nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Monday, July 7, 2008

Life's Beginning and Ending...and Vitamin D

Study suggests serotonin imbalance may be linked to SIDS.

The Los Angeles Times (7/5, Hansen) reported that "[m]ice genetically engineered to overproduce the brain chemical serotonin died at an early age after developing symptoms similar to those of sudden infant death syndrome (SIDS), suggesting improper regulation of serotonin may cause SIDS in humans," according to a study published in the July 4 issue of Science.

Doc D: This may be an important clue, but it’s WAAAAY too early to be thinking there is a simple cause-and-effect relationship here. SIDS is an incredible tragedy, but, even though we know SIDS babies lack one type of serotonin receptor, serotonin has many, and complex, functions in humans. It’s not time to start putting serotonin syrup in baby formula.

Controversial end-of-life bill heads to California Senate.

Medscape (7/4, Gandey) reported that the "California State Legislature...has amended an end-of-life care bill, known as the Right to Know Act." The legislation, known as bill 2747, "is designed to improve information and counseling for patients and, on Thursday, was amended after passing a senate committee." While the "amended bill no longer includes references to euthanasia," it "encourages the use of palliative sedation and voluntary patient starvation and dehydration." As a result, several groups, including the Association of Northern California Oncologists, oppose the bill. For the most part, "physicians are concerned that end-of-life discussions will distress terminally ill patients, and offer no benefit." But, a recent study conducted by researchers at the Dana-Farber Cancer Institute in Boston showed that "end-of-life care discussions between doctors and patients were not associated with psychological distress."

Doc D: The issue is not whether it’s a good thing to offer patients end-of-life counseling. It’s about intrusion into the doctor-patient relationship. I think doctors need to be taught and encouraged to offer and conduct these discussions. Patients who want counseling need to ask. BUT, it’s the patient and the doctor who need to decide what, when, if, and how…not the government. I understand this bill requires doctors who don’t think it’s in the best interest of their patient to proceed as the government directs to refer their patient to another doctor, and if they don’t they are subject to medical board discipline. This kind of legislation comes from those people who think they know better than you what you need.

Recent studies fuel debate over vitamin D dosage.

In a front-page article, the Washington Post (7/4, A1, Stein) reported that a "flurry of recent research indicating that vitamin D may have a dizzying array of health benefits has reignited an intense debate over whether federal guidelines for the 'sunshine vitamin' are outdated, leaving millions unnecessarily vulnerable to cancer, heart disease, diabetes, and other ailments."

Doc D: the rest of the story: Vitamin D in high doses is toxic…and there’s also some research to suggest that Vit D increases risk for some health problems. Bottom line: Situation normal, all confused up (SNACU), take no action yet.

Doc D

Opinions are entirely my own. Quotations from AMA Morning Rounds (© U S News Custom Briefings)

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