Medical Information
Lyme Vaccine Trial
For those who spend significant time out of doors joining a Lyme vaccine study may be of interest. If interested in joining the study go here: https://www.valorlymestudy.com/
COVID-19 Vaccine Questions- Do the world a favor. Get the vaccine!
Excellent interview with USA's premier vaccine expert.
Online App to Determine COVID Risk of Behavior
Four Questions to Ask Your Doctor
4 questions that patients should ask a doctor the next time the doctor recommends a medication, procedure, test, treatment or surgery.
Is this really necessary?
What are the risks?
Are there other options?
What happens if I don’t do anything?
Is this really necessary?
What are the risks?
Are there other options?
What happens if I don’t do anything?
Magical Microbes: How to Feed Your Gut
Tick Bite? See Your Doctor for Prophylactic Antibiotic Within 3 Days!
Postexposure prophylaxis with a single dose of doxycycline may be used for a significant exposure meeting all of the following criteria:
1. An engorged Ixodes scapularis tick is removed after at least an estimated 36 hours of attachment.
2. Prophylaxis is started within 72 hours of tick removal.
3. Borrelia burgdorferi prevalence in local ticks is greater than 20%.
4. Doxycycline is not contraindicated. Contraindications include pregnancy or lactation. In the US, the American Academy of Pediatrics endorses short-term use (<21 days) of doxycycline for Lyme disease in children <8 years old.
Patients who cannot take doxycycline are started on treatment if early symptoms develop.
Machata Variant- One dose of 200 mg doxycycline within 72 hours of a tick bite decreases risk of developing Lyme disease by 92%. I recommend a second dose of 200 mg doxycycline taken 24 hours after first dose. While this deviates from accepted regimen, I believe that my practice may decrease Lyme disease risk with minimal additional risk.
1. An engorged Ixodes scapularis tick is removed after at least an estimated 36 hours of attachment.
2. Prophylaxis is started within 72 hours of tick removal.
3. Borrelia burgdorferi prevalence in local ticks is greater than 20%.
4. Doxycycline is not contraindicated. Contraindications include pregnancy or lactation. In the US, the American Academy of Pediatrics endorses short-term use (<21 days) of doxycycline for Lyme disease in children <8 years old.
Patients who cannot take doxycycline are started on treatment if early symptoms develop.
Machata Variant- One dose of 200 mg doxycycline within 72 hours of a tick bite decreases risk of developing Lyme disease by 92%. I recommend a second dose of 200 mg doxycycline taken 24 hours after first dose. While this deviates from accepted regimen, I believe that my practice may decrease Lyme disease risk with minimal additional risk.
The Cancer Industry: Hype vs. Reality
The Diet That Might Cure Depression
Screening: How overdiagnosis and other harms can undermine the benefits
Marijuana- What Do We Know?
Probiotics Help Prevent Colds...Zinc Lozenges Help With a Cold
Probiotics benefit the health of everyone 6 months and older. Lactobacillus probiotics decrease the risk of getting a cold and for pre-schoolers decrease the risk of diarrhea. Zinc acetate 75 mg lozenge daily decreases nasal congestion, cough and muscle aches!
Annual Physicals Unnecessary
More than 44 million Americans who is taking part in a medical ritual — visiting the doctor for an annual physical exam. But there's little evidence that these visits actually do any good for healthy adults. The Society for General Internal Medicine even put annual physicals on a list of things doctors should avoid completely for healthy adults.
Vitamin D and Calcium
Vitamin D supplementation is now questioned. May be sensible to supplement in Winter. Obtain calcium through dietary sources: dairy, nuts, beans, green leafy vegetables, salmon and sardines.
Fasting Not Necessary Before Cholesterol Testing
The National Health and Nutrition Survey and National Death Index study of 16,000 adults over 14 years found that fasting and non-fasting cholesterols had similar prognostic value.
Prostate Cancer and PSA Testing
We once routinely screened all men over forty for prostate cancer with a prostate specific antigen blood test and a rectal exam. Screening is good, right? Dr. Mike Evan's videos help sort out this complex and challenging issue:
1) PSA test for Prostate Cancer
2) Deeper Dive on PSA Testing
3) Chief Medical Officer of American Cancer Society on PSA Testing
4) No Men Helped with PSA Testing
1) PSA test for Prostate Cancer
2) Deeper Dive on PSA Testing
3) Chief Medical Officer of American Cancer Society on PSA Testing
4) No Men Helped with PSA Testing
USPSTF encourages selective Prostate Specific Antigen screening
In 2017 the USPSTF changed the PSA recommendation from a "D" (benefits no greater than harms, don't do) to a "C" (small net benefit, do selectively). I trust the Number Needed to Treat website which concludes that PSA does not benefit men and harms one in five.
Vertigo YouTube Video Helps
Measles Epidemics Remind Us to Vaccinate!
Measles outbreaks in the United States and Europe are the direct result of well-meaning but ignorant parents failing to vaccinate against what once was and could be again be a very deadly disease. Public health officials say that at least 95 percent of a population must have immunity to control the spread of measles, which experts call the world’s most contagious human disease. Please vaccinate your children. Make sure your vaccines are up to date. What Vaccines Do You Need?
Jimmy Kimmel Hosts Doctors Favoring Vaccinations
Testosterone Screening and Treatment
Testosterone
Testosterone should not be prescribed unless there is biochemical evidence of testosterone deficiency. Many of the symptoms attributed to male hypogonadism are commonly seen in normal male aging or in the presence of comorbid conditions. Testosterone therapy has the potential for serious side effects and represents a significant expense. It is important to confirm the clinical suspicion of hypogonadism with biochemical testing. Current guidelines recommend the use of a total testosterone level obtained in the morning. A low level should be confirmed on a different day, again measuring the total testosterone.
Concussions
Dr. Mike Evans tackles this tricky subject in this video.