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Latest Posts

HRT And The “Window Hypothesis”: Hope Or Hype?

It’s only Wednesday, and so far three patients have come to their office visits carrying Cynthia Gorney’s article from Sunday’s New York Times entitled “The Estrogen Dilemma.”

The article explores the stories of three women who found relief from perimenopausal symptoms by using hormone replacement, framing the discussion in the larger context of what is being called the “window hypothesis” — the idea that starting estrogen replacement in the perimenopause and continuing it into later life may be neuroprotective and even cardioprotective, in contrast to beginning its use 10 or more years after menopause, where it can trigger heart disease, stroke and dementia. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Belly Fat Is A Risk Factor For Dementia

One of the great fears we all have is to lose our mental ability as we grow old. No one wants to end their life with dementia (such as Alzheimer’s Disease). We all should be highly motivated to do things to avoid this tragic outcome. We already know that regular exercise is good for the mind and may reduce the risk of dementia. Recent evidence shows that the use of statin medications to lower cholesterol may help reduce dementia risk. Now we have evidence that the roll of fat around your waist may be a marker for increased dementia risk.

The University of California, Berkeley Wellness Letter (February, 2010) reports on a study published in the journal Neurology that followed 1500 Swedish women for 30 years. Those with more fat around the waist were twice as likely to have dementia by age 70 compared with thinner women. A 2008 study from Kaiser Permanente that included men and women showed similar results. Read more »

*This blog post was originally published at eDocAmerica*

How To Detect And Treat Alzheimer’s Disease


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It’s said that everything comes with a price. The average American now lives almost thirty years longer than a hundred years ago. But for millions of people, the price of longevity has been Alzheimer’s disease. The greatest fear my patients express to me is, “I think I’m losing my mind.” Read more »

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

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*

When Your Significant Other Overrides Your Living Will

He knew she was angry with him.

“Whenever I come to see her, I reach out and take her hand, but she looks away.”

Husband and wife for well over 50 years, they had been through a lot.  They met in another country in another time, and to hear him tell it, it almost seemed fated that they’d end up together.  Since then, they’d moved many times, raised a family, supported each other through myriad illnesses.  They were growing old together.

Unfortunately, “growing old together” doesn’t always work out like we hope it will.  Diseases and illnesses ravage our bodies; dementia ravages our brains.  She’d long ago given up on their little garden in the backyard.  It was her favorite hobby, but she couldn’t manage it anymore. Read more »

*This blog post was originally published at code blog - tales of a nurse*

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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