2 Docs Talk: The podcast about healthcare, the science of medicine and everything in between.

One of the big scary pieces of growing old is the possiblity of developing Alzheimer Dementia. This progressive neurological disease is poorly understood, meaning the options for prevention and treatment have a long way to go.

In this episode, we talk about what the disease is, current options for treatment, the reality of prevention, and an approach to choosing long term care.

Resources:

Systematic review of studies on cholinesterase inhibitors

JAMA Neurology meta analysis of memantine

Risk reducing effect of education on in Alzheimer's disease

Lumosity fined $2 million for deceptive advertising

Non-profit vs. for profit nursing homes

CMS Five Star Rating

One of the foundational values of this show is emphasizing the importance of using the best available evidence when making decisions about medical care. 

Unfortunately the drive to publish has driven some to game the scientific publishing system. From circumventing the peer-review process to outright fraud, scientific literature is plagued with misinformation.

The scientific community is responding, though. With tools like retraction databases, research reproducibility efforts and post-publication peer review, scientists are working to maintain the highest level of inegrity in the scientific literature.

Be sure to listen all the way to the end, we get a littel personal.

Nature Magazine on the Peer Review Scam

Retraction Watch Leaderboard

Retraction Watch Timeline of Events Regarding Dr. Macchiarini

PubPeer

The Reproducibility Initiative

Why Asparagus Makes Your Pee Stink

With Zika in the news, it seemed like a good time to examine the vector borne diseases making headway here in the U.S.

In addition to Zika, we need to pay attention to Dengue Fever. Like the West Nile virus and yellow fever, these viruses are spread by the Aedes mosquito - most often Aedes aegypti. 

But don't think mosquitoes are the only issue. The Kissing Bug, which isn't nearly as sweet as it sounds, is responsible for the increasing burden of Chagas disease in the southern states. Without giving away their secret, let me just say you might not want to listen to this episode right before bedtime.

Note: This episode was recorded in mid-February. Our understanding of Zika, and its impact on the U.S. is rapidly evolving. Please keep an eye on the CDC pages linked below for the most current information.

Resources:

CDC map of areas affected by Zika

Sexual Transmission of Zika

Zika Virus

Dengue Virus

Chagas Disease

61% of Kissing Bugs Carrying Trypansoma Cruzii

This week we started talking about bugs and drugs, or infections and their treatments and we got into Clostridium difficile infection and fecal transplants. Because when it comes to this topic, we are all middle school boys. We can't not talk about it. 

In all seriousness, C. diff can be a devastating disease and the success of this treatment is beyond exciting. As Kendall likes to remind us, though, we have to watch out for the law of unintended consequences.

World Health Organization Survey on Antibiotic Use

Great Explainer Video About C. Difficile and Fecal Transplant

Freeze-dried poop for weight loss (I told you so)

Everything You Don't Want to Have to Know About Norovirus from the CDC

After a few of our previous episodes we got some great questions from a few of our listeners. In this brief update, we answer questions about our episodes on medical marijuana, breast cancer screening and concussions.

Opioid abuse is at an ever increasing high in the U.S. with overdose being a significant cause of death. 

What role do physicians, pharmaceutical companies, and the drug users themselves play in this epidemic. We examine these questions and more in this episode on the opioid problem in the United States.

Resources:

Drug Overdose Deaths by State

Draft CDC Guidelines for Prescribing Opioids for Chronic Pain

Specific Populations and Prescription Drug Misuse and Abuse

Colorectal screening is an effective tool in the prevention of deaths from colon cancer. The question is if the screening tools we use now are the most effective and safe available to us. Technological advances are making less invasive, safer tests a possibility - and sooner rather than later if we're lucky.

But today, what tests do we have, which ones work, and what should you as a patient choose when it comes to your own screening.

Resources:

Current USPSTF Guidelines for Colorectal Screening

USPSTF Draft Update Status for Colorectal Screening

Pillcam Accuracy and Safety

Cologard and FIT (Fecal Immunochemical Testing)

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If you live anywhere but under a rock, you know that Planned Parenthood has been the center of controversy in recent months. In this episode, we discuss the history of the organization and its founder Margaret Sanger. Then we dig into Planned Parenthood as it exists today and the controversy surrounding it.

The coverage of the controversy in the media is filled with innuendo and half-truths from both sides of the political spectrum. We wanted to know the facts, so we did a little searching. Since we recorded this episode, the courts in Houston did too, and found no evidence that they were profiting from the sale of fetal tissue or organs.

But, what role does Planned Parenthood play in healthcare today?

Do they provide needed services? What are those services? Is abortion their primary business? Should Medicaid funds cover their services? And finally, is there anything that can be done to curb the number of abortions performed today? (Hint: yes there is, and it has nothing to do with Roe v. Wade.)

Resources:

Where are Planned Parenthood Clinics Located?

Texas Tribune Articles on Planned Parenthood

Planned Parenthood Services by the Numbers

CDC Abortion Surveillance Report - 2012

New England Journal of Medicine on Planned Parenthood

Long Acting Reversible Contraception in Colorado

The Choice Project - LARCs in Colorado

As we enter primary season for this election year, gun violence and control is a hot topic. However, much of the discussion lives in one of two extremes, and little of it is based on actual evidence. 

With over 30,000 gun deaths each year, and over 20,000 of those death from suicide, the reality is that gun violence is a public health issue. This means we need to treat this issue from the point of view of the medical evidence. 

Today we look at the scope of the problem, what has and hasn't worked, and some thougths about what lies ahead. 

Resources:

CDC All Injuries Statistics

CDC Accidental Death Statistics

CDC Homicide and Assault Statistics

CDC Suicide and Self-Inflicted Injury Statistics

CDC Depression Statistics

Discussion of Australia's Gun Laws in the New York Times

Discussion of Missouri's Gun Laws in the New York Times

Survey of Defensive Gun Use Cited Frequently by NRA 

Methodological issues with Defensive Gun Use Survey

The supplement industry is a big one - estimates place it anywhere from $12 billion to $37 billion. 

However, if you put that number in the context of healthcare spending overall, it's not too crazy...if supplements are effective and safe.

But issues with the approval and regulations of dietary supplements make leave us with many unanswered questions about the so-called "natural" products on the market.

In this episode we examine supplements, homeopathic remedies, the placebo effect and much more. So take a listen, and leave a comment if you have thoughts on the topic.

References:

Dietary Supplement Health and Education Act of 1994

National Center for Complementary and Integrative Health

Placebos Without Deception

Perception of Drug Cost Influences Placebo Effect

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