Periodontal Disease and Pregnancy Risks

An often disagreed point in the literature is whether or not periodontal disease is associated with adverse pregnancy outcomes such as preterm births and low birth weight. I have discussed this some more on the risks of keeping wisdom teeth page over at http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html. I discussed how in a meta-analysis of 10 randomized trials in January 2011 found no evidence in favor of periodontal disease being associated with preterm births and low birth weight. The source for this study is Mariana Fampa Fogacci and et al. The Effect of Periodontal Therapy on Preterm Low Birth Weight: A Meta-Analysis. Obstetrics & Gynecology. vol. 117. issue 1. pages 153-165. January 2011. In a letter in J Can Dent Assoc 2012; 78: c120 there is an articled titled “Periodontal Disease and Pregnancy Risks,” which was published on on September 24, 2012 over at http://www.jcda.ca/article/c120 … Read more

How to Determine If a Clinical Practice Guideline is Trustworthy

An interesting article titled “How to Decide Whether a Clinical Practice Guideline Is Trustworthy,” written by David F. Ransohoff, MD Michael Pignone, MD, MPH, and Harold C. Sox, MD appears in JAMA, January 9, 2013,Vol 309, No. 2, pp. 139 -140. The article mentions how many controversies have arose recently over cancer screening guidelines. The article mentions how in 2008 Congress gave the Institute of Medicine (IOM) of the National Academies with developing standards for objective, scientifically valid, and consistent approaches to developing practice guidelines. Well as I mentioned in this blog post Tips to Prevent Medical Errors – AHRQ Congress actually gave the Agency for Health Care Policy and Research (AHCPR) in 1989 evidence-based, clinical-practice guidelines. However, the medical device industry and several doctors organizations opposed this as it was threatening to limit their profits and found a sympathetic ear … Read more

Anti Affordable Care Act (Anti ObamaCare) Ads with Uncle Sam

In the United States, with the ObamaCare exchanges set to go live on Tuesday and the looming government shutdown also set for Tuesday, I wanted to draw your attention to some recent ads you may have missed. Now I came across these ads watching Real time with Bill Maher last week, where Bill plays one of the ads on his program and discusses it. The videos are designed to deter young people from signing up for the ObamaCare exchanges and do so by featuring a young man and a young woman about to undergo prostate and pelvic exams. The ads are from from Generation Opportunity, a Virginia-based group with ties to the Koch brothers. I have embedded the two ads below and they both show two young college age students who have their first doctors appointment using the new ObamaCare … Read more

How does the U.S. Health Care System Differ From Other OECD Countries

An interesting article written by Victor R. Fuchs titled “How and Why US Health Care Differs From That in Other OECD Countries” appears in JAMA, January 2, 2013,Vol 309, No. 1, pp. 33-34.  The article attempts to discuss the difference between the U.S. Healthcare system and other countries in the  Organization for Economic Co-operation and Development (OECD). One way they differ is that the healthcare expenditures in the U.S. are twice as high. A second way they differ is that the share of expenditures funded by the U.S. government is lower. Most OECD countries have a tax-supported system healthcare system that is able to have lower administrative costs and is able to negotiate costs more aggressively with drug companies and physicians. Thirdly, there are differences in care with the U.S. being more technology intensive such as with MRIs. The author … Read more

The Immune System in Critically Ill Children with Influenza

An interesting article discussed the results of a study looking at the immune system in critically ill children. The article describes a study published in early 2013 in the January issue of Critical Care Medicine. Recent evidence indicates that the suppression of innate immune system function can occur in critically ill patients. In this study patients with innate immune suppression produced reduced amounts of tumor necrosis factor (TNF)-α  when their blood is stimulated with lipopolysaccharide (LPS). The article states “Results indicated that despite high levels of circulating pro-inflammatory cytokines, critically ill children with influenza demonstrated lower TNFα production capacity compared with healthy control subjects. Further, children who died from influenza had markedly lower TNFα production capacity compared with survivors.” Hence this study suggests that the reduction of immune function in these children who are critically ill may make them more prone … Read more