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Osteoporosis Drugs: Should We Curb Our Enthusiasm?

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A recent story on NPR accused the drug manufacturer Merck of inventing a disease, osteopenia, in order to sell its drug Fosamax. It showed how the definition of what constitutes a disease evolves, and the role that drug companies can play in that evolution.

Osteoporosis is a reduction in bone mineral density that leads to fractures. The most serious are hip fractures, which require surgery, have complications like blood clots, and carry a high mortality. Many of those who survive never walk again. Vertebral fractures are common in the osteoporotic elderly and are responsible for dowager’s hump and loss of height. There is also an increased risk of wrist and rib fractures. Read more »

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

Teens, Sleep, Depression And Suicide

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According to a study by researchers at Columbia University, teens whose parents let them go to bed past midnight were 24 percent more likely to be depressed and 20 percent more likely to have contemplated suicide than peers whose parents set bedtimes at or before 10 p.m.

The results were reported in the journal Sleep, and suggest earlier bedtimes may be protective because they increase the likelihood of getting enough sleep. According to the Centers for Disease Control & Prevention (CDC), about 4,400 Americans between the ages of 10 and 24 commit suicide each year, making it the third-most common cause of death in the age group. This is also to be the group getting the least amount of sleep, which suggests a pretty logical correlation between suicide and lack of sleep.

Data from this study comes from 15,659 U.S. students, who were in grades seven to 12 between 1994 and 1996, and their parents. Seven percent of the teens were found to have depression and 13 percent said they seriously contemplated suicide during the preceding 12 months. The association was stronger for girls and older children. Read more »

This post, Teens, Sleep, Depression And Suicide, was originally published on Healthine.com by Nancy Brown, Ph.D..

Some Insurance Companies Deny Coverage Of Facial Reconstruction After Trauma

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I noticed this article title on MDLinx, then went to the Journal of Plastic and Reconstruction website to read the full article.  The abstract is free to read, the full article requires a subscription.

The study was prompted by the authors noticing third party insurers increasingly deny coverage to patients with post traumatic and congenital facial deformities.  This denial is often cited as due to the deformities not being seen as “functional” problems.  The authors cite the recent facial transplants patients as having demonstrated  that the severely deformed are willing to undergo potentially life-threatening surgery and extended chemotherapy in an attempt in look normal. Read more »

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

What We Can Learn From Another Disproven Herbal Remedy (Ginko Biloba)

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Another one bites the dust.

The National Center for Complementary and Alternative Medicine (NCCAM) is generally a waste of taxpayer money, but they have sponsored several well-designed large trials of popular herbal supplements. And one by one these studies have shown these popular products, such as echinacea for the common cold, to be ineffective.

To add to the list, published in JAMA this week are the results of the largest and longest trial to date of Gingko biloba for the improvement of cognitive function and to treat, prevent, or reduce the effects of Alzheimers disease or other dementia. The results of the study are completely negative. Read more »

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

Can Flomax Help You Pass A Kidney Stone?

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Wilderness medicine professionals often discuss which medications should be carried on which trips. There’s usually a limit to the size of the medical kit, and precious space must be allotted to the most important items. The painful passage of a kidney stone as it travels down the ureter, enters the bladder, then exits the urinary tract via the urethra, is “epic” for anyone who has ever suffered this event. So, anything that might be helpful to facilitate the stone’s passage or ease the discomfort is a good thing. Tamulosin (Flomax) is a drug that is often prescribed by physicians to promote the passage of a kidney stone(s). It has not quite become “standard of care” to prescribe the drug, but it is increasing in popularity, largely because of the observations by patients and doctors that it seems to help. Read more »

This post, Can Flomax Help You Pass A Kidney Stone?, was originally published on Healthine.com by Paul Auerbach, M.D..

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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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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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