first do no harm

Exercise as Effective as Surgery for Knee Pain

By | July 21st, 2016|Fitness and Health|

I'm glad to see surgery subjected to meaningful control studies.  That's the standard for Acupuncture research except we also have the additional burden of adding sham acupuncture as a study arm.  Surgical studies, for some reason, don't need add a sham arm. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged [...]

Device Makers Take Dangerous Shortcuts

By | April 2nd, 2014|First Do No Harm: Risks, Follow the Money|

Turns out that Medical Device companies have making tweaks to their devices without putting them through human testing.  Calamity ensues.  First, Do No Harm. A few years ago, the Food and Drug Administration announced a stunning recall, saying that electrical wires in some St. Jude Medical heart defibrillators, which were implanted in tens of thousands [...]

Sanity on Statins: Part 4? or is it 5?

By | November 14th, 2013|Big Pharma, First Do No Harm: Risks, Fitness and Health, Follow the Money|

Can I really trust these guidelines??? Lots of news about the latest recommendations for patients with high cholesterol vis a vis drug regimens.  At first I thought it was good news, but now, reading the editorial by Rita Redberg, I realize that these recommendations could actually WIDEN the use of statins.  I will [...]

Statins Controversial in the Elderly

By | October 23rd, 2013|Big Pharma, First Do No Harm: Risks, Fitness and Health, Follow the Money|

Ancient Medicine Made Modern More controversy over statins.  This time for seniors over 70 with no heart risk. There is evidence of harm linked to statin use in seniors, he added, including muscle aches, liver toxicity and gastrointestinal distress; growing evidence of impaired memory and a heightened risk of diabetes; and some evidence [...]

Questioning Steroids for Back Pain

By | October 22nd, 2013|First Do No Harm: Risks, Follow the Money|

So a new study shows that injecting epidural saline is just as good as injecting steroids for low back pain.  I think this should be a rather big deal. This study was painstakingly done reviewing all appropriate studies to date, even taking into account publication bias. The full study here.Epidural_Injections_for_Spinal_Pain__A_Systematic.31 A handy review of what [...]

Hormone Use in Menopause Still in Doubt

By | October 2nd, 2013|Big Pharma, First Do No Harm: Risks, Fitness and Health|

Not so sure about hormone replacement... Traveling ( in Stockholm for the ISAMS conference) so won't discuss this at length.  But noteworthy is how nuanced any advantages of hormone therapy are.  Go natural, take herbs and get acupuncture.  First, Do No Harm. October 1, 2013 Study of Hormone Use in Menopause Reaffirms Complex [...]

Recommendation for Otitis Media: Watchful Waiting

By | February 25th, 2013|First Do No Harm: Risks|

New guidelines from the Academy of Pediatrics.  We've discussed the conundrum of antibiotics for otitis media here and here.  Having completed a Pediatric Residency and passed my Boards (granted, this was back in the Dark Ages), this comes as such a 180' turn around, it's sort of difficult to believe. Stricter diagnostic criteria and broader [...]

Dr.Oz: Morning Philosophizing

By | February 3rd, 2013|Fitness and Health, Follow the Money|

From the Feb 4th issue of the New Yorker, a profile of Dr. Mehmet Oz, entitled "The Operator," (he is discussing the presence of a guest "authority" on his show who explicitly rejects the tenets of science) "If I don't talk to him I have abdicated my responsibility, because the currency that I deal in [...]

Clinical Trials Subject to Bias in Reporting.

By | January 14th, 2013|First Do No Harm: Risks|

What to believe? This post is a sort of corollary of the skepticism around acupuncture research.  The flip side is that when the researchers believe in, or want something to work, the reporting becomes skewed. In this case, side effects were significantly under reported in the studies. January 14, 2013 Clinical Trials Flawed [...]

The Big Picture:Sunday Morning Philosophizing

By | November 25th, 2012|Big Pharma, First Do No Harm: Risks, Follow the Money|

One of the themes that pervade modern U.S. life. from the Big Short, by Michael Lewis  p.110 "In public markets, you have people focused on quarterly earnings rather than the business franchise.  You have people doing things for all sorts of insane reasons."  They believed, further, that public financial markets lacked investors with an interest [...]

Clostridia Dificile on the Rise

By | November 21st, 2012|First Do No Harm: Risks|

We've been discussing C.Dif (Clostridia Dificile) in the context of encouraging good bacteria.  This is from the most recent Anesthesiology Today. Dramatic Rise in Hospital Visits for C. Difficile by George Ochoa Despite efforts by the U.S. Department of Health and Human Services and antimicrobial stewardship programs to combat Clostridium difficile infections (CDIs), the national [...]

Another Article on Steroid Injection Risk

By | November 19th, 2012|First Do No Harm: Risks, Follow the Money|

For Back Pain: Relax! Or try acupuncture! We've covered the hazards of epidural steroid injections here.  But this article is a good summary of the questionable efficacy, the skyrocketing usage, and the horrors of the fungal meningitis cases.   How Back Pain Turned Deadly ..There are the doctors who overprescribe an invasive back-pain [...]

Antidepressants: #1 Drug

By | November 16th, 2012|Big Pharma, First Do No Harm: Risks|

Are Pills the Answer? Rate of antidepressant drugs has increased 400% if you compare 1988-94 to 2005-2008. Depressing...Some concerns about antidepressants here, here, and here. 1st Antidepressant ranking among prescription drugs among U.S. adults up to age 44. Antidepressants are the most common prescription medication for Americans age 18-44, and the third most [...]