.

Malignant melanoma (MM) represents the most serious of all cutaneous malignancies. It is estimated that approximately 65% to 90% are caused by UV exposure, predominantly UVA. Roughly 10% of all melanoma cases are strictly hereditary. Read more »

*This blog post was originally published at Suture for a Living*

Funding Tobacco Control Programs: A Dollar Well Spent

The Centers for Disease Control (CDC) identified tobacco use as the single biggest cause of premature death in every state in the U.S. They recommended in 2007 that New Jersey state government should spend $120 million per year on tobacco control ($13.75 per person per year, and 12% of total tobacco-related revenue to the state).

Here in New Jersey, our Comprehensive Tobacco Control Program (CTCP) started in 2000, with annual funding of just over $30 million via the Master Settlement Agreement (MSA). The program was set up to follow CDC guidelines to have components for media, evaluation, community activities, youth prevention, and smoking cessation. With the post 9/11 recession causing severe budget problems for the state, funding was drastically cut by 66% to $11 million in 2004 and then in 2009 it was cut again to around $8m. The state brings in approximately $1 billion per year from tobacco sources (MSA plus tobacco taxes) and so New Jersey has recently been spending around 1% of tobacco revenues on tobacco control. Despite being drastically underfunded, the New Jersey CTCP has had many noteable achievements. Here’s just a few. Read more »

This post, Funding Tobacco Control Programs: A Dollar Well Spent, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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