Thursday, June 15, 2017

Over the Counter Hearing Aids? Sounds great (no pun intended)!

There has been ongoing discussion for some time over how to help people use devices to improve their hearing that is both easy to use and affordable.

One problem is that MediCare actually can't cover hearing aids, barring a literal Act of Congress making such coverage possible.  Additionally, hearing aid technology has been difficult and generally required several visits to a licensed audiologist (hearing specialist) to customize them to each individual user.

Fast-forwarding to the present, the electronics technology for hearing aids has advanced just like electronics and computers in everything else.  Hearing aids that can be fully set up and used by the individual users are now seen to work nearly as well as high-end audiologist adjusted ones, at a fraction of the price (say, $300 instead of $4,000).

Congress is getting set to vote on a piece of legislation that would give the FDA three years to devise a way for hearing aids to be available over the counter after being shown to be safe and effective.  When Elizabeth Warren and Chuck Grassley are supporting the same legislation, then something is definitely up.  Stay tuned for further developments over the next few years!

Thursday, June 8, 2017

More on Drugs (or, medications)

I've come across some interesting reading on the subject of drugs and medications, and thought you might be interested since they cover the gamut of pharmaceutical research, clinical medicine and medical ethics.

If you watch TV, you may have already seen ads for a new kind of cholesterol lowering medication called Repatha.  It is injected by the patient every two weeks, and is not a statin and therefore does not have statin side-effects.  So far, so good.  Thing is, while Repatha substantially lowers cholesterol, the reduction in likelihood of heart attack or stroke is minimal, and the reduction in death from heart attack or stroke is zero.  Oh; and it costs over $14,000 every year.  The cost and the number of people who would have to take the medication to improve health is much, much higher than for the statins, and Repatha so far does not appear to be as effective as statins, either.

Mind, the medication has only been around for two years, so it's possible that benefit may become clearer over a ten year period of time.  For now though, Repatha seems like it might mostly be of interest to those who are at high risk of heart attack or stroke and just cannot tolerate statins.

Vox does a good job of summarizing a recent study on Repatha.

On the other end of the spectrum, what about re-thinking placebos

We already know that placebos can be very effective.  If a doctor prescribes something and tells you that you'll feel better, there's at least a 30-50% chance you'll feel better.  If pain is involved, the odds improve to 60-75%.  If the treatment is a sham (fake) procedure or surgery for pain, the odds improve up to 90%.  If we reveal to you that the pill or procedure or surgery was fake, the improvement does not go away!

Morphine works 50% more effectively if you know you are receiving it, compared to if it's just in your intravenous line and you can't tell that your getting it.  It works even better if you yourself control giving it to yourself, rather than asking a nurse for it.

There is starting to be open discussion of the use of open-label placebo use for some conditions, in which both the patients and doctors are fully aware of the use of a placebo for treatment.  Certainly not for cancer or life-threatening infection, but for other conditions such as back pain, or irritable bowel syndrome.  If this is both effective and safe, should we really continue to consider placebo use unethical?

And now for something completely different.  Recent studies demonstrate that single or limited treatments with ketamine can result in remission in depression, with MDMA can treat PTSD, and with psyolcibin can significantly aid patients with terminal cancer diagnoses.

Thing is, these are all considered by the FDA to be drugs of abuse characterized by high potential fore abuse with no medical value. 

Additionally, these studies are often initiated based on reports of incidental improvements in medical conditions by recreational drug users.  This raises some interesting questions.

For example, if the only things we can say with any certainty about MDMA (a/k/a Ectasy, X, Molly...) are that it doesn't seem to cause organ damage, withdrawl or life-threatening problems and largely seems to result in the user experiencing a 4-6 hour period of feeling generally happy and trusting of everyone around them, how dangerous exactly is the abuse potential of this?  Should more structured medical study actually be done?

Should the FDA consider rescheduling some of these drugs, which would make clinical testing possible?  As researchers on the clinical benefits of psylocibin ("magic mushrooms") point out, getting research grants is easier with psylocibin because it's not spelled L-S-D.

For that matter, are we going about this research all wrong?  Depression and anxiety are very common.  Certainly, the pharmaceutical industry is researching newer drugs, but really nothing new has come out since Lexapro, which is simply another SSRI and has been out long enough to be generic.  This research is by definition going to be incremental, insofar as side effect potential is intended to be minimized.  The clinical experiences with ketamine, MDMA and psylocibin are incidental to people frankly using them because they have noticeable effects on the brain ("getting high").  The beneficial effects on depression, PTSD or fear of dying seem to be a side-effect, but a noticeable side-effect that may be a result of taking a substance expected to effect the brain in a noticeable way.  This is not to say legalize everything yesterday, but it may point out a different way of looking for effective treatments of common psychiatric problems.

Wednesday, March 22, 2017

Overactive Bladder doesn't necessarily have to be treated with drugs!

Urinary incontinence is certainly not a new medical problem, but it's messy and inconvenient and can be socially very limiting.

The term "over-active bladder" is a descriptive marketing term for urge incontinence.  This means that there is urinary leakage or loss of bladder control due to the sudden urge, or need to urinate.  This is different than stress incontinence where external pressure or stress on the bladder (such as by coughing, laughing or standing up) can cause leakage of urine.

There are quite a few prescription medications that can treat urinary incontinence, and I'm sure some of them are advertised on TV.  However, it is often not necessary to take medications to improve the incontinence!  Prescription drugs for incontinence can offer some improvement, but generally not completely.  Also, side-effects are not uncommon.

Losing weight and stopping smoking can help.  Using fiber supplements (such as Benefiber) and stool softners (such as Colace) may help, since constipation is pretty common and it can cause urinary problems since the rectum is next to the bladder.

Moderating alcohol, caffeine and carbonated drinks can help, since these can be irritating to the bladder and cause the need to urinate to come on suddenly.

Kegel exercises can also help, and are useful for both women (with illustrations) and men.

If you still have urge incontinence after several months of trying these suggestions, you may want to see me to consider adding a prescription medication to what you are already doing.  Long-acting (also known as extended-release) oxybutynin is a good choice:  it's generic, once a day and works as well as anything newer. The long-acting form is more expensive than the twice a day regular form, but it is also a lot less likely to cause any side effects and may be worth the extra cost.

For stress incontinence, seeing a urologist to discuss surgical procedures can be useful.  You don't have to go forward with surgery if you'd rather not, but if the symptoms are not responding to some of the above suggestions you may at least want to see what surgery would have to offer.

Wednesday, January 11, 2017

Travel-related medicine

Yes, I know it's right after the holidays. But, it's also summer in the Southern Hemisphere!

Who travels? Actually, over a billion people travel internationally per year. Tourism is the first or second largest income source for 20 of the 48 least-developed nations.

So, what can go wrong?

Well, if you've had a heart attack or a heart bypass, you should avoid travel for 2 weeks to avoid a heart problem in flight.  If your heart attack was at all complicated (for example, heart failure), then make that 6 weeks.

The most common cause of travel-related death in non-elderly travelers is motor vehicle accidents, especially in less developed countries.  Watch carefully when crossing streets, think carefully about how to get around safely.  A bus in the daytime is probably better than a motorcycle or back of an open truck at night.

The most common infection is Traveler's diarrhea which occurs in 30-70% of travelers depending on destination and season, especially within the first 2 weeks of travel.  Interestingly, avoiding street foods, raw foods, ice or tap water don't seem to prevent illness.  Hand washing lowers your risk of diarrhea by 30%.  Pepto-Bismol (2 tablets, 4 times every day) can further reduce risk by 50-65%, if you're prone to such illnesses.  However, you should avoid this if you are allergic to aspirin, have chronic kidney disease, are breast-feeding or are on blood thinners.

As far as shots are concerned, flu and Hepatitis A shots are recommended to avoid getting flu or infectious hepatitis (from contaminated water or foods).  Do check for any need for specific shots such as typhoid or yellow fever.

Also, be aware of whether you will need a prescription for any pills to prevent malaria.  In addition, bring DEET-containing insect repellent, clothes that cover your arms and legs fully and a bed net if you are traveling to malarial areas.

This just covers a few very specific concerns.  Overall, travel is exciting and safe.  Outside of these specific medical tips, the best thing is to exercise common sense.

Feel free to see us about a month or two before travel if we can help you with advice, medications or shots. Have a great trip!

Thursday, December 22, 2016

Should I throw away expired medicines?

In many cases, the answer is no.

The requirement for an expiration date stems from the Johnson administration. The idea was to ensure that consumers and patients had some reasonable certainty that foods and medicines were still safe and fully effective when used.

Hence, medications are guaranteed to be over 90% of original potency by date of expiration. (Assuming you haven't gotten them wet, or stored them outside of recommended storage temperatures- leaving them in your car, for example.)

It turns out, there is quite a lot of interest in how potent your medications are after the date of expiration.

For example, the military has large stockpiles of emergency supplies including medications for a variety of reasons.  The FDA (your taxpayer dollars) administers the military's Shelf-Life Extension Program (SLEP), to test extended shelf-life of stockpiled medicines.  122 different medications stored in 3,005 lots were studied:
  • 88% of them extended past 1 year (were felt to be effective and usable)
  • average extension was 5 years
  • antibiotics that were studied included:
    • Ciprofloxacin- extended 55 months
    • Amoxicillin- extended 23 months
    • doxycycline- extended 50 months 
A different study looked at sealed medications at a retail pharmacy, some of which were 28-40 years past date (yes, years). Amazingly, 12 out of 14 medications were still over 90% effective!  These included acetaminophen (Tylenol), codeine and hydrocodone (NorCo, Vicodin, Lortab)and  also barbiturates. Aspirin and amphetamine were at under 90% effectiveness.

It should be stressed that unlike foods, medications do NOT become toxic with prolonged shelf-life.

Also, this information relates to dry medications.  Eye drops, inhalers, injectables are an open question.  Certainly, the EpiPen is basically inert within a month or less after expiration!

So, in a nutshell, many solid medications are probably active for up to around 5 years after expiration.

Monday, November 21, 2016

Occurrence of dementia is dropping in the U.S.; yes, dropping

Contrary to expectation, the rate of people in the U.S. becoming diagnosed with Alzheimer's dementia is actually decreasing since 2000. Compared to as recently as 1990, the rate of people being newly diagnosed with dementia went down from 11.6% to 8.8%.  At the same time, the diagnosis occurred later; the average age of new diagnosis increased from80.7 to 82.4 years old.

This may not sound like a lot, but that's a 24% improvement over time!  Next thing is to figure out why. 

People at higher risk of heart disease or stroke are generally at higher risk of dementia, such as smokers, diabetics, or people with high blood pressure or high cholesterol or those who are overweight. Yet even as people in the U.S. have more of these conditions than before, we're not seeing the continued surge in dementia that would have been expected.  Is it because the conditions are being treated more effectively?  Do the medications we use protect against dementia?  Are people better educated than before? Does it have to do with people smoking less?

The hope is that figuring out why dementia is decreasing and occurring later leads to better treatment, or even to effective prevention.

Friday, October 28, 2016

Flu Season

Flu season has arrived a bit early this year!

In El Dorado county, we have seen 9 cases of influenza in the past 18 days in folks from as young as 1 year old to 92 years old.

This is in line with nationwide flu surveillance showing very sporadic occurrence of flu so far this year.

It takes two weeks to develop full immunity from a flu shot, so it's a good idea to go to your local pharmacy and get one as soon as you can.  So far, the flu we're seeing locally and nationwide is covered in this year's flu shot.

Happily, it is not possible to get flu from getting a flu shot.  It's just that sometimes your body's immune system can make you feel feverish and achy for a few days because it is working to develop antibodies against several strains of flu.

Monday, September 26, 2016

Alternatives to Mylan Pharmaceutical's Effective but Completely Unaffordable Epi-Pen (R)

How can the price of the life-saving EpiPen have gone up from $100 to $600? 'Cuz it's not illegal.

Mylan Pharmaceuticals bought the license for the EpiPen in 2007, and has increased the cost steadily by 600% over the past nine years.  Most patients and doctors have heard of the EpiPen, and a lot of money has been spent on "branding" it, too.

The problem is that other automatic injectors for severe allergic reactions are not perfectly identical to the EpiPen.  This makes sense, since to make one that is truly identical would constitute patent infringement.  The problem is that in most states, pharmacists can't just automatically substitute a more affordable injector for an EpiPen prescription because the alternatives are not truly identical.  In California, pharmacists can make such a substitution, though in my experience they often don't.

Long story short, the Adrenaclick epinephrine injector is an EpiPen-like device that has been around long enough to also be available generically.

Using my handy GoodRx iPhone app (you can also use the app for Android phones, or the website and a printer), I see that the best price locally is at WalMart with a discount for $144.62 for a pair of generic Adrenaclick auto-injectors.

So, if you have severe allergic reactions to things like bee stings, shellfish or peanuts, there is a generic alternative to the EpiPen that can be had for 2007 prices.  Read the instructions carefully, as it is similar, but not identical, to the EpiPen.

Thursday, August 18, 2016

The California End of Life Option Act

The California End of Life Option Act was signed into law in October of last year, and became effective on the 9th of June.  This law is designed to provide a way for patients who are dying of a terminal illness to ask their doctors for medication that they could take if and when they wished to die quickly and peacefully at a time and setting of their own choice.  The law certainly includes many safeguards to prevent patients from being pressured or coerced into asking for or receiving such medications.  Also, it is a potentially time-consuming process and could take up to 2-3 months.

Physicians are not required to participate, so if this is important you need to ask your doctors whether they are willing to participate with you.  If they are not, they are required to be able to refer you to physicians who can serve you in this capacity.

For the record, I am willing to see patients requesting medication, assist with paperwork, and write prescriptions for the medication.

What follows is a hand-out I prepared as a Frequently Asked Question (FAQS) list with links to information and documents.

California End of Life Option Act

Signed into law by Governor Brown: 10/05/15 as AB-15

In effect: 06/09/16

Date of repeal by its own terms: 01/01/26, unless extended by the Legislature

It is now legal for dying patients to request a prescription for medication that would allow them the option to die peacefully at their own choosing if they wish, and it is now legal for doctors to prescribe such medication and for pharmacies to dispense it. 

Who is eligible for medical aid in dying?
·         Adults
·         Terminally ill
·         Prognosis of six months or less to live
·         Mentally capable of making own decision (Note this excludes patients with Alzheimer’s or other dementias, or patients with developmental delays.)
·         California resident
·         Acting voluntarily (without duress, fraud or undue influence)
·         Able to take and swallow the medication
·         Patients informed of all options (such as stopping life-prolonging treatment, palliative sedation, voluntarily ceasing to eat or drink, hospice care)
·         Patients informed that they may obtain, but not take the medication

Do people support this?
·         Yes. 68-74% of people in Gallup and Harris polls support medical aid in dying.

Do medical professionals support this?
·         Yes. 54% of doctors support this in a Medscape poll.
·         This Act is endorsed by the American Nurses Association/California, the California Psychological Association and the California Primary Care Association.

Do doctors have to participate?
·         No, but they have to provide information about medical aid in dying, and refer patients to supportive medical providers.

What cause of death will be on the Death Certificate?
·         Cause of Death will be the underlying terminal illness.
·         The law specifies that death from self-administering aid-in-dying medications is not suicide.

Does this affect a will or insurance?
·         No. Accessing medical aid in dying does not adversely affect a person’s will or insurance.
·         The law specifically mandates that wills, insurance, contracts and annuities are not affected if a qualified individual shortens their dying process by ingesting aid-in-dying medication.

How does this apply to disabled or older people?
·         The law specifically states that no one can qualify for aid-in-dying medication based solely on their disability or age.

How does this affect guardians or conservators?
·         Guardians and conservators may not be appointed solely because a person makes a request for aid-in-dying medication.

How long can such a request take?
·         At least 15 days, perhaps up to 3 months

How much does this cost?
·         There are at least 3 doctor visits, dedicated solely to aid in dying issues
·         The pharmaceutical company that makes the necessary medication increased the cost a few months ago to almost $3,000; at least for the easiest to use one that comes in easily opened capsules.
·         One that comes in tablets that would have to be crushed costs about $16.

Where can I find the necessary paperwork?
·         The California Department of Public Health allows you to download the necessary forms.

·         Compassion & Choices is a great resource for information.

What are the steps involved in requesting aid-in-dying medication?

Please note you must have the physical and mental ability to self-administer and ingest the medication, and you must be able to prove California residency- details to follow. Also, you yourself must make the request.  The request cannot be made on your behalf by any other person, regardless of their relationship to you. 

1.      Make a total of three voluntary requests; two oral requests 15 days apart, plus one written request using the Patient’s Request for Aid-in-Dying Drug form signed by two witnesses, directly to your doctor.
a.       No specific order is needed.
b.      The witnesses attest that you:
                                                              i.      Are known to them or have provided proof of identity (driver license, proof of voter registration in California, proof of owning or leasing property in California, or proof of filing a California tax return for the most recent tax year), and
                                                            ii.      Voluntarily signed the request in their presence, and
                                                          iii.      Appear to be of sound mind, and not under duress, fraud or undue influence.
c.       Only one witness may be related by blood, marriage or adoption, or be a person entitled to a portion of your estate upon your death
d.      Only one witness may own, operate or be employed at a healthcare facility where you receive medical care or reside
e.       Your regular doctor, consulting doctor or mental health specialist cannot be one of the witnesses.
2.      Give fully informed consent.
3.      A consulting doctor must complete the Consulting Physician Compliance Form, basically stating agreement with your Attending or regular physician.  Your regular or attending doctor must refer you to a consulting specialist for this purpose under this law. (Health and Safety code, Section 443.5 (a)(3))
4.      Complete the Final Attestation for Aid-in-Dying Drug form within 48 hours prior to ingesting the aid-in-dying medication.  This re-states your intent to take the medication, and your awareness of the consequences.
a.       After your death, this completed form must be delivered to your regular doctor so it can be included in your medical record.

You can use an interpreter, but your interpreter must sign the Interpreter Declaration Form which shows that you understand the needed forms as listed above when read to you by an interpreter.


Compassion & Choices materials 02/17/16

CMA On-Call Document #3459, 01/2016

Orentlicher, D. et al. (2015). Clinical Criteria for Physician Aid in Dying, J.Palliative Medicine, vol. 18, No. X.

Feel free to share this website with others, but please ask me before copying or distributing this posting.

Please feel free to see me if you have any questions about the End of Life Option Act.

Wednesday, July 20, 2016

Hearing aids for folks who maybe need them but can't afford them

As I've mentioned before, good hearing is not over-rated and bad hearing can be dangerous, socially isolating, and it is strongly linked to Alzheimer's dementia.

On the other hand, insurances generally only cover about $500 of what can be a $4,500 pair of hearing aids.  It's worth the money, but that doesn't help if you don't have that kind of money!  That goes a long way towards explaining why only 20% of people who need hearing aids actually have them.

Happily, there is a lot of interest in effective, more affordable devices.  However, it's definitely a "let the buyer beware" marketplace out there since they are being sold as assistive products and not pure medical devices.  Also, be aware that if you have severe hearing loss (as opposed to mild or moderate) these are not going to help you.

This article provides some information on three different models of Personal Sound Amplification Products (PSAP's) which a group of audiologists (hearing specialists) at Johns Hopkins have tested and found to be recommendable.  They do point out that so far they've only tested them in 29 people, so mileage may vary.

All three of the recommended devices are around $350, and all three are monaural which is to say that they go in one ear.  The Soundhawk and the CS50+ both look a bit like a Bluetooth in-ear headset.  The Bean T-Coil looks more like a small conventional in-ear hearing aid.  I gather that you get used to amplifying sound in one ear quickly enough. 

It certainly seems that these are all effective, comfortable devices that can help you hear better for a much more affordable price!

Monday, June 13, 2016

Proper Sunscreen Use

Julia Belluz does a great job of reviewing some of the frequently asked questions about sunscreens.

Do chemicals in sunscreens hurt me?
  • So far, there is no evidence of organ injuries or cancers being caused by chemicals in sunscreens.  Certainly, there is a known risk of skin damage and skin cancer in not using them.
Do sunscreens cause Vitamin D deficiencies?
  • No.
Do sunscreens expire quickly or get damaged by heat?
  • Consumer Reports found that sunscreens last for years after purchase, but
  • they can be rendered ineffective by being over-heated at the beach or in your car.
 Is higher SPF better?
  • SPF 30-40 is fine.  Many sunscreens overstate SPF, so if you want a general purpose SPF 15, get SPF 30 just to be sure.  On the other hand, there is very minimal additional benefit at SPF 45 or higher.
How much do I need to use?
  • Quite a bit, actually.  It takes about a fluid ounce (1 shot) to cover your whole body, on average.
  • Plus, it needs to be replenished every two hours as the chemicals have absorbed harmful UV radiation.  

The back and forth pendulum swing of narcotic pain-killer use.

The story of Prince being found to have died due to an overdose of fentanyl is reflective of narcotic pain killer use in our country.

I say our country because the U.S. represents less than 5% of the world's population but uses over 95% of its narcotic pain-killers.  I think it's unlikely that we have 95% of the world's physical pain.

Not long ago, pain-killers such as morphine, Demerol, Dilaudid, Percocet or Vicodin were pretty much only used right after a surgery or in people dying of cancer.  Prescribing these medications for long periods of time was very much frowned upon and could result in doctors coming under investigation or prosecution for over-prescribing them if complaints arose from families, pharmacies or other doctors.

Some time in the late 1990's, the pendulum swung fully in the opposite direction.  The above link does a pretty decent job of describing it.  In California, doctors were required to take a course covering this change: pain was "the fifth vital sign", pain-killer addiction was rare, tolerance to them uncommon, and patients reporting more pain were to be assumed to be suffering a worsening in their condition (as opposed to narcotic pain-killer tolerance or addiction).  Along with this, there were a number of laws, regulations or legal precedents requiring doctors to prescribe the perfectly right amount of narcotics or risk sanctions and lawsuits.  Doctors got found against for over-use and also for under-use, or for not referring patients to doctors who would prescribe pain-killers.  A surgeon on a widely read medical website shares his recollections of these times, too.

At this point, it is fair to say that this didn't work out as intended.  And mind you, intentions were good.  Chronic pain not related to cancer exists, and no one liked to see people suffering with it.

It was certainly a tipping point when Purdue Pharma developed and heavily marketed OxyContin.  I remember  a pharmacist from a big hospital center in Seattle giving a presentation on it to doctors at Marshall right after the FDA approved it.  It was touted as being a slowly released, long acting, abuse-proof non-addictive 12-hour narcotic pain killer.  It was sold as being insoluble with water so could not be injected, and providing good pain relief with only two doses a day.  Turns out, none of these statements are true.  It didn't take long for people to realize that injecting it for a fast high was impossible, but smashing it and snorting it worked just fine.  Worse yet, the pills in no way lasted 12 hours; more like 8 hours.  Worst of all, Purdue Pharma knew this, but lied.  They knew that doctors would be a lot less likely to prescribe a medication that had to be taken every 8 hours to work.  Only now are they admitting to this fraud.

Certainly, narcotic pain medications have a role in the treatment of acute and chronic pain.  It is simply time for the pendulum to swing back to a reasonable point somewhere in the middle.

Monday, June 6, 2016

Do acid reducing medicines cause dementia?

Recent press coverage suggested that proton-pump inhibitors can cause dementia.  Unfortunately, press coverage seems to have overstated this a bit.

Proton-pump inhibitors (PPI's) are a specific type of acid reducing medication used to treat a variety of conditions such as acid reflux, esophagitis and ulcers.  They include a number of prescription and over-the-counter medications such as Prilosec, Prevacid, Protonix, Nexium and Dexilant.

Basically, an article printed in April in the Journal of the Amercan Medical Association (JAMA) described a German study showing a correlation between PPI use and dementia.

Thing is, correlation is not causation.  This study did not define particular types of dementia, such as Alzheimer's, Parkinson's, Lewy body, vascular or senile dementias.  Also, it did not take into account risks such smoking or drinking.  Both of these would cause stomach problems and are common causes of being on PPI's, and both are by themselves associated with Alzheimer's disease risk.

In other words, a limited study with a number of significant weaknesses reports that many patients with various forms of dementia have taken PPI's.  It in no way establishes that PPI use causes dementia. 

Other acid reducers, called the H2 blockers include Tagamet, Zantac and Pepcid.  These, so far, have not had any  harm from long-term use associated with them.

Generally, it makes sense to use PPI's for very specific conditions such as treatment of Barrett's esophagitis or ulcer prevention with anti-inflammatory pain (NSAID) medication use and to otherwise use H2 blockers or non-medication related supportive care (such as not smoking, and modest alcohol consumption).

Wednesday, June 1, 2016

Staring at screens all days can hurt your eyes; cell phone use still not linked to brain cancer. Just saying.

The recent media coverage suggesting a link between cell phone use and brain cancer is so far a bit histrionic and less than nuanced.

So far, numerous studies have (happily) failed to demonstrate a link between cell phone use and brain cancer.  The recent media coverage involves an unpublished interval report on a long and unfinished study on such risk. 

Long story short, to suggest that this report proves that cell phone use can cause people to get brain cancer would assume:

  • risk of brain cancer due to cell phone exposure in rats equates to risk in humans (the study is using mice as test animals)
  • female brains are protected from cell phone exposure (no cancers occurred in the female rats)
  • controls are cured of cancer (the control population had lower rates of cancer than the experimentals)
This does not invalidate this ongoing study; it simply points out that the study is unfinished, the interim report unpublished and it contains a number of findings raising reasonable concerns of its scientific validity to date.  Vox and NYT did a good job of critiquing this study and its media coverage.

On the other hand, it does seem likely that staring at screens all day can make your eyes feel itchy, dry and uncomfortable. (Which makes it harder to read the screen...)  Jane Brody covers some studies on this well, and also offers some useful solutions.