Disease

Good genes and a good diet should spare most of us from developing Type II diabetes. The popular nutritional thought suggests that it is predominantly a bad diet, perhaps woven with a genetic “propensity” that gets the rest of us in trouble. A new observational study pulls at the threads of that argument.
Prediabetes is a cautionary warning, based upon a blood glucose or HbA1c, a marker of long-term glucose metabolism, that you might be at risk for developing diabetes. If prevention is indeed worth a pound of cure, prediabetes is the signal to make some changes. A new study looked at how Johns Hopkins, #8 in US News and World Report’s listing of hospitals for endocrine care, is heeding the signal.
There were more COVID deaths in 2021 than 2020, acceptance of vaccination remains stalled, and some locations are making progress but others are not. Nevertheless, masks have been coming off. Some jurisdictions have declared victory over COVID, but wishing will not make it so.
There is a structure to how we have organized care. Primary care physicians care for our day-to-day and chronic illnesses while helping us navigate the landscape to find specialists and hospital care when that is needed. They are our Sherpas – knowledgeable of the landscape and its pitfalls and nuances. You wouldn’t attempt to climb Everest without them. Ultimately, because a rope connects you, you must trust them with your life. While that may be a bit dramatic an analogy for a primary care physician, that rope, that trust, is built from many smaller, lower risk encounters. A consistent health Sherpa results in better care.
In my experience, orthopedic surgeons are the most fanatical of all surgeons regarding infection prevention. It makes sense since much of their work involves implanting hardware into bones – and an infection in a bone, let alone in the presence of hardware, is very tough to eradicate. So, when a new study looks at orthopedic thought on infection prevention, it is worth considering.
These days we’re awash in mask mandate conflicts, continuing vaccination resistance, and warnings that the wholesale disruptions to our lives “ain’t over yet.” While the media tends to focus on administrative conflicts as well as the slight, local, daily up and downticks, here we present a longer and broader view.
Imagine running long enough to get out of breath, long enough to be winded for a minute or two. Now imagine that same need for air after walking from your bedroom to the kitchen. That is the lived experience of individuals with severe respiratory illness, like the on-the-job illness we call black lung disease.
Socioeconomic risk factors have gotten much attention as they relate to disparities in health outcomes. Lower income, lower educational attainment, and so-called lifestyle issues – drinking, smoking, eating, and exercise – seem to be fellow travelers. A new mediation analysis seeks to disentangle them and point us toward the real drivers of health disparity.
We know from many studies that there is an inverse association between our intake of dietary fiber and the development of cardiovascular disease. The mechanism joining fiber to cardiovascular disease is thought to be mediated by INFLAMMATION! A new study strongly suggests that it is time to give that hypothesis a rest – as always, it is more complicated and unclear.
Disparities in healthcare are increasingly a hot topic in the journals. Two recent studies demonstrate disparity but identify very different actionable causes. As with all healthcare, it is more complicated and entangled than a single narrative or lens can explain. The data dots are correct, but there is more than one way to connect and explain them.
FAIR Health aggregates pricing and cost information for private insurers of healthcare. Its annual report, on what we might consider primary care, shows the changes wrought by COVID-19 and how we seek care. [1]