Concupiscent Curds

Jury duty

I've never been called to jury duty.  I hope I never am, but because I am (usually) a voter, the summons for jury duty is inevitable.  To be frank, I won't want to go and I'll try to get out of it since I'm the only physician in my clinic. 

However, many patients, regarding jury duty, disabled permits, and missing work or school, request excuses when one is clearly unwarranted.  Events like these come under the heading of "medical honesty."  Physicians who give in to such requests may be complimented and thanked by their patients, but they are not respected by their patients.  With the fallen respect there is also a semblance of lost trust.  (That's the same as in any relationship.)  That's why I am such a stickler about work excuses and jury duty.  I'm not doing those patients a favor if I give in to the ones with less-than-honest requests.

Tobacco companies got your back

It was revealed yesterday that a 2006 study touting the use of spiral CT's ("CAT scans") for the screening of undetected lung cancers as "highly cost-effective" was actually funded by Big Tobacco.   From Wednesday's New York Times, "'If you’re using blood money, you need to tell people you’re using blood money,' said Dr. Otis Brawley, chief medical officer of the American Cancer Society."  Naturally, the crooked doctor that took the blood money denied any attempt to hide things. 

Today's good news and bad news

The bad news is that having a big belly--like I do--remains a very high risk of developing diabetes.  The good news is that you may not remember that you have it!

Big Belly Boosts Risk of Later Dementia--AP Story

Snake oil hero

Some people have no shame in trying to make a quick buck, even if it could mean your life.  Thursday, the FDA issued warnings about online distributors hawking erectile dysfunction "supplements" called Hero and Blue Steel.  Blue Steel?!  Classy name, dudes.  To make a--ahem--long story short, the "supplements" may have similar actions to Viagra, and thus, could pose potentially serious health problems to certain men.  Another company, such as the one that bombards me with ads on sports radio, peddles a product that promises "male enhancement."  The enhancement?  An ingredient that causes a tingling or burning sensation on the skin but has no benefit whatsoever for erectile dysfunction.

There is a reason that drugs in the United States require significant studies before being allowed onto the U.S. market; there is a reason that prescription medications require a prescription.  Regardless of what you medical cynics believe---and I could often be counted in that number, actually---the FDA is trying to look out for your best interests.  Even if you won't.

Statins: the New Wonder Drugs?

Researchers in Italy have found that statins--the class of cholesterol-lowering medications which includes Lipitor and Crestor--may have a therapeutic benefit against thyroid cancer.  Statins, which inhibit the enzyme 3-hydroxy-3-methylglutaryl coenzyme-A reductase (her friends call her HMG Co-A reductase), exhibit anticancer effects in animal models and also inhibit the proliferation of thyroid cancer cells in vitro (that's in the test tube, you knucklehead).

Statins have not only been heralded for their potential benefits as cholesterol-lowering agents in the battle against coronary artery disease, but they have also been shown to exert an anti-inflammatory effect on arteries, much like aspirin does.  More, this class of meds has more recently been implicated as being beneficial in staving off Alzheimer's-type dementia.

So, are statins the next Wonder Drug?  As College Game Day's Lee Corso would say, "Not so fast, my friend."  How many times have we heard of The Next New Great Drug only to find it going the way of Vioxx a few years later?  Consider the supposedly-cholesterol-reducing-drug Zetia.  Although not in the statin family, recall last December when it was revealed that not only did the makers of Zetia reportedly withhold information about the drug's potential liver toxicity, but the coup de grace came a month later when a large study showed that Zetia failed to show any medical benefit.

It is another story of What's Good for You Today May Not Be Good For You Tomorrow.  Sometimes new science replaces previous studies.  Sometimes studies are not as they initially appear from misinterpretation or from subterfuge.  And sometimes, therefore, even your family physician doesn't always know what is best for you.

Elsie the Cow would be proud

In February's Nature Clinical Practice Endocrinology & Metabolism, researchers published a study in which vitamin D insufficiency has been identified as a potential factor in the development of diabetes.  Yet another reason to drink your milk, Andrew.

Our '08 Uniforms

The Emperor of Ice Cream

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by Wallace Stevens

Call the roller of big cigars,
The muscular one, and bid him whip
In kitchen cups concupiscent curds.
Let the wenches dawdle in such dress
As they are used to wear, and let the boys
Bring flowers in last month's newspapers.
Let be be finale of seem.
The only emperor is the emperor of ice-cream.

Take from the dresser of deal,
Lacking the three glass knobs, that sheet
On which she embroidered fantails once
And spread it so as to cover her face.
If her horny feet protrude, they come
To show how cold she is, and dumb.
Let the lamp affix its beam.
The only emperor is the emperor of ice-cream.

Source: American Academy of Poets at poets.org

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