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Health Alerts

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AND STILL MORE...
See: Health Agency: Europe's COVID Surge Could Be 'Window Into The Future' For U.S.,
(Washington Post via The Day, November 26, 2021.)

GS

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AS I KEEP REPEATING: YOU DON'T WANT THIS INFECTION!
Protect yourself. GET VACCINATED!

GS

Breakthrough COVID-19 raises risk of health problems, death

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FYI.

GS

Antibody Protection From Mild COVID-19 May Not Last

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Rapid Response for MONDAY, November 15, 2021

MORE CONTROVERSY.

We'll add this to the "Chronic Lyme" issue.
Just remember to collect and follow the data, to remember that there is an approximately 40% "Placebo Effect", and that Science, Medical and otherwise, never has all of the answers. They specialize in QUESTIONS.

GS

Mind over matter? Long COVID study sparks controversy

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"CHUBBY"?,  "PLEASINGLY PLUMP"? "BIG BONED"?
Anything but "FAT".

Well, it's highly likely that - besides the prospects of diabetes mellitis and osteoarthritis and gerd and obstructive sleep apnea and heart disease, etc, etc. - you have a high chance of developing or already having non-alcoholic Fatty Liver Disease, heading to Cirrhosis of the Liver.

See: "Weight-Loss Surgery Seen As Helping Liver", by Betsy McKay (in WSJ, U.S. News, November 12, 2021, pA3).

GS

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However, I would wait for further information and experience. Most things in life are a "risk to benefit" analysis.

GS

Are Second COVID Vax Doses Too Risky After Allergic Reaction to the First?

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Antibody Titers Before and After a Third Dose of the Pfizer Vaccine in Adults Aged ≥60

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Rapid Response for MONDAY through WEDNESDAY, November 8 through 10, 2021

MORE ON COVID 19 INFECTION AND AVOIDANCE.
Please read this report carefully. The temptation for the non-vaccinated to make ANOTHER MISTAKE will be great.
YOU DO NOT WANT TO CATCH THIS INFECTION.  NO WAY!

GS

COVID-19 pills are coming, but no substitute for vaccines, disease experts say

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MORE FACTUAL INFORMATION FOR YOUR DECISION-MAKING REGARDING COVID.

See: "Should You Vaccinate Your 5-Year-Old?", by Saphier and Makary (in WSJ November 9, 2021, Opinion, pA15).

GS

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MORE INFORMATION ON THIS STILL VERY DANGEROUS "MESS".

Meanwhile, millions of Americans are making this about "me, myself and I": about their "personal freedom", about their "control over my body", about "ME". And cynical politicians are following the perceived votes...damn the facts.
Sound familiar? We have been hearing and witnessing this mindset for at least the last two decades.
And WHAT ABOUT PERSONAL RESPONSIBILITY? WHAT ABOUT INDIVIDUAL RESPONSIBILITY FOR THOSE AROUND US, to the extent that we can help? What about taking the Vaccine, clearly proven effective and safe, for those around us as well as for our selves?  "FUGGEDDABBOUDDDET".

SHAMEFUL!

GS

COVID Vaccines' Protection Dropped Sharply Over 6 Months

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Rapid Response for SUNDAY, November 7, 2021

THIS WHOLE MESS GETS "CURIOUSER AND CURIOUSER".

"Breakthrough Cases Hinder Fight", by Denise Roland (in WSJ November 8, 2021, pA18).
Yet another reason why we should all get vaccinated - and why we should also receive current and probably future Boosters.

GS


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A LOT OF GOOD INFORMATION ABOUT COVID-19 AND VACCINES...BUT NOT FOR A CURSORY READING.

"COVID Vaccine Mandates And The Question Of Medical Necessity", by Klausner and Kojima, M.D. (in medpage today, November 2, 2021).

Bottom Line.

GS

Medical Necessity and COVID Vax Mandates

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Kids 5-11 Can Now Get Pfizer's COVID Vaccine

Vaccine After COVID-19 Infection Boosts Immune Response

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COVID Vaccines Provide 5 Times the Protection of Natural Immunity: CDC

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Rapid Response for SUNDAY, October 31, 2021

THESE ARE FACTS AND VALID INSIGHTS REGARDING THE STATE OF THE HEALTH CARE PROFESSIONS.

"Not I, Natania".  I won't let the turkeys get me down and out of my chosen Profession. I rather "Fight than Quit".

GS

Why doctors like you are leaving in droves

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UK Study: Fully Vaccinated People Can Spread Delta Variant at Home

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THIS CONDITION IS SO RAMPANT IN OUR SOCIETY TODAY
that it should itself be considered a Chronic Disease.

GS

The link between sleep deprivation and chronic disease

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Moderna’s coronavirus vaccine is safe and produces a powerful immune response in children aged 6 through 11, the company said.

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...AND THIS APPEARS TO BE EVEN WITHOUT FACTORING IN THE CONFUSION BEING FOSTERED ABOUT SEXUAL IDENTITY.  THAT IS RECKLESS!

GS

Pediatric Orgs Declare National Emergency in Mental Health

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FYI.

GS

COVID-19 Cases and Deaths by Vaccination Status

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Based upon available data and "hunch", I would for now avoid the "Mix and Match" approach and would stay with a booster of the original type received...even if it means a delay of weeks in receipt.

GS

FDA Greenlights 'Mix and Match' COVID Boosters

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INTERESTING AND IMPORTANT: THE SELF-REGULATION OF PHYSICIANS.

GS

Sanction the COVID Quacks

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MORE...this time from the American College of Physicians.

"COVID-19: CLINICAL AND PUBLIC HEALTH IMPLICATIONS OF SARS-Cov-2 IMMUNOLOGY", by Laine, Cotton, and Moyer (www.acpjournals.org, October 12, 2021).

GS, FACP

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REGARDING OBESITY.

Over a third of Americans are overweight, mainly obese (BMI of 40 or more).
The only thing the remaining 2/3 of people can agree on is to criticize Them as it's being their fault.
And the experts in metabolism and obesity can't even agree on this.

See an excellent paper on the subject that puts the entire mess in perspective...warts and all.
It is reviewed in the following piece:
"Obesity Paper Has Diet Researchers Riled Up", by Sophie Putka (MetPage Today, October 12, 2021).

The one thing that most will agree on is that, for a variety of known and unknown reasons, the
Mediterranean Diet is the Best program of the hundreds of offerings out there. That's what I use with my patients, and that is what I live myself. 

GS

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HOW MANY WAYS CAN I SAY IT?...

YOU DON'T WANT THIS INFECTION!     GET PROPERLY VACCINATED!!

GS

COVID-19 Briefing:  Is COVID-19 More Than an Infectious Disease?

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"The findings underscore the continuing need for masking and regular testing alongside vaccination...they can be carrying similar amounts of virus and could potentially spread the virus to other people."

"CAN YOU HEAR ME NOW?"     This is no time for uninformed obstinacy.

GS

Viral loads similar between vaccinated and unvaccinated people

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GOOD ADVICE FOR ALL, ESPECIALLY FOR THE NEARLY 40% OF US WHO ARE OBESE.
And it is good advice whether or not it raises HDL cholesterol, mainly determined by heredity.

GS

How to Raise Your Good HDL Cholesterol
By Dr. Mehmet Oz and Dr. Mike Roizen, MDs

New research reveals that having an HDL cholesterol level of 55mg/dL or higher helps your gut biome block common inflammatory signals so they don't damage the liver. For the 25% of American adults with non-alcoholic fatty liver disease, elevating HDL levels can help prevent serious complications such as cirrhosis.

We also know that HDL cholesterol serves as a chemical shuttle, moving heart-damaging LDL cholesterol from peripheral tissues to the liver so it can be excreted. That helps protect you from atherosclerosis, heart attack and stroke.

Research shows obesity and other diseases that trigger chronic inflammation actually turn one healthy form of HDL from a heart protector to a heart attacker. How do you tamp down inflammation and elevate your healthful HDL levels?

1. Upgrade your nutrition. Reduce your processed and total carb intake. One study found that compared to a high-carb weight-loss diet, folks on a low-carb diet had double the increase in HDL levels. Eat purple fruits and veggies and fatty fish like salmon and ocean trout. Studies on anthocyanins, extracts from purple foods like eggplant, blueberries, and purple cabbage, show they can boost HDL levels by around 14% to 19%. Another study found that eating fatty fish four times a week for eight weeks boosts HDL levels significantly.

2. Exercise every day. In one study, walking for one hour a day for 24 weeks lowered body mass index and shrank waist circumference, lowered glucose and triglyceride levels, reduced inflammatory markers, and boosted HDL levels from 44-48mg/dL. Regular exercise also increases HDL's antioxidant and anti-inflammatory powers.

3. Lose weight. Over time, if you improve your nutrition and exercise more, you will shed excess pounds. Losing just 3% of your body weight can boost your HDL level significantly. And no matter how you lose weight, you'll see your HDL level go up once you stabilize your weight at a healthy level.

As you work to increase your good HDL level, you want to lower your bad LDL cholesterol and triglycerides. HDL can only transport about a third of your blood fats. Ditching red and processed meats and all added sugars and refined grains is essential to bring LDL levels down to 70 mg/dL or lower.

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America’s big health problem just got bigger

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"HOW MUCH IMMUNITY..."
 
My Advice: Even those who had the infection should be vaccinated. You just don't want to get this thing...with its "Long Haul" possibilities.

GS

How much immunity does a prior COVID-19 infection give, and why isn’t it considered with vaccine mandates?

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NATURAL INFECTION MAY HAVE A SILVER LINING...IF YOU SURVIVE AND DO NOT DEVELOP A LATE SYNDROME.
But this is not Jenner's discovery with cowpox. You can avoid COVID -19 infection with a Vaccine.

GS

Natural infection versus vaccination: Differences in COVID antibody responses emerge

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Rapid Response for THURSDAY, October 7, 2021

AS I KEEP SAYING: YOU DO NOT WANT TO CATCH COVID-19...IN ANY FORM OR SEVERITY.
GET VACCINATED!!

GS

New data shed light on COVID-19's debilitating second act

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ON THE EVENING OF OCTOBER 5, 2021, A ZOOM LECTURE WAS PRESENTED AT L&M HOSPITAL ON THE PANDEMIC
by Dr. Onyema Ogbuagu of Yale Hospital.
A vast amount of material and study reports were presented. The following is a small percentage of the key points.
YOU DO NOT WANT THIS DISEASE!

GS

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"WHAT THE HELL YOU ARE TELLING ME?"
Granted, the always - politicizing politicians have been unfortunately joined by politicizing scientists - to the confusion of the public. But the Facts are there and they are clear: there Is a Pandemic; it has killed hundreds of millions of people and has ruined the health of many more; the Vaccines are Safe and Effective; and this Pandemic is NOT OVER by any means.

So what are the idiots who wrote and who subscribe to the comments below talking about.?
AND YES, ALL HEALTH CARE PERSONNEL MUST BE VACCINATED IF THEY WANT TO GET ANYWHERE NEAR A PATIENT!
Am I being clear enough!

GS

North Carolina Hospital Caught Plotting To Inflate COVID Numbers Fires 175 Employees For Refusing Vaccine

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Seven symptoms jointly predict COVID-19 diagnosis

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The evidence is in - one mask type stands out as the best protection against COVID-19

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Rapid Response for SUNDAY, September 26, 2021

IF YOU WANT SOME RELIABLE FACTS (AND OPINIONS) ABOUT AMERICA AND THE COVID-PANDEMIC,
read the new book by Dr. Scott Gottlieb (former Commissioner of FDA and close confidant of the White House on these matters):
"UNCONTROLLED SPREAD: Why COVID-19 Crushed Us And How We Can Defeat The Next Pandemic" (Harper Collins, 2021).

The following are some key points that I gleaned from reading this expose.
"IS ANYBODY THERE? DOES ANYBODY CARE?"   Even after this experience??

GS

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Rapid Response for SUNDAY, September 19, 2021

NOW HEAR THIS!

HERE IS A COLLECTION OF RECENT ARTICLES WHICH TOGETHER REPRESENT THE "PENTAGON PAPERS"
OF OUR GOVERNMENT'S ADMINISTRATIVE FAILURES REGARDING RESPONSE TO THE COVID-19 PANDEMIC.

The bright spots were the early warning given by Dr. Scott Gottlieb and President Trump in January, 2020; the
Warp Speed creation and mass production by the Trump Administration of highly effective vaccine; and the herculean efforts by our Health Care System and the troops at the bedside.

The rest reflect yet another failure of Government Administration, directly leading to much loss of life and - as bad - loss of confidence in Science. Nearly all of these articles appeared in the WSJ Opinion section in the last two weeks.

1) "Covid Confusion At The CDC"
2) "What If Covid Were 10 Times Deadlier?"
3) "The Case for Boosters Is Strong".
4) "The Lives Lost to Undervaccination".
5) "How Science Lost The Public's Trust".
6) "The Death of Science", by Victor David Hanson.

And the best, a summary book by Dr. Scott Gottlieb: "Uncontrolled Spread" (Harper Publishing, 2021). The revelations in this book produced both surprise and anger in me.

GS


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Study: Sleep 'Sweet Spot' Helps Prevent Alzheimer's

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WE HAVE BEEN ADDING 25 - OH VITAMIN D TESTING TO ALL OF OUR BLOOD TESTING FOR MANY YEARS - AND HAVE BEEN USING VITAMIN D3 SUPPLEMENTATION FOR ALL THOSE WITH DEFICIENCY.

GS

Further evidence that vitamin D might protect against severe COVID-19 disease and death


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NOT CONCLUSIVE, BUT REASONABLE AND REASSURING.
Another reason to get vaccinated.

GS

Effect of Vaccination on COVID Transmission

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NOW HEAR THIS:

THE VACCINES ARE SAFE AND EFFECTIVE, INCLUDING FOR PREGNANT WOMEN AND THEIR UNBORN CHILD.
(Tests for children under 12 are currently in progress).
THE DISEASE CAN KILL.  IT CAN ALSO MAIM FOR LONG PERIODS - AS IN "LONG-HAUL COVID".
BE RATIONAL, INFORMED, HONEST AND TRUTHFUL WITH YOURSELF WITH ANY OBJECTION.
THEN REMEMBER: ALL OF LIFE'S CHOICES INVOLVE A RISK-TO-BENEFIT ANALYSIS. CHOOSE WISELY.

GS

Long-Haul COVID Brings Long Road to Recovery

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WHAT ARE THE UNVACCINATED TRYING TO PROVE?
What they are not trying to prove is coming across loud and clear.

GS

Vaccines effective against Delta variant

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I'VE BEEN TELLING YOU SO.

As I tell my patients: "I'm going to keep practising until I get it Right".

GS

To Keep Dementia at Bay, Postpone Retirement

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Rapid Response for SATURDAY, September 11, 2021

"UNA MAS".

THE ARGUMENT BETWEEN VACCINATIONS FOR ALL AND FREE WILL RE. VACCINATIONS.

After a personal debate ("On the one hand...On the other hand"):
1) I know on no valid religious objection that trumps the personal and societal Good of Vaccinations.
2) Especially in a pandemic that has killed millions world-wide as well as locally, every person has a Responsibity to get vaccinated - to protect himself and those around him. I know of no valid reason not to get vaccinated: a personal responsibility and in most cases an act of free will. The exception Requiring vaccination would be in the active Health Care Field.
3) In all other cases, regarding the above vs. Liberty / Free Will decisions:
                                                       "LIVE FREE OR DIE"

AS ONE FREEDOM IS LOST OR SURRENDERED, OTHERS WILL BE PROGRESSIVELY EASIER TO LOSE.
BEWARE!.

GS


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THIS PRINCIPLE SHOULD BE CALLED BY ITS PROPER TERM: "TRIAGE", WELL -KNOWN AND CRITICAL IN MILITARY MEDICINE.
I served two years of active duty as a physician in the Army Medical Corps at the 97th General Hospital in Frankfurt, Germany...where on each of those two years I was assigned as Triage Officer during three days of Field Hospital exercises - receiving up to 100 mock casualties who had to be immediately triaged among four categories ranging from Immediate Care to Expectant Care (ie.delayed minimal and expecting death).
Tough...but Vital when the crisis presents itself.

GS

Crisis Standards Activated in Idaho as Hospitals Overflow

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More Medical Boards Warn Against Spreading COVID Vax Falsehoods

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VITAMIN D DEFICIENCY EXISTS IN NEARLY EPIDEMIC FORM IN OUR POPULATION.
This vitamin is involved in many more metabolic processes besides bone health.
Its deficiency can also be involved in some allergic conditions, such as recurrent hives.
We have been monitoring this and treating it with Vitamin D3 for at least a decade.

GS

Vitamin D emerges as possible treatment for COVID-19

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How Does Natural COVID Immunity Compare to Vaccine Immunity?

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Rapid Response for TUESDAY, September 7, 2021

ALWAYS YOUNG ENOUGH TO LEARN SOMETHING...

GS

Super Heated Water

A Warning

I saw this article on the internet about super heated water and wanted to share it with you. I had this happen to me years ago and it scared the hell out me. I didn't get burned but the water boiled up and out of the cup. Here is the article.

A 26-year old man decided to have a cup of coffee. He took a cup of water and put it in the microwave to heat it up (something that he had done numerous times before). I am not sure how long he set the timer for, but he wanted to bring the water to a boil. When the timer shut the oven off, he removed the cup from the oven. As he looked into the cup, he noted that the water was not boiling, but suddenly the water in the cup 'blew up' into his face. The cup remained intact until he threw it out of his hand, but all the water had flown out into his face due to the build-up of energy . His whole face is blistered and he has 1st and 2nd degree burns to his face which may leave scarring.

He also may have lost partial sight in his left eye. While at the hospital, the doctor who was attending to him stated that this is a fairly common occurrence and water  should never be heated in a microwave oven. If water is heated in this manner, something should be placed in the cup to diffuse the energy such as a wooden stir stick, tea bag, etc, (nothing metal).

General Electric's Response:
Thanks for contacting us; I will be happy to assist you. The e-mail that you received is correct. Microwaved water and other liquids do not always bubble when they reach boiling point. They can actually get superheated and not bubble at all. The superheated liquid will bubble up out of the cup when it is moved or when something like a spoon or tea bag is put into it.

To prevent this from happening and causing injury, do not heat any liquid for more than two minutes per cup. After heating, let the cup stand in the microwave for thirty seconds before moving it or adding anything into it.
Here is what a local high school science teacher had to say on the matter: 'Thanks for the microwave warning. I have seen this happen before. It is caused by a phenomenon known as super heating. It can occur any time water is heated and will particularly occur if the vessel that the water is heated in is new, or when heating a small amount of water (less than half a cup).

What happens is that the water heats faster than the vapor bubbles can form. If the cup is very new, then it is unlikely to have small surface scratches inside it that provide a place for the bubbles to form. As the bubbles cannot form and release some of the heat that has built up, the liquid does not boil, and the liquid continues to heat up well past its boiling point.

What then usually happens is that the liquid is bumped or jarred, which is just enough of a shock to cause the bubbles to rapidly form and expel the hot liquid. The rapid formation of bubbles is also why a carbonated beverage spews when opened after having been shaken.

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THIS IS IMPORTANT!  DON'T MISTAKE CHRONIC RHEUMATOID ARTHRITIS FOR OSTEOARTHRITIS.

GS

Delayed RA Diagnosis Can Have Serious Consequences

In a recent continuing medical education-certified activity, Vibeke Strand, MD, MACR, FACP, and Jon T. Giles, MD, MPH, provided expert insight into patient-centered approaches for managing rheumatoid arthritis (RA).
This first of 3 PER Pulse™ Recaps regarding this activity focuses on strategies for providing prompt diagnosis of RA. Below are some highlights:
  • Individuals may have detectable levels of RA-related autoantibodies up to 10 years before onset of clinical disease, but synovial tissue is thought to remain normal in at-risk individuals until shortly before RA is clinically detectable.1
  • Since joint damage can occur in the first few months after disease onset, and early diagnosis and treatment will prevent the progression of this damage in 90% of early cases, timely identification of patients with early RA is crucial.2,3
  • The following signs and symptoms are commonly used to classify patients with RA: symptom duration of at least 6 weeks; swelling or tenderness in small and/or large joints; positive serology for rheumatoid factor or anticitrullinated protein antibodies; and abnormal C-reactive protein or erythrocyte sedimentation rate.4
“We’ve seen where delays in diagnosis and treatment result in damage to the joints that we can’t necessarily turn off later down the line.”
— Jon T. Giles, MD, MPH

References
1.    Scherer HU et al. J Autoimmun. 2020;110:102400.
2.    Aletaha D et al. JAMA. 2018;320(13):1360-1372.
3.    Allard-Chamard H et al. Clin Lab Med. 2019;39(4):525-537.
4.    Aletaha D et al. Ann Rheum Dis. 2010;69(9):1580-1588.

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CDC: Fully Vaxxed Shouldn't Worry About Boosters Yet

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'Hot Enough for You?' It's No Joke for COPD Patients

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Rapid Response for THURSDAY and FRIDAY, September 2 and 3, 2021

AMEN.

GS

ACP Continues to Push for COVID-19 Vaccines, Masks in Schools

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REGARDING FLU VACCINE FOR THE 2021-2022 SEASON.
OCTOBER IS A GOOD MONTH IN WHICH TO RECEIVE THIS VACCINE.
It is then more likely to cover a late-winter outbreak, as often occurs.

GS

ACIP: Updated Vaccine Guidance for the 2021-2022 Influenza Season

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ON ALCOHOLIC BEVERAGES: ONCE MORE, WITH FEELING....

GS

Alcohol can cause immediate risk of atrial fibrillation

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CDC Panel Unanimously Backs Pfizer Vax, Fortifying FDA Approval

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MY ADVICE: GET THE VACCINE...AND GET THE BOOSTER  EIGHT MONTHS AFTER THE SECOND DOSE!
Don't be STUPID.

GS

COVID boosters work at curbing severe cases, Israel study finds

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GET THE BOOSTER SHOT EIGHTH MONTHS AFTER THE SECOND VACCINE SHOT (PFIZER OR MODERNA).   J&J ISSUE STILL BEING EVALUATED.

GS

What you need to know about COVID-19 booster shots

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EVERYBODY KNOWS THIS...DON'T YOU?

GS

Dr. Chauncey Crandall, M.D., writes:

Heart attack patients often take longer to seek help if they have gradual symptoms, which may put them at increased risk of death, according to authors of a study published in the European Journal of Cardiovascular Nursing.

Gradual symptoms begin with mild discomfort that slowly worsens, while abrupt symptoms are sudden and cause severe pain. Study author Sahereh Mirzaei, from the University of Illinois at Chicago, and her team analyzed data from 474 heart attack patients seen at U.S. emergency departments.

Symptoms were gradual in 44% and abrupt in 56% of these patients. Those with gradual symptoms waited eight hours to seek medical help, compared to 2.6 hours for those with abrupt symptoms.

A delay of no more than two hours is recommended for the best outcomes. Waiting longer increases patients’ risk of serious complications and death, according to the researchers.

Symptoms were triggered by exertion, such as running, climbing stairs, or shoveling snow, in 54% of men with abrupt onset and a diagnosis of ST-elevation myocardial infarction, which is a particularly serious type of heart attack requiring quick restoration of blood flow to blocked arteries.

Mirzaei said men with ischemic heart disease or multiple risk factors such as high blood pressure, diabetes, high cholesterol, or a family history of heart disease should be aware that chest pain or discomfort after physical activity or exercise could be a heart attack.

Dr. Chauncey W. Crandall is author of Dr. Crandall’s Heart Health Report newsletter. He is a Yale graduate and is chief of the Cardiac Transplant Program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Florida. He practices interventional, vascular, and transplant cardiology.

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PLEASE NOTE: THIS IS CONCERNING MEDICAL MARIJUANA...
NOT "RECREATIONAL" MARIJUANA, FOR WHICH THERE IS NO JUSTIFICATION.
It's just STUPID.

GS

Medical marijuana: risks and benefits, according to research

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THE FOLLOWING IS A VERY LONG AND COMPREHENSIVE ARTICLE ON THE MANY MALIGN CAPABILITIES OF COVID-19 INFECTION. I SUGGEST THAT YOU USE IT JUST AS A REFERENCE FOR SPECIFIC TOPICS OF INTEREST.
BOTTOM LINE: DON'T CATCH THIS!

GS

Neurologic Manifestations of SARS-CoV-2 Infection

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...AND THERE ARE OTHER REPORTS THAT INDICATE THAT NO AMOUNT OF ALCOHOL INTAKE
IS SAFE.

GS

Even light drinkers may be at increased risk of GI cancers

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Rapid Response for WEDNESDAY, August 18, 2021

THE CASE FOR VACCINATION, IN A NUTSHELL.

GS

Stop the excuses, step up, get vaccinated

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NOW YOUNG CHILDREN ARE SUBJECT TO SERIOUS COVID-19 INFECTION.
See also the position of the American Academy of Pediatrics: that all children 2 years old or older should wear masks in school; and that reported medical ill effects of such mask usage are "myths".

In my opinion, the psychologic effects are still to be determined, and should be monitored by parents and teachers.

GS


As Children's COVID Cases Surge, There's Another Virus On The Rise

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Updates for Connecticut Physicians, APRNs, PAs, and RNs: 

COVID-19 Epidemiology: COVID-19 case rates continue to rise in Connecticut. All Connecticut counties currently have either substantial or high levels of community transmission.  Since late July, all Connecticut SARS-CoV-2 specimens for which variant identification has been performed are the highly transmissible Delta variant. 

COVID-19 Vaccines: On Friday, ACIP recommended that people who are moderately to severely immunocompromised could receive a third dose of mRNA COVID-19 vaccine.  

For patients/families who reported having vaccine-associated myocarditis >90 days ago, CDC plans to reach out to assess long-term outcomes. Patients could receive a letter and/or other outreach to gather information and follow-up with healthcare providers for clinical information. 

COVID-19 Control Measures: Given what we know about the Delta variant, vaccine effectiveness, and current vaccine coverage, layered prevention strategies, such as wearing masks, are needed to control transmission of the SARS-CoV-2 virus.  

COVID-19 Testing: Who should get tested for COVID-19 infection? 

Learning Resources to Share:

CT DPH Provider Call-in: Please join us on Sept. 10 for our next Healthcare Updates and Q&A session. Register at: https://us02web.zoom.us/meeting/register/tZIld-6rqzMuE9dMkSPTxj1d_VcGeyWMWKVK 

Vivian Leung, MD

Infectious Diseases Section

Connecticut Department of Public Health

DPH_CovidVaccine_InfertilityMyth_7-20-21 FINAL.pdf

DPH_CovidVaccine_Pregnancy_7-16-21 FINAL.pdf


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...AND THE DRUM BEATS ON....

GS

Myocarditis Observed in Children After Receipt of BNT162b2 Vaccine

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The F.D.A. is expected to authorize a third shot of the Pfizer and Moderna vaccines as soon as Thursday for certain people with weakened immune systems.

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THIS IS USEFUL INFORMATION, IN ADDITION TO THE CDC ADVICE FOR PREGNANT AND BREAST - FEEDING MOTHERS ALSO TO BE VACCINATED.

GS

Natural COVID Infection May Not Protect as Well as Vaccination

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Rapid Response for SUNDAY, August 8, 2021

THE MOST CONSEQUENTIAL STORY UNFOLDING NOW IN AMERICA IS NOT
the *Biden presidency, or the stolen 2020 national election, or the immigration crisis, or the crises in crime and policing, or the Western fires, or deaths from illicit drug use, or suicides in disconnected / "tuned in" young people,  or the risk of losing a conflict with China, or the loss of our longest war in Afghanistan....

No, the most consequential story is again the COVID-19 PANDEMIC!
To paraphrase Winston Churchill, it is - if we are lucky - "the end of the beginning".
For background beginning in March 2020, see the contents of my web site Category entitled:
"Health Alerts".
Then check out the following articles that appeared in recent media releases:
1) "Top Biden Health Official: We're 'Failing' On COVID", (Newsmax, August 8, 2021;
2) "What To Do With Our COVID Rage", (NY Times Sunday Review, August 8, 2021;
3) "The CDC Needs To Stop Confusing The Public", (ibid); 4) "The COVID-19 vaccine Quandary", (ibid);
4) "The COVID-19 Vaccine Quandary", by Dr. Robert A. Linden (in the Day August 8, 2021, pB3).
5) "Vaccines And Masks Are the Way Out" (NYTimes Editorial, August 8, 2021.)

My Bottom Line:
You don't want this infection: not asymptomatic, not mildly symptomatic, not severe, not re-infection, not with lingering debilities, and not fatal.
Everything in Life is a Risk-to-Benefit analysis.  Here the benefit of taking the Vaccine vastly outweighs any risk. In addition, avoid crowds...and use an effective mask when that is not possible.

THINK. THEN ACT.

GS

Top Biden Health Official: 'We're Failing' on COVID

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Rapid Response for SATURDAY, August 7, 2021

FDA Approves Monoclonal Antibody to Curb Severe COVID in Vulnerable

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"CAN YOU HEAR ME NOW?"

GS

Debate Is Over: COVID Vax Doubled Protection for the Previously Infected

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Rapid Response for MONDAY through FRIDAY, August 2 through 6, 2021

DAMNABLE, BY THE DAMNED. ONLY A USSC HOLDING THAT HUMAN LIFE BEGINS AT THE MOMENT OF CONCEPTION, AND IS PROTECTED FROM THAT MOMENT, WILL SUFFICE.

GS

Subject: University Admits Harvesting Kidneys From Unborn Babies While Their Hearts are Still Beating
 
University Admits Harvesting Kidneys From Unborn Babies While Their Hearts are Still Beating 
The University of Pittsburgh may have inadvertently provided more evidence this week that aborted babies may be being born alive and left to die so that their organs may be used for scientific research, according to the Center for Medical Progress.

https://www.lifenews.com/2021/08/05/university-admits-harvesting-kidneys-from-unborn-babies-while-their-hearts-are-still-beating/

LifeNews.com is a very good source of prolife info.

This is on the level of Nazi doctor Josef Mengele.

For Life,
Tom Byrne

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SURVIVING IN THE WILD. YOU NEVER KNOW....

GS

How To Survive One Terrifying Challenge In The Wild

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Rapid Response for MONDAY, July 26, 2021

IN MY OPINION, THIS IS CORRECT.
Our Ethical obligations to our patients and to each other are not optional.

GS

AMA, 55 Other Groups Urge Healthcare Vax Mandate

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Rapid Response for FRIDAY, July 23, 2021

"CAN YOU HEAR ME NOW?

GS

ISRAEL STUDIY: PFIZER SHOT JUST 39% EFFECTIVE IN HALTING DELTA

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Rapid Response for THURSDAY, July 22, 2021

THESE ARE THE CURRENT COVID 19 FACTS...AND NOT ONLY FOR THE HOSPITAL STAFF.
So please...Wise Up regarding the current vaccines and regarding continued use of masks in populated areas.
Thank You.

GS
 
Dear Colleagues:
 
We are fortunate that here in the Northeast, vaccination rates are among the highest in the country. It’s different nationally, though – the spread of the Delta variant is resulting in more cases and more hospitalizations. The large surges are happening in places where vaccination rates are low, but we are seeing a slight increase even in our region. The majority of these cases are in unvaccinated people, but breakthrough cases – where fully vaccinated individuals develop COVID-19, are also increasing. It’s important to note that the rate of hospitalization and deaths in fully vaccinated individuals are extremely low – proving that the vaccines are hugely effective in reducing severe cases of the disease.
 
In light of recent events, it important to remind all employees and medical staff, even those who are fully vaccinated, to stay home from work if you have any COVID symptoms. We must do all we can to prevent exposures to our patients and our coworkers.
 
The fact that the vast majority of the recent increase in COVID-19 cases occurs in unvaccinated individuals supports the importance of mandatory vaccination for all employees and members of our Medical staff, which we announced 2 weeks ago. If you aren’t yet vaccinated, please visit the Vaccine Information Center on the intranet for the latest vaccine clinic schedules and deadlines for COVID-19 vaccination. Of note, starting this week, our Occupational Health teams and managers will be granted access to identify individuals who have not yet been vaccinated. That said, vaccination status will only be disclosed to Occupational Health, an individual’s manager, and Medical Staff Administration for members of the Medical Staff.
 
Before the end of August, please get vaccinated, and encourage your coworkers to do the same. Also, self-monitor for symptoms and err of the side of caution if you don’t feel well – stay home and get tested. Both of these important actions are critical to ensuring we continue to keep our patients and colleagues as safe as possible.
 
Sincerely,
 
Thomas Balcezak, MD, MPH
Chief Clinical Officer
Yale New Haven Health

Self Schedule Symptoms Comb 103020 (PDF)
 
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Rapid Response for SUNDAY, July 18, 2021

GOOD TO KNOW.

GS

These people have the best health, according to research

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Rapid Response for MONDAY through SATURDAY, July 12 thtough 17, 2021

"NOW HEAR THIS..."

Please remember that, in addition to abundant information and commentary about Covid-19 stored throughout this Rapid Response section since March, 2020, more recent information is posted in the "Health Alerts" section of this web site.
•    "What You Need To Know About the Highly Contagious Delta Variant", by Bever and Achenbach (in theday.com, July 09, 2021).
•    "Pfizer To Seek OK For 3rd Vaccine Dose; Shots Still Protect", by Lauran Neergaard (in theday.com, July 8, 2021).
This Covid Pandemic is certainly not over yet!

GS

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ON THE ONE HAND....
ON THE OTHER HAND.
?
STAY TUNED.

GS

Climbing the Pandemic Failures Chart: Research on Masking Kids

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What Are the Dangers When Vaccinated, Unvaccinated Folks Mingle?

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COVID-19 Forum V: Evaluation and Care of Patients With Persistent Symptoms Following Acute SARS-CoV-2 Infection

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Think Twice Before Giving the COVID Vax to Healthy Kids

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ALL THE MORE REASON NOT TO GET INFECTED AND DEFINITELY TO GET VACCINATED.

GS

Don't Drop the Ball on Long COVID

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REGARDING COVID-19 INFECTION, THE AFTERMATH... AND VACCINATION.
  1. Infection produces a robust and protective antibody level. The duration of that level is not known.
  2. Vaccination after actual infection produces Very High antibody levels. It also produces a stronger adverse reaction to the vaccination. Bottom Line: except for specific contra-indications: GET VACCINATED!
  3. A small percentage of teenagers who receive the vaccine have been getting a Myocarditis.
  4. "Long-Haul" symptoms after infection are real and troubling. Be aware of that possibility.
  5. This Field in In Flux.   STAY TUNED.
  6. "My Covid Patients Need To See Their Families", by Daniela Lamas, M.D.     YES, THEY DO!  The related isolation over the past year - and continuing even now - has been devastating for patient and loved ones. We now have enough information and testing tools to solve that problem.
GS

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YES, SUCH BREAKTHROUGH INFECTIONS CAN AND DO OCCUR, ALTHOUGH RARELY.
So what do we do?   Common Sense!               "It ain't over yet".

GS

CDC: COVID-19 Vaccine Breakthrough Infections Investigated

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Rapid Response for SUNDAY through TUESDAY, May 23 through 25, 2021

SO YOU MAY NOT DRINK ENOUGH TO GET CIRRHOSIS OF THE LIVER.
But that would be the Easy Alternative...and Faster.
How would you like to glide into your 70's, 80's and 90's with Half a Brain?

GS

The End of Happy Hour? No Safe Level of Alcohol for the Brain

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Rapid Response for SUNDAY, May 16, 2021

NEWS FLASH: THE COVID-19 PANDEMIC IS NOT OVER YET,  NOT IN THE WORLD AND NOT IN THE U.S.A.

Not with the disease - and the new variants - boiling over elsewhere and as close as in Great Britain.
Not in the fevered brains of the anti-vaxers.
Not in the faulted calculus of a much greater number of people who never learned that all of life is a risk / benefit analysis - and who are not taking the vaccine.
Not among the Irresponsibles who don't give a damn.

So: continue to use common sense, and masks and social distancing...and avoid unprotected crowds for another few months.

And Please read, in its entirety, the excellent article by Niall Ferguson entitled:
"How A More Resilient America Beat A Mid-Century Pandemic" (in WSJ May 1-2, 2021, Review, pC1).
In addition to relating in great detail the difference between the Asian Flu pandemic of 1957 and this one, the author clearly describes the relevant differences between great numbers of today's Americans and their grand-parents and great-grandparents.  And therein lies the Rub, as well as the lessons to be learned - if enough of us are educable.

I have a personal story about the Asian Flu and the summer of 1957.
On July 1 of that year, having just graduated from Medical School, I began a one year Mixed Internship at Roosevelt Hospital in New York City. My first rotation was in the very busy Emergency Room, which covered from the Hudson River to Lexington Avenue and from 86th Street to 33rd Street. Toward the end of that first week, we received a seriously ill 24 year old Greek student right off the boat from Europe.
He was dead within 24 hours. Then came the news that he had succumbed to the "Asian Flu", new to us.
Then came the order that all of our staff should present immediately to receive a "vaccine".
About half of us could not break away from our duties. The other half received the vaccine - and half of them promptly became quite ill. We covered for them for a couple of days. I never caught the Asian Flu.
As regards Covid-19, so far so good.

Back to my original message: THE COVID-19 PANDEMIC IS NOT OVER YET.

GS

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Rapid Response for FRIDAY, May 7, 2021

...AND YOU'LL START TO FEEL ITALIAN TOO.   BUONA SALUTA!

GS

Does eating a Mediterranean diet protect against memory loss and dementia?

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This week’s updates for Connecticut Physicians, APRNs, PAs, and RNs:

 

COVID-19 EpidemiologyCase rates remain high in many parts of Connecticut, particularly Fairfield and New Haven counties, putting unvaccinated people at risk. The B.1.1.7 (“UK”) variant, more transmissible than the “wildtype” SARS-CoV-2 virus, continues to be our most prevalent variant of concern.

 

COVID-19 VaccinesFDA and CDC lifted the pause on J&J’s COVID-19 vaccine. We have confidence that this vaccine is safe and effective and that known and potential benefits outweigh known and potential risks.  

         Vaccine safety monitoring will continue; new information about TTS (thrombosis-thrombocytopenia syndrome) will be brought to ACIP as needed. 

         A total of 15 cases of TTS, including the original 6 reported cases, have been reported to VAERS. All cases occurred in women ages 18–59. Reported symptom onset was 6–15 days after vaccination. 

         J&J vaccine providers should review the Fact Sheet for Healthcare Providers and provide the Fact Sheet for Recipients to patients. 

         CDC held a call to update clinicians on J&J and TTS today at 2pm. Slides and recording will be posted after. 

Walk-up clinics for COVID-19 vaccination are starting! See ct.gov/covidvaccine/walkup for >50 vaccine providers across the state that will no longer require an appointment prior to vaccination. Share this option with patients who find access to an appointment or online scheduling to be a barrier to vaccination.

Communications CornerWant to improve communications with people “on the fence” about COVID-19 vaccination? Careful and deliberate messaging can increase vaccine uptake and get us closer to herd immunity and a sense of normalcy. Try these talking points to increase vaccine confidence.  

         The vaccine seems like it was rushed through. How do we know it’s safe? All three of the currently available COVID-19 vaccines have passed rigorous safety, effectiveness, and manufacturing quality standards in order to obtain authorization for use in the US. As we saw with the recent pause of the J&J vaccine, CDC and FDA, along with the ACIP, take safety concerns and unexpected adverse effects very seriously and have made safety of these vaccines their top priority.   

         There doesn’t seem to be an end in sight. I don’t believe that vaccination will put an end to this pandemic. Vaccination is another tool, and a very effective one, to help reduce the spread of infection. Masking, physical distancing, and hand hygiene were our best tools last year. Now we have the COVID-19 vaccines, another way to help us fight the virus. Nothing will put an immediate stop to this pandemic, but increasing the population of vaccinated people, along with our other tools, will help reduce the spread and bring us closer to “normal”.  

         I feel like I’m doing everything I can already (masking, physical distancing). I’ve managed to keep myself safe so far, why take the risk with the vaccine? The measures we have all been taking in the last year are important. The vaccine offers another layer of protection so that even if you are accidentally exposed, you’re protected.  

 Remind patients that both doses of mRNA vaccine are needed. CDC and FDA continue to recommend two doses for full vaccine protection, which does not occur until a full 2 weeks after the final dose. 

COVID-19 Testing: Testing is essential for understanding if vaccines and other mitigation measures are working and infections are decreasing. While we know that vaccines are effective in preventing hospitalizations and 

e illness, continued testing helps us understand vaccine effectiveness against infection (even asymptomatic infection), as well as vaccine effectiveness in the setting of circulating variants. COVID-19 testing should continue when there is clinical suspicion for COVID-19, regardless of vaccination status. 

COVID-19 Control MeasuresCDC will periodically update their Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination as vaccine effectiveness and COVID-19 epidemiology evolves. This link can help guide your healthcare facility’s policies and procedures. 

Learning Resources to shareCan COVID-19 vaccination affect fertility? 

         The American College of Obstetricians and Gynecologists (ACOG) and The Society for Maternal-Fetal Medicine (SMFM) released a joint statement affirming that studies do not indicate any adverse effects on female reproduction or fetal/embryonal development. 

         CDC’s V-safe Pregnancy Registry demonstrated that the side effects and adverse events observed among pregnant individuals did not indicate any safety concerns.  

         SMFM’s Provider Considerations for COVID-19 vaccine counseling, as well as ACOG’s Conversation Guide for Clinicians are useful tools to engage pregnant and lactating women.   

         UNICEF’s Navigating pregnancy during the COVID-19 pandemic offers answers to common questions asked by pregnant women and their families. 

 

CT DPH Provider Call-in: Please join us on Friday at noon for updates and a Q&A session. Register at: https://us02web.zoom.us/meeting/register/tZApcOCgqDsqHNYNmNe81S4x2hfGpVMGgWYF 

Vivian Leung, MD

Infectious Diseases Section

Connecticut Department of Public Health

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"NOW HEAR THIS"...AND DO IT IF YOU GET THE OPPORTUNITY.
No danger to you...and you can literally Save A Life.

GS

CPR and COVID-19-when is it safe to save a life?

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ADEQUATE SLEEP IS A VITAL PART OF HEALTH. THE CONVERSE IS ALSO TRUE.
The quality of sleep is also vital.
In recent decades there has developed an epidemic of broken sleep, very often due to Obstructive Sleep Apnea - a condition which is easily diagnosed and easily treated - if first considered.
So: CONSIDER IT.

GS

Middle-aged people who sleep six hours or less a night may be more likely to develop dementia in their late 70s, a study found.

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Post-COVID Syndrome in Individuals Admitted to Hospital With COVID (BMJ)

Multiorgan Impairment & Long COVID (BMJ)

Serious Clinical Outcomes in COVID Survivors

Multiorgan Dysfunction & COVID ALLMEDX Search Results

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COVID & Underlying Medical Conditions ALLMEDX Search Results

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PUTTING THINGS INTO PERSPECTIVE; AKA "COMMON SENSE".
Meanwhile, all of this is causing even more people to decide not to receive any vaccine, as some of my patients have been telling me - despite my advice.

Bottom Line: the minimal risk of adverse reactions from the vaccine (eg. serious allergic reactions, serious blood clots...) is far outweighed by minimizing contracting Covid -19 infection - which will be even more likely this Fall and Winter if a second wave of the Pandemic is facilitated by too few vaccinated persons.
Your Choice. Your Future.

GS

Vaccines Carry Far Lower Risk for Rare Blood Clots Than COVID, Study Shows

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Patients Allergic to COVID Vax Got Dose 2 With Graded Dosing

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ONCE MORE, WITH FEELING:  THIS AIN'T OVER, BY A LONG SHOT.
Continue common sense precautions: social distancing, masks when that's not possible, and NO GROUPS.

GS

Next Winter May Be Rough: Models Predict 'Considerable Surge'

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Delayed Large Local Reactions to mRNA-1273 Vaccine Against SARS-CoV-2

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Rapid Response for MONDAY through WEDNESDAY, April 5 through 7, 2021

COVID 19 INFECTION. ANOTHER OF MANY REASONS WHY NOT TO GET THIS INFECTION -
AND WHY TO TREAT IT AGRESSIVELY AT ANY BUT THE MILDEST STAGE.
My educated guess: this, and the other manifestations of diffuse injury in "Long Haul" patients, are not the results of the virus itself - but of the excessive response of our Immune System to that invasion (ie. Cytokine Storm / Sepsis).

GS

'Beyond a Reasonable Doubt': Harm to Brain From COVID Can Be Severe

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COVID-19 Treatments: What's In, What's Out

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Rapid Response for THURSDAY through SUNDAY, April 1 through 4, 2021

LIFE, AND THE KIND OF LIFE YOU HAVE, IS MAINLY CHOICES.
Choose carefully.

GS

5 tips to stave off dementia as you age

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COVID-19  SERIOUS INFECTION...THE AFTERMATH.

Could these be the results of Sepsis - caused injuries incurred during the initial illness?
You Bet They Can.  More reasons for considering the use of Steroids during the serious illness, to stem the gross over-reaction of the Immune System (aka Sepsis) during that illness.

GS

Many Hospitalized COVID Patients Develop New Ailments Later

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ALL OF LIFE IS A  RISK-TO-BENEFIT ANALYSIS.

GS

Allergy may not be absolute obstacle to COVID-19 vaccine

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Fully vaccinated Americans can travel “at low risk to themselves,” but should still wear masks, social distance and wash their hands, the C.D.C. said.

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FDA approves 2 rapid coronavirus tests to be sold over-the-counter for at-home use

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Initially Mild Covid Then Serious Symptoms Kicked In (NYT)

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My Advice: Don't Go Yet,  unless the need is urgent.

GS

What You Need to Know About Flying During the Pandemic

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COVID Vaccines Could Lose Their Punch Within a Year, Experts Say

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Rapid Response for TUESDAY, March 30, 2021

REGARDING THE COVID-19 PANDEMIC, ONE YEAR IN.

Please read and follow the recommendations in this Ct. Dept. of Public Health Update.
"The life you save may be your own"...or that of a loved one. That includes especially those fully vaccinated.

"NOW IS NOT THE END. IT IS NOT EVEN THE BEGINNING OF THE END. BUT IT IS, PERHAPS, THE END OF THE BEGINNING". (Winston Churchill, after the Battle of El Alamein, November 1942).

********************

GS

This week’s updates for Connecticut Physicians, APRNs, PAs, and RNs:  
COVID-19 Epidemiology: COVID-19 case rates are rising in Connecticut, as is the proportion of the B.1.1.7 variant, estimated to be at 40% of new cases.

•    Over 90% of Connecticut’s population lives in a “red alert” town. While case rates have decreased among persons age 70 and older, they have plateaued or increased among all other age groups. The 20–29 year old age group has the highest case rate.

•    The B.1.1.7 (“UK”) variant continues to be the most prevalent variant across CT. This variant spreads more efficiently than the “wildtype” SARS-CoV-2 virus and has been found to be associated with increased mortality in the UK. 

•    People who are not > 14 days past a full COVID-19 vaccine regimen are at increased risk for infection with COVID-19, severe disease, and death. 

•    Vaccine breakthrough cases do occur, as no vaccine is 100% effective. Vaccine breakthrough cases should be treated as potentially infectious, and close contacts should quarantine. 

•    Clinicians should report cases of laboratory-diagnosed COVID-19 among individuals > 14 days past their last dose of a full COVID-19 vaccination regimen.
COVID-19 Vaccines: ALL Connecticut residents > 16 years of age will be eligible for COVID-19 vaccination on April 1. 

•    The Pfizer-BioNTech vaccine is the only COVID-19 vaccine with EUA for individuals 16 and 17 years of age. 

o    16/17-year-old children should only register for vaccination at sites offering Pfizer-BioNTech. 
o    16 and 17 year-olds should have a parent/guardian present with them at their vaccination appointment.  Minors under age 18 cannot be vaccinated by a healthcare provider without parental consent. 

•    The Homebound Individual Intake Form can be completed for any individual who is physically unable to go to a vaccination clinic. These individuals must also have no prior history of anaphylaxis or severe allergic reaction requiring the use of an epinephrine auto-injector (e.g., EpiPen).
COVID-19 Control Measures: With spring break and Easter holidays approaching, travelers should follow recommendations outlined in Connecticut’s Travel Advisory, which is consistent with CDC Travel recommendations. 

•    Interim public health guidance for fully vaccinated people can be found here.  

•    If visiting with high-risk, unvaccinated people, all COVID-19 control measures (masking, physical distancing, hand-washing) should be implemented even if all visitors are fully vaccinated.  

•    When possible, visits should be held outdoors or in well-ventilated areas. CDC recently updated guidance on ventilation in non-healthcare settings which can help with decisions on ventilation strategies.    

COVID-19 Testing:  

•    COVID-19 vaccination does not affect SARS-CoV-2 diagnostic (molecular/PCR or antigen) testing. Vaccinated individuals with COVID-19 symptoms should isolate and get tested if indicated. 

A positive antibody test could indicate either previous infection or vaccination. An antibody test should not be used to assess immunity to COVID-19 or the need for vaccination in an unvaccinated person.
 
Reminder about childhood vaccinations: With the disruption of both in-person learning and routine well-child visits due to COVID-19, childhood vaccination rates have declined. Healthcare providers are encouraged to identify and follow up with families whose children have missed doses to get appointments scheduled.

Learning resources to share. IPC (Infection Prevention and Control) practices remain the best defenses against the spread of COVID-19. CDC’s new infection control training collaborative, Project Firstline, helps frontline healthcare workers gain an understanding of infection control principles and confidence to implement protocols.

CT DPH Provider Call-In: As this Friday is a state holiday, there will be no Provider Call-in this week. Please join us on April 9 for our next session.

Sincerely,  
Vivian Leung, MD
Infectious Diseases Section
Connecticut Department of Public Health

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Breaking News: The Moderna and Pfizer vaccines are proving highly effective in preventing coronavirus infections under real-world

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Rapid Response for SUNDAY, March 28, 2021

"SCIENCE" AIN'T WHAT IT USED TO BE, IF IT EVER WAS...A PURE, PRISTINE SEARCH FOR TRUTH UNBLEMISHED BY THE ALL TOO HUMAN MOTIVES OF ITS SEARCHERS.

The following is Required Reading for all who Want the Truth - and who can Handle the Truth:
"Science, Politics, And COVID: Will Truth Prevail?", by Scott W. Atlas, M.D., (in Imprimis, http://www.hillsdale.edu, February, 2021).

GS

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Encephalopathy Common, Often Lethal in COVID-19

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CDC issues Urgent Vaccine Update

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COVID-19 AND IMMUNOSUPPRESSED PATIENTS - A SPECIAL CASE.

It is estimated that about 1/2 million people have had organ transplant and are immunosuppressed from treatment.
Also, about 11 million people are immunosuppressed from medications given for other conditions.
They don't have the same antibody effect from the vaccines - and they should not assume that they do.

See the article and interview on this subject by Martin Makary, ME, MPH in the March 23, 2021 issue of Medpage today.

GS

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COVID-19:   ANOTHER REASON WHY WE ARE CERTAINLY NOT OVER THIS YET.
And more reason for continued INDIVIDUAL RESPONSIBILITY!

GS

Vaccines alone may not be enough to end pandemic: Study

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B.1.1.7: Is a New U.S. COVID Surge Coming?

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Rapid Response for SATURDAY, March 20, 2021

RR#1

"INFORMATION IS POWER".
     AND THE REVERSE IS ALSO TRUE.

So here is more and continuing information about the status of the COVID-19 PANDEMIC.

1) "...insufficient data to recommend..." Lack of data is not data of lack. The Scientists need more humility when dealing with their Clinician colleagues. Good Luck with that.

2) COVID -19 re-infections are rare, but they do occur, especially in the elderly. We should all be alert to this possibility. And the differential diagnosis between this and other respiratory illnesses is often not easy.

3) A www.medpagetoday article by zdoggmd, dated March 16, 2021, is entitled: "Op-Ed: Did We Hurt Healthcare Workers With Bad Mask Advice". It seems that was the case, as we "followed the science" instead of heeding common sense. The "super-spreaders" were not in the ICU, where highly effective protection was used...but in the ED and other hospital areas, where less effective or ineffective modalities were used.

4)"When Will It Be Safe To Travel After Getting The COVID-19 VACCINE?"   NOT NOW, NOT YET!

5) An article in medscape.com reports that examining asymptomatic adults for COVID-19 would add another 16 million cases to the number of infections in the U.S. That would double the number of clinically diagnosed cases.

6) A Reuters article in medlinx.com notes that "Blood type A was associated with a greater risk of severe SARS-CoV-2 in one recent study and a higher risk of contracting the disease in another."

7) An article in medscape.com reports "AZ Vaccine Safe Overall But Questions Remain Over Unusual Clots", notably the very severe "Disseminated Intravascular Coagulation (DIC) and Cerebral Venous Sinus Thrombosis (CVST). Here again remember: "POST HOC, ERGO PROPTER HOC" is poor logic. But questions also continue regarding the overall effectiveness of the Oxford/AstraZeneca (AZ) vaccine.
So: would I take that vaccine if I were in a high impact area? Yes. Remember "Risk To Benefit Analysis".

Wow. This is becoming a full-time part-time job. But, with reports of as many as 40% of persons unsure about taking the vaccine, and trusting their personal physician over the CDC / NIH scientists, I accept the responsibility to stay current and knowledgeable.

GS

RR#2

WHO, EMA Stick by AstraZeneca Vaccine

RR#7

THE PANDEMIC AND MENTAL HEALTH: THIS IS THE GENERALLY INVISIBLE PART, BUT POSSIBLY THE MOST LONG-LASTING AND CONSEQUENTIAL.

GS

A National Mental Health Crisis in America (APA)

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MORE ABOUT COVID-19 VARIANTS AND "LOOSENING OF RESTRICTIONS" IN CONNECTICUT.

Dr. Ko said that he "wouldn't call it a gamble...".
Of course it's a gamble: it's a careful risk-to-benefit analysis between serious health risks and serious economic / educational / social risks. We're just starting to see the depth of those other risks...less in those States that did the analysis and much more in those States that did not.
ALL OF LIFE IS A RISK-TO-BENEFIT ANALYSIS.

GS

Yale epidemiologist: We’re in a ‘race against time’ with coronavirus variants

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WHAT THE HELL!!       WHO KNEW?!!       WHO SHOULD HAVE KNOWN?!!

Here is a Mammoth American Disgrace that requires both Civil and Criminal Investigation, well before COVID.

GS

Why 130,000 Nursing Home Patients Died of COVID-19

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Differential Diagnosis for Suspected Cases of COVID

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Rapid Response for TUESDAY through FRIDAY, March 16 through 19, 2021

HERE IS THE LATEST LIST OF "AUTHORIZED AND/OR VALIDATED THERAPIES" FOR COVID-19 INFECTION...AND THOSE THAT ARE "NOT".

However, "Insufficient data", that is from "double-blind cross-over studies", are not necessarily sufficient to ignore interim clinical experience of many careful and observant physicians at thousands of bedsides.
Check out "Vitamin D" as one example.
Of course, there are thousands of other examples of old and continuing medical treatments discovered with only careful clinical observation. You can start by reading the classic;
"Microbe Hunters", by Paul DeKreuf (1926).
And then there is "Dexamethasone", a corticosteroid which took four months to receive the IMPRIMATUR of the scientists, while I among others was discussing its use as a "no-brainer" in March and April of 2020. How many patients were affected by that delay?

GS

COVID-19 Treatments: What's In, What's Out

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I AGREE, EXCEPT FOR THE PART ABOUT THE "POTATOE CHIP BAG".
Best to eat the chips and throw away the bag.

GS

Don't Throw the Stethoscope Away!

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AND MORE...ALL GOOD ADVICE.

GS

When Will It Be Safe to Travel After Getting the COVID-19 Vaccine?

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STILL MORE ON COVID-19 PANDEMIC. THE STORY CONTINUES             BE  AWARE.

GS

COVID-19 Virus Reinfections Rare, but Riskiest After Age 65

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SO NOW, WHEN WE CAN'T DIAGNOSE A CASE, WE'LL ALWAYS HAVE THIS.
I hope more diagnostic criteria are forthcoming - or its use will be abused, as the true diagnosis goes undetected.

GS

'Long COVID' Gets a New Name

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HERE, JUST ONE OF THE SEVERAL LIFE STYLE ISSUES THAT CAUSE OR SUPPORT 50% OF ILLNESSES.

GS

Alcohol and cancer: A fine line

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Rapid Response for TUESDAY and WEDNESDAY, March 16 and 17, 2021

MY CURRENT BOTTOM LINES REGARDING WHERE WE ARE IN THE PANDEMIC - AND WHAT TO DO:

1) UNLESS YOU HAVE A SPECIFIC ALLERGY HISTORY NOTED HERE, GET THE VACCINE ASAP, PREFERRABLY THE TWO-DOSE VACCINE.

2) IF YOU HAVE A HISTORY OF AN ANAPHYLACTIC REACTION TO A PRIOR VACCINE, OR A DIAGNOSIS OF "MULTIPLE MEDICATION SENSITIVITY SYNDROME," DELAY FOR A FEW WEEKS WHILE A POSSIBLE CONNECTION TO POLYETHYLENE GLYCOL ALLERGY IS INVESTIGATED.

3) EVEN IF YOU HAVE BEEN FULLY VACCINATED AT LEAST TWO WEEKS EARLIER, AVOID CROWDS AND AIR TRAVEL FOR SEVERAL MONTHS. AND MASKS AND SOCIAL DISTANCING ARE STILL GOOD IDEAS.

4) SCHOOL CHILDREN ARE A SPECIAL CASE. FOLLOW THE EXAMPLE AND EXPERIENCE OF SO MANY PRIVATE SCHOOLS THAT HAVE SUCCESSFULLY AND SAFELY REMAINED OPEN THROUGHOUT THE PANDEMIC. WE HAVE NOT YET RECOGNIZED THE ADVERSE EFFECTS ON CHILDREN, OF WHICH THE LOSS OF AT LEAST A YEAR OF SCHOOLING IS A MINOR PART.

5) BOTH FOR INDIVIDUALS AND FOR SOCIETY, OUR APPROACH AND DECISIONS NEED TO BE BASED ON A RISK-TO BENEFIT ANALYSIS.

6) AND THEN THERE IS THE INFORMATION IN THIS ARTICLE. WE ARE FAR FROM FINISHED WITH THIS PANDEMIC.

GS

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Rapid Response for SUNDAY, March 14, 2021

NOW A "THREE FOOT RULE".
Always the need in Politics to be "in control".  The "science" is an after-thought.
If you're closer than three feet, "you should be in a hotel room."

GS

Fauci: US Weighs 3-Foot Distancing Rule, a Major Change


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Rapid Response for TUESDAY through FRIDAY, March 9 through 12, 2021

THE OTHER PANDEMIC, OF WHICH WE ARE ALL VICTIMS.
People Really Need People. Touching is critical.
And "being connected" through all the gizmos was always One Big Lie.

Please read the landmark book published by Ashley Montague in 1971:
"TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN".

GS

The Real Price Of Draconian CCP Virus Lockdowns Will Be Felt By People For Years To Come

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Rapid Response for TUESDAY through FRIDAY, March 9 through 12, 2021

SO MANY ISSUES. SO LITTLE TIME.
But of course I'll do my best.

1) Receiving Vaccines, any vaccines based upon personal risk, is a GOOD THING. "Anti-Vaxers" are just plain emotional and/or stupid. They are also irresponsible as related to childhood vaccinations, which inactions put all the others at risk. They should be made to pay for this; eg. mandatory home-schooling.

2) In a Pandemic such as the present one, Everyone should receive a COVID-19 vaccine, barring a scientific reason not to - of which there are very few.

3) Then come the issues of Production and Distribution. The Production "WARP SPEED" effort and actuality of the Trump administration was totally successful should be highly praised. The Distribution/ Availability has been fumbled and politicized - and should be taken to task at the local and State levels. A particularly pithy reaction on this subject should be read: "Op-Ed: The Ethics Of Vax Schemes and Schemers", by Arthur Caplan, PhD and Kyle Ferguson, PhD (in medpagetoday.com, March 9, 2021).

4) And now, what can you do after vaccination? The CDC has come out with various proposals, both complex and variable. My advice: the proposals are too broad. Take your time and use common sense. Once again during this Pandemic year, the scientists and "scientists" are waxing political.

5) Regarding the entire issue of "Lock-Downs", a matter of contention from the outset, the Medical / Scientific professions have also been divided. See the opinions of Dr. Atlas and Dr. Bhattacharya, both of Stanford Medical School, as well as the Great Barrington Declaration (with over 50,000 medical and scientific signatories). This debate is all the more poignant as we see the serious adverse economic and personal effects of those actions, affecting all of our children and at least 40% of our adults.

6) And "Lest We Forget": the totally self-dealing Teachers Unions. For more, much more on this disgrace, see the section entitled "Public Education Politics" on my web-site.

7) Regarding "Death with Dignity", aka "Assisted Suicide": Another Abomination...like Abortion.
See two articles:
a) "Assisted Suicide Lobby Spreads Falsehoods To Promote Systemic Ableism", by Stephen Mendelsohn (in ctmirror.org, March 8, 2021);
b) "Ireland's Bishops Call Dying With Dignity Bill 'Fundamentally Flawed" (in cruxnow.com, March 11, 2021). This article has the advantage of dissecting the many errors and problems included in a piece of legislation now before the Ireland leaders.

8) Beware "Boom to Bust".  We have seen the likes of the current stock market before: in 1929, 1987, 2008.
Our current Federal Legislature, despite the narrowest of margins between serious differences in political and economic positions, is proceeding headlong into a likely abyss for the nation. These are not "drunken sailors". They are INSANE!. See also "When The Boom Turns To Bust", by Andy Kessler (WSJ March 8, 2021, Opinion, p15).

9)This is especially true given the challenge of China. This threat, in all its forms,  is much greater than that posed by the USSR at the height of the Cold War. And who do we have "leading" us?
A so-far illegitimate President* Biden.

I never wish away time. But I Can't Wait For November, 2022.

GS

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Rapid Response for SATURDAY and SUNDAY, March 6 and 7, 2021

ANOTHER EXAMPLE OF THE PERFECT BEING THE ENEMY OFTHE GOOD.
Dr. Fauci is right on the Science. The Surgeon General is right on the Common Sense.
My question: where was the "Warp Speed" regarding the DISTRIBUTION? 
POLITICS, that's where.

GS

Trump's Surgeon General Is Schooling Fauci As Israeli & Canadian Science Support His Argument

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RARELY A DULL MOMENT IN CLINICAL MEDICAL PRACTICE.  JUST LISTEN AND PAY ATTENTION.

GS

Rhabdomyolysis a presenting sign of COVID-19 in an adolescent

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BOTTOM LINE: A FULLY VACCINATED PERSON IS PERSONALLY SAFER,
BUT YOU STILL HAVE TO FOLLOW THE PRECAUTIONS TO SAFEGUARD OTHERS AROUND YOU.

GS

Can vaccinated people still spread the coronavirus?

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Rapid Response for THURSDAY through SATURDAY, February 18 through 20, 2021


RR#4

PRECISELY!

GS

Fauci Unmoved by One-Dose COVID Vax Studies

RR#5

"TRUE, TRUE, AND RELATED".

GS

This comes from Dr. Patrick Teefy, Cardiology Head at the Nuclear Medicine Institute University Hospital, London Ont.

1. Let's say it's 7:25 pm and you're going  home (alone of course) after an unusually hard day on the job.
  
2. You're really tired, upset and frustrated.
  
3. Suddenly you start experiencing severe pain in your chest that starts to drag out into your arm and up into your jaw.     You are only about five km from the hospital nearest your home.
  
4. Unfortunately you don't know if you'll be able to make it that far.
  
5. You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself.
  
6. HOW TO SURVIVE A HEART ATTACK WHEN  ALONE?
  
Since many people are alone when they suffer a heart attack without help, the person whose heart is beating  improperly and who begins to feel faint, has only about 10 seconds left before losing consciousness.
  
7. However, these victims can help themselves by coughing repeatedly and very vigorously.
  
A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest.
  
A breath and a cough must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again.

8. Deep breaths get oxygen into the lungs and  coughing movements squeeze the heart and keep the blood  circulating. The squeezing pressure on the heart also helps it to regain a normal rhythm.
  
In this way, heart attack victims can get help or to a hospital.
  
9. Tell as many other people as possible about this. It could save their lives!
  
10. A cardiologist says: "If everyone who gets  this email & kindly sends it to 10 people, you can bet that we'll save at least one life.
  
11. Rather than sending jokes,  please contribute by forwarding this email which can save a  person's life....
  
12. If this message comes around to you  ..... more than once..... please don't get irritated.... We all need to  be happy that we have many friends who care about us and we are being reminded of how to tackle... Heart attacks.... when we are alone.

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PATIENTS WITH ACUTE COVID-19 INFECTION:

This is Important: ASK YOUR DOCTOR ABOUT EARLY ANTICOAGULATION IF YOU NEED HOSPITALIZATION!

GS

More Evidence Supports Early Anticoagulation in COVID-19

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"MEDICAL ASSISTANCE IN DYING", "MEDICALLY ASSISTED SUICIDE" AND RELATED DESCRIPTIONS
have one thing in common: they are a Damnable perversion of a physician's duty to his patient:
"PRIMUM NON NOCERE": FIRST, DO NO HARM.
Whatever the watered - down statements currently used by new medical school graduates as substitutes for the
Oath of Hippocrates, this concept and promise should remain inviolate by all physicians.

But it is not. Nor, as it seems, are the methods used painless or "merciful".
See the article which follows:
"Canada's Medical Assistance in Dying = Torturous Death".

GS

Canada's Medical Assistance in Dying = Torturous Death

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WHAT??  COMMON SENSE?
How did THAT get into the discussion?

GS

Double-Masking Is A Double Distraction

#ZeroCOVID or #HarmReduction?

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I AGREE.

GS

Don't Fear Patients Reading Their Clinical Notes: Opinion

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CORONAVIRUS UPDATE: What you can do safely after you're vaccinated

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THE COVID-19 VACCINE.  THIS IS HOW IT IS SUPPOSED TO WORK, IN ORDER TO WORK.
 
GS

Second COVID Shot Packs Punch

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C.D.C. research finds that tightly fitted masks, or doubling up with both cloth and surgical masks, could reduce virus transmission by up to 96.5%.

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Why the US Is Underestimating COVID Reinfection

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Latest From Annals of Internal Medicine - 9 February 2021

Major Update: Remdesivir for Adults With COVID-19
Should Remdesivir Be Used for the Treatment of Patients With COVID-19? Rapid, Living Practice Points From the American College of Physicians (Version 2)

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Rapid Response for TUESDAY, February 9, 2021


A VERY IMPORTANT DISCUSSION ABOUT OUR FUTURE WITH COVID-19.

Will "the Perfect be the Enemy of the Good"?
That can happen here. Remember: Everything In Life Is A Risk-To-Benefit analysis and choice.

GS

#ZeroCOVID or #HarmReduction?

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NOW HEAR THIS...

Henceforth, all my continuing articles, personal and reproduced, about COVID-19 will be posted on the "HEALTH ALERTS" section of this web site.

GS

Asthma Patients Get Reassurance on COVID-19

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MORE INFORMATION ON TREATMENT OF SERIOUS COVID-19 INFECTIONS.
Most infections are asymptomatic or mild.
But serious infections, usually including chest symptoms like cough and shortness or breath, require prompt identification and prompt and effective treatment. Identification is aided by monitoring with an O2 saturation meter, available in most pharmacies, looking to detect if the level is dropping from a normal of 97-98% through the 90's and into the upper 80's, even without shortness of breath. That requires hospitalization and aggressive treatment.
The article from the World Health Organization posted below addresses such treatment...although still hesitant to discuss a vital part of that treatment.
The treatment modalities mentioned are: a) low dose anticoagulants; b) the prone position, which improves oxygenation.
What is not mentioned, even nearly a year after treatment advice began and still seven months after Dexamethasone was gingerly embraced, is the critical importance of adrenocorticosteroids, which I began recommending in this section and in the Rapid Response section beginning in April, 2020.
For too many months the experts were not "following the science".
For more on this you might Google "COVID-19 and steroids".
Be Alert. Beware.

GS

WHO issues new clinical advice on treating COVID-19 patients

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THIS IS IMPORTANT, BECAUSE IT AFFECTS ALL OF US
WHO USE ANY ALCOHOL AT ALL.

"One Alcoholic Drink A Day Can Lead To This Serious Condition, Researchers Say", by Amy Capetta (in yahoo.com, January 16, 2021).

GS

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Rapid Response for SATURDAY, January 16, 2021

THE NEWS, IN BITS AND BYTES.

Due to the massive and increasing amount of News (Real, not Fake) now being generated, largely based upon the Pandemic and by the imminent departure of President Trump, I will try to offer important issues in the most cryptic form. My common sources continue to be the WSJ, The Day, http://www.ctmirror.com, yahoo,com, and my e-mail deliveries from various sources.
GS

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HERE, THE MOST RECENT EXAMPLE OF THE POLITICS OF COVID-19 "SCIENCE". 
This proposal, to "delay" administering the second dose of the vaccine, generally called the Immunizing dose as being the effective one in immunizations, is all politics and no science..
Shameful - especially by those saying "follow the science".

GS

Experts Debate Wisdom of Delaying Second Vaccine Dose

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Nutritional Deficiencies in Gluten-Free Diet

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Rapid Response for SATURDAY, December 26, 2020

MORE ABOUT THE COVID-19 PANDEMIC: "ON THE OTHER HAND..."

See the article by Scott W. Atlas, M.D. entitled:
"A Pandemic Of Misinformation", (in WSJ December 22, 2020, Opinion, pA17).
In view of the prostitution of the mainstream media during the last five years, including as we are urged to "follow the Science", my life-long advice to myself and to anyone else ("cross-read" different sources for important topics), following the Science and "science" is now much more difficult and hazardous.

GS

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COVID immunity lasts at least eight months, new data reveals

NOW HEAR THIS!
HIGH BLOOD PRESSURE IS ONE OF THE MOST POORLY CONTROLLED ILLNESSES, BY PHYSICIANS AND BY PATIENTS, DESPITE THE AVAILABILITY OF EXCELLENT MEDICATIONS FOR LONG-TERM USE.

BEWARE! YOUR FUTURE WELLNESS OR DISABILITY IS IN YOUR HANDS.

GS

Association of cumulative systolic blood pressure with long-term risk of cardiovascular disease and healthy longevity

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COVID-19: THE DISEASE AND THE TREATMENTS: MORE...

GS

A Side-by-Side Comparison of the Pfizer/BioNTech and Moderna Vaccines

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CDC Says Three COVID-19 Symptoms Are Most Common

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EXCELLENT ANALYSIS OF THE CAREFULLY CONSTRUCTED MESS
CALLED "HEALTH CARE".

This has been obvious for decades. See my numerous commentaries since the early 1980's (and perhaps earlier - check it out) on this web site and posted in the local newspaper. A logical mechanism to achieve this approach - the Health Savings Account - was suppressed in its crib and since then by the people who have financially benefited most by such actions. And that does Not include most physicians.

GS

Nothing will change unTIL healthcare is treated for what it is: a commodity.

-P

Price Transparency: How to Fix Healthcare

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The New COVID Symptom Every Woman Needs to Know

Fauci: 'Something very strange' about COVID

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Oncology is not my field of expertise.
But these sources may be of help to you and to your physician.

GS

Lung Cancer Survival: Latest Research

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This is a useful article.
But its Pulmonologist contributors continue to suffer - with their patients -  from the same chronic myopia that they have been subject to since at least the 1960's, when they had an inferiority complex vs. their English colleagues. That was all the more trend - setting since those English doctors had and implemented a vendetta against Allergists in their country...considered competitors by them.
Throughout all the decades since then, during which time I have been a prime witness while practising Allergy and Chest Diseases, Pulmonologists have been studiously avoiding any recognition of the central role played by respiratory allergies - in the form of co-existent Bronchial Asthma - in at least 30% of their "COPD" patients. That is a term that I do Not use, in preference to making a Diagnosis of Chronic Bronchitis with or without Bronchial Asthma and several other illnesses often buried within the rubric "COPD". The result: their patients too often are prevented from receiving treatment for the most treatable and often reversible of their combined conditions. That is a shame.
Of course, after having had me in their midst for 56 years, some of our regional pulmonologists - but not all - have seen the light. Thank you for that.

GS

Year in Review: COPD

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Rapid Response for TUESDAY through FRIDAY, November 17 through 20, 2020

MORE ON NEW INSIGHTS ABOUT COVID-19 PANDEMIC.

1) This article is actually worth studying. It's all about the
Central Role of the Immune System - for good and for ill.
"'Breakthrough Finding' Reveals Why Certain COVID Patients Die", by Liz Szabo (Kaiser Health News, November 15, 2020).
It would have been better for the experts to have realized  that in March instead of in July.
2) "How South Korea Avoided A COVID-19 Lockdown", by Molly Walker, MedPage Today, November 15, 2020. They started much earlier than did the Western world. And they have a much more compliant populace. In any case: Good For Them.
3) By contrast, see: "Op-Ed: The Grand Failure Of Managing The COVID Cases", by Aronoff and Milstein ( MedPage Today, November 15, 2020). They decry the lack of Central Planning (aka Socialism) vs the Individual Responsibility and Regionalism that is this country - and that identified this administration's massive and largely effective approach to this moving target. "Never Trumpers" never give up. More about that in another coming RR.
4) And then there is this: "In Health Care, When Is Enough, Enough?", by Rebecca Pieper Esposito, RN (in ctmirror.org, November 19, 2020). Excellent and right on point.

GS

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Rapid Response for SUNDAY, November 8, 2020

LET'S TALK ABOUT OUR CURRENT KNOWLEDGE OF THE COVID-19 PANDEMIC.
You can follow all of this in Real Time via the Rapid Response reports which I have posted since late Winter of this year.

1) "In The Beginning", December 2019 - March 2020, little was known - except for some Fake News from China, from the World Health Organization, and from craven politicians like Clinton and Biden while President Trump took some wise and decisive actions.
2) Whether from the medical people or from the scientists or from the scientist / politicians, what we began getting were educated guesses, just-plain guesses and "projections". Many turned out to be wrong, facilitated by the traditional worship of too many "experts" at the altar of the "double-blind / cross-over study" to the exclusion of careful observation at the bedside, long clinical experience and just plain common sense.
Meanwhile, President Trump successfully mobilized a massive Public / Private effort, truly a War Effort, to provide needed medical supplies and hospital beds.
3) Of course, by that time the entire matter was already politicized during the most consequential national election year in decades.
4) Quite late, the experts began to "see the light" - highlighted by their "discovery" of the effectiveness of Dexamethasone, aka Adrenocorticosteroids - which I had been yelling / writing about since early April. Check it out.
5) Beginning quite early in this effort, there became obvious a debate between "fighting the virus" at  All Costs  through various forms of isolation and quarantine vs. fighting the virus through common sense methods while avoiding the destruction of our national and Personal economy. That tension continues, partly on valid grounds - but mainly on the nearly total politicization of the issues. What A Shame that the Democrats and the Never Trumpers and the Trump Derangement Syndrome victims thereby have caused tens of thousands of unnecessary deaths - from the disease and from the "treatment".

But now there is new and documented information on which to base personal and State and National decisions.

a) The delayed but now implemented treatment modalities Work, producing a fatality rate (ie. dying From, not dying With Covid-19) of 0.06%!!
b) Active Immunity resulting from having had the infection does produce lasting personal protection.
c) Passive Immunity - resulting antibodies - can be effective as a treatment modality for others.
d) The coming vaccines, coming soon, will be effective - they drawing upon experience derived from vaccine formulation for earlier other Corona viruses.
e) Well over 98% of persons who are infected with the virus remain asymptomatic(!).

NOW HEAR THIS.
Use Common Sense: Social Distancing (6+feet); an effective Mask when that is not possible or when in doubt; effective Hand Washing frequently;
and  AVOID CROWDS!!!  For, given the immaturity and self-centeredness of so many of the recent generations - you will always find some of them in crowds.
The Rest is Politics.

GS

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Rapid Response for SUNDAY, November 1, 2020

IMPORTANT INFORMATION REGARDING TESTING FOR COVID-19 - AND RECOMMENDED ASSOCIATED ACTIONS.

These four authoritative articles are too lengthy to reproduce here - but are posted IN TOTO in the "Health Alerts" section of this web site.
THIS IS NOT ONLY FOR MEDICAL AND SCIENTIFIC PERSONNEL,
BUT FOR ALL OF US.

Remember: We all have to live with this challenge for a long time, following common sense instructions. And yes, a few of us will die. But the vast majority of us know that's NOT THE END. I'm very sorry for those who don't - or won't - believe that.

GS

Importance of False Positives (NYT)

Implications of False Positive COVID Results

Positive Results in Asymptomatic Patients: How to Handle

False Negative COVID Results: Recent Research

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Rapid Response for SATURDAY, October 31, 2020

"CAN YOU HEAR ME NOW?" - AGAIN?

1) Aspirin is an ANTI-INFLAMMATORY.
The Inflammatory part of the Immune System is excessively active during anything but a mild COVID-19 case!
I have been stating this since March in this section. It should not have been rocket science.
It took four months for the scientists and academicians to come to this realization and to recommend Dexamethasone - a Steroid and an anti-inflammatory for "cytokine storm". Then came the "need" for Double-Blind/ Cross-Over studies to "confirm".
Must the use of aspirin go through the same labyrinth while patients suffer and die?.
"Follow the Science"...but beware myopic scientists.

GS

Aspirin Use is Associated with Decreased Mechanical Ventilation, ICU Admission, and In-Hospital Mortality in Hospitalized Patients with COVID-19

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Rapid Response for MONDAY and TUESDAY, October 19 and 20, 2020

"COVID-19, SEPSIS, STEROIDS..."
Academicians still looking for "acceptable evidence" (ie. double-blind, crossover studies, their gold standard).
I hope that experienced clinicians at the bedside have not still been waiting for this before acting. For it would have cost more lives. 
See my statements on the subject beginning in late March in this section about inflammatory overdrive, cytokine storm, sepsis - and Steroid use.

This is how Science at times can get in the way of education, training, experience - and common sense in the treatment of our patients.

GS

Does COVID-19 Cause Sepsis?

Evidence for Steroids in Severe COVID-19 Grows Stronger

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SUNDAY, October 11, 2020

MORE ON LIVING WITH THIS PANDEMIC.

This article describes 5 important insights and treatments for COVID-19 which I have been reporting about on this RR site since they each became known beginning in March. Particularly the "cytokine storm" and its treatment should have been an early no-brainer.

That's why panic and anxiety should have no place as we go forward living with this challenge for many months to come. Will we all survive? Probably not. But everything in life is a Risk-To-Benefit analysis.
So USE COMMON SENSE: social distancing; an effective mask when that is not possible; hand washing; and Avoiding Large Gatherings...where there will always be some selfish idiots generally between the ages of teens and thirties. Also, get your Flu shot; and reverse any poor life-style habits which are much more likely to kill you prematurely.
And "DON'T WORRY, BE HAPPY".

GS

Professor of Pharmacy at U of Toronto update on advances made to deal with COVID-19

A professor of Pharmacy at U of Toronto sent this clearly worded update to his family.
For this pandemic there’s a greater chance of survival for those getting infected 3 months later like June 2020 than those who got infected 3 months earlier say February 2020. The reason for this is that Doctors and scientists know more about Covid-19 now than 3 months ago and hence are able to treat patients better. I will list 5 important things that we know now that we didn’t know in February 2020 for your understanding.  
 
1. COVID-19 was initially thought to cause deaths due to pneumonia - a lung infection and so Ventilators were thought to be the best way to treat sick patients who couldn’t breathe. Now we are realizing that the virus causes blood clots in the blood vessels of the lungs and other parts of the body and this causes the reduced oxygenation . Now we know that just providing oxygen by ventilators will not help but we have to prevent and dissolve the micro clots in the lungs. This is why we are using drugs like Aspirin and Heparin ( blood thinners that prevents clotting) as protocol in treatment regimens in June 2020.
 
2. Previously patients used to drop dead on the road or even before reaching a hospital due to reduced oxygen in their blood - OXYGEN SATURATION. This was because of HAPPY HYPOXIA where even though the oxygen saturation was gradually reducing the COVID-19 patients did not have symptoms until it became critically less, like sometimes even 70%. Normally we become breathless if oxygen saturation reduces below 90%. This breathlessness is not triggered in Covid patients and so we were getting the sick patients very late to the hospitals in February 2020. Now since knowing about happy hypoxia we are monitoring oxygen saturation of all Covid patients with a simple home use pulse oximeter and getting them to hospital if their oxygen saturation drops to 93% or less. This gives more time for doctors to correct the oxygen deficiency in the blood and a better survival chance in June 2020.
 
3. We did not have drugs to fight the corona virus in February 2020.  We were only treating the complications caused by it... hypoxia. Hence most patients became severely infected. Now we have 2 important medicines FAVIPIRAVIR & REMDESIVIR ... These are ANTIVIRALS that can kill the corona virus. By using these two medicines we can prevent patients from becoming severely infected and therefore cure them BEFORE THEY GO TO HYPOXIA. This knowledge we have in JUNE 2020... not in February 2020.
 
4. Many Covid-19 patients die not just because of the virus but also due the patient’s own immune system responding in an exaggerated manner called CYTOKINE STORM. This stormy strong immune response not only kills the virus but also kills the patients. In February 2020 we didn’t know how to prevent it from happening. Now in June 2020, we know that easily available medicines called Steroids, that doctors around the world have been using for almost 80 years can be used to prevent the cytokine storm in some patients.
 
5. Now we also know that people with hypoxia became better just by making them lie down on their belly - known as prone position. Apart from this a few days ago Israeli scientists have discovered that a chemical known as Alpha Defensin produced by the patients White blood cells can cause the micro clots in blood vessels of the lungs and this could possibly be prevented by a drug called Colchicine used over many decades in the treatment of Gout. So now we know for sure that patients have a better chance at surviving the COVID-19 infection in June 2020 than in February 2020, for sure.
 
Going forward there’s nothing to panic about Covid-19 if we remember that a person who gets infected later has a better chance at survival than one who got infected early.
 
Let’s continue to follow precautions, wear masks and practice social distancing.

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Rapid Response for SUNDAY, September 27, 2020

AND, WITH REGARD TO "CYTOKINE STORM" AND ADRENOCORTICOIDS IN COVID-19 DISEASE,
permit me to say:            I TOLD YOU SO!

GS

Does Virus Dose Or Load Predict How Sick You Get With COVID-19?

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Rapid Response for SUNDAY, September 20, 2020

FOR THOSE READERS WITH A MORE SCIENTIFIC / MEDICAL BENT,
I offer here two articles on important and timely subjects.

1) Regarding COVID-19 Infections, especially with Inflammatory Hyper-reaction:
"The Role Of IL-6 And Other Mediators In The Cytokine Storm Associated With SARS-CoV-2 Infection" ( in Journal Allergy and Clinical Immunology, Vol 146, #3, Sept. 2020).

2) Regarding the use of Medical Cannabis for Chronic Pain:
"New Guidelines Issued On Medical Cannabis For Chronic Pain", by Ryan Basin (in http://www.medpagetoday.com/meetingcoverage,Sept 13, 2020).

GS

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HERE IS AN INFORMATIVE ARTICLE ON OUR IMMUNE SYSTEM
AND ITS RELEVANCE TO A PANDEMIC LIKE THIS.
"The Coronavirus Is New, But Your Immune System Might Still Recognize It",
by Katherine Wu (in NYTimes August 8, 2020).

GS

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YES, STRESS CAN KILL YOU.

GS

Pandemic Stressors Give Rise to 'Broken Heart' Syndrome

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Rapid Response for SATURDAY, July 25, 2020

STATISTICS HAS NEVER BEEN MY STRONG POINT.
But this article is sobering - although the title seems hyperbolic.

See: "COVID-19 More Deadly Than Cancer Itself?" (in www.medpagetoday.com/hematologyoncology)

There are several messages here, all of which should be obvious.
1) "Straighten up and fly right", so you won't get or worsen all those "life-style" related "comorbidities" that represent 50% of all illnesses.
2) Follow medical advice and instructions, especially during these difficult times when adherence is difficult but vital.
3) Don't catch Covid-19! Follow the common sense precautions; don't be STUPID.
4) If you consider yourself to be within one of the groups studied,
DON'T PANIC!   Work The Problem. And wait for the next Study that Clarifies this one. There will surely be one. There always is.

GS

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"IS ANYBODY THERE? DOES ANYBODY CARE?"
You had better care...smokers and relatives of smokers alike.

GS

There's No Safe Way to Smoke
By Dr. Mehmet Oz and Dr. Mike Roizen, MDs

When Gomez (John Astin) and Morticia (Caroline Jones) Addams settled in for a shared hookah session in the 1965 "The Addams Family Meets the Undercover Man" episode of their TV show, it seemed exotic and daring.


Fifty-five years later, hookah/waterpipe smoking has become all too common. One 2013 study published in the British Medical Journal found that half of younger Americans ages 18 to 30 got their tobacco smoke through hookahs.


But that's no way to dodge the dangers of smoking.


For the first time, a study has evaluated the relative risks of developing chronic obstructive pulmonary disease (COPD) and lung cancer from smoking tobacco cigarettes, e-cigarettes, and hookahs. The findings took our breath away.

The research, published in the European Heart Journal, found that compared with nonsmokers, tobacco cigarettes increased the risk of COPD by 704%, waterpipes by 218%, and e-cigarettes by 194%.

When it came to lung cancer, tobacco cigarettes blew up the risk by an astounding 1,210% and waterpipes increased the risk of lung cancer by 122%.


Then there's the finding, published recently in Nicotine & Tobacco Research, that if you get COVID-19 and are a smoker, it nearly doubles your risk of progression to serious complications.


Clearly, there's no way to get around the dangers of smoking tobacco.


But you can successfully quit. There are a multitude of resources online, including through the Centers for Disease Control and Prevention and Dr. Mike’s Cleveland Clinic. Check them out today and breathe easier for a lifetime.


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Rapid Response for THURSDAY and FRIDAY, July 16 and 17, 2020


WE SHOULD ALL STAY UP-TO-DATE REGARDING OUR OWN MEDICAL CARE...
in a health care delivery environment that now requires each of us to be our own Advocate - or to have an effective Advocate - who will "rattle the cage" when necessary.
Another article on point: "Slow Medicine: COVID -19 Exposes What's Wrong With U.S.Healthcare.", by Michael Hochman, M.D., MPH (in medpagetoday.com,July 6, 2020). Message: Less is More.

GS

Drug Treatment for COVID-19: A Quick Summary

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AT LEAST 50% OF ALL ILLNESSES ARE LIFE-STYLE RELATED.
"Can you hear me now?"

GS

'It Is Best Not to Drink Alcohol': American Cancer Society

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Rapid Response for SUNDAY, May 17, 2020

YOU MAY KNOW ALL OF THIS. BUT MAYBE YOU DON'T.

GS

COVID-19 Sequelae Can Linger for Weeks

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Rapid Response for THURSDAY and FRIDAY, April 16 and 17, 2020

MORE ON CORONAVIRUS:  MY OBSERVATIONS...

For at least the last several weeks, I have been sharing my observations on this pandemic and on the professional and public approaches to it. This is from the vantage point of a life attentively lived since 1933 - and as a still practising physician since 1957, in Allergy / Immunology and Chest Diseases - and also in the Army Medical Corps in a General Hospital. I report this simply to note that I am not a neophyte making these observations.
So now, let's begin with a review of the Stages of this Pandemic.

Stage 1 consisted of Rumors, partial information, withheld and false information - from at least early December through January.
By that time, at least President Trump had enough information and insight to close the American borders to Chinese travelers and then to others.

Stage 2, February, was a gathering storm wherein the Professional Advisors - as distinguished from the Leaders - provided the history of past pandemics and the Projections based upon that history and some Facts. It soon became clear that the Advisors tended to project far into the future, still based on then - limited Facts...and that they restricted themselves exclusively to the public's medical needs without regard to that same public's economic needs. That was probably as it should be.

Stage 3. But there was another story to be told, equally important in the long run, related to the survival of the same public / patient and of the entire nation. As more Facts became available, the Projections became more tenuous and less grave, without change in the approach of the Professionals. That too was probably as it should be. But no one should be surprised that those Leaders, charged with serious decision- making should and would start taking charge. This is analogous to the Military structure, with the Leaders / Commanders and then with the Service personnel who Advise but who Do Not Lead.

Stage 4 is therefore where we are now, where it is clearly inappropriate for  the Professionals to insist on the Medical needs of the patient in their beds and who resist consideration for the patient on Main Street trying to feed his or family.
It is all the more inappropriate when the treating Professionals have begun to have serious misgivings regarding HOW TO TREAT THEIR PATIENTS:
Is the pathophysiology of this new virus infection one of direct invasion or rather one triggering that blunt weapon of the Immune System called the Inflammatory System. The treatment would be largely different.
Does the ventilator help or harm? Should the patient's position be supine or prone? Is Oxygen deprivation the real issue? Has Hypercoagulation been missed? Should Steroids be a basic part of treatment instead of being maligned?
So, the Professionals have enough to do without arguing with the policy-makers dealing with the other patient on Main Street.
Here, an interesting report notes that "Dr. OZ Apologizes for Saying Schools Should Reopen Because 'Only 2 to 3 Percent More People Could Die", (in http://www.yahoo.com/entertainment, April 17, 2020). Once this Professional decided to comment on Policy, he should not have apologized. He was rightly reflecting the Fact that - in a crisis situation - the concept of Triage is basic to planning and to implementation.

All of the above is entirely in keeping with my comments as they developed over the past several weeks in this section.
Here I offer three other relevant articles:
a) "Fine to Failing: Rapid Declines in COVID-19 Patients Jar Doctors, Nurses", (www.medscape.com, April 15, 2020).
b) "COVID-19: Damage Found In Multiple Organ Systems", (www.medlinx.com, April 16, 2020).
c) "Almost 10K HCWs Infected, At Least 27 COVID-19 Deaths in U.S., CDC Says", (www.medscape.com, April 17, 2020).

Therefore, what is needed now, in addition to the best medical care for the greatest number, is a Sense of Proportion, Reason, Common Sense by the LEADERS, and a healthy regard for Freedom and Liberty on the part of each of us individual citizens.

GS

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Rapid Response for TUESDAY, April 14, 2020

MORE ABOUT THE "TWO - EDGED SWORD".
See: "Emergency room doctor, near death with coronavirus, saved with experimental treatment", by Richard Read, (in LA Times, 4/14, 2020)

GS

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SATURDAY, April 11, 2020

RR#2

CORONAVIRUS VS THE WORLD: AN ENIGMA.

What we all are going through should be a humbling experience for all of us:
individuals, professionals, politicians, clergy - all of us. For despite our education, training and experience through the ages, we know very little about what is happening to us from this pandemic. "Should be..." is the operative phrase.
But is it? Or are we, each of us blindfolded, describing the proverbial Elephant based upon which part of that animal we feel?
And are we bravely declaring our "treatments" solely on that basis?

As individuals, we try to rely on the "experts" and on our leaders. But at some point, since we are free citizens and since Everything in life is a "Risk-To-Benefit" analysis, we must make our own choices for ourselves.
Here I refer to a choice between optimal physical health and necessary economic health...between social distancing and work.

As professionals, we must decide how much to base our professional actions on the available Facts, or whether we rely on Projections for far-reaching decisions. Whether it is the pronouncements of the Epidemiologists, based too often on Projections before the availability of Facts, extending far into the Future, or whether it is the treatment protocols of Practicing Physicians - based upon what they actually know and too little on what they do not know (eg. the so far unknown pathophysiology of the Coronavirus - and whether ventilators are actually helpful or harmful), or whether it is the eternal struggle of Politicians between being helpful vs. self-help, or whether it is the inclination of Clergy to be esoteric vs. down-to-earth useful, a Lot Of Humility is needed at this time.
We Need More Than We Are Getting!

And in the process, Trial and Error - and risking being Wrong - is not only OK...it is Absolutely Necessary. That is the only way to achieve Truth, even at the expense of Lives and Reputations and Careers, while Individuals - you and I - make our own trials and errors, and live or die by them.
That is the greatest Freedom and the most Responsible Action.

SO, LET'S GET OUT OF OUR FUNK AND ENGAGE THIS CHALLENGE.

GS

RR#3

HERE IS AN EXAMPLE OF PRACTICING PHYSICIANS DOING WHAT THEY KNOW - AND NOT REALIZING WHAT THEY DON'T KNOW.
In this case, however, they should know or at least suspect, as I indicated weeks ago in this section.
The Inflammatory System, an integral part of our Immune System, is a
BLUNT INSTRUMENT, too often inclined to over-react to a serious threat - and ending up killing the host before the threat does.
That is called "Sepsis" or "Septic Shock".
That is what is what I believe - based on education, training and experience, is happening here to the sicker patients with Coveravirus.
What to do? Treat Septic Shock...AND USE ADEQUATE AMOUNTS OF ADRENOCORTICOSTEROIDS!
Still reluctant? A big mistake for you, the physician...and Lethal for your patient. Call it "Trial and Error" if you will.  But it is based on solid physiology and pathophysiology. And the stakes could not be higher for your patient.

GS

Rapid Declines in COVID-19 Patients Jar Doctors, Nurses

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Rapid Response for TUESDAY through FRIDAY, March 17 through 20, 2020

ON THE CORONAVIRUS PANDEMIC.
Until further notice, I will be restricting my RR comments and references to this subject. Please review rrelated comments already posted throughout this month.

1) "What To Do If You Have Covid-19", by Ana Radelat (in The Day, March 20, 2020).
As is nearly always the case from this journalist for CTMirror.Org, this is informative and useful.
 2) The following is a helpful Editorial in The Day (March 18, 2020):
"Beware Simple Solutions To Complex Health And Economic Crisis".
But then The Day published an article out of the Mercury News of San Jose, California: "Test Kits Debacle" (March 17, 2020). Thanks for Nothing.
3) "Ethicists Agree On Who Gets Treated First When Hospitals Are Overwhelmed By Coronavirus", by Olivia Goldhill (in Quartz: qz.com, March 19, 2020).
Read it and understand that choices and decisions may have to be made, called "Triage"...as in military circumstances.
4) The following type of articles are the opposite of Helpful: they can be harmful. They are totally speculative, especially as regards America in relation to the rest of the world. And they can easily promote Panic, often followed by dismissal of the entire matter. Just Human Nature.
"Covid-19: How Many People Will Die?" (in mdlinx.com/internal medicine, March 19, 2020)
5) And then there is this; why am I not surprised?
"US Officials: Foreign Disinformation Stoking Virus Fears", by Miller and Long, Associated Press, March 16, 2020.

If you are reading this,     CONGRATULATIONS!
I have been sharing a vast amount of information and commentary with the public for decades via this web site (asthma.drsprecace.com).

Furthermore, my medical practice in Allergy / Chest Diseases, including Coordination of Care, continues without interruption and with a few appropriate modifications due to the current situation.

GS

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Rapid Response for SUNDAY, March 15, 2020

CORONAVIRUS: SOME GOOD AND PRACTICAL ADVICE.
See: "What To Do If You Think You Have Coronavirus", by Kristen Aiken (in Huffpost Life, March 13, 2020).

GS

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Rapid Response for THURSDAY and FRIDAY, March 12 and 13, 2020

RR#1

ABOUT THE CORONA VIRUS "PANDEMIC".
The following are some helpful articles, as well as some personal observations.

1) "10 Myths About COVID-19", by Natasha Priva Dval, M.D. (in http://www.medicalbag.com, March 12, 2020).
2) "State Has 3 More COVID-19 Cases: Doctors Answer Questions During Virtual Forum", by Erica Moser (in The Day March 12, 2020).
3) "What SARS, MERS, And COVID-19 Have In Common", by Amanda Gardner (in http://www.msn.com/en-us/health/medical).

At this point, here are some personal observations / "guesses" that I have developed based upon: a) the typical 'hair-on-fire" reportage from the media; b) the early and continued efforts of the World Health Organization to plant the current American experience squarely into that of the World; c) the weaponization of the entire story here for partisan gain; d) the belief that nothing emanating from China can be accepted at face value.

A) Even on a good day, very scarce any more, the mainstream media promotes high anxiety and panic - it sells;
B ) These two words expressed by President Trump in his recent address to the nation were right on point:"...foreign virus...."  What is happening in America is a far cry from what is happening in the rest of the world. There are several reasons for this, including the early action taken here to exclude Chinese travelers from entering this country.  That is and was impossible for all of Europe and Eurasia, invaded by millions of migrants - many from the Middle East and from Africa, episodic hot-beds for viruses like MERS and EBOlA.
C) The well-established disease called "Trump Derangement Syndrome" is poised in this election year to break out into an even more virulent form.
D) Although some of the actions being taken on Wall Street and Main Street are prudent, I suspect that "when the smoke clears" we will have a lot to regret.
E) Imagine if last Fall we were suddenly told that "the new URI Virus" was  breaking out through the country and the world, and that millions of people were coming down with it - with some actually dying from it.
"URI=Upper respiratory infection", otherwise known as the "common cold".
I am not making light of this. But folks, Get A Grip!

Ultimately my only advice is: USE COMMON SENSE!

GS

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Rapid Resposne for SATURDAY and SUNDAY, March 7 and 8, 2020

THIS INFORMATION WAS ALSO THE SUBJECT OF A REPORT BY TUCKER CARLSON ON FOX RECENTLY.
In how many ways is America vulnerable, thanks to our SWAMP?

Read it and weep. And then get very angry!

GS

FDA Cites Shortage of One Drug, Exposing Supply-Line Worry

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Rapid Resposne for FRIDAY, March 6, 2020

Will COVID-19 Expose Physician Shortfall, EMTALA Shortcomings?

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Coronavirus Vaccine? Here is What Israeli Researchers Are Saying

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Rapid Response for SATURDAY, February 29, 2020

"ASK YOUR DOCTOR"

Well, here's your answer as far as Diets are concerned.
Also, visit our diet and nutrition web site, currently under re-construction:
www.medidietresources.com.

GS

Top 5 physician-recommended diets

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Rapid Response for FRIDAY, February 21, 2020

Practising Without A Medical Licence!
"Wake up America. Insurance Companies Prescribe Your Medications", by Christine Alexandra Bottone, (in ctmirror.org, Feb 22, 2020).
No hyperbole: THE GOD'S HONEST TRUTH.
Read it'. Weep. And then get Angry and Motivated.

And the Last Stop Is Nowhere In Sight.

GS

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Rapid Response for SUNDAY, February 9, 2020

THE "ANTI-VAX MOVEMENT", IN ALL OF ITS MANIFESTATIONS,
is much more dangerous than events like Zika and Coronavirus.
WAKE UP. AMERICA.

GS

Anti-vax movement is based on an 'entirely fraudulent publication': NIH chief Francis Collins

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Rapid Response for SATURDAY , February 1, 2020

SO YOU WANT TO PAY LESS FOR HEALTH INSURANCE...AND HEALTH?

Now, this is something you should Really Get "Woke" On".

1) Good Health is your responsibility. Start by "picking the right parents"...and being the right parents. Choose your mates wisely. Genetics Counts!
2) At least 50% of illness and health care delivery is Life-Style related: Obesity, excess alcohol use, smoking, illicit drugs, sexually transmitted diseases, avoidable stressors, avoidable adverse occupational exposures.... If that's you, live and die with it...and don't expect me to pay for it.
3) Don't go to your doctor with a "national lottery" mentality. Medical Mal-practice is a growth industry for lawyers, not for doctors. Most adverse outcomes are not the result of negligence - and don't lead to wins in MM suits. But that's why over 25% of health care costs are related to "defensive medicine": physicians and other "providers" trying to protect themselves by over-testing and over-treating.
4) The "Medical - Industrial Complex" is massive and growing, consisting of health care insurers, the hospital industry, the pharmaceutical industry - and your Government / legislators beholden to all kinds of pay-backs.  The higher the costs, the higher the profits. You the patient, and now the physicians who are becoming mere widgets in the system, are the fodder.
That's the diagnosis.
What is the Treatment?

A) Be aware of your genetic background, your heredity. Learn from it and adjust your life and actions accordingly. As an example,women with a family history of breast cancer should know about their Brac 1 and 2 status.
B) Live a prudent life-style. It's easy, safe, responsible and reassuring.
C) Although it is becoming much more difficult, search for and select a good doctor who can also be a good friend - for life. There are still some out there, although they are ever dealing with M
 Outrage at the stupid, unfair and cynical conditions under which they increasingly have to operate - even the private practitioners who are still out there literally fighting on your behalf.
D) Be a Knowledgeable Advocate for yourself - or have one with you at all health care encounters - especially in hospital ER's or as in-patients. It's a jungle out there. Ask questions. Demand answers that you can understand. Rattle the Cage. The time is long gone when you could "don't just do something; lie there".
And demand effective changes in health care costs:
Health Savings Accounts that force you to Think about what costs you are incurring. Self-Insure prudently.
Government Negotiations with pharmaceutical companies regarding drug prices - something that your legislators made it UNLAWFUL for them to do in the Medicare Act of 2002! I wonder why.
And don't expect prior medical problems that are the direct result of irresponsible personal Life-Style to be covered by prospective health insurance policies.

ARE YOU "WOKE" NOW?

GS

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Rapid Response for TUESDAY and WEDNESDAY, January 21 and 22, 2020

ONE WAY TO "MAXIMIZE EHR USE":
Don't us it.
Employ registered nurses and para - professionals and "scriveners"...
and pay the fine for EHR non-use...
and get back to your trusting patients. Only individual physicians can solve their individual problems, individually.

GS

Five ways to maximize EHRs

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Rapid Response for SUNDAY, January 19, 2020

IN THE CARE OF PATIENTS, DIAGNOSIS IS KEY, TRUMPED ONLY BY CARING.
That has been my medical mantra from the outset.
That is why I chose the specialty of Internal Medicine.
And that is why, 62 years later, I am still looking for the right "key".
I'll continue practising until I get it right.

GS

How Diagnostic Excellence Is Like Jazz

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Rapid Response for FRIDAY and SATURDAY, January 17 and 18, 2020

SAD, AND TRUE.
What is also true is that physicians and nurses allowed themselves to be compromised all too easily into this siren-song of IT.
And MD and RN professional organizations quickly became part of the problem - and profit from it.

GS

Is 80% of Your Day at a Screen? Sorry, You're No Longer a Physician

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Rapid Response for SUNDAY, January 12, 2020

TI TOLD YOU SO...

GS

The Best and Worst Diets for 2020

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Rapid Response for FRIDAY, January 3, 2020

RR#2

THOSE OF US WITH ITALIAN OR OTHER MEDITERRANEAN HERITAGE HAVE BEEN LIVING THIS ALL OF OUR LIVES.
Please see my web-site, posted for many years and currently under revision: medidietresourses.com.
MANGIA, MANGIA, MANGIA.

GS

Mediterranean Diet Best Overall of 2020

RR#3

"'TIS A TALE AS TOLD BY AN IDIOT, FULL OF SOUND AND FURY...
SIGNIFYING NOTHING".

Is that what the incessant discussions on Health Care delivery and cost will be? It will certainly be a prime subject of debate during this 2020 election year.
Having been a practising physician for over 62 years and an attorney specializing in Health Law for nearly 36 years, I have some thoughts on the subject...which I have been sharing on this web site and elsewhere for decades.
See my most recent offering recently posted as a Rapid Response.
See also the following articles appearing elsewhere:
ONCE AGAIN, WITH FEELING:

Physicians, historically the "Captains" of the health care ship and protectors of their patients' interests, have been intentionally marginalized - now widgets in the Medical - Industrial Complex.
The too-patient patients have been anesthetized to the current personal and financial brutality.
A not-so-patient public is the Only body with the power to effect change.
As Bobby Jindal ends his article:
"The best way to prevent a government-run health system is to offer solutions that lower prices based on competition and transparency." (Emphasis added).

GS

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Rapid Response for SUNDAY, December 29, 2019

"END RELIGIOUS VACCINE EXEMPTIONS, NO EXCEPTION"
(The Day Editorial, Dec. 29, 2019)

Can't improve on this; won't even try.

GS

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Rapid Response for WEDNESDAY and THURSDAY, December 25 and 26, 2019

ALTHOUGH I CONSIDER ALL OF MY RAPID RESPONSE OFFERINGS TO BE A PUBLIC SERVICE,
this one really is.

Netflix offers a good scientific study of the effects of ALCOHOL INTAKE.
The following are the take-away findings.
  1. Individual tolerance for alcohol varies among individuals. The important variable is the body content of water. The greater the body mass - and especially of muscle mass as distinguished from fat, the greater the tolerance. Also, be well-hydrated if planning to consume alcohol.
  2. Having food in the stomach increases tolerance by delaying absorption, since alcohol is metabolized in the small intestine.
  3. Alcohol intake increases appetite and thus increases calorie intake in addition to the substantial calorie content of the beverage itself.
  4. Alcohol intake adversely affects quality of sleep, The second half of a night's sleep is especially disrupted. This is increasingly true as we age.
  5. 80% of drinkers will get a hangover. This effect is mediated by an inflammatory process. A fried meat and vegetable meal, with or without an NSAID, can be helpful.
  6. Alcoholic beverages vary in problematic components other than the alcohol content. The darker the beverage, the greater of these components. Thus, lighter - colored beverages are better, especially vodka.
  7. More recent studies have shown that alcohol in any quantity is a potential carcinogen, involving several different cancers - especially breast cancer.
Most things in life involve a Risk To Benefit analysis. Having the facts helps.

GS

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Rapid Response for SATURDAY, December 7, 2019

READ THIS!    THE LIVELIHOOD AND LIFE YOU SAVE MAY BE YOUR OWN.
The Health Care delivery system has become a largely Wall Street profit driven business. There is no "win-win". There is only "win-lose", as usual with the business types. And the doctors and most other health care providers have become powerless widgets in the system despite their best efforts to protect their patients. In fact, in decades-ago better years those physician efforts to shield their patients from the progressive pain of revolutionary changes is part of the reason why we're all here.
Physicians, individual and "organized", have never had power or influence over the business and political types. They tried to "go along to get along", to have a place "at the table". Instead, they have been relegated under the table. Only the patient / public, individual and organized, have had potential massive power. But they never used it.
Now the only way to survive a trip into the health care system is to be your own advocate or to have a personal advocate: to question, to demand answers, and to demand personal, efficient and cost-effective attention - to RATTLE THE CAGE!  Especially if your doctor is an employee of the hospital or other large health care service, he or she is IMPOTENT to serve, to protect and defend you in your time of need.
And that is the reason for the galloping "burnout". It's not burnout at all for these people who survived a crucible of heat and pressure in becoming health care "providers". The reason is MORAL INJURY.
NOW YOU, THE PATIENTS, HAVE TO HELP THEM - with your voices, with your demands, with your feet, with your political "representatives".
No More "Mr. Nice-Guy". Your personal welfare - and your life - depend on it.

George A. Sprecace,M.D., J.D.

NONPROFIT HOSPITALS SHOULD NOT BE SUING PATIENTS WHO CAN'T PAY

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DO YOU WANT TO LIVE TO 100?
Then check out Dan Buettner and the "Blue Zone" on google.
It rings very true.
But first you should want to live to 100.

GS

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FOR THOSE INTERESTED IN "ALTERNATIVE AND COMPLEMENTARY MEDICINE", this article seems reliable and useful.
"Aye, and there's the rub". Much information on these subjects falls into the category of "urban legends".

GS

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Rapid Response for FRIDAY, November 29, 2019

HERE IS VALUABLE MEDICAL INFORMATION THAT WE ALL SHOULD BE AWARE OF, AT PRACTICALLY ANY AGE.
See: "What Science Tells us About Preventing Dementia", by Anne Tergesen (in WSJ Journal Report - Encore, Mov. 18, 2019,pR1).

GS

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Rapid Response for THURSDAY, November 28, 2019

WHILE THE DEMOCRATIC CANDIDATES ARE OFFERING OUT-OF-MIND
HEALTH CARE IDEAS, WHAT'S WRONG WITH THIS?
NOTHING!  FINALLY BRINGING THE CONSUMER BACK INTO THE NEGOTIATION.
See: "Trump's Big Health Care Win", by Neeraj Sood (in The National Interest).

GS

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WE HAVE BEEN WAITING FOR THIS FOR QUITE A WHILEGS

ACIP: Pneumococcal Vaccine Recs Updated in Patients 65 Years and Older

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Rapid Response for WEDNESDAY and THURSDAY, October 30 and 31, 2019

RR#1

I WOULD BE SAYING THIS ALSO IF REPUBLICANS WERE RUNNING THIS D0-NOTHING HOUSE OF REPRESENTATIVES:

THROW THE BUMS OUT!

GS

Democrats Fighting for Foreign Countries’ Right to Rip Off U.S. Patients

RR#2

THIS IS WHAT HAPPENS WHEN "PATIENT SATISFACTION" COMMANDS AN OUTSIZED PERCENTAGE (EG. 30%) OF THE OVERALL SCORE FOR "HEALTH CARE QUALITY" RANKINGS - ON WHICH REIMBURSEMENT IS BASED. 
STUPID!

GS

Patient satisfaction: A danger to be avoided

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Rapid Response for SUNDAY, October 27, 2019

APART FROM WASHINGTON, HERE IS SOMETHING ELSE INFURIATING.
See: "Symposium: Solving America's Drug Pricing Problem" (in The Journal of Legal Medicine, April - June, 2019).
No, you won't find a solution there...but you will find some of the elements of causation.
Stay Well.

GS

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Rapid Response for SUNDAY, October 13, 2019

"MORAL INJURY".
EXACTLY THE RIGHT TERM FOR WHAT'S AILING PHYSICIANS.

GS

MD Says: How Doctors Can Stop Burnout and Moral Injury

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Rapid Response for WEDNESDAY, October 9, 2019

Interesting information, as is much that is written about Bronchial Asthma.
But there are three important issues that are being missed by most physicians and most commentators:
1) the central importance of a carefully taken medical and allergy history, by a certified Allergist or by a trained and motivated health care provider. This would most often lead to complete diagnosis and a treatment program that should include Allergy Immunotherapy for those allergens that cannot be avoided.
2) the uselessness of the "diagnosis" of COPD, actually a waste-basket for undiagnosed components of Obstructive Airway Diseases: Bronchial Asthma, Chronic Bronchitis and other consequences of personal and occupational life.
3) the proper and experienced use of oral corticosteroids, both tablet and inhaled, often used with a "all or nothing at all" approach.
4) the utility of biologics in selected cases - but not nearly as important as the  above.

That approach will get our asthmatics better and keep them better.

GS

Asthma Control in the Elderly: A Test of Personalized Coaching

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AN ARTICLE LIKE THIS WILL ALWAYS MAKE A PHYSICIAN NERVOUS.

But, as usual, there is one thing above all else that is most useful:

a complete, careful and patient MEDICAL HISTORY - taken from the patient and also from any others with direct knowledge.

At times it is necessary, after a complete physical exam and all useful tests have been performed, to take the HISTORY again, from the beginning.

That is the Science and the Art of Medicine.

GS

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Rapid Response for SUNDAY, August 11, 2019


SO, WHAT WRONG WITH THESE EFFORTS,
except that President Trump is proposing them?

GS

Trump Administration's Plan to Lower Healthcare Costs


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10 medical laws all doctors should know

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MENOPAUSE: THE FORGOTTEN ILLNESS,
except by women and their  "significant others".

This is important. We all should do better in dealing with this misery. See: "Menopause's Long Learning Curve" (in ctmirror.org, July 26, 2019).

GS


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Rapid Response for FRIDAY, July 19, 2019


Supplements: the Wild, Wild West of Medicine

EDITED VERSION, although I'm not sure why you want to post it. Most people are frightened of supplements, and do what their doctor tells them to do.

----------------------------------------------
All I had to do was read the first two sentences to suspect that Kevin Campbell, M.D. is a shill for Big Pharma. Or, he is one of the many medical practitioners who remain safely entrenched in the comfort zone that conventional medical training continues to place physicians in. I read further, only to be convinced of this notion. The line in the second paragraph about FDA-approved drugs being tested until they're safe was a good belly laugh.

Given the doctor's claim that the vetting process for supplements is diametrically opposed to that of pharmaceuticals, I guess we can all let out a giant sigh of relief considering that not a week goes by that we don't hear about one or more people being severely injured or killed by an 'FDA-approved', 'painstakingly tested' pharmaceutical. Tell me, would you rather try a lifestyle/diet change (or experimentation with various natural supplements) to mitigate your psoriasis, or regularly ingest an 'FDA-approved' pharmaceutical that "solves" the problem of an overactive immune system by . . . crushing it to the point where disclaimers of potential cancer and TB are required? Don't go on that 3rd-world vacation with this drug in your system; you may not come back alive.

Given the rash of morbidly-obese people in the late 1980s who ingested phen-fen at a rate many times what was recommended (subsequently experiencing a virtually exploding heart), properly researched and dispensed supplements are a good hedge on the all-too human behavior of excess. 'If one pill does X, ten pills will be ten times better, right?' Wrong. Multiply the effects of this dangerous, often fatal mindset with pharmaceuticals whose potency can be hundreds of times that of a supplement.

By the way, just because science isolates a specifically efficacious compound in nature doesn't mean that turbo-charging it is necessarily healthy. Ascorbic acid is great for preventing rickets. However, the half-dozen other bioflavinoids in citrus fruits are physiologically required for Vitamin C to properly do its job. And, don't forget that if you megadose on Vitamin C, make sure to keep up your magnesium intake, which then affects calcium. Supplements can be misused just as pharmaceuticals can be. But, I'd rather my kid fool around with a pop gun than a loaded .45.

Simply put, "scientists" like this physician are often scared (sh)witless of the effects of the "multi-billion-dollar" business of supplements on their bottom line and very expensive careers. As the population ages in the next few decades, Big Pharma is building to be a multi-trillion-dollar business, pal.

Here's the deal: there are definitely pharmaceuticals that no supplement can beat or even match. But that has never been the argument. It has been the intellectually dishonest argument that seemingly non-partisan professionals like this guy try to push.

Supplements are most often about prevention as well as maintenance of wellness. Name one of the many hundreds of 'FDA-approved' pharmaceuticals (in laughably record-time, I might add) that is about prevention of disease. And, things like statins don't count because diet, exercise, and/or supplements known as milk thistle and guggul/gugulipid (in addition to others that a simple Google or WebMD search will reveal) are just as effective at maintaining healthy lipid metabolism without the dangerous side effects that 'FDA-approved' pharmaceuticals note in their boilerplates that often read with the comic tone of The Onion.

Were I one of the millions who complains about the cost of healthcare in general and the cost of prescriptions specifically (while doing little or nothing to live a healthy lifestyle), I'd also be one of those who swallows every pharmaceutical the conventional medical community pushes like the latest street drug.

The point is that supplements (reputable, pure supplements, not the trash sold at convenience stores) are the modern equivalent of an apple a day. Consequently, they will continue to be denigrated by mainstream medical practitioners and Big Pharma because they are a threat to their biggest cash cow, massive human ignorance and laziness.

As for the good doctor's final question to the reader, "I ask you today, would you take a supplement?", my answer is an emphatic, "With bells on."

- P

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Rapid Response for MONDAY through WEDNESDAY, July 8 through 10, 2019

PARENTS, THIS IS SERIOUS.
There are too many sedentary, I-Phone addicted, overweight kids. Especially with a family history of Diabetes, these are their prospects even before they enter adulthood. Sad.
This most be a Call To Action.

GS

'Like Watching a Car Crash in Slow Motion'

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Rapid Response for SATURDAY , July 6, 2019

MEDICAL ALERT: ADD THIS TO YOUR LIST OF POLITICS AND POLITICIANS
that can be dangerous to your health.

GS

8 dangerous bugs to avoid this summer

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Rapid Response for THURSDAY, July 4, 2019

FOR THE GENERAL PUBLIC - AND ESPECIALLY FOR PHYSICIANS WHO ARE AT GREATER RISK -
this should serve as an important warning about their vulnerable health in these very stressful times.
There are various kinds of stressors for all of us. But the worst is RESENTMENT, a psychologic acid born of lack of control over one's life and labors. That is the stressor that will result in cancer and sudden death.
Physicians were not self-selected to become impotent victims of the world around them. They require significant Control over their work in order to be effective, in their work and in their lives.
Colleagues: If I am describing you and your situation...get the hell out of there while you still have your health, your family, your self-image, and your effectiveness as a care-giver. The First Rule Service is Survival.

GS

Many doctors have this disorder and don’t even know it

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Rapid Response for WEDNESDAY, July 3, 2019

"BACK TO THE FUTURE".Many doctors have this disorder and don’t even know it

GS

Superbugs surrender to Civil War-era medicines

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Rapid Response for SUNDAY, June 15, 2019

"MORALITY". REMEMBER THAT TERM?
When was the last time that you heard or read that concept mentioned in journalism, in the media or in the tripe flowing out of Hollywood and Washington like bilge water from a foundering vessel?
And yet, there are two areas where we should still expect Morality to be the true compass directing their actions.

One is Religion, specifically the Catholic Church for Catholics. We now know the frayed status of that expectation. For an update on that matter, see two articles recently published in the Washington Post relating to the further reports of Archbishop Carlo Mario Vigano'.

The other is the Medical Profession and allied health care professions. Whereas we can all augment or even supplant the failings of our religion with our own spirituality and morality, we cannot heal ourselves from the illnesses that our bodies and minds are subject to. But the effectiveness of those professions and of their practitioners is under great and increasing challenge.

See two articles that clearly describe the dangers to all of us.
"The Business of Health Care Depends On Exploiting Doctors And Nurses", by Danielle Ofri (in NYTimes June 8, 2019, Opinion).
"It's Not Moral Injury: It's Burnout (Or Something Else)", by Michael J. Asken, PhD (in Medical Economics June, 2019).

'CAVEAT EMPTOR'. The life you save may be your own.

GS

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TIME FOR A POTPOURRI OF MEDICAL NEWS OF DIRECT CLINICAL APPLICATION.
Most of these come from the Journal of Allergy and Clinical Immunology: In Practice, particularly the May-June 2019 edition. These are bottom lines. Look it up if you want more.

•    Several articles address the problem of aspirin and NSAID sensitivity, manifesting either as hives or - much more seriously - as acute asthma. The latter is called Samter Syndrome. The issue is important not only for the possibility of a severe reaction, but also because successful desensitization to aspirin would enable use by the patient, thereby improving the asthma and/or nasal symptoms. Another article notes that nasal / sinus surgery facilitates the possibility of aspirin desensitization.
•    Beef Allergy, the "a-gal syndrome" recently described, can also involve products of porcine origin.
•    An article on 275 cases of childhood anaphylaxis points to the severity of these reactions, the requirement for epinephrine, and the frequent need for multiple doses of epinephrine.It would appear that children are usually treated better than adults, for whom the use of epinephrine is often wrongly omitted.
•    Biologic Therapy, building on the long-standing clinical appreciation that much disease involves the Inflammation component of the Immune system, often a blunt instrument, and on the extensive research into the many Interlukins (IL 1-50+) involved, has come into wide use. In the fields of Allergy, Bronchial Asthma and Atopic Dermatitis, IL 4, 5, and13 are prominent and are now targets of agents like Dupixent, Nucala and Fasenra. The original Biologic in this area of clinical conditions, the anti-IgE Xolair, has been in wide use for the last 10 years. All are appreciated as needed additions to the armaments available to Allergists, Dermatologists and Pulmonoligists

GS


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CONFESSIONS (NOT MANY) AND CONCERNS (A LOT) OF AN “ANCIENT MARINER” (62+ YEARS).
May 19, 2019 - GEORGE A. SPRECACE, M.D., J.D.
  1. In a large and long-standing medical practice of Allergy and Chest Diseases, adult and pediatric, including about 70% Bronchial Asthma and Chronic Bronchitis, a small minority are hyper-eosinophilic and a small minority are oral steroid dependent.  Of the several reasons for that situation, the evaluation and treatment of allergies – including allergy immunotherapy – is high on the list.
  2. Why are allergy evaluations and AI for this group of patients not well promoted, even by certified Allergists? This is wrong and dumb.  And of course the relationship between Allergists and Pulmonologists resembles a Kabuki Dance. The discovery of Xolair and its embrace by Pulmonologists has finally been a boon to their long-suffering asthmatics and some chronic bronchitics.
  3. I have long considered the role of Inflammation central in all manner of disease states. But it is a blunt instrument in the Immune System, easily capable of over-reacting, injuring or killing the patient before the disease does. The discoveries of the Interleukins as mechanisms of specific inflammation, followed by specific Biologics to counter their action, have been a great boon to the understanding and to the treatment of many diseases. Nevertheless, the threat of Sepsis must always be kept in mind – and treated early and aggressively, including with Steroids.
  4. The use of LABA medications, providing the body with constant effect of beta agonists, is controversial. I do not use them, concerned about the development of tolerance to these valuable medicines when really needed. We all saw this in the past with the overuse of “rescue inhalers”.
  5. The avoidance of serious acute episodes and hospitalizations requires close follow-up, patient cooperation, aggressive treatment, and Physician Availability at all times.
  6. Low-dose constant antibiotics during the Fall – Spring months for some patients is very helpful. Incidentally: Z-PAC DOES NOT WORK FOR RESPIRATORY TRACT INFECTIONS!
  7. Notwithstanding Pulmonologists’ embrace of COPD as a diagnosis, I consider it a failure of diagnosis until the components of the disease process are defined: inflammation (smoking, recurrent infections, work exposures, autoimmune diseases, etc…AND ALLERGIES). All such patients require an allergy evaluation, in my opinion, since an allergic component – found in up to 30% of such patients when sought – may be the most treatable or the only reversible part of their disease process.
  8. Coordination of Care matters. GERD, OSA, Obesity, medically treated hypertension, all play a role in the diagnosis and treatment of Bronchial Asthma and Chronic Bronchitis, with or without concurrent Paranasal Sinusitis.  A properly trained and motivated Allergist is in an ideal position to do this, in view of his training and his frequent contact with these patients.
  9. Beware schlock and monetized “Science” and the need to “publish”.
  10. In evaluating a new patient, TAKE THE TIME TO LISTEN TO THE ENTIRE STORY. In 70% of all medical cases, the patient will give you the diagnosis – if you LISTEN.
  11. What is it with allergies, asthma and referrals from Pediatricians? Why do they resist?
  12. Atopic Dermatitis, properly diagnosed, is an ideal condition for treatment by Allergists. Only one of at least two types of Atopic Dermatitis is based on allergies. But Careful treatment of that group can produce the most rewarding results.
GS

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LOW CALORIE SWEETENERS: NOT A GOOD IDEA.

GS

Study: Do Low-Calorie Sweeteners Increase Body Weight?

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CLEAR AS MUD.

Especially relating to family, and with the uniform understanding that a physician-patient relationship has thereby been formed - with all of its mutual obligations -  there is no ethical prohibition to a physician being so available. This is especially true in the current situation of sometimes unavailable or unhelpful personal physicians.

In my opinion, this availability does not hold true for "friends", except in urgent or emergent situations.

They can rely on their personal physician - until they have completed a medical visit with you, if desired.

GS

How to handle medical requests from friends and family

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Rapid Response for SATURDAY, May 10, 2019

EXCELLENT ARTICLE ON THE CURRENT LIFE - AND PLIGHT - OF PHYSICIANS.
As for me, in my 62nd year as a practising physician - and counting - I still enjoy it...
and I won't let the ignorant Bastards get me down.

GS

Would you let your son or daughter be a doctor?

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Research Shows Long-Term Clinical Results of Allergen-Specific Immunotherapy

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Rapid Response for SUNDAY, May 5, 2019

RR#1

READ IT AND WEEP.
Then call me "Old School"...Please.

GS

The Powerful Phrase That’s Ruining Medicine

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NOW HERE'S SOMETHING TO LIKE...AND IT LIKES YOU TOO.

GS


Nut Consumption and Cardiovascular Disease

Tree Nuts and Glycemic Control in Diabetes

Almonds and Cholesterol Management

Nut Intake and Cancer-Related Mortality

Nut Consumption and Body Weight

Tree Nut Allergy

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TAKE A BREAK FROM YOUR CURRENT COMPLAINTS ABOUT "HEALTH CARE".

GS

Worst health advice of all time

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AND REMEMBER: AZITHROMYCIN ("Z-PAC") DOES NOT WORK FOR RESPIRATORY TRACT ILLNESSES.

GS

These commonly prescribed drugs may have lethal effects

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Worst states to practice medicine in 2019

"WHAT CAUSES CANCER?  IT'S COMPLICATED", by Arthur W. Lambert (in WSJ April 2, 2019, Opinion, pA17).

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Rapid Response for SATURDAY, April 13, 2019

RR#1

ON ANAPHYLAXIS, ITS DIAGNOSIS AND TREATMENT.
Listen Up, Folks. The life you save may be your own.
AND REMEMBER EPINEPHRINE!!  That is the proper initial treatment...not the other stuff, which is too often substituted.

GS

Don't miss anaphylaxis in the hospital

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Rapid Response for FRIDAY and SATURDAY,  March 29 and 30, 2019

...AND THEIR PROFESSIONAL PROGENY WHO ARE STILL TRYING TO DO THE SAME.

GS

10 doctors who changed the world

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Rapid Response for MONDAY,  March 11, 2019


What Socialized Medicine Looks Like
John C. Goodman

Left-wing Democrats in Congress have decided on a new version of “Medicare for All.” Turns out its going to be nothing like the Medicare program seniors are used to. What they have in mind is what we see in Canada.

Everyone (except American Indians and veterans) will be in the same system. Health care will be nominally free. Access to it will be determined by bureaucratic decision making.
Here’s what to expect.

Overproviding to the Healthy, Underproviding to the Sick. The first thing politicians learn about health care is this: most people are healthy. In fact, they are very heathy – spending only a few dollars on medical care in any given year. By contrast, 50% of the health care dollars will be spent on only 5% of the population in a typical year.

Politicians in charge of health care, however, can’t afford to spend  half their budget on only 5% of the voters, including those who may be too sick to vote at all. So, there is ever-present pressure to divert spending away from the sick toward the healthy.

In Canada and in Britain, patients see primary care physicians more often than Americans do. In fact, the ease with which relatively healthy people can see doctors is probably what accounts for the popularity of these system in both countries.

But once they get to the doctor’s office British and Canadians patients receive fewer services. For real medical problems, Canadians often go to hospital emergency rooms – where the average wait in Canada is four hours. In Britain, one of every ten emergency room patients leave without ever seeing a doctor.

A study by former Congressional Budget Office director June O’Neill and her husband Dave O’Neill found that:
  • The proportion of middle-aged Canadian women who have never had a mammogram is twice the U.S. rate.
  • Three times as many Canadian women have never had a pap smear.
  • Fewer than 20% of Canadian men have ever been tested for prostate cancer, compared with about 50% of U.S. men.
  • Only 10% of adult Canadians have ever had a colonoscopy, compared with 30% of US adults.
These differences in screening may partly explain why the mortality rate in Canada is 25% higher for breast cancer, 18% higher for prostate cancer, and 13% higher for colorectal cancer.
A study by Brookings Institution scholar Henry Aaron and his colleagues found that:
  • Britain has only one-fourth as many CT scanners as the U.S. and one-third as many MRI scanners.
  • The rate at which the British provide coronary bypass surgery or angioplasty to heart patients is only one-fourth of the U.S. rate, and hip replacements are only two-thirds of the U.S. rate.
  • The rate for treating kidney failure (dialysis or transplant) is five times higher in the U.S. for patients age 45 to 84 and nine times higher for patients 85 years of age or older.
We can see the political pressure to provide services to the healthy at the expense of the sick in our own country’s Medicare program. Courtesy of Obamacare, every senior is entitled to a free wellness exam, which most doctors regard as virtually worthless. Yet if elderly patients endure an extended hospital stay, they can face unlimited out-of-pocket costs.

Rationing by Waiting. Although Canada has no limits on how frequently a relatively healthy patient may see a doctor, it imposes strict limits on the purchase of medical technology and on the availability of specialists. Hospitals are subject to global budgets – which limit their spending, regardless of actual health needs.

In addition to having to wait many hours in emergency rooms, Canadians have some of the longest waits in the developed world for care that could cure diseases and save lives. The most recent study by the Fraser Institute finds that
  • In 2016, Canadians waited an average of 21.2 weeks between referral from a general practitioner to receipt of treatment by a specialist – the longest wait time in over a quarter of a century of such measurements.
  • Patents waited 4.1 weeks for a CT scan, 10.8 weeks for an MRI scan, and 3.9 weeks for an ultrasound.
Similarly, a survey  of hospital administrators in 2003 found that:
  • 21% of Canadian hospital administrators, but less than 1% of American administrators, said that it would take over three weeks to do a biopsy for possible breast cancer on a 50-year-old woman.
  • 50% of Canadian administrators versus none of their American counterparts said that it would take over six months for a 65-year-old to undergo a routine hip replacement surgery.
Jumping the Queue. Aneurin Bevan, father of the British National Health Service, declared, “the essence of a satisfactory health service is that rich and poor are treated alike, that poverty is not a disability and wealth is not advantaged.” Yet, more than thirty years after the NHS was founded an official task force (The Black Report) found little evidence that the creation of the NHS had equalized health care access. Another study (The Acheson Report), fifty years after the NHS founding, concluded that access had become more unequal in the years between the two studies.

In Canada, studies find that the wealthy and powerful have significantly greater access to medical specialists than less-well-connected poor. High-profile patients enjoy more frequent services, shorter waiting times and greater choice of specialists. Moreover, among the nonelderly white population, low-income Canadians are 22% more likely to be in poor health than their U.S. counterparts.
These results should not be surprising. Rationing by waiting is as much an obstacle to care as rationing by price. It seems that the talents and skills that allow people to earn high incomes are similar to the talents and skills that are useful in successfully circumventing bureaucratic waiting lines.

No Exit. The worst features of the U.S. health care system are the way in which impersonal bureaucracies interfere with the doctor-patient relationship. Those are also the worst features of Canadian medical care. In Canada, when patients see a doctor the visit is free. In the U.S., the visit is almost free – with patients paying only 10 cents out of pocket for every dollar they spend, on average. In both countries, people primarily pay for care with time, not with money. The two systems are far more similar than they are different.

In Britain, private sector medicine allows patients to obtain care they are supposed to get for free from government. Middle and upper-middle income employees frequently have private health insurance, obtained through an employer. A much larger number of Britons use private doctors from time to time. The rule seems to be, “If your condition is serious, go private.”
Canada, by contrast, has basically outlawed private sector medical services that are theoretically provided by the government. If doctors, patients and entrepreneurs think of better ways of meeting patient needs they have no way of acting on those thoughts.

This is where the U.S. system is so much better—even though, as in the Canadian system, U.S. Medicare pays doctors the same way it did in the last century, before there were iPhones and email messages. Many U.S. employer plans are just as bad.

But because U.S. employers are free to meet the needs of their employees rather than live under the dictates of a politically pressured bureaucracy, one of the fastest growing employee benefits is concierge care. For as little as $50 a month for a young adult, patients can have 24/7 access to a doctor by phone and email and all the normal services that primary care physicians provide.
Uber-type house calls, consultations by phone, email and Skype, cellphone apps that allow people to manage their own care and other innovations in telemedicine are taking some parts of the private sector by storm.

These are the kinds of innovations that would be outlawed if the congressional Democrats have their way.

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THIS IS A TROUBLING REPORT ABOUT A NEW LETHAL RISK, DECADES OLD, FOR MANY WOMEN.

GS

Popular Cosmetic Procedure Is Killing Women

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NOW HEAR THIS: CHECK YOUR VITAMIN D LEVEL. IT'S PROBABLY QUITE LOW.
Then replete with vitamin D3.

GS

Vitamin D: Researchers continue to explore wide range of benefits

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Rapid Response for SATURDAY,  February 2, 2019

RR#1

NOT SO SMART...

GS

Here's how your smartphone is hurting your health

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Rapid Response for SATURDAY, January 26, 2019

RR#2

REGARDING VACCINES AND IMMUNIZATION:

"The World Health Organization has ranked vaccine hesitancy - the growing resistance to widely available lifesaving vaccines - as one of the top 10 health threats in the world."
See: "How To Inoculate Against Anti-Vaxxers" (Editorial, NYTimes Jan. 20, 2019, Sunday Review, p10).

Informative and well-presented, this article only begins to expose the great health danger posed by this latest mindless fad.  And it gives short shrift to the one main action that needs to be taken: "Get tough".
Through immediate Federal and State legislation, no infant or child (since "pre-school" is now being offered in infancy!) should be admissible to school without official evidence of having been properly vaccinated.
I can hear the bellowing now. Well: Shut Up! You are endangering our entire society needlessly.
Having taken that action, implement the other actions proposed in this useful editorial.

GS

RR#3

SOCIOLOGY: "IT AIN'T WHAT IT USED TO BE".
In my college course in 1950, I had to look to the Hopi Indians as a topic for my course Paper.
No more. Sociology has become Behavioral and Abnormal Psychology, with recent generations flirting with "weird and weirder". Of course, that's an overstatement - but not by much.
One article that caught my attention, given my work, is entitled:
"Preparing Your Practice For Tomorrow's Patients", by James F. Sweeney (in Medical Economics, May 10, 2018). "And at roughly 80 million strong, the largest generation alive, Gen Z is too big to ignore for physicians who plan on being in business past the next 10 years."
Not even I plan for that! But it's interesting. I have only one question:
And Whose's Preparing Gen Z. For The Real World?

GS

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Rapid Response for MONDAY, January 21, 2019

SORRY: FAT IS FAT, NOT FIT.
Although under reconstruction, please visit my other website entitled: www.medidietresources.com.
Here is a "Cliff Notes" version:
1) Your choice is to lose, or to gain a lot more. You won't stay where you are.
2) Weigh yourself daily! No surprises. No cowards.
3) The Mediterranean Diet has been declared by many peer-reviewed articles to be the best diet.
4) The Mediterranean Food Pyramid is the American diet on its head. Check it out.
5) The Rule of Half: cut your portion size IN HALF - NOW!.
6) Eat four to six times per day, smaller portions and the right food.
7) Get thee to a Glycemic Index of foods (especially Carbs)...and avoid all foods above an Index of 50.
News Flash: Pasta, specifically 100% duram semolina wheat, has a glycemic index of 25!  Enjoy.
8) Exercise! Walking is best.
9) This is not a "flash in the pan". This is life-long...and it's DELICIOUS.

GS

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Rapid Response for SUNDAY, January 20, 2019

"DO SECOND OPINIONS TRULY AVERT MISDIAGNOSIS?"
I encourage second opinions. They help the patient and myself.

GS

Do second opinions truly avert misdiagnosis?

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HERE'S SOME USEFUL HEALTH INFORMATION, HOT OFF THE PRESS:

1) Flu-Mist vs. Flu Shot?  GET THE FLU SHOT.
2) Allergic to Peanuts? STAY AWAY, AND CARRY AN EPINEPHRINE AUTO-INJECTOR AT ALL TIMES.

GS


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Rapid Response for SATURDAY, January 12, 2019

THIS IS IMPORTANT.
"Reach Out And Touch Someone".

GS

New epidemic affects nearly half of American adults

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Rapid Response for WEDNESDAY, January 9, 2019

NOW HEAR THIS!

GS

Physicians urge caution regarding medical uses of marijuana and cannabinoids

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Rapid Response for WEDNESDAY through SATURDAY, January 2 through 5, 2019

"WHEN MEN WERE MEN".
When was that?
Psychological and physiological research finds that many young men are in a funk.
They are confused and intimidated in their dealings with many of the opposite sex.
They are depressed, with an increasing incidence of alcohol and drug use and suicides.
They are more resistant to attempting lasting relationships and especially marriage.
They have lower testosterone and sperm levels.
And more. Look it up.
And why?
Here I offer one diagnosis.
"Manhood" among some of the younger generation has been co-opted by the females. Not Ladies and not Women,  of whom there are still many...but "females" who have rejected their unique genetic role (among many roles) as mothers and nurturers of every generation since Adam and Eve.
In that context, "men" become the enemy. Everything else follows logically and inevitably.
Unless, that is, "manhood" defines and embraces a new "Status of Forces", isolates the "females" through total lack of attention, seeks out the Ladies and the Women as equal partners, and becomes defenders of the new generations that they help to form, to embrace and to support through life-long attention from the moment of their conception.
Meanwhile, many men of the younger generations are losing their psychological and physiological moorings - as men, as males, and as cognitive human beings.
That need not be.

GS

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Rapid Response for TUESDAY, January 1, 2019

HERE'S A NEW YEAR'S RESOLUTION.     I'LL BET THAT YOU ARE DEFICIENT IN VITAMIN D.
An easy bet, given the fact that most people are deficient these days. THAT'S IMPORTANT,  as you will read here, not only to avoid some diseases but also at times to treat some...like recurrent HIVES.
So: get your 25 - Hydroxy Vitamin D level taken (blood test). And seek treatment for deficiency with Vitamin D3.
Now: Doesn't that feel better?

GS

Vitamin D: Recent research uncovers new benefits

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Rapid Response for WEDNESDAY through SATURDAY, December 26 through 29, 2018

RR#3

"Five Ways Nixing The ACA Could Upend The Entire Health System", by Julie Rovner/ Kaiser Health News, (in ctmirror.com Dec. 25, 2018). THAT WOULD LIKELY BE TRUE, IF THE BUREAUCRATS, THE POLITICIANS, BIG PHARMA, THE HOSPITAL - INDUSTRIAL COMPLEX AND "ORGANIZED MEDICINE" CONTINUE TO EMBRACE "A CAMEL: A HORSE DESIGNED BY COMMITTEE". It doesn't need to be that way. And I have been writing and publishing about this since the late 1970's.  Look it up, throughout my web site.

RR#4

PHYSICIAN, KNOW THYSELF.  PATIENT, KNOW THY PHYSICIAN.
The life you save may be your own.

GS

Why doctors end up hating their bosses

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Rapid Response for MONDAY, December 24, 2018

THERE ARE FOUR KINDS OF MEDICAL RESEARCH, ALL DEPENDENT UPON VAST AMOUNTS OF FUNDING.
  1. Original Research, beginning de novo;
  2. New Research building upon research results already reported, sometimes many decades ago:
  3. Research essentially re-doing established work of the past, with or without attribution;
  4. Research that totally ignores established work of the past that still supports current mainstays of medical treatment.
It is the fourth kind of research that I address here: work establishing Allergy Immunotherapy, first in the clinical laboratory and practices of pioneers like Dr's Robert Cooke and William Sherman beginning in the 1920's...and then entirely verified in the immunology laboratories of scientists like Dr's. Larry Lichtenstein and Ichizaka in the 1960's.

That Allergy Immunotherapy is a bed-rock of desensitization treatment for serious inhalant allergies - particularly bronchial asthma and combined asthma / chronic bronchitis.

And It Is Being Studiously Ignored...by both practising clinicians who never bothered to become familiar with it, and by researchers who would rather not lose research grants while giving passing attention to the central role of inhalant allergy in these fields. This leaves the patient to search out his or her needs.

See the following extensive article entitled:
"Advances In Asthma In 2017:Mechanisms, Biologics, And Genetics.", in J. Allergy Clin Immunology, November 2018.
See if I missed anything.

GS

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FIGURES LIE, AND LIARS FIGURE.

HERE ARE THE FACTS ABOUT HEALTH CARE IN AMERICA VS. THE WORLD.

"Single Payer's Misleading Statistics", by Scott W. Atlas, in WSJ December 18, 2018, Opinion, pA19.

GS

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THIS IS MEDICAL INFORMATION...NOT SOCIAL COMMENTARY.

A few years ago, I reported in this section medical information (and implicit advice, given the Health implications) regarding possible defense against Prostate Cancer and Breast Cancer.
Both then and now, medical research found that increase in ejaculations in men over time reduced the incidence of prostate cancer. (See: medlinx.com/internal-medicine/article/3218?utm).
At that time, I also reported medical information that increase in breast suckling for women reduced the incidence of breast cancer.
Once again, there is implicit advice here.

GS


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What You Need to Know About Vitamin D

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Rapid Response for FRIDAY and SATURDAY, December 7 and 8, 2018

NOW HEAR THIS!
If an established Asthmatic is not treated with an accurate and complete diagnosis, with effective environmental control - especially involving pets, with an effective (and not excessive) program of anti-allergic and anti-inflammatory medications, with prompt on-call and effective treatment of superimposed respiratory tract infections, and WITH ALLERGY IMMUNOTHERAPY FOR UNAVOIDABLE ALLERGENS, he or she, at whatever age, is BEING POORLY TREATED.
And that is also true - and possibly especially so - for the many patients, undiagnosed by their Pulmonologists, who continue to miss combined Bronchial Asthma and Chronic Bronchitis, mis-labled as "COPD",
Everybody so affected, whether, parent or patient or primary care physician or pulmonologist:
EITHER LEARN, OR GET TO A CERTIFIED ALLERGIST, OR
GET OUT OF THE BUSINESS
George A. Sprecace., M.D., F.A.C.P, J.D.
asthma.drsprecace.com


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Α-gal Syndrome vs Chronic Urticaria

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Rapid Response for SUNDAY, November 18, 2018

BRONCHIAL ASTHMA: THE MOST TREATABLE - AND OFTEN THE MOST POORLY TREATED -  SERIOUS MEDICAL CONDITION.
I have been writing about and treating Bronchial Asthma for many decades. That information is available in several sections of this web site, and is up-dated regularly.
Today, I present the latest caution, prompted by the very recent re-approval by the FDA of Primatene Mist as an OTC medication for the treatment of "mild asthma".
WRONG, AND POTENTIALLY DANGEROUS.
In this position, I am joined by a Joint Statement just released by the major medical organizations dealing with such subjects : "Several Asthma, Allergy Groups Express "Deep Concern" Over Primatene Mist Approval" (MPR, November 12, 2018).
Use and overuse can easily result in a rebound worsening of the asthmatic bronchospasm, resulting in crisis situations.

There may be usefulness for Primatene Mist, only by prescription and under a doctor's emergency advice, in case of acute laryngospasm...and then FOLLOWED IMMEDIATELY by transfer to an Emergency Room - in view of the medication's propensity to produce worse rebound.
BEWARE: The life you save may be your own.

GS


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Rapid Response for SUNDAY, October 21, 2018

AKA "RED MEAT ALLERGY", ALSO CAUSED BY BITE OF "LONE STAR TICK".

It's a wild world out there. Be aware.

GS

Meet the new 6-legged cause of infection, allergy, and life-threatening disease

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Rapid Response for FRIDAY, October 12, 2018

THIS IS AN IMPORTANT HEALTH ADVISORY.
A majority of people are deficient in Vitamin D.

In recent decades, Vitamin D has been found to be vital for many body functions besides bone health.

Now comes the reproduced article.

Please get your 25-OH Vitamin D blood level drawn. If the level is below 30, contact your physician to prescribe Vitamin D3, 1000 or 2000 units per day, with repeat blood levels every four months.
You're Welcome.

GS

MRSA Bacteremia Treatments Compared

Vit. D Deficiency and Sepsis Mortality

Statins May Decrease TB Risk

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Rapid Response for SUNDAY, October 7, 2018

FOR YOUR CONSIDERATION, AS YOU SIP YOUR MORNING COFFEE.

GS

The dangerous effects of caffeine

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This Allergist Is 106 Years Old, and He's Not Slowing down Anytime Soon

What the Newest Medical Show, New Amsterdam, Gets Wrong

Design Features of this Device May Be of Interest to Your Patients

Racial Differences Uncovered in Debilitating Itchy Skin Condition

Individuals with Atopic Dermatitis More Likely to Have Antibody Response to S Aureus Superantigens

Inaccurate Penicillin Allergies Worsens Antimicrobial Resistance

Anaphylaxis: Treating A Potential Killer

The Breastfeeding-Asthma Link

Now Hiring at Doximity: Director of Medical Content

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Rapid Response for SATURDAY, October 6, 2018

ANOTHER OF THE MANY WAYS IN WHICH "LIFE STYLE" ISSUES ACCOUNT FOR WELL OVER 50% OF ALL HEALTH CARE COSTS.
"STUPIDO. STUPIDO. STUPIDO".

GS

Study: E-Cigarette Injuries Drastically Underestimated

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Rapid Response for FRIDAY through SUNDAY, September 28 through 29, 2018

MMMM MMMM GOOD.

GS

Yes, chocolate is good for you—but there's more to unwrap 

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Rapid Response for THURSDAY through SATURDAY, September 20 through 22, 2018

"THE DECLINE OF THE DIAGNOSIS" = THE DECLINE OF MEDICINE.
Here is an article, written by Joel B. Levine, M.D. and appearing in the September 2018 edition of Connecticut Medicine, which crystallizes the decline of Clinical Medicine...that is, the medical care that directly impacts every patient.
Apart from the 50% of a clinician's time that must be spent "documenting" on an increasingly redundant "electronic health record".
Apart from the rapidly increasing loss of private practitioners to the role of hospital employees tied to the "15 minute office visit", no matter what.
Apart from the decades-long theft of services identified as "adjustments", wherein a physician's reasonable and customary fee is discounted by 40-50% by insurance payors on a "take it or leave it" basis.
Apart from the sometimes idiotic regulations under which physicians are forced to practice...if they want to get paid at all.
This article describes how some physicians allow themselves to make a snap "diagnosis" without time to develop a "differential diagnosis" list  upon which to explore and act. The National Quality Forum, formerly the Institute of Medicine "acknowledges that the EMR (electronic medical record) is inherently incapable of such a clinical synthesis. The EMR demand for a billable action at the end of every encounter creates an ongoing need for a conclusion when one may not, as yet, have emerged." Resulting wrong diagnoses produce many adverse events and deaths.
Master clinicians are master diagnosticians. "By being smart, a masterful physician was invariably quicker to the right answer and cheaper."
"Sadly, we are being persuaded that medicine is not nearly as difficult as we thought it to be. All you need to do is keep the electricity bill paid."

GS

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Rapid Response for SUNDAY, September 16, 2018

"LIFE AND DEATH IN THE GREAT 1918 INFLUENZA PANDEMIC"
At this, the 100th anniversary of the "SPANISH INFLUENZA", John Ruddy and The Day perform another very useful public service:

to remind their readers that things are not always as they seem...and that contact with one's physician early on in an illness is much better than playing catch-up - or not catching up at all.

The following is a brief over-view, including my opinion of the lessons to be drawn from the 1918 devastating experience - and applicable to a future similar experience.
  1. That Influenza was extremely lethal. A future episode may be no less lethal if we rely only on vaccines and antibiotics.
  2. In that pandemic, it was the young, healthy and immuno-competent who were mainly affected. WHY?
  3. One theory relates to the variable availability of immune resistance, among young and old, from exposure to prior epidemics of the 1890's and of 1909, and to genetic mutations. Possible, but not sufficient for explanation, in my opinion.
  4. The pathologic findings in the lungs (the main cause of death being an overwhelming pneumonia and suffocation): bacteria were very hard to culture, and the lung tissue resembled the effects of toxic / inflammatory destruction.
  5. It is well-known that the Inflammatory System, a basic part of our Immune System, is a Blunt Instrument - not a scalpel - easily capable of doing more harm to the host than the invader might do...even killing the host itself, as in "Septic Shock".
  6. Most of the Influenza victims had robust Immune Systems.
  7. It is highly likely that the inflammatory response to the initial viral invasion killed the patients, through Sepsis and the implementing "Cytokine Storm".
  8. WHAT TO DO?
a) Seek the advice of your physician early-on, certainly within hours of developing significant symptoms and/or signs.

b) Be aware of the increasing capability of viruses, even in non-asthmatic and non-bronchitic patients, of producing substantial bronchospasm requiring aggressive anti-asthmatic treatment.

c) Patient and physician should have a high index of suspicion for the early signs of Sepsis...and should intervene with hospitalization and aggressive treatment immediately.

d) In the event of the above developments, the use of high-dose Steroids should be added promptly - not just "considered" - to counter the otherwise devastating effects of an Inflammatory System run amok.

THIS IS NOT OVER-REACTION. This may well save your life.

And - in the increasingly inattentive, hurried and even impersonal domains of today's medical care areas - you must have an effective ADVOCATE to present and if necessary to argue your case.

A Google Search under "Spanish Influenza, 1918" and under

"Sepsis and Steroids" will produce many relevant references.

Just don't get bogged down in the favorite ploy of some academicians, as distinguished from clinicians :
"On the one hand; on the other hand".

GS

Life and death in the great 1918 influenza pandemic

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Rapid Response for SATURDAY, September 15, 2018

RR#1

PLUS, WHAT WE LEARNED IN MEDICAL SCHOOL:
from the patient's point of view, the THREE MOST IMPORTANT QUALITIES OF A PHYSICIAN;
Ability, Affability, and AVAILABILITY...IN REVERSE ORDER!

GS

Do you have the 10 qualities that make a good doctor?

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Rapid Response for SATURDAY, September 1, 2018

"NO BRAG. JUST FACT".

Patients under my care for Allergy and Chest Diseases receive all of these services...in addition to "coordination of care"...at no extra cost. That's the way I've been practicing for six decades - and counting.

GS

Concierge Medicine Is Changing the Physician Practice Landscape

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Rapid Response for FRIDAY, August 31, 2018

ENJOY "HOOKING UP" INDISCRIMINATELY AS PART OF THE SOCIAL SCENE?
YOU DUMMIES!
Read the Linked article: "STDs Reach Record Levels in CT, Early Data Show", by Jake Kara and MacKenzie Rigg, in ctmirror.org, August 30, 2018.
Then "Google" Gonorrhea, Chlamydia and Syphilis. Read about Herpes for "extra credit". Then see if you "enjoy".

GS

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Rapid Response for SUNDAY, August 5, 2018

BINGO!
This is THE TRUTH, THE WHOLE TRUTH, AND NOTHING BUT THE TRUTH...
about physicians, the Medical Profession and the patients they find it increasingly difficult to care for properly.
This could only have been written by a Good Doctor. THANK YOU.

GS

Physicians aren’t ‘burning out.’ They’re suffering from moral injury

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PS: MOST PEOPLE ARE DEFICIENT IN VITAMIN D (less than 30 of 25 OH Vitamin D).
All patients should be tested. If deficient, they should receive Vitamin D3, 1,000 or 2,000 units daily. They should be re-tested every few months to avoid toxic levels (ie. above 70).

GS

Vitamin D: Recent research uncovers new benefits

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Rapid Response for WEDNESDAY and THURSDAY, August 1 and 2, 2018

PAYING FOR HEALTH CARE DELIVERY: THE MACRO AND THE MICRO.
Let's start with the MACRO...and with the obvious.

"Yes, the government should help those in need; but there is no fundamental reason that your and my health care and insurance must be so screwed up to achieve that goal".
So ends a recent article by John H. Cochrane entitled: "The Tax-And-Spend Health-Care Solution (WSJ July 30, 2018, Opinion, pA17. The author compares the current Health Care payment experience nation-wide with our experience with national telephone service and with national air service before and after finally producing a rational solution. Of course, why these vital and massive services were "so screwed up" was because businesses with great political clout wanted great profit - without competition. And our fearless leaders obliged. The same is true now - and for decades - with the Health Care Industry.

And now onto the MICRO. See: "The GOP's Clean Bills Of Health Savings" (in the same edition of WSJ, Editorial, pA16). As I have been writing for decades on this web-site and in the lay press, Health Savings Accounts have been a logical solution for decades...and have been thwarted for decades by the same organizations with great clout and by their wholly-owned subsidiary, the Government. And we are all, providers as well as consumers of health care, getting screwed!

GS

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Link between diabetes and cancer risk firmly established

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Beef jerky, processed meats linked to maniac episodes

Do omega-3 supplements really benefit the heart?

Alzheimer's risk 10 times lower with herpes medication

Good news for heavy coffee drinkers

Fats or carbs: What causes obesity?

Evidence to support 'breakthrough' drugs often very limited

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Rapid Response for SUNDAY, June 24, 2018

RR#1

"SEVERAL NOTABLE MEDICAL SOCIETIES HAVE ISSUED ETHICAL STATEMENTS DISCOURAGING PHYSICIANS FROM TREATING FAMILY MEMBERS AND FRIENDS."
This statement is too sweeping and is generally wrong, especially in today's health care delivery climate...where every patient needs a diligent advocate.
Furthermore, all of my patients are my friends, as are my family members.
In the informative discussions presented in this article, Dr. Gold is more doctrinaire than informed; Dr. Prager is too anxious; and Dr. Abbate presents the best of the arguments.
In the final analysis, "it takes two to tango". Doctor and Patient should make the decision for themselves.

GS

Incidence of Extrapyramidal Symptoms Higher With Certain Antidepressants

RR#5

THE HEALTH INDUSTRY AND ITS PARTICIPANTS: PART II.

GS

I remember when the Health Care Industry represented 8% of GDP. So, they went along just doing the same old things, like employer and employee tax deductability for health care expenditures, like suppressing health savings accounts that would bring patients back to caring about what they seek in health care, like making no effort to address the 50% of health care costs (ie. sickening life styles), like letting insurance companies run amok, like treating health care providers (the only ones who can really affect health care demands and costs) like the enemy, like Legislating a Prohibition against the Government being able to negotiate drug costs, like treating potential patients (ie. all of us) just as votes ("a chicken in every pot, a car in every garage").

So now, Health Care costs represent 17+% of GDP. What was that that Einstein said?

GS

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Rapid Response for FRIDAY, June 22, 2018

THE HEALTH CARE INDUSTRY AND ITS PARTICIPANTS:
the patient- public, health care professionals, payors, government...
This industry is approaching 20% of the GNP, a vital part of us.
Three recent articles in the WSJ will provide a detailed primer to the facts. And they augment several decades of personal writings on the subject.
(See the relevant sections of asthma.drsprecace.com)
•    "A Health Fix For Mom And Pop Shops", by Alexander Acosta, June 19, 2018.
•    "Exit From ObamaCare", Editorial, June 20, 2018.
•    "Health Savings Accounts for Everyone", by Scott W. Atlas, June 20, 2018.
The physical, mental and financial health you save may be your own.

GS

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Rapid Response for FRIDAY, May 18, 2018

RETARDING ADVANCED PRACTICE REGISTERED NURSES.
and efforts by some in their professional organizations to allow unsupervised practice.
My interactions with APRN's has been uniformly favorable. They are humane, highly motivated, fairly well educated and trained...and effective in what they do.
BUT THEY DON'T KNOW WHAT THEY DON'T KNOW!
That is the worst and most dangerous kind of ignorance.
It's not their fault, not even their responsibility. Their career path just does not provide for the comprehensive education, training and experience vital for the ultimate responsibility of a physician for the care of a patient entrusted to his or her care.
That is the one reason to work against free-standing APRN practice. It's not about turf or professional insecurity.
Therefore, please support efforts to retain APRN medical practice within the supervision of a licensed and practicing physician.

GS

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Rapid Response for SUNDAY, May 13, 2018

REGARDING DRUG  PRICING:
See the article published in The Day (May 12, 2018) entitled:
"Few Teeth In Trump's Prescription To Reduce Drug Prices".
"But it does not include his campaign pledge to use the massive buying power of the government's Medicare program to directly negotiate lower prices for seniors."
"Drugmakers generally can charge as much as the market will bear because the U.S. government doesn't regulate medicine prices, unlike most other developed countries."

AND DO YOU KNOW WHY?
Because your Senators and House Representatives in Congress, in passing the Medicare Modernization and Prescription Drug Act of 2002, specifically prohibited the Government from negotiating prices with the drug cartel.
Why did they do this? Because they did not want to lose the many millions of dollars of contributions to themselves from the drug companies. And to hell with their constituents. That's why.

President Trump cannot unilaterally reverse that. Only Congress can repeal or pass Laws. Indeed, there is now a Bill in Congress which would address that issue: "The Medicare Drug Price Negotiation Act of 2017.

It is going nowhere. Why not? Reread the above. And don't swallow the cyinical and divisive blame game being constantly dumped on the President. THE SWAMP HAS PROVEN TO BE MUCH DEEPER THAN ANY OF US IMAGINED. But give him time. He has accomplished a great deal of good, despite all manner of obstruction, in a short time.

GS

Few teeth in Trump’s prescription to reduce drug prices

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Rapid Response for WEDNESDAY, May 9, 2018

ABOUT MARIJUANA, OTHER THAN STRICTLY SUPERVISED MEDICAL USE:
DON'T BE STUPID!

GS

SAMHSA Head Stands Firm on Marijuana's Dangers—Also says younger generation of providers is key to opioid fight

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Rapid Response for SATURDAY, May 5, 2018


THIS IS GOOD ADVICE ABOUT TICKS.
Also:
1) Take a shower right after any walk in a wooded area;
2) Remember that Lyme Disease is much more likely to occur in a person who has already had one or more bouts of Lyme Disease than in a person who by this time in this region has never had the disease;
3) A rash, or "the target rash" does not occur in all cases. Any "flu-like symptoms" especially between Spring and Fall are suspect and should be tested for Lyme Disease and the other diseases related to tick bites.
As always, a diagnosis is most likely made by thinking about it as a possibility.

GS

Check for ticks every day, health district advises

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Rapid Response for TUESDAY and WEDNESDAY, April 17 and 18, 2018

MORE ON THE COMING DEMISE OF MEDICAL CARE - AND OF THE MEDICAL PROFESSION ITSELF- IN AMERICA. THIS IS OBSCENE!
A personal note. I have been a practicing physician for  61 years...and counting. I have never closed my practice to new patients. I have always taken all patients, regardless of the accompanying payment schemes, some miserable and all subjecting me and my medical colleagues to theft of services of about 40% of my income for the last 30 years.
"No Brag. Just Fact".

But I have refused to get sucked into the vortex described below: electronic health records for clinical care; performing work 10 points below my pay grade; sitting on hold - or allowing my staff to sit on hold, etc. I and my staff work WITH patients, not FOR patients. we require that they do their part.
Meanwhile, many tens of thousands of good physicians have given up private practice - or medical practice entirely, even choosing suicide! Not Me.
But you, the patient, are right now at great and increasing risk. You are receiving less and less effective and timely care. And only you can unite to reverse this lethal trend - because the regulators and the legislators don't give a damn for the health care personnel that they are trampling with abandon. Rise and Fight; or Sit and Die a slow death.
I kid you not.

GS

ER Docs: Secretaries with Medical Degrees

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Drinking in Adolescence Derails Normal Brain Development

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LET'S TALK ABOUT MARIJUANA.
Executive Summary: Medical Marijuana, YES; Recreational Pot, NO.
SOME FACTS.

1) The brain has many endo- and exo- cannabinoid receptors, ready to engage as part of the brain's endorphin systems.
2) There are many type of cannabinoid chemicals, natural and synthetic, that can be manipulated by manufacturers for specific effects.
3) A person's response is dependent on dose, frequency, route, types and ratios of chemicals.
4) When smoked, peak effect is in 15-20 minutes; duration is about one hour, then promoting further desire.
5) "Spice" is a synthetic cannabinoid, easily subject to overdose...and can be sprayed on other related drugs. It is not detectable in urine, but requires more extensive and expensive tests for detection. Withdrawal symptoms begin within 2-4 hours of withdrawal.
6) Cognitive effects: acute for 1-6 hours; residual for 7 hours to 20 days; long-term effects for 3+weeks; chronic effects possibly persistent. These effects include academic performance, driving and psychiatric illnesses.
7) Addictive in 10% or more of users. Withdrawal effects, including gastrointestinal, sleep and irritability effects, can last 10-14 days.
8) Age at onset of use is critical. Much worse in children and adolescents, including permanent reduction of IQ. There is evidence that use is now extending down to Middle School children!

MEDICAL MARIJUANA HAS MUCH MORE TO RECOMMEND IT,
in a "risk-to-benefit" analysis, and evidence-based.

Therefore: MEDICAL MARIJUANA, YES. RECREATIONAL POT, NO.

GS


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Rapid Response for Friday, April 6, 2018

MORE ATTACKS ON THE DOCTOR-PATIENT RELATIONSHIP.

GS

Doctor-Patient Relationship Compromised By Oppressive 'Quality' Reporting Requirements

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PLEASE ALSO CHECK OUT OUR MEDIDIETRESOURCES.COM SITE, CURRENTLY UNDER RE-CONSTRUCTION.

GS

Pecans Fight Heart Disease and Diabetes

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Rapid Response for TUESDAY, March 20, 2018

NOW HEAR THIS.
Judicial Watch is an excellent source of Real News, issue by issue.
Here is an example.

GS

Docs in AMA Survey Really, REALLY Hate Prior Authorizations

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HERE'S A GOOD AND QUICK SUMMARY OF "AUTOIMMUNE DISEASES".

GS

What happens when your body attacks itself

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Rapid Response for FRIDAY, March 9, 2018

JUST SO YOU KNOW: TWO THINGS ABOUT VITAMIN D.
1) In the last couple of decades, Vitamin D has been found to be important in many body functions besides bone health. This article points to another likely connection.
2) Probably a majority of people have Vitamin D levels below the minimum considered adequate (30-100). Certainly that is true of my patients.

Therefore, all should have their blood 25-OH Vitamin D level drawn and reviewed with their physician with the above in mind. In addition, it is now recognized that replacement should be with Vitamin D3 rather than with Vitamin D2.

JUST SO YOU KNOW.

GS

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Rapid Response for SUNDAY, March 4, 2018

REGARDING YOUR DOCTOR: HANDLE WITH CARE!

GS

One-third of physicians at major US hospital are 'burned out'

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Rapid Response for SUNDAY, February 25, 2018

REGARDING ALCOHOL, DEMENTIA AND CHRONIC ALCOHOLISM.
"True,True, and Related".

How do you want to spend your increasingly likely decades of life after your 60's?

GS

Alcohol use disorder is a 'major risk factor' for dementia

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Rapid Response for SATURDAY, February 24, 2018

READ IT AND WEEP: ABOUT HEALTH CARE DELIVERY TODAY.
Completing my 60th year in private medical practice, I don't work for patients; I work with patients, who have their own responsibilities for their health.
And as far as "concierge medicine" is concerned, I offer that daily, 24-7, without extra cost.
"No brag. Just fact".

GS

Health care's fundamental problem: Your doctor doesn't work for you

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MIGRAINE HEADACHES...NOT JUST A BAD PAIN.
First, get a clear diagnosis, preferably with a Neurologist,  ruling out other possible causes.
Then get the best treatment you can find, both for the acute episodes and for maintenance treatment to reduce or avoid the episodes. And also consider acupuncture with a qualified practitioner for treatment.
Protect your blood vessels, all of your blood vessels.

GS

Migraine linked to risk of many cardiovascular diseases, especially in year 1 after diagnosis

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IS THIS CLEAR TO YOU? THAT MAKES ONE OF US.
The important message is to use the safest medication...but NOT TO TOLERATE GERD / HEARTBURN.

GS

PPIs Lower Risk of Peptic Ulcer Disease

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CONCUSSIONS FROM PARTICIPATION IN COLLISION SPORTS MAY TURN OUT TO BE ONE OF THE MOST PERVASIVE AND SERIOUS MEDICAL CONDITIONS OF THIS GENERATION, AFFECTING OUR CHILDREN MOST OF ALL.
"Is anybody there? Does anybody care?"

GS

FDA approves blood test that determines severity of concussions

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This is not an acute coronary syndrome

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Rapid Response for TUESDAY, February 13, 2018

AND YOU WONDER WHY "DEFENSIVE MEDICINE" IS ALIVE AND WELL...AND IS RESPONSIBLE FOR 25-30% OF ALL HEALTH CARE COSTS?
WHAT A WASTE!
The only "Medical Malpractice Reform" that will work is the establishment of Health Care Courts, analogous to Patent and Bankruptcy Courts. The only impediment to that is the Trial Bar.

GS

Study: Half of doctors sued by age 55

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Rapid Response for SUNDAY, February 4, 2018

REGARDING THE CURRENT FLU EPIDEMIC.
1) Immunizations of all kinds are the most effective and cheapest form of medical care. To refrain from or to neglect getting immunized is STUPID; and for any parents and their children is IRRESPONSIBLE. Regarding the annual Flu vaccines, "egg allergy" is no longer considered an impediment to getting the shot. And you can still get the 2017-2018 Flu shot now.

2) The characteristics of this year's Flu epidemic resemble those of the Pandemic of 1918: the young and healthy are more likely to get seriously ill and to die. That is probably because the Inflammatory part of our Immune System is a BLUNT INSTRUMENT, prone to over-reacting to an invader, thus at times being itself the cause of death rather than the infection. The obvious example is SEPSIS. Therefore, make sure your physician considers high-dose Steroids in case of serious or grave illness.

3) Any "cold" is not "just a cold". It is a viremia, involving the entire body and capable of causing serious illness besides the well-known problems. Thus, treat a "cold" aggressively from the outset. My patients are given a "Cold Regimen" and are urged to use it. If you wish a copy of that Regimen, without thereby establishing a physician-patient relationship, send me a stamped, self-addressed envelope with your request. Meanwhile, an important note: "Z-PAK" DOES NOT WORK FOR RESPIRATORY TRACT ILLNESSES.

GS

CDC: US Flu Outbreak Worsens; Hospitalizations Highest in Nearly a Decade

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Rapid Response for TUESDAY, January 30, 2018

"PHYSICIAN, HEAL THYSELF."
That is my intent, as I complete my 85th year today.
For that, I thank God, my parents and my great family.
My inspiration is my mother, who lived well to age 95.
Other inspirations are noted in this direct quote from the Mayo Clinic Health Letter for December, 2017:

"Astronaut John Glenn returned to space at age 77.
Frank Lloyd Wright was still working at age 91.
Ronald Reagan was elected to his second term at age 73.
Dr. William Worrall Mayo founded Mayo Clinic at age 70.
Recently, Robert Merchand set a new world record for his age group by bicycling nearly 17 miles in one hour. Mr. Merchand is 102 years old.
What makes the difference among such people? Why do some stay young and vibrant despite their 'true age'?
Most people who live long, healthy lives are just regular  folks who refuse to equate age with illness and inactivity."

As I approach my 61st year as a physician, continuing an active medical practice of 40 hours per week (half/time for me), I intend to continue with this privilege as long as I am competent. That's my plan.

HAPPY BIRTHDAY TO ME.

GS.
January 30, 2018.

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Rapid Response for MONDAY, January 29, 2018

THIS IS GOOD NEWS FOR PATIENTS WITH SLEEP ISSUES.
Sleep Specialists are swamped with evaluations, resulting delays in attention.
Attentive non-sleep specialists who take a little time can make the diagnosis as well, then leading to specific treatment.
I have diagnosed scores of patients with Obstructive Sleep Apnea, actually an epidemic in recent years, by using three tests: a careful History, a Sleep Questionaire, and an Overnight O2 Saturation Test performed in the home.

Remember: good quality and quantity of Sleep is vital to good health.
OSA untreated can result in refractory high blood pressure, gastro-esophageal reflux, obesity, diabetes, heart attack and stroke.

GS

Provider Types and Outcomes in Obstructive Sleep Apnea Case Finding and Treatment: A Systematic Review

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Laughing Is Key to Good Health
By Mehmet Oz, M.D., and Michael Roizen, M.D.

From 1995 to 2014, comedies took in $38.6 billion at the box office — more than action, adventure and horror movies.
And that's not even counting romantic comedies, which grossed $9.1 billion.
While you might think that comedies are simply a great way to start off an evening with your significant other or spend an afternoon with the kids, they offer even more to all of you (that's moviegoers everywhere): They bring laughter, a great medicine.

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Rapid Response for SUNDAY, January 28, 2018


REGARDING ADEQUATE SLEEP, IN QUANTITY AND QUALITY...
Now hear this:
adequate sleep is the single most important controllable factor for GOOD HEALTH.
It is also the most abused and overlooked, other than the other miserable "life style habits" - which are responsible for over 50% of all illnesses and health care costs.
Sleep disturbances are Diagnosable and Treatable.
TALK TO YOUR DOCTOR. And if he or she isn't thinking straight because of sleep deprivation also, Run, Don't Walk to the nearest Sleep Specialist!
The life and quality of life you save Will be your own, for decades to come.

GS

Middle Age Sleep Problems Tied to Cognitive Decline Down the Line


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Rapid Response for THURSDAY, January 25, 2018

WHAT? A VOICE OF REASON CRYING IN THE WILDERNESS?
And something is definitely wrong when there is an ICD - 10 code, among over 60,000 other codes, for
"Had argument with in -laws."    I kid you not.

GS

Electronic Health Records: Is It Time to Uncouple Billing and Documentation Requirements?

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Rapid Response for SATURDAY, January 20, 2018

REGARDING THE IMPORTANCE OF ACCESS IN HEALTH CARE...
We were taught in Medical School that the three most important attributes of a physician to a patient are Ability, Affability and Availability - IN REVERSE ORDER!
I took that message to heart. During almost all of my 60 years in the practice of Medicine...and counting...I have been available to all of my patients all of the time: 24/7, directly through my three phone numbers. I don't call it "Botique" or "Consierge" Medicine. I don't charge extra for it. I just do it as part of good Medicine, Specialty Care and with Coordination of Care among my patients' other physicians. For this, I require only one thing: that patients do their part in dealing with their own care. I don't do things For patients. I do them With patients...or I don't do them at all. And for that I have been called "a living and breathing anachronism". Well,
"No Brag. Just Fact".

GS

Access...A Critical Benefit Of Concierge Medicine

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Rapid Response for FRIDAY, January 19, 2018

"BEFORE YOU CAN BE OLD AND WISE, YOU MAY BE YOUNG AND STUPID.
But don't push your luck.

GS

This is what happens to you if you take the Tide Pod Challenge

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Rapid Response for MONDAY, January 15, 2018

NOW HEAR THIS, PATIENTS AND SOON-TO-BE PATIENTS:

"THE LIFE YOU SAVE MAY BE YOUR OWN".

GS

Health insurance headaches cause continual stress for most physicians, survey finds

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HERE IS ANOTHER REASON, A VERY IMPORTANT ONE, WHY I DO NOT USE LABA INHALERS.
The continuing original reason is that the 24 hour effect on the body of such medications tolerizes the body against their effectiveness when needed in a "rescue inhaler".

GS


Starting new COPD inhaler tied to heart attack risk

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Rapid Response for FRIDAY, January 12, 2018

ON IMMUNIZATIONS (VACCINATIONS):
Folks, immunizations are the cheapest and most effective form of health care available.
If you fail to take them, you are negligent. If you intentionally refuse, you are reckless, especially with regard to your children.

GS

Potentially deadly flu virus is widespread in 46 states

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Rapid Response for SUNDAY, January 7, 2018

EXERCISE AND THE ELDERLY:

"The Best Things In Life Are Free".

GS

Muscle Inactivity More Harmful for Older People

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THE ARTICLE PROVIDED HERE DISCUSSES GENDER IDENTITY.
This has become a complex, confused and politicized subject.

Indeed, numerous other scientific questions have also become polluted by the injection of social / political demands.

In this case, the author offers strong reasoning for one position.

Please search also questions like the following for a more comprehensive review: Gender Identity and Intrauterine environment: Nature and Nurture.
My personal position is to urge great caution and expert medical advice in dealing with children with sexual identification issues. As always: "Primum Non Nocere / First Do No Harm".

Please see also the several articles in National Geographic, January 2017, entitled: "Gender Revolution".

GS

I’m a Pediatrician. How Transgender Ideology Has Infiltrated My Field and Produced Large-Scale Child Abuse.

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Rapid Response for SUNDAY, December 31, 2017

WOW!   MAYBE "WE ARE WHAT WE EAT".
This information, about Depression, is important...and CHEAP!

GS

‘Compelling’ Evidence for Probiotics in Treatment of Depression

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"JUST SAY NO."  HELL NO!

GS

Should Physicians Facilitate Lethal Injection Executions?

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More evidence links high-potency marijuana use to first-episode psychosis

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Rapid Response for SUNDAY, December 17, 2017

THESE PSYCHIATRISTS SHOULD HAVE THEIR HEADS EXAMINED.
No personal professional examination? And then divulge a "professional" opinion?
That's medical malpractice.
What psychiatrists should be allowed - and required - to do in all cases where they have reason to believe that a third party is at imminent risk, is to divulge that information to the proper authorities in order to protect the third party.
That's what "the world needs now". Not schlock.

GS

Is the Goldwater Rule Outdated?

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Rapid Response for FRIDAY and SATURDAY, December 2 and 3, 2017

THESE DAYS, WITH ALL THE NEGATIVE VIBES AROUND US,
we can use all the help we can get. And these are even pleasant.

GS

Moderate coffee drinking more likely to benefit health than to harm it

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Rapid Response for SATURDAY and SUNDAY, November 25 and 26, 2017

FINALLY: SOMEBODY IS STARTING TO LISTEN, IF ONLY BECAUSE IT'S COSTING MONEY.
The government regulators and the ivory tower researchers, in their hell-bent quest for "data", are in the process of destroying Health Care and its "providers".
What's going on is obscene.
STOP!!

GS

Counting the costs: US hospitals feeling the pain of physician burnout

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Rapid Response for THURSDAY, November 23, 2017


Targeted strategies better for birth cohort HCV testing

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Rapid Response for WEDNESDAY, November 15, 2017

ABOUT ELECTRONIC HEALTH RECORDS IN CLINICAL MEDICINE:
"True, True, and Related", an excellent exposition.
And may I add: I Told You So, about 8 years ago.
I do not use EHR'S in my clinical practice. And I am penalized 2-4% of my Medicare payments per year for that decision. My patients are just fine.

GS

Morning Break: GOP Tax Bill to Repeal ACA Mandate; EHRs' Burdens on Docs; Indy Sues Opioid Makers

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Rapid Response for MONDAY, November 13, 2017

FINALLY, THE WORD FROM THE MEDICAL "ON HIGH" AGREES WITH THOSE OF US WHO HAVE BEEN TREATING HYPERTENSION AGGRESSIVELY FOR MANY DECADES.

And we even had to go through the period about three years ago when some cost-conscious "gurus" proposed 160 mm Hg. as a good BP for the elderly. Crazy.

Essential Hypertension is the most important, most prevalent and most easily treated of the many chronic diseases that beset us, most often at a relatively early age. This is especially true if there is a family history of hypertension. The alternatives to good BP control are stroke, heart disease, dementia and a shortened and uncomfortable life span.
"CAN YOU HEAR ME NOW?"

GS

Half of US adults have high blood pressure in new guidelines

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Rapid Response for FRIDAY, October 27, 2017

DO WE NEED ANOTHER 80 YEARS OF RAMPANT DEBILITY AND DEATH FROM SMOKING?

GS

Vaping Elicits Immune Response in Lungs

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Rapid Response for SUNDAY, October 8, 2017

MORE ON INFLAMMATION, A PART OF OUR PROTECTIVE IMMUME SYSTEM...
but too often at the core of many illnesses. A Blunt Instrument.

GS

Suicidal Thoughts Linked With Brain Inflammation

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Rapid Response for SUNDAY, September 30, 2017

INTERESTING AND IMPORTANT, ESPECIALLY THE PART ABOUT PROLONGED SEDENTARY BEHAVIOR DESPITE ADEQUATE EXERCISE.

Couch potatoes become mashed potatoes.

GS

Sedentary Behavior and Mortality in Older Adults

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MORE ON THE CENTRAL ROLE OF INFLAMMATION IN DISEASE PROCESSES, FOR GOOD AND FOR ILL.

GS

Can Anti-Inflammatory Agents Be Used to Treat Bipolar Depression?

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Rapid Response for SUNDAY, September 9, 2017

THIS IS WHAT I HAVE BEEN SAYING FOR DECADES ABOUT
INFLAMMATION.

The inflammatory process, part of our Immune System, is a very blunt instrument that can at times hurt or kill you. Learn about it, both the internal mechanisms and external agents.

GS

Researchers Find ONE Root Cause of 5 Chronic Diseases

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Former medical director focuses addiction responsibility on prescribers

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AS I HAVE BEEN SAYING FOR DECADES, THE INFLAMATION ARM OF THE IMMUNE SYSTEM - THAT VERY BLUNT INSTRUMENT - IS AT THE HEART OF MANY IF NOT MOST DISEASES.
It is often as likely to kill as to cure.

GS

VIDEO: Inflammation’s role in atherosclerosis confirmed in CANTOS

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Rapid Response for SUNDAY, July 16, 2017

Our families are products of the free market system. Nobody gave us anything. Nor did we expect it. In that system, there were always winners and losers. Then that was allowed, even expected - like the tides. Given the last two or three generations, losing is not allowed. Everyone must be a "winner", with "participation awards", with diluted grades at both levels of the spectrum, and above all with ENTITLEMENTS. The word itself indicates the mind - set: we don't have to earn or be responsible...we are Entitled. The concept has now altered the genetics of hundreds of millions of voters and potential voters and illegal voters. The Democratic and Republican and Republicrat politicians have done their job well.
Thus, whether we are dealing with what the author N.N.Taleb has coined "IYY" ("Intellectual yet idiot") or just with run of the mill hypocracy  / cynicism, THERE MUST BE NO LOSERS, as is inevitable in a free market system.
And there is another problem. The "Free Market System" (aka. Wall Street in many minds) is simply not to be trusted. Washington is considered not the only "swamp". I think you will agree that some of this has been earned.
So, what to do?
For that, you need to read or re-read my many commentaries regarding HEALTH CARE REFORM" which populate my web site. They are all designed to re-inject Personal Responsibility into the Health Care System. They are all doable, given the legislative will. And they will all be attacked: "YOU CAN'T TELL ME WHAT TO DO, JUST GIVE ME MY ENTITLEMENT".
The end-game of that unsustainable scenario: with or without "medical care", prepare to suffer and die.
"In a democracy, the people always get what they deserve".

GS

Although there are of course bad actors in the free market, they are held accountable for their actions. Bad actors in government are much more dangerous because they have the ability to use force over others (that is the essence of government) and the government just throws more money at problem programs and departments while private companies are decimated by the market, the SEC, and the DOJ when the do something fraudulent (as they should be).

The Failure to Repeal Obamacare Is an Intellectual Failure

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Rapid Response for SUNDAY, July 2, 2017

IMPORTANT:
HEALTH CARE COVERAGE, "PRE-EXISTING CONDITIONS", AND GENETIC TESTING.
A genetic pre-disposition is Not a "pre-existing condition". I argued that years ago, including on this web site. But I then cautioned patients and the public not to undertake genetic testing unless and until iron-clad safeguards for their equal insurability were in place. Those safe-guards eventually came in the form of a Federal Law: GINA.
See the article published in ctmirror.org July 2, 2017:
"Safe Under ACA, Patients With Pre-Existing Conditions Now Afraid", by Charlotte Huff / Kaiser Health News.
Of course, when dealing with lawyers and paid-off legislators, "it depends on what the meaning of the word 'is' is".
Any new Health Care legislation MUST safeguard the equal insurability of persons who might seek information about genetic pre-dispositions before any "manifest disease" is diagnosed. The alternate - no protection or weasel-word "protection" would effectively eliminate this important method of avoiding "manifest disease" in time.

GS

MORE, EVER MORE, ON HEALTH CARE. 
This report has it exactly right.

GS

Elizabeth Warren Came Up With An Insane Idea That Would Destroy America

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The Difference Between Crohn’s, UC, and IBD - HealthLine.Com

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Rapid Response for SATURDAY, May 6, 2017

IMPORTANT HEALTH INFORMATION FOR US OUTDOOR TYPES...
especially the part about possible transmission of this severe tick-borne disease within 30 minutes of a bite - and no treatment.
BEWARE.

GS

Powassan Virus: the Tick-Borne Disease That Can Be Worse Than Lyme - Yahoo.Com

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Rapid Response for WEDNESDAY through FRIDAY, March 1 through 3, 2017

"OBAMACARE LITE".
Is that the best that Republicans controlling the House of Representatives, the Senate and most Statehouses can do?

Conservatives Fight to Stop ‘Obamacare Lite’ - Lifezette.Com
See also the article entitled: "Leaked ObamaCare Bill Fires Up Debate", in doximity.com, Health Affairs, Feb. 25, 2017.

Between the politics involved for  House members already preparing for their 2018 elections, and the massive cost of Health Care in general, the answer may be yes. 

But there is another way if enough of them are true  patriots and heroes: REDUCE HEALTH CARE COSTS BY ADDRESSING THE FOLLOWING PROBLEMS:
  1. Half of all health care costs are due to unhealthy health habits, "life-style related". I recently heard one politician say that "personal responsibility cannot be legislated". The Hell It Can't! Has he ever heard of motivation, of legal coercion if necessary?
  2. Drug costs are much too high and are artificially propped up by Government action. Remember the specific provision placed in the Medicare Act of 2002 by recipients of Big Pharma graft (aka "donations")...the one that PROHIBITS THE GOVERNMENT FROM NEGOTIATING DRUG PRICES?
  3. Employer provided Health Care benefits to employees, tax deductible to both, have for decades shielded both from the results of their health choices and treatments. Marvelous. Health Savings Accounts, properly structured, can restore patient consideration and decision-making into those choices.
  4. Half of all Health Care costs are generated in the last 6 months of a person's life.  Given mechanisms for meaningful choice (ie. Advanced Directives actually completed by the patient and actually followed by physicians and families), a vast amount of these costs would disappear...without any reference to "assistance in dying:". 
  5. Now we go to the doctor and "take a chance on the National Lottery", ie, Medical Malpractice suits.  Wasteful, unjust to all and simply a money machine for the Trial Bar, this situation generates about 25% of Health Care costs that are called "Defensive Medicine" ordered by health care professionals to protect themselves.  Health Care Courts, akin to Bankruptcy and Patent Courts with their special expertise, would generate more Justice at much less cost than the current "system" provides - and would obviate the need for "Defensive Medicine".
Physicians and related health care workers, by virtue of their position at the entrance to Health Care, are responsible for ordering over 20% of all such costs.  Pay them adequately (not now the case) and remove the unnecessary encumbrances on their professional expertise, and they will do a better job of triage, care, coordination and education. This is not happening now. 

SO YOU SEE, YOU DO HAVE CHOICES.
ANY PATRIOTS, ANY HEROES OUT THERE?

GS

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Rapid Response for SATURDAY, January 28, 2017

ATTENZIONE!

In recent months, several useful clinical topics - apart from the ever-present "urban legends" - have been reliably reported and deserve inclusion in standard medical practice, in my opinion.

1) Regarding Proton Pump Inhibitors (eg. Nexium, Protonix, etc), the plethora of recent warnings have been found by GI specialists to be overblown.  The most important goal is controlling GERD totally. If medications like Ranitidine (H2 antihistamines with dual effect) and Sucralfate work, fine.  If they don't, continue the use of PPI's.

2) Low Vitamin D has been found to be both nearly epidemic in the general population and important in many more areas of Health than just regarding bone health.  Thus, Vitamin D levels should be obtained on all patients (25 Hydroxy Vitamin D), and levels below 30 should be treated aggressively with Vitamin D replacement.
3) Sleep Deprivation is clearly an epidemic in today's society. There are many causes, including addiction to phones and gizmos used to and through bedtime, and the inordinate and inhuman demands of some employers to have employees "on call" at all times.  But an easily diagnosable and treatable cause is Obstructive Sleep Apnea, also present in epidemic form if looked for.  I use a Sleep Questionnaire and a Nocturnal O2 Saturation Test (performed at home) as screening devices. If either or both of these and the patient's initial history are suggestive, I order an Overnight Sleep Study, preferably performed in a formal Sleep Lab.  If that test is positive for OSA, the patient is placed on CPAP and/or on O2 during all hours of sleep. Untreated OSA  contributes to or causes obesity, GERD, high blood pressure, diabetes...and sudden death during sleep!

4) The following is an "oldie but a goodie": THE PROPER EVALUATION AND TREATMENT OF BRONCHIAL ASTHMA.
Notwithstanding the resistance and temerity of too many Pulmonary physicians to acknowledge this decades-long established fact, Bronchial Asthma - and also Chronic Bronchitis (aka "COPD") cannot be properly evaluated or treated without an Allergy Evaluation. In fact, COPD is a waste-basket diagnosis without that, a point at long last acknowledged by the admission of combined COPD - Bronchial Asthma syndrome. The patient, at least, should recognize this...and should self-refer if necessary.

5) Mental Health in today's world is much more than the absence of established psychiatric disease...and much more  than taking handfuls of psychotropic medications. See the section on this web-site entitled "Physician - Patient Spirituality" for some valuable insights.

6) Most patients these days have 3,4,or 5 different physicians. And too often, they don't talk to each other about the patient's multiple and often intertwined conditions and needs.  Seek out a physician who adds "coordination of care" to his or her offerings in your behalf.

7) We learned in Medical School (for me having graduated 60 years ago) that "the three most important attributes of a physician from the viewpoint of a patient are: Ability, Affability, and Availability...
in REVERSE ORDER."  Make sure that your physician is AVAILABLE  to you when you need him.

GS

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Rapid Response for SUNDAY, January 15, 2017

"PEOPLE NEEDING PEOPLE"

GS

Most doctors ignore one of the most potent ways to improve health, Penn experts say - MDLinx.Com

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"Best of 2016" from MDLinx.Com
 <--- Visit to access each of the articles below.

The 20 best journal summaries in Internal Medicine in 2016.
  1. Dietary water intake and bladder cancer risk: An Italian case-control study
  2. Meta-analysis of potassium intake and the risk of stroke
  3. Association between vitamin D deficiency and antinuclear antibodies in middle-aged and older U.S. adults
  4. Coffee and caffeine intake and risk of urinary incontinence: A meta-analysis of observational studies
  5. Chocolate intake and incidence of heart failure: Findings from the cohort of Swedish men
  6. How statins aid the immune system
  7. The Centers for Disease Control and Prevention opioid guidelines: Potential for unintended consequences and will they be abused?
  8. Coffee and green tea consumption in relation to brain tumor risk in a Japanese population
  9. Coffee intake and the incident risk of cognitive disorders: A dose-response meta-analysis of nine prospective cohort studies
  10. Sugar addiction: The state of the science
  11. Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study
  12. Statin myopathy: Over-rated and under-treated
  13. Coffee consumption is positively associated with longer leukocyte telomere length in the Nurses’ Health Study
  14. Discontinuation of statins: What are the risks?
  15. Infusing pleasure: Mood effects of the consumption of a single cup of tea
  16. Effect of vitamin D3 supplementation on blood pressure in adults: an updated meta-analysis
  17. Multivitamin use and the risk of cardiovascular disease in men
  18. Coffee consumption and risk of cardiovascular events in hypertensive patients: Results from the HARVEST
  19. Association of breakfast intake with incident stroke and coronary heart disease
  20. Add-on effects of a low-dose aripiprazole in resolving hyperprolactinemia induced by risperidone or paliperidone
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Rapid Response for TUESDAY and WEDNESDAY, December 13 and 14, 2016

THE STATE OF OUR HEALTH CARE SYSTEM
By George A. Sprecace., M.D., J.D.
A Recent Interview with Adam Sprecace, PE,
On the Lee Elci Radio Show, December 13, 2016
Q&A


Note:  You can also hear the segment broadcast on December 30, 2015...


1) A BRIEF SUMMARY OF HEALTH CARE IN AMERICA?
Quality: excellent at the top; modest on average, and decreasing.
Access: sporadic.
Cost: excessive and wasteful.
IN GREAT NEED OF EFFECTIVE REFORM.

2) WHAT HAS LIFE BEEN LIKE, WORKING IN THE TIME OF OBAMACARE?
(eg. patient workload, reimbursement rates and dependability, electronic record-keeping, etc.)
Workload increasing; compensation decreasing; EMR’s poor for the private practicing physician and patient, necessary for hospitals but generating increasing cost and workload and decreasing quality as measured by productive provider – patient interaction.

3) HOW HAS OBAMACARE AFFECTED PHYSICIANS?
Much more stress and strain, with less physician and patient satisfaction.
Physician burn-out and declining physician health.
Pressure to practice UNETHICALLY: eg. ACO’s, BUNDLING, etc., which for first time would force the physician’s self-interest to work at variance with that of his or her patient, with whom he has a Fiduciary Responsibility.

4) IS OBAMACARE GETTING BETTER OR WORSE?
Increased premiums, reduced coverage….
Obamacare was and is a Christmas Tree of Wants, with no attention given to needed Health Care Reforms. The Goals are reduced costs at any cost, and increased Regulations by many who have no knowledge of what they are doing. Example: THE 30 DAY READMSSION RULE, which substantially  penalizes hospitals for readmitting an inpatient within 30 days of discharge…EVEN FOR AN UNRELATED READMISSION DIAGNOSIS! 

5) WHAT ABOUT THE PENALTIES FOR REFUSING TO BUY MEDICAL CARE COVERAGE UNDER OBAMACARE?
20 million subject to penalty. 8 million paid penalty. 12 million exempt. Thus, more subject to penalty than were covered.

6) WHAT’S BEEN HAPPENING WITH RELIGIOUS HOSPITALS THAT REFUSE  TO FOLLOW OBAMACARE MANDATES?
Endless Litigation, including the USSC. Coercion: loss of Freedom of Religion, reduced quality and availability due to intimidation and decisions in a System (ie. Catholic Hospitals) that is nearly the largest in the nation.

7) WHAT WOULD YOU CHANGE ABOUT OBAMACARE?
Repeal and Replace, with a two year transition period. a) increase insurance policy competition across State lines; b) reduce and rationalize Regulations; c) make all patients financially at stake at every encounter (HSA’a, co-pays, defined contribution instead of defined benefit plans, etc; d) retain coverage for pre-existing conditions while imposing penalties for continued bad life-styles, which account for about 50% of all health care costs; e) as “Defensive Medicine” accounts for 20-30% of health care orders – costs, REFORM MEDICAL MALPRACTICE LAW – eg. Health Law Courts; f) promote and enforce End Of Life Decisions – 50% of Medecare costs occur in the last 6 months of a recipients life!;g) make electronic medical records OPTIONAL for private physicians; h) re-think and revise EMTALA LAW – currently a poor and wasteful use of ER’s; i) prohibit UNETHICAL medical practice and payment programs; j) pay physicians fairly – they are now bearing the brunt of this Christmas Tree. ETC.

8) DO PHYSICIANS AND HOSPITALS GENERALLY AGREE WITH YOUR POSITIONS ON OBAMACARE?
Most physicians, yes.  Hospitals are ambivalent: gaming the system where they can; merging and selling out; trying to “go along” so as to “be at the table” when government decisions are made – not working; acting like trained businessmen when dealing with professionals: “win-lose” instead of “win-win”, treating professionals like widgets…. A bad plan.

WHAT IS YOUR PROGNOSIS?
Short-Term, GUARDED. Much damage has been done.  Long-Term, FAIR, now that competents have retaken the ASYLUM.

NB: GEORGE A. SPRECACE, M.D., J.D. has been writing and speaking on this subject since the late 1970’s, a practicing physician for 60 years…and counting. These Commentaries are found on www.asthma.drsprecace.com

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The retirement issue that no one is talking about - Yahoo!

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Rapid Response for SUNDAY, November 20, 2016

‘Medical’ Marijuana a Con - American Center for Democracy

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Rapid Response for MONDAY, August 29, 2016

MEANWHILE, BACK IN THE MEDICINE CABINET...

GS

JAMA study: Why are drug prices so high, and what can be done about it? - MDLinx.Com

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Rapid Response for FRIDAY, August 26, 2016

Chemicals banned decades ago linked to increased autism risk today - MDLinx.Com

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Rapid Response for FRIDAY, May 13, 2016

"VALUE-BASED MEDICAL CARE".
Sounds like a no-brainer, right?

Not when your Government defines and implements it!

In fact, although our Health Care Regulators are doing as much as possible to make it sound like "motherhood and apple pie", THE DRIVER FOR THIS PLAN IS REDUCTION IN HEALTH CARE COSTS, at any cost.

And the vehicle for this trip is inherently UNETHICAL: rewarding physicians for providing less health care, and punishing them for providing more health care...perverse incentives that for the first time place the interests of physicians in opposition to the interests and needs of their patients.
It is RATIONING ON STEROIDS, couched in such reasonable terms as "evidence-based medicine", "efficient health care delivery" and "patient satisfaction".

NOW HEAR THIS: That's exactly how I have always practiced Medicine in my 59 years as a physician. But that will not shield me from being crippled with yet more demands for "documentation" beginning in 2017; and it will not prevent me from being penalized 4% of my receivables beginning in 2019 unless I want a 4% increase by cheating my patients of the care they need. That's what we're talking about, without the sugar-coating.

THE ABOVE IS DIRECTED MAINLY TO THE PATIENT / PUBLIC.  For the Regulators don't give a damn about what physicians and other health care providers care or say. They do care about what the voters say. 

So: "DON'T JUST STAND THERE.  DO SOMETHING", for a change.

GS

Value-based care 101 - InternalMedicineNews.Com

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Frequent Ejaculation Linked to Decreased Prostate Cancer Risk - Consultant360.Com

AND WHILE WE'RE AT IT, MEDICALLY SPEAKING:
Look up "Can breast feeding and breast sucking reduce the incidence of later breast cancer?"

GS

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Rapid Response for SUNDAY, October 26, 2014

RR#1

AM I A MIND-READER...OR WHAT?

"Articulate, Arrogant, Asinine".

GS

White House Presses States to Reverse Mandatory Ebola Quarantine Orders  - NYTimes.Com

RR#2

EBOLA VIRUS INFECTION and protection of Americans

Now comes the latest victim of Political Correctness run amok.

The prime responsibility of our government is to protect its people from threats near and far.  It's responsibility is not to rehabilitate a continent ravaged by the excesses of former colonial powers and by the corruption of its own leaders.  But that is exactly what our reckless "leaders" are touting to justify their refusal to quarantine America from a potential pandemic...an action successfully taken by some of the African nations themselves.  This is not "panic".  It is common sense and basic protocol for the management of infectious diseases of all kinds.

Then you have a litany of negligent actions and inactions taken by our own politicized "professionals": on - the - job training and making it up as they go along, all the while looking over their shoulders for the approval of their political masters.
"WHERE IS IT WRITTEN..." that
Meanwhile, the Governors of several States are to be lauded for their initiatives in defense of their own citizens.  Or can we expect Attorney General Holder to initiate legal process prohibiting such action "in order to protect Liberia..."

We can't "...stop the world".  And we can't "get off".  But we can object.  We can demand. We can Vote! 

"Is anybody there? Does anybody care?"

GS

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Rapid Response for FRIDAY, September 18, 2014

FEE FOR SERVICE: GETTING A BAD RAP FROM THE BEAN COUNTERS.  BUT ONCE AGAIN THEY ARE WRONG.  READ THIS.

GS

I thought you would like to read the attached article: Friday Feedback: Docs Defend Fee-for-Service Click http://www.medpagetoday.com/PracticeManagement/Reimbursement/47748 for the full story: Sign up at http://www.medpagetoday.com/updateProfile.cfm?action=register for your FREE, once-daily, Medical News Daily Headlines Email. MedPage Today(R) provides physicians and &#39;expert patients&#39; real-time coverage of breaking medical news and the top stories in health and medicine. Physicians, PAs, Nurses, and Pharmacists may also receive CME/CE credit as part of our news coverage. Our content is reviewed and accredited by the University of Pennsylvania School of Medicine, Office of Continuing Medical Education (OCME). OCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. There is no cost to use the service. Visit MedPage Today www.medpagetoday.com now. At MedPage Today, we are Putting Breaking Medical News into Practice(R).

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E-Cigarettes Just More Smoke and Mirrors, Doctors Say - Yahoo News

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2/11/2012

KEEPING DEMENTIA AND ALZHEIMER’S DISEASE AT BAY

The following is a summary of the most recent foray into achieving this goal.  It is based upon a TV interview on the Today Show (February 11, 2012) between Lester Holt and a Professor of Geriatrics from California.  And it says a lot. 
  1. To enhance short and long-term memory: Focus on the topic; Snap a mental picture of the subject matter; Connect it to something else of interest to you. 
  2. Add to your regular diet foods abundant in anti-oxidants (see lists readily available, mainly vegetables, fresh and dried fruits), omega 3 oils (fish, nuts), and whole grains (especially oat and corn).
  3. Obesity promotes dementia.  Regain and maintain a proper weight.
  4. Anxiety promotes dementia.  Don’t be “Outcome Oriented”…”What if…” this or that.  Be “Process Oriented”: control what you can control; and then observe how the issue plays out.  “A little sugar…” in the form of rest and relaxation will help this “medicine go down”.
  5. Exercise, both physical and mental, is vital.  A daily brisk walk is all it takes.  And studying a new language or a musical instrument are potent exercises. 
  6. Humor…and a good laugh…help everything.  See the section on my web-site (www.asthma-drsprecace.com) entitled “A Bit of Whimsey”. 
  7. Make and keep friends, in every sense of that word.  And if you are lucky enough to be married, work on making that person your Pal. 
  8. Heredity is not destiny.  More relevant to destiny is what you do with your body, your mind and your time. 
YOU CAN DO THIS.  If not, at least buy Long-Term Nursing Home Insurance…because you may well be headed there.

GS

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KEEPING DEMENTIA AND ALZHEIMER’S DISEASE AT BAY

The following is a summary of the most recent foray into achieving this goal.  It is based upon a TV interview on the Today Show (February 11, 2012) between Lester Holt and a Professor of Geriatrics from California.  And it says a lot. 

  1. To enhance short and long-term memory: Focus on the topic; Snap a mental picture of the subject matter; Connect it to something else of interest to you. 
  2. Add to your regular diet foods abundant in anti-oxidants (see lists readily available, mainly vegetables, fresh and dried fruits), omega 3 oils (fish, nuts), and whole grains (especially oat and corn).
  3. Obesity promotes dementia.  Regain and maintain a proper weight.
  4. Anxiety promotes dementia.  Don’t be “Outcome Oriented”…”What if…” this or that.  Be “Process Oriented”: control what you can control; and then observe how the issue plays out.  “A little sugar…” in the form of rest and relaxation will help this “medicine go down”.
  5. Exercise, both physical and mental, is vital.  A daily brisk walk is all it takes.  And studying a new language or a musical instrument are potent exercises. 
  6. Humor…and a good laugh…help everything.  See the section on my web-site (www.asthma-drsprecace.com) entitled “A Bit of Whimsey”. 
  7. Make and keep friends, in every sense of that word.  And if you are lucky enough to be married, work on making that person your Pal. 
  8. Heredity is not destiny.  More relevant to destiny is what you do with your body, your mind and your time. 
YOU CAN DO THIS.  If not, at least buy Long-Term Nursing Home Insurance…because you may well be headed there.

GS

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Experts Assess Health Risks of Airport Full-Body Scanners, Emily P. Walker

Offerings by George A. Sprecace M.D., J.D.:    (Scroll down or click here for More Relevant Offerings)

"TRUE, TRUE...AND RELATED".  Good advice, especially about the Obstructive Sleep Apnea, of which there is an epidemic, most often undiagnosed.  GS

Mayo Clinic - Aspirin not a joke!

Dr. Virend Somers, a cardiologist from the Mayo Clinic who is lead author of the report in the July 29, 2008 issue of the Journal of the American   College of Cardiology

Most heart attacks occur in the day, generally between 6 A.M. and noon, Somers said. Having one during the  night, when the heart
should  be most at rest, means that something unusual happened. Somers and his colleagues have been working for a decade to show that sleep apnea is to blame.

1.   If you take an aspirin or a baby aspirin once a day, take it at night. The reason: aspirin has a 24-hour "half-life" therefore, if most heart attacks happen in the wee hours of the morning, the aspirin would be strongest in your system.

2.  FYI, aspirin lasts a really long time in your medicine chest for years, (when it gets old, it smells like vinegar). Please read on.

Something that we can do to help ourselves - nice to know.
Bayer is making crystal aspirin to dissolve instantly on the tongue. They work much faster than the tablets.

Why keep aspirin by your bedside? It's about Heart Attacks: There are other symptoms of an heart attack besides the pain on the left arm. One must also be aware of an intense pain on the chin, as well  as nausea and lots of sweating, however these symptoms  may also occur less frequently. Note:  There may be NO pain in the chest during a heart attack.

The majority of people (about 60%) who had a heart attack during their sleep, did not wake up. However, if it occurs, the
chest pain may wake you up from your deep sleep.

If that happens, immediately dissolve two aspirins in your mouth and swallow them with a bit of water.

Afterwards:
- call  911
- phone a neighbor or a family  member who lives very close by
- say "heart attack!"
- say that you have taken 2 aspirins.
- take a  seat on a chair or sofa near the  front door, and wait for their arrival and...
- do NOT lie down.
Our Health Care Future, GS

June 28, 2009

Until this year, "the Flu" was a viral disease of Fall and Winter, with occasional extension into early Spring.  Thus, a "flu-like illness" occurring in late Spring or Summer produced a search for tick-borne diseases like Lyme Disease, Babesiosis, and /or Anaplasmosis (formerly known as Ehrlichiosis). 
 
This Summer season there is another bad actor out there: Swine Flu, otherwise known as H1N1 Influenza.  It can be tested for by ordering an Influenza A test which, if positive, is further tested for Swine Flu virus.  But now that is not enough.  Tick-borne diseases must also be sought (requiring specific testing) when the patient presents with a "flu-like illness".  Please do not dismiss such symptoms and "tough it out".  Consult your physician; and share this information with him or her.  All of these illnesses are more or less treatable.  And all of them can produce serious consequences if not diagnosed and specifically treated in timely fashion.

GS

Immunization Notice, November, 2006, GS

Bronchial Asthma, COPD, and Inflamation, GS

  • Here is a report with which I agree: "Doctors See Benefit From Net-searching Patients", by Tyler Chin (American Medical News - www.amednews.com - Aug. 15, 2005, p1).  "As more people go online for health information, physicians are finding that research can deepen levels of conversation during visits".  So, please surf the rest of this web site, in addition to the Mediterranean Diet site: This is a public service gift...that keeps on giving.
  • But there are risks to patients' direct access to frequently raw medical data, not yet peer reviewed, and to pharmaceutical information which is often "mere puffery", not filtered by a "learned intermediary".  The recent and continuing problem with COX-2 Inhibitors, and currently the Vioxx case, are examples...with serious risks affecting both producers and consumers.  SO, "ASK YOUR DOCTOR".
  • The Patient Safety and Quality Improvement Act of 2005, recently signed into law andalso discussed on the same page of the above reference, sounds good - but stay tuned.  It may be too good to be true...and still to risky for health care providers to buy into.  More to come on this.

  • And to finish this offering on another medical note, this year "just a cold" may not be the right attitude...considering the past and possibly continuing difficulties with getting the flu vaccine, and with the possible arrival here of Bird Flu - God forbid.  Everyone, and especially people with other illnesses, should check with their physician for anything but mild symptoms.  Don't try to "tough it out" this time around.

    GS
     

    One of the most common dangers encountered by all of us who, especially in the summertime, stray to the shore, or the hills, or just to the golf course is the possibility of being struck by lightning.  One can survive, but dying is often not the worst of it.  A very informative article on the subject appears in this month's issue of Field and Stream" entitled "Thunderstruck", by Keith McCafferty (p32).  Unless I'm wrong, you don't know all that you should know in order to protect yourself and your family from this threat from the skies, even from the blue skies.

    GS
     

    Physicians and their patients are in tough times partly because, in a mis-guided and paternalistic effort to shield their patients from the turmoil, physicians in the 1980's and early 1990's did not keep their patients informed and did not seek their political help.  They also had this quaint idea that politicians and legislators gave a damn about their points of view and input.  We all learned otherwise.  So, in addition to all the warnings I have been sharing since the late 1970's  (see other relevant categories on this web-site),  here are some more that may make a real difference to the most altruistic of your physicians.

    1. "Pay for Performance" is one of the latest brainstorms being tested.  If not structured properly, physicians' income, already discounted over 30% from what they legitimately earn,  will be based - not on proper procedures - but on successful outcomes.  So now your physician would be held responsible for your adherence to instructions, for your taking your medications, and for all the other stupid life-style things that you might do...in addition to having chosen the wrong genetic stream at conception.
    2. "Cultural Competency Training".  Physicians  may be required to handle not only the medical problems of that patient from Haiti, but also to discuss her problem in her mother tongue and with sensitivity to her beliefs in voodoo.
    3. There is planned a further decrease in the already borderline reimbursment for treatment of Medicare patients, stretching several years down the road.
    4. Some States are considering taxing physicians 1% of their gross income for the permission to take care of Medicaid patients.  Their care, in which most of us participate, is often the most time-consuming and always the very least reimbursed.
    Patients take note: even the most caring and committed physicians may decide that they have been insulted, denigrated and marginalized once too often.  These smart and energetic people have always had other options.   This is not a threat.  Rather, it is a call for help.

    GS

    Health Alerts...June, 2006 GS

    Flu Season, 2004, GS

    Rules to Live By, GS

    There's a Fungus Among Us, GS

    WAZZUP?! - New and Notable, GS

    Xolair and Bronchial Asthma, GS

    Advice for Living a Long, Healthy and Happy Life, GS

    How to "Winterize" Yourself, GS

    Smallpox Vaccine, GS

    Hygiene Theory, GS

    Peanut Allergy, GS

    Bio/Chemical Terrorism, GS

    September 11, 2001, GS

    Keeping Insects at Bay, GS

    Scrombroid Poisoning, GS

    Medical Abstracts, GS

    The Next Allergy Season, GS

    Emergency Room Treatment of Acute Bronchial Asthma, GS

    Flu 2000-2001, GS

    Biting Insects, GS

    Flu 2000, GS

    Regarding Medical Errors, GS

    Lyme Vaccine, GS

    More Relevant Offerings:
    Sleep is Food for the Brain, Paul J. Licata, D. O.
    "Might as Well Dance", Author Unknown

    Good Advice For All Of Us, All The Time, As Long As We Still Have Time..."Slow Dance"

    "Risks and Benefits of Gene Therapy",
            by Philip Noguchi, M.D., the New England Journal of Medicine, 348:3, Jan 16, 2003, p193

    "The Real Face Of Cloning",
            by Tim Friend, USA Today, Jan. 17-19, pA1

    "Sexual Healing"
            by Melissa Gotthardt, Modern Maturity (AARP), Jan-Feb. 2003, Self Care, p14.


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