An article and editorial in the New England Journal of Medicine of August 21, 2008 questioned the efficacy and appropriateness of the HPV (human papilloma virus) vaccine in young women, which concerned many parents in our practice. The article actually focused on the cost and health care policy implications of the vaccine rather than its safety and effectiveness in individuals. Both Dr. Kanner and Dr. Isselbacher believe the public policy concerns that were raised in that article do not trump the HPV vaccine’s continued usefulness for our young women.
The NYTimes today had an excellent and long piece on the use and probable overuse of the cardiac CT angiogram. The essence of the argument was that the CT angiogram of the heart was only occasionally helpful while costly in money and radiation exposure. The cardiac calcium score, which I have and continue to recommend frequently, differs in important ways, including much lower radiation and lower cost. Most important, we use it primarily to reaffirm the negative, that healthy “risk factors” really are accurate, because the cholesterol and blood pressure predictors of cardiovascular health are good but hardly infallible. Even the Framingham Heart Study is incorporating cardiac calcium scores in their risk evaluations.
A member of the OHC weight management program sent this compendium of nutritional and behavioral suggestions to me. The list of 100 items constitutes a good reminder of the large and many smaller points that can be helpful in achieving a realistic and sustainable nutritional balance. It is worth a quick run-through. Thanks to Don Engelman.
The Study and the Results: In this week’s Journal of the American Medical Association (JAMA, March 5, 2008; 299(9): 1027-1035), an article by Roy Soetikno et al. showed that flat colon polyps, which are quite difficult to visualize compared to the mushroom-shaped or polypoid variety, are nevertheless quite common, being found in a bit over 9% of 1819 male patients…
The Study: A superb study concerning the cardiac calcium score was published in December 2007 in the Archives of Internal Medicine. It looked at about 3600 women aged 45 to 84 who were considered to be at low risk of heart disease (less than 10% chance in the next decade) according to the Framingham Risk Score. That score is based…
The Story: The Boston Globe on February 25, 2008 cited a recent paper in the journal Nature Biotechology that indicated that certain statin medications (used for control of high cholesterol) might impair the functioning of critical cellular components called mitochondria. The mitochondria are tiny structures that generate the necessary energy (in the form of a substance called ATP) for our…
Q: We really like the coffee you serve. Where is it from? A: Our coffee beans are from the Doka plantation in Costa Rica. Dr. Kanner visited there in 2006. We usually serve the peaberry, but occasionally the Italian roast. The distributor is Tico foods from Texas, who can be found at http://www.otnfinefood.com. About $10 per pound delivered.
Those words are the pithy summary of the essence of good eating as clearly and delightfully described in Michael Pollan’s new book, In Defense of Food. Dr. Kanner strongly recommends you get it, read it, and pay attention to what he says. Pollan’s short article following, from the Feb 2007 New York times, is a good warmup. Nutritionism
The X-ray procedure called CT colonography or virtual colonoscopy can effectively substitute for optical colonoscopy, with certain reservations.
Jane Brody’s excellent article from the NYTimes, With Fruits and Vegetables, More Can Be Less, on the value of eating high-volume but low-calorie density foods — vegetables, soups, salads, and fruits — as the essential strategy to weight loss and maintenance. Dr. Kanner fully concurs in the approach detailed by Ms. Brody, the New York Times health writer, that puts…