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Latest Posts

Making Discoveries About Type 1 Diabetes From Long-Term Survivors

It’s hard to imagine what it was like to live with type 1 diabetes 80 years ago. Insulin was a brand new and relatively untested drug, the only way to check blood sugar levels was by testing boiled urine, syringes had to be sterilized, and needles sharpened by hand. Couple those challenges with the common complications of diabetes—heart disease, kidney failure, nerve damage, blindness, and more—and life expectancy for someone with type 1 diabetes wasn’t that long.

Spencer M. Wallace, Jr., was diagnosed with type 1 diabetes in 1931, at age 7. He’s now an active 87-year-old who plays golf several times a week. He isn’t alone as a long-term survivor. Since 1970, almost 3,500 men and women who have lived with the disease for a half century have been recognized by the Joslin Diabetes Center in Boston with bronze 50-year medals. Forty-five of them Read more »

*This blog post was originally published at Harvard Health Blog*

Obama’s Going Grey, But Do Presidents Age Faster Than The Rest Of Us?

It’s more than just a few flecks. President Barack Obama, who turned 50 in August, is definitely going gray. He’s said the color change runs in his family and has mentioned a grandfather who turned gray at 29.

But others see it as a sign that the presidency is taking a toll on Obama, as it has other on presidents. Dr. Michael Roizen, of RealAge.com fame, says presidents age twice as fast as normal when they’re in office. The main cause, he says, is “unrequited stress—they don’t have enough friends to mitigate the stress,” which brings to mind the line commonly attributed to Harry Truman: if you want a friend in Washington, get a dog.

Accelerated presidential aging? Not so.

The only problem with this notion of accelerated presidential aging is that it just ain’t so, according to S. Jay Olshansky, a professor at theUniversity ofIllinois at Chicago and a longevity expert. Read more »

*This blog post was originally published at Harvard Health Blog*

Elderly Heart Failure Patients Choose Longevity Over Quality Of Life

Don’t assume elderly heart failure patients are assumed to prefer improved quality of life over longevity, study authors noted. The majority of them prefer longevity over quality of life, half expressed a desire for resuscitation if needed, and it was difficult to predict individual preferences.

Researchers looked at patients’ willingness to trade survival time for quality-of-life and the preferences for among 622 heart failure patients aged 60 or older participating in the Trial of Intensified vs. Standard Medical Therapy in Elderly Patients with Congestive Heart Failure.

End-of-life preferences were assessed by using a time trade-off tool and one question concerning CPR preference. To assess time trade-off, patients were asked whether they preferred living 2 years in their current state of health or living 1 year in excellent health. If 1 year in excellent health was chosen, the patients were asked whether they would prefer 2 years in their current state of health or 6 months in perfect health. If 2 years in the current state were chosen, then they were asked whether they would prefer 2 years in their current state of health or 18 months in perfect health. The series continued until the choices were the same. This time point subtracted from 24 months derived the number of months of survival time that the patient would be willing to trade.

End-of-life preferences were assessed at baseline, and at 12 and 18 months. Read more »

*This blog post was originally published at ACP Hospitalist*

When Public Health Legislation Is More Effective Than Physician’s Advice

Last month, my family was involved in a scary traffic accident en route to the Family Medicine Education Consortium‘s North East Region meeting. I was in the left-hand eastbound lane of the Massachusetts Turnpike when a westbound tractor trailer collided with a truck, causing the truck to cross over the grass median a few cars ahead of us. I hit the brakes and swerved to avoid the truck, but its momentum carried it forward into the left side of our car. Strapped into child safety seats in the back, both of my children were struck by shards of window glass. My five year-old son, who had been sitting behind me, eventually required twelve stitches to close a scalp laceration. Miraculously, none of the occupants of the other six damaged vehicles, including the truck driver, sustained any injuries.

Family physicians like me, and physicians in general, like to believe that the interventions we provide patients make a big difference in their eventual health outcomes. In a few cases, they do. But for most people, events largely outside of the scope of medical practice determine one’s quality and length of life, and Read more »

*This blog post was originally published at Common Sense Family Doctor*

Moderate Drinking Can Be Beneficial For Middle-Aged Women

Middle-aged women who drink alcohol moderately yet regularly throughout the week may age more healthfully, according to data from the Nurses’ Health Study.

Photo by  Sigfrid Lundberg via Flickr and a Creative Commons licenseAfter adjusting for variables such as smoking, women who drank light or moderate amounts of alcohol had a modestly increased chance of successful ageing compared to nondrinkers. For example, compared to nondrinkers, women who drank 5 to 15 g of alcohol per day (between one-third and one drink per day) at middle age had about a 20% higher chance of successful ageing, defined as being free of 11 major chronic diseases and having no major cognitive, physical or mental health limitations at age 70.

Independent of total alcohol intake, women who drank alcohol regularly had a better chance of successful ageing than occasional drinkers. Thus, compared to nondrinkers, women who drank five to seven days a week had nearly a 50% greater chance of successful ageing whereas women who drank only one or two days a week had a similar likelihood of successful ageing.

Researchers measured alcohol consumption at midlife using Read more »

*This blog post was originally published at ACP Internist*

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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