“At some point, it is what many of us experience in our lives as the physician-child paradox. You hold out hope for the best possible outcome, but when the data and your parent are staring you in the face, it is hard to deny the odds and experience. [..] At the end of the day, the look of defeat remained on his face. He had been a good sport, but the outcome was not going to change. Either he or fate had decided it. I could not tell. “I love you,” he said. “I love you, too, Dad,” I replied. … Read More
All posts by Anupam
“The COLONPREV trial—published online in The Lancet—is, therefore, a landmark study. It is the first randomised controlled trial to compare colorectal cancer deaths in people screened with the two most commonly used methods: colonoscopy and faecal immunochemical test (FIT), an antibody-based test for haemoglobin, indicative of blood in the stool. The study finds that invitation to biennial FIT-based screening is non-inferior to invitation to one-time colonoscopy in terms of colorectal cancer mortality at 10 years. These results build on the NordICC trial, published in The New England Journal of Medicine, which showed that invitation to colonoscopy reduced colorectal cancer risk … Read More
“[Green] I was really surprised to learn that tuberculosis is the deadliest infectious disease in the world. Even though I cared about global health, I would have bet my life that it was malaria or H.I.V., because those diseases get so much more attention. They still don’t get nearly enough attention, it must be said; people don’t pay enough attention in the rich world to problems in the global South. [..] It’s not easy to cure, but neither was my brother’s cancer. My brother had cancer a couple of years ago; it cost about 150 times more to cure than … Read More
“The tobacco and ultra-processed food industries exemplify the detrimental effects of corporate influence on public health. For decades, tobacco companies lobbied aggressively against health regulations, contributing to millions of preventable deaths worldwide. Despite still causing more than 8 million tobacco-related deaths annually, the tobacco industry now claims through its public-relations campaigns and selective science that it focuses on “harm reduction”, particularly by selling new products such as e-cigarettes. These tactics allow the industry to argue that it deserves a seat at the policy table, all while shifting to new types of addictive and harmful products, targeting youth, and continuing to oppose tobacco … Read More
A research group assessed plasma proteins between 1997 and 1999 from over 6200 middle-aged (45-69 years) individuals. They followed these people for 20 years and tracked 45 age-related diseases and multi-morbidity. They used SomaScan version 4.0 and 4.1. In addition to proteins for overall organismal age, they had clusters of proteins for arteries, brain, heart, immune system, intestine, kidney, liver, lung and pancreas. “[Results] Over 123 712 person-years of observation (mean follow-up 19·8 years [SD 3·6]), and after excluding disease cases at or before baseline, higher organ age gaps were associated with an elevated risk of 32 out of the 45 … Read More
“We compared public-access naloxone strategies using more than 14 000 cases of opioid poisoning in Metro Vancouver over a 6-year period. We found that the 647 take-home naloxone sites were within a 3-minute walk to more than one-third of all opioid poisonings and had high coverage efficiency (Table 2) [the top five location categories for coverage efficiency were: government office, take-home naloxone site, convenience store, retail store and pharmacy]. In addition to existing operations that distribute take-home naloxone kits, which are likely taken elsewhere, take-home naloxone site locations appear generally well-aligned with where opioid poisonings occur, so they are also … Read More
“A report last week from the World Health Organization reveals that 597,000 people died of malaria last year, overwhelmingly children under age 5, and an estimated 263 million people were sickened. Thousands of families cradled a baby dying from a preventable fever; thousands of pregnancies ended in stillbirth or maternal death. For a time in the early 2000s, it seemed as if the world was gaining ground against malaria, but progress has stalled, cases have risen and the hopes for its near-elimination by 2030 have been scuttled. Global warming, armed conflict and lack of funding are all factors. And while new vaccines … Read More
JAMA interviewed Sarah C Hull, associate director of the biomedical ethics program at Yale. “[JAMA] [..] What are the biggest moral dilemmas that you think we’re facing with AI [artificial intelligence], especially within this area? [Hull] I think that we need to be very careful when deploying tools that act human vs tools that are decidedly not human acting. I think that ethically, it can become a lot more complex when you have really advanced generative AI that can seem very humanoid, but very importantly does not possess moral agency and does not have a fiduciary responsibility for the well-being … Read More
“In 1990, it was hypothesized that humanity was approaching an upper limit to life expectancy (the limited lifespan hypothesis) in long-lived populations, as early gains from improved public health and medical care had largely been accomplished, leaving biological aging as the primary risk factor for disease and death; the rate of improvement in life expectancy was projected to decelerate in the twenty-first century; and e(0) [life expectancy at birth] for national populations would not likely exceed approximately 85 years (88 for females and 82 for males) unless an intervention in biological aging was discovered, tested for safety and efficacy and broadly … Read More
“Despite the convenience and value of telehealth, many states have rolled back COVID-19 pandemic–era flexibilities and reimposed strict licensure requirements for telemedicine. Thus, as it was prepandemic, so it is again that a physician, duly licensed in their home state, is prohibited from consulting or following up with an out-of-state patient via video or phone unless they are also licensed in the patient’s state. Penalties for doing so without that license can amount to tens of thousands of dollars in fines and potential imprisonment. Despite growing pressure to respond to patient preferences and widespread evidence of the benefits of interstate … Read More