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From The CDC: Top Ten Greatest Public Health Achievements

The Center for Disease Control published the top ten public health achievements from 2001-2010, the first decade of the 21st century.  In no order they are:

  • Vaccine-preventable Diseases – new vaccines for herpes zoster, pneumonia, HPV and rotavirus have saved thousands of lives  When you add in the older vaccines for diptheria, pertussus, tetanus and measles/mumps millions of lives have been saved around the world.  (I saw diptheria in Haiti and it is horrible)

  • Tobacco Control- We have been battling tobacco since 1964 but there is finally progress with more states enacting smoke-free laws and raising cigarette taxes.  By 2010, the FDA banned flavored cigarettes and established restrictions on youth access.  We have a long way to go.  Smoking costs us all about $193 billion a year on medical costs and loss of productivity.


  • Motor Vehicle Safety –Enforcing seat belt and child safety legislation has reduced deaths from crashes.  Teen drivers have new policies too.
  • Cardiovascular Disease Prevention-During the past decade, age-adjusted heart disease and stroke deaths declined.  What worked? Treating hypertension, elevated cholesterol and smoking…along with improved treatment and medication. Read more »

*This blog post was originally published at EverythingHealth*

Morgellons: When People Mistakenly Believe They Have Parasites

I saw a patient recently for parasites.

I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite.  The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism.

The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem.  There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who  I saw in clinic who, while we talked, ate a raw garlic clove about every minute.

“Why the garlic?” I asked.

“To keep the parasites at bay,” he told me.

I asked him to describe the parasite.  He told me they floated in the air, fell on his skin, and then burrowed in.  Then he later plucked them out of his nose.

At this point he took out a large bottle that rattled as he shook it.

“I keep them in here,” he said as he screwed off the lid and dumped about 3 cups with of dried boogers on the exam table.

To my credit I neither screamed nor vomited, although for a year I could not eat garlic.  It was during this time I was attacked by a vampire, and joined the ranks of the undead. Read more »

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

Safe Injection Protocols Are Not Being Followed By Clinicians

Thanks to Laura Landro for shining light on unsafe injections in her WSJ blog, “Unsafe Injection Practices Persist Despite Education Efforts.”

Landro writes:

“A new push is underway to eliminate unsafe injection practices, which remain a persistent safety problem despite years of efforts to educate clinicians about the risks of re-using needles, syringes and drug vials.

In the U.S., failure to follow safe practices in delivering intravenous medications and injections has resulted in more than 30 outbreaks of infectious disease including hepatitis C, and the notification of more than 125,000 patients about potential exposure just in the last decade, according to health-care purchasing alliance Premier Inc.”

As a registered nurse this is unthinkable.  Learning to administer injections safely is “patient care 101.”  There is no excuse for any health care professional to unsafely inject patients.

Patients in the hospital, ambulatory surgical centers or outpatient settings, should expect that their nurses, doctors and other clinicians are administering injections safely. Read more »

*This blog post was originally published at Health in 30*

FluPhone Tracks “Super Spreaders” Of Disease

“Are you a super-spreader?” That’s the catchphrase for a new study out of the University of Cambridge. However, if you answered “yes”, you may want to stay home and cover your mouth, because the study was designed to track the spread of influenza using cellular phone technology.

The study (and accompanying app) is called FluPhone, and it uses cell phones to collect information on social encounters within the study sample of participants in Cambridge. A phone’s Bluetooth antenna detects encounters with other participants and also records the proximity to each other. The built-in GPS chip tracks each user’s location, but this feature was disabled due to recent ethical concerns. Finally, the phone’s 3G/GPRS antenna sends all the proximity data automatically back to researchers for analysis. Other features include the ability to program a specific disease model by introducing a virtual “pathogen” which can be transmitted via Bluetooth when at least two users are near each other.

In addition to revealing useful data about the spread of disease and how to minimize its effects, the study could also be helpful for creating more effective public health messages.

More from the University of Cambridge: FluPhone: disease tracking by app…

Research project page…

FluPhone participant website…

*This blog post was originally published at Medgadget*

Drug Resistant Bacteria Found In Half Of US Meat And Chicken

Drug-resistant strains of Staphylococcus aureus were found in nearly half of meat and poultry samples, and were likely from the animal themselves, a study reported.

Meat Department by Anthony Albright via Flickr and Creative CommonsResearchers collected and analyzed 136 samples of 80 brands of beef, chicken, pork and turkey from 26 retail grocery stores in Los Angeles, Chicago, Washington, D.C., Fort Lauderdale, Fla., and Flagstaff, Ariz. Among the samples, 47% were contaminated with S. aureus, and 52% of the strains were resistant to at least three classes of antibiotics–and some to nine antibiotics.

Translational Genomics Research Institute, a non-profit research organization, conducted the study and published results in Clinical Infectious Diseases.

DNA testing suggested that the food animals themselves were the major source of contamination. 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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