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In fact, that’s the reason I put this website together… to not only get information for myself but also to share it with others. That’s sort of my nature, you see. For over 15 years I’ve been a magazine reporter and editor… I like to find out the facts as best I can, and then I like to present them in a clear way for anyone who’s interested. Read more at: http://walkfit-review.com/

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By Celebrity Diagnosis

Yahoo! recently released its data on the Top 10 internet search topics of 2011. Here are the results, compared with the previous two years.

For three years running, both Kimberly Noel Kardashian and American Idol, a reality TV singing competition show, both made the top 10 lists.
 

As we reported last year, the dominance of celebrities and other pop culture phenomena in these lists caused one commentator to conclude that the general pubic are all slack-jawed yokels and that the internet is not a serious tool for information dissemination.

Our thesis at Celebrity Diagnosis is that the public’s interest in celebrities and popular culture can be leveraged as Teachable Moments in Medicine to increase health literacy and medical knowledge. Teachable moments depend upon cuing events made available through the Goody-Gaga Effect, which is the marked increase in volume of search engine traffic for specific diseases and conditions that correlates with a celebrity association with that disease or condition. The Goody-Gaga Effect was named after Jade Goody and Stefani Joanne Angelina Germanotta (aka Lady Gaga).

During the past year, Ms. Kardashian’s public medical history has taught us about psoriasis, a condition that affects both her and her mother Chris Jenner, and triggered debate about patients’ demands for procedures and treatments that may not be medically indicated. American Idol has been a rich source of teachable moments across a wide variety of medical conditions including:

• Disease of the vocal chords including hemorrhages, strains, nodules and granulomas
• Orthopedic injuries and hepatitis
• Ulcerative colitis
• Tourette’s and Asperger’s Syndromes
• Other health hazards of reality shows including exacerbation of pre-existing conditions and suicide

By Gary Schwitzer

This is about a HealthDay story headlined, “British Study Suggests Mammograms Do More Harm Than Good,” that fails to address the big picture — much less what this same news organization reported just two days earlier.

Just two days before the British study story, HealthDay reported on a Dutch study under the headline, “Mammograms Cut Risk of Breast Cancer Death by Half, Study Finds.” Our review team commented:

“Given the documented public confusion
about mammography, any given story about a new study needs to provide
more context than this one did … We’re not sure that women will be any
more clear about the state of the evidence after reading this story.
There’s been much debate about the benefit of mammography screening and
whether the benefits outweigh the harms.  This story does not really
help women put the information into context, nor does it help them
analyze whether this is news that really matters.”
So what happens?  Two days after that story, HealthDay publishes the
British study story WITH NO REFERENCE TO THE DUTCH STUDY!  That’s
exactly the point we made in our review of the earlier story.
What are women to make of these two different messages in two days’ time from HealthDay?

• British Study Suggests Mammograms Do More Harm Than Good
• Mammograms Cut Risk of Breast Cancer Death by Half, Study Finds

I don’t mean to pick on HealthDay.  This could have been any news
source; I just saw it on HealthDay because we monitor their work daily.
But think of a woman who is in the midst of trying to decide about
mammography for herself – and she reads this kind of disjointed,
disconnected news coverage that offers no context, no analysis, no
linking to what was reported the same week – in short, no help!
The "mammography du jour" story treatment serves no one.

By Nancy Walsh

In a recent issue of the New Yorker, long-time staff writer Michael Specter explored the nature of the
placebo effect in medicine, primarily by describing the work of Ted Kaptchuk,
who directs Harvard University’s Program in Placebo Studies and the Therapeutic
Encounter (PiPS). The program’s mission is “to examine the placebo response and
the implications of medical ritual, the patient-provider relationship, cultural
context, and the power of imagination and hope in the healing process. Through
endeavors in the clinical, basic, and social sciences, bioethics, the history
of science and philosophy, PiPS seeks to elucidate, quantify, optimize and
reaffirm the humanistic and more intangible dimensions of health care.”
Kaptchuk, who studied Chinese medicine in Macau and
practiced acupuncture for many years, is arguing for a shift in contemporary
medicine away from high-tech and pure science to a greater emphasis on healing.
Having recently received funding from the National Institutes of Health, he and
his colleagues are undertaking neuroimaging and molecular studies to understand
the biological underpinnings of the placebo response.
In one study, he and his group acknowledged that a problem
in directly exploring the placebo effect in a clinical setting was the use of
deception — not letting patients and providers know of they are receiving an
active drug or not. So they designed a randomized study in which patients with
irritable bowel syndrome were given pills they were told were “an inert
substance, like sugar pills” or no treatment. After 21 days, patients given the
placebo had significantly different changes on global improvement scores (5
versus 3.9, P=0.002) and symptom
severity (P=0.03).
In another study, patients with asthma were randomized to
treatment with an albuterol inhaler, a placebo inhaler, sham acupuncture, or no
treatment. The albuterol group experienced 20% improvement in forced expiratory
volume in one second (FEV₁) measured on spirometry, and the other
three groups all improved by 7%. However, when patients were asked if they felt
better, 50% on albuterol reported improvements, as did 45% of those using the
placebo inhaler, and 46% of those who had sham acupuncture, compared with only
21% of those who had no treatment (P<0.001).
The researchers concluded that, while objective measures such as FEV1 are important in asthma care, “other
outcomes such as emergency room visits and quality-of-life metrics may be more
clinically relevant to patients and physicians.”
Specter concludes his article with a personal anecdote. He
had been experiencing chest pain and was worried, being an overstressed
middle-aged man, so went to his doctor, who conducted a careful examination.
The physician told him he was fine, but needed to relax — and the pain simply disappeared.
This was an example of “exactly the type of ritual that, according to Kaptchuk,
will have to play a critical role in the future of American health care.
So what do you think should be the role of placebo — if any — in
tomorrow’s medicine?

Wow at the new Kindle Fire – awesome, isn’t it? And the price is all kinds of cheap. No reason to not buy Kindle Fire for EVERYONE (and especially for yourself!)

By Kristina Fiore

Even during specialty conferences that meet in the same city
year after year — like the recent San Antonio Breast Cancer Symposium – rarely do attendees have a chance to get a sense of place. 
Reporters, like doctors, are confined to the walls of the
convention center most of the day, from which they head straight for dinner at
tried-and-true spots with colleagues, only to immediately retire to the same
old hotels.
It’s not until I’m at the airport waiting for my return
flight that I get the chance to sit down with a copy of the local magazine or newspaper to
learn more about the place that I’ve just spent a week in.
Luckily, this most recent trip to San Antonio, my colleagues
happened upon a new dinner spot – but only because we couldn’t get into
Rosario’s, one of the most popular Mexican restaurants in San Antonio, on a
crowded Saturday night.
Though it was just two blocks down the road, none of us had
heard of Tito’s before. A colleague had noticed it while he was driving around earlier that day. Apparently, none of the other folks waiting for hours outside
Rosario’s had noticed it either, because the place was nearly empty – and for
no good reason. The food was fantastic, and the cuisine was far more creative than
that of our over-packed staple.
Of course, I still don’t feel I know San Antonio on the
whole any better, but it’s good to know that a fresh experience in an often-visited place may be just around the corner.

By Shalmali Pal

As a healthcare professional, when you see "CMS," it’s likely that you think of the agency that administers Medicare. For me, CMS also stands for "cleanse, moisturize, sunscreen." That’s been my skincare routine for nearly a quarter of a century and, combined with good genes, I’ve had ID-checking store clerks do a double-take at my 1969 birthdate.

Recently, I’ve noticed some fine lines around the eyes … maybe the hint of a wrinkle or two … wait, is that an age spot?!? This turn of events sent me flying to my nearest high-end self-service cosmetics emporium, determined to nip this aging thing in the bud.

I stared at the wall of skin care products in front of me: Was I looking at a retail display or the directory at a medical plaza? It seems that every dermatologist now has his or her own skin care line.

There’s Dr. B, waging a one-man war on pores. Dr. K makes battling keratosis pilaris seem like a noble mission. Dr. P has a rootin’-tootin’ line of fresh and fruity facial toners. Dr. M has captured radiance in a bottle. And Dr. W has so many mushroom-based creams, I wonder if I can marinate my face and tonight’s dinner in them.

This is the controversial world of over-the-counter cosmeceuticals, where aesthetics cozy up to science — or pseudoscience, depending on your perspective. Cosmeceuticals, which include skin care, sunscreens, botanicals, and enzymes, rake in $6.5 billion annually in the U.S.

Its success has been due partly to the blend of medical smarts and savvy marketing: Grave yet glamorous MDs offer access to the proverbial fountain of youth with signature products that, by their own accounts, feature exotic ingredients and took years to develop.

Critics have taken these doctors to task for promoting products in which their financial stake is as plain as the nose on your face. Others counter that it’s not unethical for dermatologists to sell commercially to consumers; they just shouldn’t plug namesake products in-office to their patients.

Regardless of the moniker on the bottle, I noticed that doctor-designed skin care has much in common: The packaging is elegant yet still clinical. Product descriptions are peppered with technical terms like "biocompatible," "regeneration," "cellular matrix," and "photodynamic."

The prices for these potions range from "That’s the same as my health insurance co-pay" to "Is there a loan officer on the premises?"

Pretty packaging aside, what’s the difference between these products and what I can find in my local drugstore? I ran a highly unscientific experiment and compared ingredients between one dermatologist’s face peel and a mass-market brand.

Both contained glycolic acid as a main component. The doctor’s version was formulated without parabens, a preservative that’s been linked to skin irritation and more serious illnesses, and without dyes (the other brand listed "red-33" as an ingredient). But the mass-market peel was $10 less and the bottle was bigger.

Ultimately, Dr. P won me over with his mid-priced, silky serum for, ahem, mature skin. Will it work? Ask me in four to six weeks when I’ve been promised visible results.

Until then, I confess that the sight of the glass bottle — with its bold red lettering and inky black rubber stopper — perched on my bathroom counter brings a smile to my face. Laugh lines aside, isn’t happiness supposed to be a great beauty elixir?

By Gary Schwitzer

Some months I can’t wait for my new issue of Prevention magazine to
arrive, just so I can see how they’ve stretched the envelope this time.
How about this month’s cover, trumpeting a Cancer Vaccine Breakthrough in big yellow font at lower left of the cover?

So I started flipping through the Table of Contents for the big story.  Hmmm … nothing there.  Odd.
So I started flipping through the pages of tips for “jiggle-proof
arms and abs” and such and … voila … on page 13, I found the big story under
another “Cancer Breakthrough” heading.

In 16 words in that little box, I learned that a vaccine was “moving into the testing phase.”
Usually, reasonable people would wait until we’ve moved out of the testing phase before declaring something a breakthrough.
But, hey, the cover worked like a publisher’s dream. It sucked me
in. Hiding the 16-word meat of the story away from the Table of Contents
sucked me in even further, forcing me to scan the ads and the features
that read like ads.
Years ago, patients urged me to write my column entitled, “The 7 Words You Shouldn’t Use in Medical News.”
Breakthrough was one of them.  This is the kind of story they had in mind.

Wow at the new Kindle Fire – awesome, isn’t it? And the price is all kinds of cheap. No reason to not buy Kindle Fire for EVERYONE (and especially for yourself!)

Let’s take a look at the new Kindle Fire, where you can buy one cheap, all it’s amazing features…and do a Nook Color vs Kindle Fire comparison AND a Color Kindle vs iPad comparison (videos so you can SEE the difference).

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A guide to the hottest mobile apps around. Both iOS and Android. Curated by the Dolphin Browser team. http://hotapps.squidoo.com/

By Gary Schwitzer

As
one clear sign of how we want to help improve the flow of health care
information – not just criticize things we see that are communicated
inadequately – we’ve built a section of HealthNewsReview.org called The Toolkit. 
We plan to continue to add to the Toolkit as time permits and we
welcome your nominations for topics you’d like to see addressed.
We think that journalists and consumers can learn from reading the
collection of primers, backgrounders, and links that we’ve gathered
there.

The Tips For Understanding Studies  include:

• Does The Language Fit The Evidence? – Association Versus Causation
• Resources for Reporting on Costs of Medical Interventions
• “Off-label” Drug Use and Marketing
• 7 Words (and more) You Shouldn’t Use in Medical News
• News from Scientific Meetings
• Absolute vs. Relative Risk
• Number Needed to Treat
• Commercialism
• Single Source Stories
• FDA Approval Not Guaranteed
• Phases of Drug Trials
• Medical Devices
• Animal & Lab Studies

Our list of independent experts
– which, by the way, will soon be updated – is meant to help
journalists who may not know where to find non-conflicted sources for
their stories.

By Crystal Phend

Here in Budapest, where the EuroEcho meeting is underway, is the Golden Eagle Pharmacy Museum.

Housed in the medieval location of a pharmacy of the same name, it features medicine mixing tools, a 16th century "physicians’ desk reference" on preparation of medicines, and replicas of a pharmacy "counter" and a laboratory. There are
also paintings illustrating what it was like to work in one
in the days when pharmacist and physician weren’t separate positions.

It’s a small but interesting museum in the castle district of Budapest.
I’d recommend it to any clinicians or radiologists in town for the
conference. After catching up on MedPage Today‘s coverage, of course.

Whether you’re looking for books or great music, Barnes & Noble is a great place to shop. Also, don’t forget about the Nook, B&N;’s very own e-reader. If you don’t have the nook reader, you can still purchase nook books and read them on your computer or tablet with the nook reader program.

Barnes & Noble gift cards are also very popular gift ideas, perfect for Christmas! Besides books and music, B&N; also carries a great selection of DVDs (movies, tv shows, and even exercise programs), electronics, and more.

By Kevin, M.D.

Intensive care specialist Jim DeMaine details a tragic case of a teenager in the intensive care unit (ICU) with cystic fibrosis.

When do you turn of the ventilator?  The decision to prolong the dying process, especially in a teenager, is gut-wrenching. 

"Surprisingly, about 70% of deaths in the ICU’s are related to withdrawal of the ventilator – the only thing that is prolonging the dying process," Dr. DeMaine writes. "The decision to withdraw the ventilator, even when expected and supported, is never easy but it does show respect for the wishes of the patient as reflected in family discussions. There are times when the ventilator is continued for days, weeks, or even months when the surrogate decision makers disagree – but fortunately the futile continuation of care is unusual. Ethics consultations and recommendations are invaluable in such situations."

Obtaining both an ethics consult, as well as a second opinion, as was done here, is always recommended.

But it doesn’t make the decision any easier.

***

The term "wellness" is increasingly being used by medical institutions.

But, as gastroenterologist Michael Kirsch writes, is it simply becoming a marketing term?

Hospital and medical marketers may not know how to cure disease, but they sure can count. The vast majority of Americans have pursued alternative medicine for one reason or another. The medical establishment has expanded its healing mission to gain access to this huge and growing market. Conventional hospitals, where cardiac catheterizations and colonoscopies are performed, now offer a variety of wellness programming to extend their branding into the surrounding communities.

Interesting, if perhaps a tad cynical, take.  But perhaps it’s a wake-up call for traditional medicine to start treating patients more holistically, rather than focusing on the disease itself.  It’s a subtle philosophical shift that is needed to prevent patients from flocking to alternative therapies.

By Greg Laub

Countless times I have left my GPS
on and plugged into the cigarette lighter (does anyone really still
light their cigarettes with this device?), and pretty much the same
number of times it was followed by my wife nagging me to never do it
again.

Sure, I get it – you can drain the car battery by leaving the GPS on, and I try to remember to shut it off – but unplugging it? How much battery is really being used with the GPS turned off?

Well,
it turns out just enough. Apparently the GPS continues to draw current,
initially to keep its internal battery charged, and then afterwards
just to maintain the charge.

Unfortunately for me, I found this one out the hard way.

About a month ago, I found my car battery actually died because the GPS was plugged in
(though not on) over a long weekend. I learned my lesson. Listen to your wife. Oh, and, unplug the car charger.

But I’m a
stubborn sort. See, while I admit I was wrong, I mostly attributed this
as a fluke that was caused by not starting the car for almost four days.
Surely it wouldn’t happen in a couple of hours, or overnight. So while I do try to
remember to unplug the GPS every time, sometimes it slipped my mind,
especially if I’m only leaving the car for a short time.

But
then last week I received an email from a close friend whose neighbor
had an incident the previous night. Apparently, she left her charger
plugged in, and after just a couple of hours, the cigarette lighter
overheated and started a nasty car fire.

My friend was nice enough to forward me some lovely photos of the Suburban:
  

 

The photos floored me. Luckily they caught the fire quickly, as their car
was in the garage and the kids were inside sleeping. But what if they
didn’t catch it? It could have hit the engine, or fuel tank within the
hour.

And then it hits me — I left our GPS plugged in again!

Immediately I hustled out to the car, found everything to be fine, and — what will
now be a common occurrence — I unplugged our GPS.

Sometimes, I suppose, other people learn the hard way for you.

By Kevin, M.D.

Health care is obviously changing around us.  In a guest post, Yale physician Ed Volpintesta encourages new medical graduates to get involved with politics, so doctors can have a voice in the changes:

… spend some time in medical politics. Your state and county medical societies, the medical profession need your help. Without it they are not as strong as they need to be. Don’t believe that doctors cannot push back against the forces that are against them. They can.

I agree.  During heath reform, doctors were far too silent.  If we aren’t involved in the changes, others outside of clinical medicine will make crucial health policy decisions that can greatly impact physicians.

***

Recently, the U.S. Preventive Services Task Force (USPSTF) modified its prostate cancer screening guidelines, causing a firestorm of reaction.

I wrote a piece on the issue, citing contrasting editorials from USA Today and the New York Times.

The public is clearly confused, but in the end, the decision to screen will come down to an individual patient decision:

 … it will be difficult to undo decades of prostate cancer screening practice. Cancer is emotionally and politically charged. The new USPSTF guidelines are useful in bringing false positives and the fallacies of early cancer screening into the national conversation, but that’s about it.

So, what am I going to do? I’m going to discuss the new guidelines, and give my recommendation, which will be consistent with that of the USPSTF. But the ultimate decision is the patient’s, and I will respect their choice, whether they want to be screened for prostate cancer, or not.

It’s becoming increasingly apparent that when it comes to cancer screening, nuance will make it difficult to issue blanket, population-based guidelines.

Do you suffer from lower back pain? You’re definitely not alone. Back pain is one of the most common chronic conditions that people deal with. There are many ways to treat back pain … some take pain relievers to make the symptoms, while others consider mattresses, chiropractors, and a variety of home back relief equipment.

Wall murals are a great addition to any room. To shop a wide selection of wall murals at great, low prices, check out the website above. You’ll find a wide variety of choices for many ages … You can do something like the Buzz Lightyear mural for a young to mid-age child, or the giraffe is perfect for a baby or toddler. There’s other great choices, like football, Star Wars, and other Disney characters.

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Read the included story book while placing baby Jesus in the manger, surrounded by the three wise men, Mary and Joseph and all the manger animals. Nativity set measures 17.3″ W. Includes six adult figures (2.95″ H), an angel (2.05″ H) and much more.