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Podcast #22 The Placebo Effect

Kate Rusk recorded and live streamed this episode on the science channel Inertia TV in March, 2018. Kate, Coffee Brown, and I discussed the power of the placebo effect, what it means for the evolution of the brain, and the evolution of social behavior. We riff on martial arts, mind […]

How much oxygen is too much?

Coffee Brown and I recently recorded a podcast on that most necessary molecule for mammalian life – O2. The question we consider: should medics send patients to hospital with 100% oxygen? Should all patients get supplemental oxygen in the hospital? The answer: an emphatic no! First author Derek Chu and […]

Disease or adaptation, normal or abnormal?

Peter Soeters and Peter De Leeuw of Maastricht University Medical Center wrote an interesting perspective piece entitled Disease or adaptation, another look at the practice of medicine, that was published in January in the journal Postgraduate Medicine. They write: “thanks to the great advances in medical technology we are now […]

Blood sugar and microbiome

I just came back from the Keystone conference on the microbiome and metabolism in Banff, Canada, where Eran Elinav of the Weizmann Institute of Science presented research on the relationship between  high blood sugar and the microbiome, published this week in the journal Science. (Click on the image below for […]

Evolutionary emergency medicine

My specialty is emergency medicine. My teaching interest is evolutionary medicine. My research area is the microbiome. I am often asked, “What does evolution and the microbiome have to do with emergency medicine?” My answer – almost everything. Here is the deal, folks. Evolution is happening in us and around […]

The Trojan horse of sepsis bundles

“All is for the best in this best of all possible worlds” – Dr. Pangloss in Voltaire’s Candide Whether septic shock provides a defense to the host is an open question – one that is increasingly relevant to emergency and critical care. Even if certain features of sepsis represent host […]

Lessons from the ADRENAL trial

The ADRENAL trial is the recently published, and influential, randomized controlled trial of hydrocortisone in patients with sepsis. There are two lessons to be learned from the ADRENAL trial. Lesson #1. The first is a small lesson. Should we be using steroids in sepsis? Answer: no. This was a big […]

Better than nature

We are about to learn whether giving corticosteroids in sepsis is a good idea or bad. I am on record predicting a negative result. [Update – The ADRENAL trial, now published in the New England Journal of Medicine showed that corticosteroids did not improve mortality. It did shorten ICU stay […]