In cancer treatment, detection of a tumor in an early stage markedly increases the chance of favorable outcomes.
Can the much-aligned blood thinner, warfarin, occasionally help in early detection of cancer?
Few pharmacologic agents receive more bad press than warfarin. Stories, which are too numerous to count, like “Did warfarin kill my father,” can be widely found on Internet forums, search engines, and are often quoted by reluctant patients — whose numerator of bad warfarin experiences is one.
It is true that warfarin has a narrow therapeutic window — a small difference between an effective dose and dangerous dose. Read more »
*This blog post was originally published at Dr John M*
We all know about “doctor time.” No matter how hard I try, the clock seems to out sprint me. Morning rounds in the hospital go longer than expected, a colleague stops you with a question, a son forgot his lunch, or something else. The list is long.
In fact, as a very well-educated patient, it seems that the doctors I choose for myself and family are even later than I. It seems that most good doctors have long waits. A coincidence?
However accepted “doctor time” is in the office or hospital, it doesn’t work the same in the bike racing world. In the land of genetically endowed androids, the clock waits for no one in particular. It turns out that our pizza-sponsored team has a few doctors who run on “doctor time” in real life. Read more »
*This blog post was originally published at Dr John M*
Occam’s razor is a well-known logical principle often applied in medicine. It states that the simplest explanation for a complaint or symptom is usually the correct one. Most of the time, Occam’s razor serves the diagnostician well, but when the actual problem is complex or unexpected, patients can be sent down expensive and even life-threatening diagnostic rabbit holes.
A friend of mine is an 80-pack-a-year smoker. He was complaining of shortness of breath, worsening over a couple of months, and his primary care physician sent him to a pulmonologist. The assumption was that the shortness of breath was related to COPD from his chronic smoking — and that indeed would have been the most likely explanation. Read more »
Life sometimes gets in the way of daily posting. Specifically, the treadmill of life sometimes roars too fast.
But as I strolled through the hospital this morning, there was a plain piece of white paper taped to the wall around the nurses station. Although I’m not overly religious (and even highly conflicted about which rituals are the right ones), these words from a pastor/celebrity stopped me for a moment:
Attitude
The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than success, than what other people think or say or do. It is more important than appearance, giftedness or skill.
It will make or break a company, a church, or a home. The remarkable thing is that we have a choice every day regarding the attitude we will embrace for that day.
We cannot change the past, we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is plan on the one thing that we have, and that is our attitude.
I am convinced that life is 10 percent what happens to me and 90 percent how I react to it. And so it is with you. We are in charge of our attitudes.
As a cardiologist programmed to “alert” most of the time, words such as these help me. I haven’t seen the studies yet, but I’m guessing that positive attitudes reduce inflammation, which is good for our atria, and our arteries.
JMM
*This blog post was originally published at Dr John M*
“Short people have higher heart risk” screams the headline on CNN.com, treating it as a statement of fact. “Shortness Boosts Heart Disease, Death Risk” is the headline in a HealthDay story seen on BusinessWeek.com.
Wrong.
Such a study as the one being described can only establish association — it CANNOT prove causation. So it’s wrong to say short people have higher risk. It is wrong to say shortness boosts risk.
Blogger and cardiac electrophysiologist Dr. Wes Fisher beat me to the punch by blogging about the continued journalistic confusion between association and causation. He wrote:
“About the only thing that can be concluded from this so-called “analysis” is nothing more than maybe we should consider studying if this association actually exists.”
Tell ’em, Dr. Wes. And tell ’em, Randy: “Short people got no reason” to worry — at least not yet — from this study.
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