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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 […]

2018 ISEMPH Conference Announcement

As chair of the 2018 Program Committee for the International Society for Evolution, Medicine, and Public Health, I am delighted to announce our 4th annual meeting taking place this year in spectacular Park City, Utah, August 1-4, 2018. The conference will be anchored around presentations by six internationally-celebrated keynote speakers. […]

Toe fevers, nose fevers?

The Roman Celsus in the 1st century A.D. identified four classical signs of inflammation: Calor, dolor, rubor, and tumor; these are heat, pain, redness, and swelling. Some of the most annoying symptoms of influenza, for instance, involve vascular congestion of mucous membranes, from increased blood flow leading to tissue swelling […]

Fat fights back

Is fat a immune organ, vital for host defense? In 2015, an important study in Science suggested that fat has an important immune function that prevents invasion by pathogens From Dermal adipocytes protect against invasive Staphylococcus aureus skin infection: “Adipocytes have been suggested to be immunologically active, but their role […]