3 values
<p>My job requires long periods of computer screen use. I have good eyesight (20/15) and don't wear glasses, but I definitely notice my eyes feeling fatigued at the end of the day. Sometimes when I'm short on sleep, I have trouble focusing or see slightly blurred vision.</p> <p>I want to protect my eyesight as much as possible. What are the best practices for doing so if you spend a lot of time staring at screens?</p>
How can I protect my eyesight when using computers?
[ "eye", "computers", "lifestyle" ]
CC BY-SA 3.0
[ { "answer_id": 85, "body": "<h3>20-20-20 Rule</h3>\n<p>Every 20 minutes of looking at the screen, look at something 20 feet away for 20 seconds. Also, try to blink a lot.</p>\n<h3>Adjusting settings</h3>\n<p>Using a larger font to read helps to reduce eye strain. Adjusting your brightness helps, usually brighter screens are better in brighter rooms, dimmer screens are better in dark rooms.</p>\n<p>Also, try to make your computer screen lower than your eyes; more of your eye is covered by your eyelid when you look down, so there will be more lubrication and you will subconsciously blink more.</p>\n<h3>Eating</h3>\n<p>Eat foods with vitamin A, which helps with the health of your eyes. See <a href=\"\">this question</a> for more.</p>\n<hr />\n<p><a href=\"\" rel=\"noreferrer\"><sup>The 20-20-20 Rule: Preventing Digital Eye Strain</sup></a><br />\n<sub><a href=\"\" rel=\"noreferrer\">Computer vision syndrome: a review of ocular causes and potential treatments</a></sub><br />\n<sub><a href=\";utm_medium=PDF&amp;utm_campaign=PDFCoverPages\" rel=\"noreferrer\">Assessing Computer Vision Syndrome Risk for Pilots</a></sub><br />\n<sub><a href=\"\" rel=\"noreferrer\">Eyestrain</a></sub></p>\n", "score": 79 }, { "answer_id": 468, "body": "<p>There are some options you have to reduce eye strain.</p>\n\n<ul>\n<li><p>You can get an anti glare cover for your monitor</p></li>\n<li><p>You can also adjust lighting of your work area (not always possible) \nby lowering internal lighting and blocking external lighting.</p></li>\n<li><p>You can adjust the setting of your monitor to make the brightness<br>\nsimilar to your surroundings which will help with strain</p></li>\n<li><p>You can blink more often to keep your eyes from drying out You can \ntake breaks both by leaving your computer or by moving your eyes<br>\naround the room/desk and avoiding your computer every once in a<br>\nwhile.</p></li>\n<li><p>You can set up your desk to make sure printed material is in easy eye\nreach and lighted similarly</p></li>\n<li><p>You can look into getting specialized gaming/computer glasses which<br>\nare designed to reduce eye strain and fatigue</p></li>\n</ul>\n\n<p><a href=\"\"></a></p>\n", "score": 25 }, { "answer_id": 1104, "body": "<p>The primary risk is what is called Computer Vision Syndrome (<a href=\"\">ref</a>, <a href=\"\">ref</a>, <a href=\"\">ref</a>).</p>\n\n<p>The American Optometric Association (referenced above) recommends the following changes in viewing habits to alleviate symptoms:</p>\n\n<blockquote>\n <p>Some important factors in preventing or reducing the symptoms of CVS\n have to do with the computer and how it is used. This includes\n lighting conditions, chair comfort, location of reference materials,\n position of the monitor, and the use of rest breaks.</p>\n \n <ul>\n <li><strong>Location of computer screen</strong> - Most people find it more comfortable to\n view a computer when the eyes are looking downward. Optimally, the\n computer screen should be 15 to 20 degrees below eye level (about 4 or\n 5 inches) as measured from the center of the screen and 20 to 28\n inches from the eyes. </li>\n <li><strong>Reference materials</strong> - These materials should be\n located above the keyboard and below the monitor. If this is not\n possible, a document holder can be used beside the monitor. The goal\n is to position the documents so you do not need to move your head to\n look from the document to the screen.</li>\n <li><strong>Lighting</strong> - Position the computer\n screen to avoid glare, particularly from overhead lighting or windows.\n Use blinds or drapes on windows and replace the light bulbs in desk\n lamps with bulbs of lower wattage. </li>\n <li><strong>Anti-glare screens</strong> - If there is no\n way to minimize glare from light sources, consider using a screen\n glare filter. These filters decrease the amount of light reflected\n from the screen.</li>\n <li><strong>Seating position</strong> - Chairs should be comfortably\n padded and conform to the body. Chair height should be adjusted so\n your feet rest flat on the floor. If your chair has arms, they should\n be adjusted to provide arm support while you are typing. Your wrists\n shouldn't rest on the keyboard when typing.</li>\n <li><strong>Rest breaks</strong> - To prevent\n eyestrain, try to rest your eyes when using the computer for long\n periods. Rest your eyes for 15 minutes after two hours of continuous\n computer use. Also, for every 20 minutes of computer viewing, look\n into the distance for 20 seconds to allow your eyes a chance to\n refocus. </li>\n <li><strong>Blinking</strong> - To minimize your chances of developing dry eye\n when using a computer, make an effort to blink frequently. Blinking\n keeps the front surface of your eye moist.</li>\n </ul>\n \n <p>Regular eye examinations and proper viewing habits can help to prevent\n or reduce the development of the symptoms associated with Computer\n Vision Syndrome.</p>\n</blockquote>\n\n<p>Also, from WebMD:</p>\n\n<blockquote>\n <ul>\n <li><strong>Tweak your computer settings.</strong> You don't have to live with the factory-installed settings on your computer if you're uncomfortable. Adjust the brightness, contrast, and font size until you find the best settings for your vision.</li>\n </ul>\n</blockquote>\n\n<p>Gunnar glasses: Studies have shown <a href=\"\">some short term relief</a> but generally no evidence has yet surfaced to support benefits of these glasses for long term health.</p>\n", "score": 22 }, { "answer_id": 907, "body": "<p>You can also use <a href=\"\" rel=\"noreferrer\">f.lux</a>, it is a software that adjusts automatically and according to your location the brightness and contrast of your monitor. It lowers UV light during day, and lowers IR light during night.</p>\n", "score": 13 }, { "answer_id": 235, "body": "<p>The health of your eyesight when using computer it really depends what kind of screen you're using and many other factors (DNA, diet, etc.), but in general, modern monitors (such as <a href=\"\" rel=\"nofollow\">LCD</a>, <a href=\"\" rel=\"nofollow\">LED-backlit</a>, <a href=\"\" rel=\"nofollow\">white-LED</a>, <a href=\"\" rel=\"nofollow\">OLED</a>) does nothing to the health of your eyes, unless you're still using <a href=\"\" rel=\"nofollow\">CRT</a> monitor. The bigger issue is rather neck and back if you don't site properly.</p>\n\n<p>Remember, if you feel your eyes are not comfortable, you may adjust the brightness and contrast of your screen.</p>\n\n<p>If you're using computer for too long, it's completely normal that your eyes would be tired and it really depends on the person (professionals can spent 8-12 everyday for years and their eyesight is perfect, for other 1h is enough). </p>\n\n<p>In this case, you simply need a rest. It's usually advice to do short breaks and take a fresh air. You may also consider to train your eye muscles as a number of <a href=\"\" rel=\"nofollow\">ophthalmologists</a> believe that an exercise programme based on something called the <a href=\"\" rel=\"nofollow\">Bates Method</a> may keep eyes in better shape.</p>\n\n<p>See: <a href=\"\" rel=\"nofollow\">Can you really train your eyes to see better?</a> where we can read:</p>\n\n<blockquote>\n <p>Some of the principles of the Bates Method are already accepted by mainstream eye care.</p>\n</blockquote>\n\n<hr>\n\n<p>More information about older monitors:</p>\n\n<p><strong><a href=\"\" rel=\"nofollow\">CRT</a></strong></p>\n\n<p>If you're using CRT most people experience mild discomfort unless the <a href=\"\" rel=\"nofollow\">refresh rate</a> is set to 72 Hz or higher. A rate of 100 Hz is comfortable at almost any size. It's usually advice to have a screen protector. However CRT are long lost technologies and this doesn't apply anymore to LCD monitors. </p>\n", "score": 6 }, { "answer_id": 11235, "body": "<p><a href=\"\" rel=\"noreferrer\">The Vision Council</a>, which represents the manufacturers and suppliers of the optical industry, suggests the following tips to prevent and lessen digital eye strain:</p>\n\n<ul>\n<li>Adjust the brightness of your device. Consider changing your background color from bright white to cool gray.\nAttach a glare reduction filter to your computer screen.</li>\n<li>Frequently dust and wipe digital screens to help reduce glare.</li>\n<li>Adjust your screen so that it is directly in front of your face and slightly below eye level. Do not tilt a computer\nmonitor.</li>\n<li>Position yourself or your device so there is sufficient distance between your eyes and the screen.</li>\n<li>Lessen the amount of overhead and surrounding light that is competing with your device’s screen.</li>\n<li>When using a computer, first sit in your chair and extend your arm. Your palm should rest comfortably on the\nmonitor (as if you’re high-fiving the screen).</li>\n<li>Keep handheld devices a safe distance from your eyes and just below eye level.</li>\n<li>Increase text size to better define the content on your screen. Use the settings control to make adjustments that\nfeel comfortable to your eyes.</li>\n<li>Remind yourself to blink more often. Staring at a digital screen can affect the number of times you blink, causing\neyes to dry.</li>\n<li>Take a 20-20-20 break: Every 20 minutes, take a 20-second break and look at something 20 feet away.</li>\n<li>Parents should limit the amount of screen time for children, and reduce their screen time in front of children so as\nto set healthy standards in the home.</li>\n<li>Blink. Breathe. Break.</li>\n</ul>\n\n<p>Also check the following image as a guidance:</p>\n\n<p><a href=\"\" rel=\"noreferrer\"><img src=\"\" alt=\"Computer Eye-gonomics - tips to prevent and lessen digital eye strain\"></a></p>\n\n<p>Source: <a href=\"\" rel=\"noreferrer\">Digiteyezed - The daily impack of digital screens on the eye health of Americans</a></p>\n", "score": 6 } ]
<p>The received wisdom seems to be that bending forward for prolonged periods of time is bad for the back. Fine. However, the "received wisdom" has been, for a long time now, that sitting bolt upright is the best posture for the back. However, <a href="">a study</a> actually concluded that much more of a reclined posture was actually better for the back:</p> <p><img src="" alt="Back posture image"></p> <p>So, what is the scientific consensus on this, or is it still under debate?</p>
What&#39;s the best long-term sitting posture?
[ "research", "lifestyle", "back", "posture", "sitting" ]
CC BY-SA 3.0
[ { "answer_id": 495, "body": "<p>The best long-term perfect posture is subjective due to the variety of body types, incorrect posture differs from person to person and person's proper posture can be incorrect posture for someone else and vice versa.</p>\n\n<p>Usually the good sitting posture can be determined by the following methods:</p>\n\n<ul>\n<li>Support your back to avoid back pain.</li>\n<li>Adjust your chair.</li>\n<li>Rest your feet on floor.</li>\n<li>If you're using computer, then:\n\n<ul>\n<li>place your screen at eye level,</li>\n<li>place your keyboard in front of you when typing,</li>\n<li>position and use the mouse as close to you as possible,</li>\n<li>avoid screen reflection,</li>\n<li>if using spectacles, it's important to see the screen easily without having to raise or lower your head.</li>\n</ul></li>\n<li>Make frequently used objects accessible (such as telephone, stapler),\nso you can avoid repeated stretching or twisting to reach things.</li>\n</ul>\n\n<p><sup>Source: <a href=\"\" rel=\"noreferrer\">How to sit correctly</a> at NHS</sup></p>\n\n<p>The common mistakes involve:</p>\n\n<ul>\n<li><p>Hunched back and 'text neck'.</p>\n\n<p><img src=\"\" alt=\"Hunched back and &#39;text neck&#39;.\"></p>\n\n<blockquote>\n <p>When hunching over a computer, your head may tend to lean forward, which can cause stiffness and pain in the neck.</p>\n \n <p>Over time, this type of posture can contribute to you developing a rounded upper back, a condition called kyphosis, which can cause shoulder and upper back stiffness and pain.</p>\n</blockquote></li>\n<li><p>Poking your chin.</p>\n\n<p><img src=\"\" alt=\"Poking your chin.\"></p>\n\n<blockquote>\n <p>The poking chin posture is often caused by sitting too low, a screen set too high, a hunched back or a combination of all three.</p>\n \n <p>A poking chin posture can lead to muscle weakness around the neck, compressing the neck joints, which over time can lead to stiffness and pain in the neck, shoulders and upper back and cause headaches.</p>\n</blockquote></li>\n<li><p>Rounded shoulders.</p>\n\n<p><img src=\"\" alt=\"Rounded shoulders.\"></p>\n\n<blockquote>\n <p>Rounded shoulders are typically caused by poor posture habits, muscle imbalances and an uneven exercise regimen, such as too much focus on chest strength and neglecting the upper back.</p>\n \n <p>Over time, these muscle imbalances will result in poor positioning of your shoulders, which can lead to shoulder and neck stiffness and pain.</p>\n</blockquote></li>\n<li><p>Sitting cross legged.</p>\n\n<p><img src=\"\" alt=\"Sitting cross legged.\"></p>\n\n<blockquote>\n <p>Over time you may develop muscle imbalances in your hips, which can cause stiffness and pain in the hips and lower back.</p>\n</blockquote></li>\n<li><p>Cradling your phone.</p>\n\n<p><img src=\"\" alt=\"Cradling your phone.\"></p></li>\n<li><p>Slouching in a chair.</p>\n\n<p><img src=\"\" alt=\"Slouching in a chair.\"></p></li>\n</ul>\n\n<p><sup><a href=\"\" rel=\"noreferrer\">Common posture mistakes and fixes</a> at NHS</sup></p>\n\n<p><a href=\"\" rel=\"noreferrer\">Wikipedia</a> summarise that in the following way:</p>\n\n<ul>\n<li><p>rounded and elevated shoulders and a pushed-forward head position,</p>\n\n<blockquote>\n <p>This position places stress on the spine between the top of the neck and skull and the base of the neck and upper shoulders.</p>\n</blockquote></li>\n<li><p>a forward tilting of the hips which is increasing the curve of the lumbar spine, and a protruding stomach</p>\n\n<blockquote>\n <p>This position places stress over both the hip joints and lower back.</p>\n</blockquote></li>\n</ul>\n\n<p>Poor posture can result in musculoskeletal distortion in the neck, and lower and upper back, it can also impede the ability of the lungs to expand and many other injuries.</p>\n\n<p>When the posture is correct, it allows your body muscles to breathe at optimum capacity.</p>\n", "score": 24 }, { "answer_id": 5659, "body": "<p>Short answer: <em>there is <strong>no best long-term sitting</strong> posture</em>. If there is any, <em><strong>take care of posture</strong> (I'd risk to say <strong>upright</strong> is best)</em>, and move every certain amount of time in the chair and/or around.</p>\n\n<p>I'm for positive responses so let me elaborate a bit more. All cautious considerations, as <code>kenorb</code> properly states, are ok. However, even if some of those considerations attend to the actual question, which was <em>what should I DO when sitting?</em> (notice the question was not pointed so much as to what NOT doing). What follows is an intent to give further argumentation in how to achieve the goal of sitting in a way that can take care of good posture in general, how and mostly why.</p>\n\n<p>Rather move around once in a while, and shift between different subtle positions. When you are sitting for long, you don't want to atrofiate your muscles, nor your posture. Hence several considerations: </p>\n\n<ul>\n<li><p>Check the post <a href=\"\">sitting is the new smoking</a>, and the main answer: <em>The solution is simple. Move.</em></p></li>\n<li><p>Consider that <strong>what you need to take care of</strong> when sitting <strong>is your whole body/organism</strong>, and not just a part.</p></li>\n<li><p>When sitting backwards you can alleviate your lower back for a while, but doing so as a norm can weaken that area as well.</p></li>\n<li><p>Remember that the human posture, standing or sitting or moving, has a certain balance. We have anterior and posterior muscles surrounding our body to make this balance possible. This is why I would infer that if one has <em>bad posture</em> (not necesarily back problems) along the day...reclining can be more easy going. But in the same coin, in the long run this may not favor good posture and a distributed and balanced muscle development.</p></li>\n<li><p>The study you mention says that <em>the 135-degree posture, suggesting less strain is placed on the spinal disks</em>. Of course this may be true, but to conclude from that that it'd be best to not sit at 90º is rather far fetched. I figure in some way that the article suggests that maximum relaxation can always be best. But in reality: (<em>if we assume not to be jello floating in a liquid environment</em>) <strong>we do need a certain amount of tension</strong> to function properly. Remember the fat moveless couch potatoes from the movie <a href=\"\" rel=\"nofollow noreferrer\">Wall-E</a> that underdevelop muscles and even bone-structure.</p></li>\n<li><p>Again, the reference you take mentions volunteers with <em>healthy backs</em>, this ussualy means that they'd have no problems in that area, but I'd argue that not many people reach a full healthy posture in a broader sense.</p></li>\n<li><p>See what kind of chair you have available. Some may favor a certain way of sitting or several.</p></li>\n</ul>\n\n<p>Also, <a href=\"\" rel=\"nofollow noreferrer\">Galen Cranz's been researching <strong>chairs</strong>: here interview and book reference</a>.</p>\n\n<hr>\n\n<p>Since many people don't only sit, but also are <em>in front of a pc</em> let me add:</p>\n\n<ul>\n<li><p>If you can use a keyboard near your lap, this can be better than having it a higher level. I find the latter to thrust your elbows, shoulders, upper-back and neck upwards.</p></li>\n<li><p>Consider, like apple co-creator Oz Wozniak did: <a href=\"\">Dvorak</a>'s effort and resulting keyboard configuration. The main aim there is not for speed but for comfort, and avoiding carpal tunnel syndrome. </p></li>\n</ul>\n", "score": 7 }, { "answer_id": 12849, "body": "<p>From my experience, it is better to change postures while you sit long. </p>\n\n<p>Most often, I sit in a posture similar to below yoga posture 'Padmasana' in my chair, but not for so long, just for 5 or 10 minutes. It really helps to reduce the tension on the back. </p>\n\n<p>Actually, it need not be in exactly this position, just cross your legs as you can. After 5 or 10 minutes you can go back to your normal sitting posture as suggested in above answers. Whenever you feel tension on the back just try this posture for a few minutes.</p>\n\n<p>Try this out and see how it goes.</p>\n\n<p><a href=\"\" rel=\"nofollow noreferrer\"><img src=\"\" alt=\"enter image description here\"></a></p>\n", "score": 1 } ]
<p>Cellular phones are taking ever increasing part in our lives, and I keep hearing people saying they are harmful to our health.</p> <p>Are there any scientific researches so far proving or disproving those claims?</p> <p>I found couple of semi-scientific articles:</p> <ol> <li><p><a href="">Is there any link between cellphones and cancer?</a> which says: </p> <blockquote> <p>The possible connection between cellphones and cancer is controversial. Many years' worth of studies on cellphones and cancer have yielded conflicting results<br> ...<br> In one study that followed more than 420,000 cellphone users over a 20-year period, researchers found no evidence of a link between cellphones and brain tumors<br> ...<br> Another recent study suggested a possible increased risk of glioma — a specific type of brain tumor — for the heaviest cellphone users, but no increase in brain tumor risk overall.</p> </blockquote></li> <li><p><a href="">Long-term Cell Phone Use Linked to Brain Tumor Risk</a> which says: </p> <blockquote> <p>Long-term use of both mobile and cordless phones is associated with an increased risk for glioma, the most common type of brain tumor, the latest research on the subject concludes.<br> The new study shows that the risk for glioma was tripled among those using a wireless phone for more than 25 years and that the risk was also greater for those who had started using mobile or cordless phones before age 20 years.</p> </blockquote></li> </ol> <p>Though the second appears to conclude direct health risk, I'm pretty sure it's not yet any hard proof otherwise we would have seen huge lawsuits being filed all over the place.</p> <p>If really harmful, what factors are in place e.g. cellular phone model, signal strength, etc?</p>
Is there any health risk in cellular phones?
[ "cancer", "brain", "cellular-phone", "bioelectromagnetics", "health-outcomes" ]
CC BY-SA 4.0
[ { "answer_id": 39, "body": "<p>The IARC has concluded that <a href=\"\">cell phones are a \"possible carcinogen\"</a> due to the amount of evidence going both directions.</p>\n\n<p>The gist of it is summarised on the website itself:</p>\n\n<blockquote>\n <ul>\n <li>Cell phones emit radiofrequency energy, a form of non-ionizing electromagnetic radiation, which can be absorbed by tissues closest to\n where the phone is held.</li>\n <li><p>The amount of radiofrequency energy a cell phone user is exposed to depends on the technology of the phone, the distance between the\n phone’s antenna and the user, the extent and type of use, and the\n user’s distance from cell phone towers.</p></li>\n <li><p>Studies thus far have not shown a consistent link between cell phone use and cancers of the brain, nerves, or other tissues of the head or\n neck. More research is needed because cell phone technology and how\n people use cell phones have been changing rapidly.</p></li>\n </ul>\n</blockquote>\n\n<p><sub><a href=\"\">Mobile phone and cordless phone use and the risk for glioma – Analysis of pooled case-control studies in Sweden, 1997–2003 and 2007–2009</a></sub> </p>\n", "score": 34 }, { "answer_id": 5856, "body": "<blockquote>\n <p>Exposure to ionizing radiation, such as from x-rays, is known to increase the risk of cancer. However, although many studies have examined the potential health effects of non-ionizing radiation from radar, microwave ovens, cell phones, and other sources, there is currently no consistent evidence that non-ionizing radiation increases cancer risk <a href=\"\" rel=\"noreferrer\">(1)</a>.</p>\n</blockquote>\n\n<p><strong>Source</strong>: <a href=\"\" rel=\"noreferrer\"></a></p>\n\n<p>You might find my answer to <a href=\"\">this question</a> helpful.</p>\n", "score": 11 } ]
<p>I've read conflicting information on how many eggs one can eat per day:</p> <p><a href="">Daily Health Post - How Many Eggs a Day Can You Safely Eat?</a></p> <blockquote> <p>How many eggs a day can you safely eat? Apparently, as many as you want, if you pay attention to your total calorie intake and are careful about carbohydrate intake. If you have diabetes, you can safely eat eggs too, but will need to be particularly attentive to carbohydrates and blood sugar control.</p> </blockquote> <p><a href="">Men's Fitness - Am I Eating Too Many Eggs?</a></p> <blockquote> <p>A 2008 report from the Physicians Health Study backs up Smith’s suggestion, finding that eating one egg per day is generally safe—but that more than that can increase your heart disease risk later in life. (Note that we’re talking about yolks here. You can have unlimited whites.)</p> </blockquote> <hr> <p>More details:</p> <ul> <li>The individual is healthy, BMI of 20, has no major medical condition, and regarding sports activities walks 30 minutes per day.</li> <li>Eggs are large chicken eggs (50 grams)</li> <li>I am looking for an approximate upper bound on the number of eggs one can eat per day on average while staying healthy in the long run</li> </ul>
How many eggs can one eat per day?
[ "nutrition" ]
CC BY-SA 3.0
[ { "answer_id": 681, "body": "<p>Metabolic rate, individual genetics, cholesterol-absorption controversies, nutrients of the egg, size of the egg, and definition of \"maximum\" all contribute to ambiguity.\n<a href=\"\">This list of egg sizes and corresponding nutrition panels with daily recommended values is a good starting place</a>, but I will also address this in a general context of what experts recommend and nutrient content.</p>\n\n<p><strong>Cholesterol</strong></p>\n\n<p>When people talk about eggs, they usually want to talk about cholesterol.</p>\n\n<p>The problem is that the body doesn't fully absorb all of the cholesterol, so there's no hard rule. What we do know is:</p>\n\n<ul>\n<li>A large egg contains about 185 mg of cholesterol. <a href=\"\">{2}</a></li>\n<li>Although there is no precise basis for selecting a target level for<br>\ndietary cholesterol intake for all individuals, the AHA recommends<br>\n&lt;300 mg/d on average. <a href=\"\">{3}</a></li>\n<li>Your body doesn't absorb everything you eat. (That's part of why we go to the bathroom.)</li>\n</ul>\n\n<p>Registered dietitian Leslie Beck recommends:</p>\n\n<blockquote>\n <p>People at high risk for cardiovascular disease – e.g. people with diabetes, high cholesterol, and/or hypertension and smokers – should definitely limit their intake of egg yolks... some experts advise avoidance.</p>\n</blockquote>\n\n<p>However, for healthy people with no medical condition, regular exercise and maintaining a healthy weight are better strategies to guard against heart disease and stroke, not cutting down on eggs (for <a href=\"\">70</a> - <a href=\"\">75%</a> of the population). The two studies cited indicate that consumption of eggs does not raise cholesterol levels significantly for about 3/4ths of the population.</p>\n\n<p><strong>Fat and Calories</strong></p>\n\n<p>Each egg yolk contains 6 g of fat and 54 kcal. Even though they're full of nutrients, they still do contain calories, so factor that into your daily intake. Someone who does an average amount of physical activity would probably require an average amount of eggs. Definitely not something on the level of dozens, but even so, giving any numbers would be hard since there are so many factors in play.</p>\n\n<p><strong>Vitamins and Minerals</strong></p>\n\n<p>Eggs are naturally rich in vitamin B2 (riboflavin), vitamin B12, vitamin D, selenium and iodine. They also contain vitamin A and a number of other B vitamins including folate, biotin, pantothenic acid and choline, and essential minerals and trace elements, including phosphorus. <a href=\"\">{6}</a></p>\n\n<p>Before reaching a daily recommended value of any of these nutrients though, you would probably far exceed the daily recommended values for fat and calories first, but it's possible to overdose on anything, so be sure to keep track of how much of these nutrients are in each egg that you consume in the event that you're burning off all the fat and calories.</p>\n\n<p><strong>Summary</strong></p>\n\n<p>To know your \"maximum\" number of eggs, you should probably talk to a dietitian.</p>\n\n<p><strong>Sources</strong></p>\n\n<ul>\n<li><a href=\"\"></a></li>\n<li><a href=\"\"></a></li>\n<li><a href=\"\"></a></li>\n<li><a href=\"\"></a></li>\n<li><a href=\"\"></a></li>\n<li><a href=\"\"></a></li>\n</ul>\n", "score": 30 } ]
<p>There are people who avoid preparing their food in microwave ovens for various health-related reasons. The claims most often stated are:</p> <ul> <li>Microwave radiation is harmful.</li> <li>Microwaving destroys vitamins and other nutrients.</li> </ul> <p>Is there any scientific evidence to suggest that microwaved food is less healthy compared to food prepared in more conventional ways?</p>
Is food prepared in a microwave oven less healthy?
[ "nutrition", "bioelectromagnetics", "microwaves" ]
CC BY-SA 4.0
[ { "answer_id": 477, "body": "<p><strong>TL;DR</strong>: No, food cooked via a microwave oven is generally not less healthy than food cooked by other methods. </p>\n\n<hr>\n\n<p>In general, cooking by any method destroys or reduces nutrient value<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Does Cooking Food Reduce the Vitamin Content?\">1</a>,<a href=\"\" rel=\"nofollow noreferrer\" title=\"The Claim: Microwave Ovens Kill Nutrients in Food\">4</a></sup>. This is due to a number of factors:</p>\n\n<ul>\n<li><p>Solubility. Water-soluble nutrients (like Vitamin B, C) are highly prone to leach out if cooking in water<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Does cooking vegetables diminish their nutrients?\">2</a></sup> (boiling, for example). Fat-soluble nutrients are at a similar risk when cooking in a fat medium or when the fat is lost in the process (e.g., frying, grilling)<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Why, How and Consequences of cooking our food\">5</a></sup>.</p></li>\n<li><p>Heat. Both fat- and water-soluble nutrients are susceptible to heat from any cooking source, while mineral nutrients are less so<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Why, How and Consequences of cooking our food\">5</a></sup>. </p></li>\n<li><p>Duration. Methods with shorter cook times (e.g., stir-frying, blanching, microwaving) reduce the effects of heat degradation because the food is not exposed to heat for as long<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Why, How and Consequences of cooking our food\">5</a></sup>.</p></li>\n</ul>\n\n<p>(It's not even always a loss: some nutrients are <em>more</em> available after cooking, because heat breaks down thick cell walls that our digestive system has trouble with, which means that the nutrients are easier for our bodies to uptake<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Fact or Fiction: Raw veggies are healthier than cooked ones\">3</a></sup>.)</p>\n\n<p>Each cooking method has a <strong>different combination</strong> of the above factors, and so has different effects on nutrients in food. Microwave cooking has the advantage of not cooking in water, and being able to reach a higher heat in a shorter time. Depending on the food, this means that microwaving is sometimes <em>better</em> at preserving nutrients. For example, boiling spinach causes a much higher loss (77% vs. almost none) of <a href=\"\" rel=\"nofollow noreferrer\">folate</a> compared to microwaving<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Claim: Microwave Ovens Kill Nutrients in Food\">4</a></sup>.</p>\n\n<p>Of course, when people make claims about microwaved food being less healthy, they are <em>usually</em> referring to a fear that the act of microwave heating (<a href=\"\" rel=\"nofollow noreferrer\">dielectric heating</a>) is 'unnatural' in some way, or is subjecting the food to dangerous radiation (which may then be ingested). This is simply not supported<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Microwave Oven Radiation\">9</a></sup> by scientific literature, which indicates that microwave ovens, when used properly, are safe and effective -- with <strong>two caveats</strong>:</p>\n\n<ul>\n<li><p>Human milk. The CDC<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Proper Handling and Storage of Human Milk\">6</a></sup> does not recommend heating human milk in the microwave, because of the risk of uneven heating of the liquid (which could scald a baby), and because there is some evidence<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Effects of microwave radiation on anti-infective factors in human milk\">7</a></sup> that it decreases its anti-infective properties.</p></li>\n<li><p>Superheating of liquids. If water is heated in a microwave in a smooth container, it can pose a risk of scalding due to superheating<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Microwave Oven Radiation\">9</a></sup>. From <a href=\"\" rel=\"nofollow noreferrer\" title=\"Superheating: Occurrence via microwave oven\">wikipedia</a>:</p>\n\n<blockquote>\n <p>Superheating can occur when an undisturbed container of water is heated in a microwave oven. When the container is removed, the water still appears to be below the boiling point. However, once the water is disturbed, some of it violently flashes to steam, potentially spraying boiling water out of the container. [...] There are ways to prevent superheating in a microwave oven, such as putting a popsicle stick in the glass or using a scratched container.</p>\n</blockquote></li>\n</ul>\n\n<p>In conclusion, microwaving food is a safe alternative to cooking via other methods<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"Microwave Oven Radiation\">9</a></sup>. Any cooking method will decrease the nutritional value of food, but this is usually an acceptable tradeoff because of the benefits gained from cooking<sup><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Why, How and Consequences of cooking our food\">5</a></sup>. Microwaves do not cause food to be radioactive or acutely dangerous in any way.</p>\n\n<h3>References</h3>\n\n<ol>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Does Cooking Food Reduce the Vitamin Content?\">Does Cooking Food Reduce the Vitamin Content?</a> - SFGate</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Does cooking vegetables diminish their nutrients?\">Does cooking vegetables diminish their nutrients?</a> - HowStuffWorks</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Fact or Fiction: Raw veggies are healthier than cooked ones\">Fact or Fiction: Raw veggies are healthier than cooked ones</a> - Scientific American</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Claim: Microwave Ovens Kill Nutrients in Food\">The Claim: Microwave Ovens Kill Nutrients in Food</a> - New York Times</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"The Why, How and Consequences of cooking our food\">The Why, How and Consequences of cooking our food</a> - European Food Information Council</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Proper Handling and Storage of Human Milk\">Proper Handling and Storage of Human Milk</a> - Centers for Disease Control</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Effects of microwave radiation on anti-infective factors in human milk\">Effects of microwave radiation on anti-infective factors in human milk</a> - Quan R, Yang C, Rubinstein S, Lewiston NJ, Sunshine P, Stevenson DK, Kerner JA Jr. Pediatrics. 1992 Apr;89(4 Pt 1):667-9.</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Superheating: Occurrence via microwave oven\">Superheating: Occurrence via microwave oven</a> - Wikipedia</li>\n<li><a href=\"\" rel=\"nofollow noreferrer\" title=\"Microwave Oven Radiation\">Microwave Oven Radiation</a> - U.S. Food and Drug Administration</li>\n</ol>\n", "score": 30 }, { "answer_id": 460, "body": "<p>Heat in a microwave oven is generated by the rotation of water molecules by bombarding them with electromagnetic radiation in the microwave spectrum (non-ionizing electromagnetic waves between common radio waves and infrared frequencies) causing polarized molecules in the food to rotate or collide and subsequently thermal energy is built up (<a href=\"\">dielectric heating</a>).</p>\n\n<h3>Heat-sensitive vitamins and nutrients</h3>\n\n<p>One 1998 study shown that microwaving food can lead to faster breakdown of vitamin B<sub>12</sub><sup><a href=\"\">1998</a></sup>. This is because microwaved food can get locally hotter than the boiling point of water (100°C/212°F).</p>\n\n<p>Another <a href=\"\">study from 2007 by J. Agric. Food Chem.</a> show a general decrease in the levels of all the studied compounds except for mineral nutrients which were stable under all cooking conditions:</p>\n\n<blockquote>\n <p>Vitamin C showed the greatest losses mainly because of degradation and leaching, whereas losses for phenolic compounds and glucosinolates were mainly due to leaching into water. In general, the longest microwave cooking time and the higher volume of cooking water should be avoided to minimize losses of nutrients.</p>\n</blockquote>\n\n<p>So it seems that the most heat-sensitive nutrients such as folic acid, vitamins B and C (mainly water-soluble vitamins)are the most affected when microwaving food.</p>\n\n<h3>Broccoli</h3>\n\n<p>One study published in The Journal of the Science of Food and Agriculture in 2003 found that microwave cooking destroyed more flavonoids than other methods. When steamed or cooked without water, the broccoli retained most of its nutrients and antioxidants.</p>\n\n<p>Loss of flavonoids in Broccoli Study:</p>\n\n<ul>\n<li>Microwaved: 97%</li>\n<li>Boiled :66%</li>\n<li>Pressure Cooked: 47%</li>\n</ul>\n\n<p>According to Dr Cristina García-Viguera, leader of the study:</p>\n\n<blockquote>\n <p>During microwave heating they leach into the cooking water, removing their nutritional benefits from the foodstuff.</p>\n</blockquote>\n\n<p>However other studies didn't show a high loss of nutrients with microwave cooking, in fact two studies indicate that microwave cooking helps retain flavonoids better than other methods.</p>\n\n<p><sup>Source: <a href=\"\">Healthy Microwave Cooking of Vegetables</a></sup></p>\n\n<h3>Tomatoes</h3>\n\n<p>Loss of flavonoids from Tomatoes:</p>\n\n<ul>\n<li>Microwaved 65%</li>\n<li>Boiled 82%</li>\n</ul>\n\n<p><sup>Source: <a href=\"\">Healthy Microwave Cooking of Vegetables</a></sup></p>\n\n<h3>Potatoes</h3>\n\n<p>Loss of flavonoids from Potatoes:</p>\n\n<ul>\n<li>Microwaved 45%</li>\n<li>Boiled 60%</li>\n<li>Baked 100%\n<sup>Source: <a href=\"\">Healthy Microwave Cooking of Vegetables</a></sup></li>\n</ul>\n\n<p>To minimize phenolic losses in potatoes, microwaving should be done at 500W<sup><a href=\"\">2008</a></sup>.</p>\n\n<h3>Spinach</h3>\n\n<p>Study at Cornell University showed that spinach retains nearly all its folate when cooked in a microwave<sup><a href=\"\">NYT</a></sup>.</p>\n\n<h3>Bacon</h3>\n\n<p>Study at Cornell University found that bacon cooked by microwave has significantly lower levels of cancer-causing nitrosamines than conventionally cooked bacon<sup><a href=\"\">NYT</a></sup>.</p>\n\n<h3>Acrylamide health risks</h3>\n\n<p>Acrylamide is considered a potential occupational carcinogen by U.S. government agencies<sup><a href=\"\">wiki</a></sup> and it can be found in starchy foods, such as potato chips/crisps, French fries and bread that had been heated higher than 120°C (248°F)<sup><a href=\"\">2002</a></sup>. Acrylamide levels appear to rise as food is heated for longer periods of time.</p>\n\n<p>Unlike frying and baking, based on FDA studies<sup><a href=\"\">2008</a></sup>, microwaving whole potatoes with skin on to make “microwaved baked potatoes” does not produce acrylamide, although unlike deep-frying, it has limited effectiveness in reducing glycoalkaloid (i.e. solanine) levels<sup><a href=\"\">1999</a></sup>.</p>\n\n<p>However acrylamide can been found in other microwaved products such as popcorn.</p>\n\n<h3>Foodborne illness</h3>\n\n<p>Microwave ovens are frequently used for reheating leftover food, and bacterial contamination may not be repressed if the safe temperature is not reached, resulting in <a href=\"\">foodborne illness</a>.</p>\n\n<h3>Radiation</h3>\n\n<p>The radiation produced by a microwave oven is non-ionizing (in comparison to X-rays and high-energy particles which are associated with the cancer risks).</p>\n\n<p>Long-term studies to assess cancer risk have so far failed to identify any carcinogenicity microwave radiation (2.45GHz) even with chronic exposure levels<sup><a href=\"\">1998</a>, <a href=\"\">1998</a></sup>.</p>\n\n<p>However, with the oven door open, the radiation may cause damage by heating, although the modern design of microwave ovens is equipped with safety switches that turn off the radiation when the door is open and ovens are sufficiently insulated to allow only \"minimal leakage\" when the oven is working.</p>\n\n<h3>Conclusion</h3>\n\n<p>Any form of cooking will destroy vitamins and other nutrients in food, but it depends how much water is used in the cooking, how long the food is cooked and at what temperature<sup><a href=\"\">2006</a></sup>.</p>\n\n<p>However comparative cooking method studies generally find that, if properly used, microwave cooking does not affect the nutrient content of foods to a larger extent than conventional heating<sup><a href=\"\">1995</a></sup>.</p>\n\n<p>See also:</p>\n\n<ul>\n<li><a href=\"\">Microwave: Effects on food and nutrients</a> at Wikipedia</li>\n<li><a href=\"\">Microwave cooking and food safety</a> at CFS</li>\n</ul>\n", "score": 16 } ]
<p>Can MRIs have any deleterious effect on one's health? Or would it be safe to have say 5 MRIs per year?</p>
Can MRI scans be dangerous for one&#39;s health?
[ "side-effects", "mri", "medical-imaging", "bioelectromagnetics" ]
CC BY-SA 4.0
[ { "answer_id": 37, "body": "<p>One of the greatest benefits of MRI scans is their safety. Unlike PET, X-ray, CT and most other scans, MRIs use the properties of body tissues in magnetic fields to produce an image. The MRI machine produces a powerful magnetic field which interacts with body tissues to produce radio waves, which are in turn interpreted by a computer to determine the location of the tissues.<a href=\"\" rel=\"noreferrer\"><sup>1</sup></a></p>\n<p>This does not, however, mean MRIs are completely without risk. First and foremost, an MRI machine is basically a giant magnet. If one has metal in his or her body, from a medical implant, car accident, or even an improperly done tattoo, the MRI machine can move it, potentially violently. In the case of medical implants, an MRI machine can easily destroy any electrical components.<a href=\"\" rel=\"noreferrer\"><sup>2</sup></a> There are a number of different reasons metal might be present in the body.<a href=\"\" rel=\"noreferrer\"><sup>3</sup></a> This is why MRI technologists are trained to ask, repeatedly, about any metal that may be present.</p>\n<p>In addition to metal, some MRIs involve contrast media, chemicals injected or consumed that increase visibility of certain tissues in MRI scans. These chemicals are normally removed by the body rather quickly, and except in individuals with reduced kidney function, are for the most part safe. However, there have been cases of allergic reactions and side effects.<a href=\"\" rel=\"noreferrer\"><sup>4</sup></a> Also, recently, questionable studies have presented possible links between gadolinium-based contrast agents and nephrogenic systemic fibrosis, though the American FDA has stated that this link is only significant in patients with kidney disease, as <em>&quot;NSF has not been reported in patients with normal kidney function&quot;</em>.<a href=\"\" rel=\"noreferrer\"><sup>5</sup></a></p>\n<h3>In Short</h3>\n<p>In healthy individuals, with properly-functioning kidneys, no medical implants, no improperly-done tattoos, and no metal embedded in the body, MRIs are completely safe, once or even quite often.</p>\n", "score": 44 }, { "answer_id": 24, "body": "<p>While they're sometimes confused by the public, X-Ray CT (computed tomography) and MRI (magnetic resonance imaging) work by entirely different priniciples. X-Ray radiation is harmful, and any unnecessary exposure should be limited. MRI works by putting the subject into a very strong magnetic field and using radiowaves to excite specific nuclei. </p>\n\n<p>The potential dangers of MRI are equivalent to the dangers of strong magnetic fields and radiowaves (and potentially any contrast medium that is used, which can cause allergic reactions). </p>\n\n<p><a href=\"\">According to the FDA:</a></p>\n\n<blockquote>\n <p>There are no known harmful side-effects associated with temporary exposure to the strong magnetic field used by MRI scanners. </p>\n</blockquote>\n\n<p>Due to the strong magnetic field you need to avoid bringing any metal objects near the MRI, they will be attracted by the magnet and become dangerous projectiles.</p>\n", "score": 28 } ]
<p>The following tooth cracks are noticeable when a torch is shining on them (without the torch, they aren't visible). Are they serious? How viable are the teeth, and might they need to be replaced with false teeth in the near future? There is no pain experienced, but they seem to look quite bad:</p> <p><img src="" alt="Teeth 1"> <img src="" alt="Teeth 2"></p>
What are these lines in teeth?
[ "dentistry" ]
CC BY-SA 3.0
[ { "answer_id": 14, "body": "<p>I believe that those lines are craze lines. <strong>\"Craze lines are merely cracks in the enamel that do not extend into the dentin.\"</strong> They occur because of stress in your teeth, ie: grinding your teeth, biting your nails, and even routine use of your teeth. What you've said also matches up with craze lines in that you don't experience any pain. Those craze lines aren't nearly as bad as some other teeth. Craze lines rarely lead to tooth breakdown, so you almost definitely won't have to get them replaced. There are some studies that say that craze lines may be spots where cavities can form, but these potential problems can be easily detected by dentists.</p>\n\n<p>Most craze lines, like the ones below, are much worse than yours.</p>\n\n<p><img src=\"\" alt=\"Craze Lines\"></p>\n\n<hr>\n\n<p><a href=\"\" rel=\"noreferrer\"><sup>Craze Lines: Hairline Cracks In Your Front Teeth\n</sup></a></p>\n", "score": 35 } ]
<p>I love all kinds of <a href="" rel="noreferrer">pungent</a> food such as chili peppers etc., the hotter the better.</p> <p>I'd like to know, are there any significant dangers or benefits related to consuming them?</p> <p><img src="" alt="enter image description here"> <img src="" alt="enter image description here"> <img src="" alt="enter image description here"> <img src="" alt="enter image description here"></p>
Is eating spicy hot (pungent) food (hot chilli &amp; peppers etc.) healthy or harmful?
[ "nutrition", "risks", "benefits", "healthy-cooking" ]
CC BY-SA 3.0
[ { "answer_id": 180, "body": "<p>Obviously some spicy foods are better for you than others, but I am assuming you want an answer about spicy foods in general. </p>\n\n<p>One of the biggest benefits of eating spicy foods, especially chili peppers, is that it helps you lose weight. Spicy foods help to raise your metabolic rate, which will slow down your weight gain. If you eat spicy foods often, the effects add up.<sup>1</sup></p>\n\n<p>A 2007 study by Nottingham University<sup>2</sup> found that spicy foods can help kill cancer cells. Capsaicin, which is what makes many foods spicy, attacks the mitochondria of the cancer cells, triggering their death. </p>\n\n<p>Spicy foods have also been found to help decongest your sinuses. A 1998 study<sup>3</sup> found that a capsaicin nasal spray helped to clear the sinuses of people. Eating spicy foods has been known to have a similar effect.<sup>4</sup></p>\n\n<hr>\n\n<p>Now for some risks of eating spicy food.</p>\n\n<p>When you are eating spicy foods, there are only a few risks to watch out for. Spicy foods have been known as foods that can trigger heartburn, so anyone with heartburn should avoid them.<sup>5</sup> Some spicy foods that don't contain capsaicin, like horseradish, can sometimes damage tissue.<sup>6</sup></p>\n\n<p>There are usually more risks when handling spicy foods, especially peppers. If pepper juice gets in your eye, it will cause pain and possibly swelling. If this ever happens, there are ways to flush out your eyes.<sup>7</sup> Handling peppers and sometimes horseradish before eating can cause pain, swelling, redness, and irritation in your hand. To avoid this, wear gloves when cutting peppers and wash your hands thoroughly after (washing with milk will help).<sup>6</sup></p>\n\n<hr>\n\n<p><sup>[1] <a href=\"\" rel=\"noreferrer\">Chili Peppers May Solve Obesity Epidemic</a></sup></p>\n\n<p><sup>[2] <a href=\"\" rel=\"noreferrer\">How spicy foods can kill cancers</a></sup></p>\n\n<p><sup>[3] <a href=\"\" rel=\"noreferrer\">The long-term effects of capsaicin aqueous spray on the nasal mucosa</a></sup></p>\n\n<p><sup>[4] <a href=\";pg=PA230&amp;dq=spicy+food+sinuses&amp;hl=en&amp;ei=LNFBTuucJK_WiALql92nBQ&amp;sa=X&amp;oi=book_result&amp;ct=result&amp;resnum=3&amp;ved=0CDUQ6AEwAg#v=onepage&amp;q=spicy%20food%20sinuses&amp;f=false\" rel=\"noreferrer\">Diseases of the Sinuses: A Comprehensive Textbook of Diagnosis and Treatment</a></sup></p>\n\n<p><sup>[5] <a href=\"\" rel=\"noreferrer\">Heartburn Prevention Tips for Spicy Food Lovers</a></sup></p>\n\n<p><sup>[6] <a href=\"\" rel=\"noreferrer\">Can Eating Extremely Spicy Food Be Harmful to Your Health?</a></sup></p>\n\n<p><sup>[7] <a href=\"\">Removing Pepper Juice From Eyes</a></sup></p>\n", "score": 42 }, { "answer_id": 403, "body": "<p>The chilli pepper is usually referred to plants from the genus Capsicum and the substances that give chili peppers their intensity when ingested or applied topically are <a href=\"http://capsaicin\" rel=\"noreferrer\">capsaicin</a> and several related (called as <a href=\"\" rel=\"noreferrer\">capsaicinoids</a>).</p>\n<p>Health benefits of eating chilli peppers can include:</p>\n<ul>\n<li><p><a href=\"\" rel=\"noreferrer\">Chilli peppers 'help to burn fat'</a> (<a href=\"\" rel=\"noreferrer\">study</a>)</p>\n<blockquote>\n<p>The effects of capsaicin, the chemical that makes peppers and chillies hot, have been studied again in a small trial investigating what effects hot red (cayenne) pepper has on energy expenditure, body temperature and appetite.</p>\n</blockquote>\n</li>\n</ul>\n\n<ul>\n<li><a href=\"\" rel=\"noreferrer\">Chillies lower blood pressure.</a><sup><a href=\"\" rel=\"noreferrer\">2010</a></sup></li>\n<li>Effects on gastric emptying and intestinal transit<sup><a href=\"\" rel=\"noreferrer\">1992</a></sup>.</li>\n</ul>\n<p>Nutritional value (per 1 pepper ~45g):</p>\n<ul>\n<li>Vitamin C: 181%</li>\n<li>Vitamin A: 10%</li>\n<li>Vitamin B-6: 5%</li>\n<li>Iron: 2%</li>\n<li>Magnesium: 2%</li>\n</ul>\n<p>Yellow and green chilies (which are essentially unripe fruit) contain lower amount of carotene and vitamin C substances.</p>\n", "score": 12 }, { "answer_id": 5008, "body": "<p>Red chilies contain large amounts of vitamin C and small amounts of carotene (provitamin A). Yellow and especially green chilies (which are essentially unripe fruit) contain a considerably lower amount of both substances. In addition, peppers are a good source of most B vitamins, and vitamin B6 in particular. They are very high in potassium, magnesium, and iron. Their very high vitamin C content can also substantially increase the uptake of non-heme iron from other ingredients in a meal, such as beans and grains.</p>\n\n<p>A very large study published by the British Medical Journal found some indications that humans who consume spicy foods, especially fresh chili peppers, were less likely to die of cancer or diabetes</p>\n\n<p><strong>Sources:</strong> </p>\n\n<ul>\n<li><a href=\"\" rel=\"noreferrer\"></a></li>\n<li><a href=\"\" rel=\"noreferrer\"></a></li>\n</ul>\n", "score": 12 }, { "answer_id": 15118, "body": "<p>There is one exception that has not been mentioned. There is a condition called Cholinergic Urticaria, which is hives due to excess heat and sweat. It is in the category of physical allergies, and more information can be found here: <a href=\"\" rel=\"nofollow noreferrer\">Medscape Cholinergic Urticaria</a>. One of the triggers is spicy food. This <a href=\"\" rel=\"nofollow noreferrer\">article</a> explains that dietary changes that remove foods that elevate the body temperature help tame the symptoms. Removing capsaicin foods eliminates a trigger for these reactions.</p>\n", "score": 3 } ]
<p>It's been argued by various medical organizations that male circumcision has various medical benefits, such as reducing the risk of catching HIV, or reducing the risk of urinary tract infections, for instance. Are there any respectable scientific studies to back these assertions up?</p>
Are there any health benefits to male circumcision?
[ "urology" ]
CC BY-SA 3.0
[ { "answer_id": 18, "body": "<p>There is evidence that neonatal circumcision saying that the benefits of circumcision outweigh the risks.</p>\n\n<p>According to a study done on neonatal circumcision<sup>[1]</sup>, the lifetime benefits of being circumcised outweighed the risks 100 to 1. Some of the risks people may associate with circumcision are very unlikely. Excessive bleeding only happens 0.1% of the time, infections 0.02% of the time, and loss of penis 0.0001% of the time. The percentage of death is only 0.00001%. </p>\n\n<p>Overall, it shows that males who have been circumcised require half as much medical attention as males who have not been circumcised. Also, the overall risk of circumcised men having serious medical implications is 1 to 5000; this includes things like HIV and other sexually transmitted diseases. </p>\n\n<p><a href=\"\">This graph</a> contains other relevant information.</p>\n\n<p>There are some people who disagree with the article mentioned above.<sup>[2]</sup> In a direct statement against the article, it is said that the article is \"marred by bias.\" They note how the article fails to mention many things, such as statements against circumcision and harms in sexual experience. It doesn't completely refute the article that says circumcision is beneficial, but it is something good to think about.</p>\n\n<hr>\n\n<p><sup>[1] <a href=\"\">Circumcision Rates</a></sup></p>\n\n<p><sup>[2] <a href=\"\">Bias and Male Circumcision</a></sup></p>\n", "score": 26 }, { "answer_id": 427, "body": "<p>There is some evidence which supports that male circumcision reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa<sup><a href=\"\">(1)</a>,<a href=\"\">(2)</a></sup>, however the evidence of an HIV benefits for men who have sex with men is less clear<sup><a href=\"\">(3)</a>,<a href=\"\">(4)</a></sup> and its use to prevent HIV in the developed world is unclear either<sup><a href=\"\">(5)</a></sup>.</p>\n\n<p>The treatment option for pathological phimosis, refractory balanoposthitis and UTIs is only contraindicated in cases of certain genital structure abnormalities or poor general health<sup><a href=\"\">(6)</a>,<a href=\"\">(7)</a></sup>.</p>\n\n<p>WHO recommends considering circumcision as part of a comprehensive HIV program only in areas with high rates of HIV (e.g. Africa)<sup><a href=\"\">(8)</a>,<a href=\"\">(9)</a></sup>.</p>\n\n<p>Therefore if you're not living in Africa or areas with high rates of HIV, the potential risks outweighs health benefits associated with circumcision. As currently no major medical organization recommends non-therapeutic neonatal circumcision, and no major medical organization calls for banning it either.</p>\n\n<p>See also: <a href=\"\">Circumcision</a> at Wikipedia</p>\n", "score": 20 }, { "answer_id": 15635, "body": "<p>Circumcision is a form of sexual mutilation performed on male infants usually for religious reasons unrelated to putative health benefits. The claim of reduced risk for HIV infection is supported by this <a href=\"\" rel=\"nofollow noreferrer\">Cochrane review</a> but applies to Africa. Another review looked at urinary tract infections and found <a href=\"\" rel=\"nofollow noreferrer\">insufficient data</a> to draw conclusions.</p>\n\n<p>Circumcision has traditionally been conducted without analgesia and there are some data to suggest <a href=\"\" rel=\"nofollow noreferrer\">stress related manifestations</a> develop in these children compared with the uncircumcised. Furthermore, there have been well publicised <a href=\"\" rel=\"nofollow noreferrer\">deaths</a> resulting from the traditional Jewish practice of sucking on the foreskin to prevent bleeding causing herpes. In any other jurisdiction, this could be considered paedophilia.</p>\n\n<p>Interestingly Iceland is looking to <a href=\"\" rel=\"nofollow noreferrer\">ban</a> neonatal circumcision.</p>\n", "score": 5 } ]
<p>There is a popular perception, and many marketing claims, that organic produce (and food in general) is <strong>healthier</strong> than food grown with conventional methods.</p> <p>Most commonly, the reasons given are: less or no pesticide use, lack of synthetic/chemical pesticides and herbicides, no artificial growth hormones, genetic modification, or other "interference" with nature, and higher nutritional content due to better soil conditions and better/natural fertilizers.</p> <p>Are there any studies that back up these claims?</p>
Are organic foods healthier than conventional foods?
[ "diet", "nutrition" ]
CC BY-SA 3.0
[ { "answer_id": 385, "body": "<p><strong>TL;DR</strong> - Organic foods don't seem to have a significant difference as of what studies can prove, which is why conventional or organic, people should make sure they're getting the proper nutrients that their bodies need.</p>\n\n<hr>\n\n<p><strong>Brief History of Pesticide Usage</strong></p>\n\n<p>The first recorded use of insecticides is about 4500 years ago by Sumerians who used sulphur compounds to control insects and mites, whilst about 3200 years ago the Chinese were using mercury and arsenical compounds for controlling body lice. In the 1920s there were even cases of using arsenic, which was replaced by DDT usage until the new chemical was discovered to have severe consequences (harm to <a href=\"\">non-target plants and animals</a> as well as problems with <a href=\"\">residues</a>). DDT is linked with cancer, endocrine disruption, and reproductive and developmental effects. Over time, people began to switch to organic pesticides to get away from the health scares (or threats) of these synthetic chemicals.</p>\n\n<p>To address the question, we should first be clear about what organic means.</p>\n\n<p><strong>Regarding produce:</strong></p>\n\n<blockquote>\n <p>Contrary to what most people believe, \"organic\" does not automatically mean \"pesticide-free\" or \"chemical-free\" ... it means that these pesticides, if used, must be derived from natural sources, not synthetically manufactured.</p>\n</blockquote>\n\n<p><strong>Regarding Farmed Meats (some of the key requirements):</strong></p>\n\n<ul>\n<li>Must be raised organically on certified organic land</li>\n<li>Must be fed certified organic feed</li>\n<li>No antibiotics or added growth hormones are allowed*</li>\n<li>Must have outdoor access</li>\n</ul>\n\n<p>Organic food covers a wide variety of techniques and different types of foods that all have their own types of legal loop-holes, or possible work-around strategies.</p>\n\n<p>There are many pesticides that are naturally produced by plants which farmers use, but that doesn't mean they aren't dangerous. In contrast, just because a pesticide is synthetic doesn't immediately indicate that it's more dangerous than natural products. Some pesticides that are approved by the government may be harmless in small quantities, but when organic producers attempt to refuse these, they may turn to alternatives that are even more dangerous, just to keep the label \"organic\".</p>\n\n<p>In another case, farmers could claim \"natural methods are insufficient to address critical issues of production\", and then treat their animals with antibiotics while still calling the meat organic.</p>\n\n<p>On the other side of this issue, some people argue that the less chemicals we consume in general, the better. Even if they might be government approved, that doesn't prove they're completely non-toxic.</p>\n\n<p>The Stanford paper claim that there just isn't enough evidence to prove a significant difference in health benefits/risks. They don't necessarily have more nutrients, decrease the risk of any diseases, or have higher nutritional content except for phosphorus, which most people get enough of anyways. However, the study <em>does</em> suggest organic foods contain less pesticides. The health risks of consuming less pesticides though, <strong>are still contested</strong>. \"Additionally, organic chicken and pork appeared to reduce exposure to antibiotic-resistant bacteria, <strong>but the clinical significance of this is also unclear</strong>.\"</p>\n\n<p><strong>Well what about taste?</strong></p>\n\n<blockquote>\n <p>Taste is to a large extent subjective. Add to that\n different varieties, different weather conditions, different soil\n types and different soil management practices...</p>\n</blockquote>\n\n<p><a href=\"\"> - Does Organically Grown Food Taste Better?</a></p>\n\n<p>It's nearly impossible to give a definitive answer of which tastes better. To pile onto the confusion, it's possible that the taste differences touted by some may simply derive from a <a href=\"\">\"health halo\"</a>.</p>\n\n<p><strong>Genetically Modified Organisms</strong></p>\n\n<p>In response to the scares involved with pesticides in general, people began to research methods to minimize the amount of pesticide used. Basically, DNA from an external source is inserted into a plant so that the plant inherits some desirable traits. This allowed plants to develop natural immunities to certain bacteria and produce more or bigger produce. Over time, people became scared of GMOs as too good to be true. For the most part, scientists agree that GMOs pose no greater risk than conventional food (<a href=\"\">Expert evaluations from Europe found no verifiable toxic or deleterious effects from GM foods and crops</a>). There are still legitimate concerns about using GMOs, such as allergy development in humans, toxicity levels of naturally produced pesticides in the plant, and <a href=\"\">antibiotic resistance</a> of bacteria, but for the most part these are tested before distribution. Public wariness may be influenced by <a href=\"\">labels and commercialism.</a></p>\n\n<p><a href=\"\"><strong>Secondary Effects of Organic Farming</strong></a></p>\n\n<p>Organic farming is good for the environment in the sense that it often leads to less pollution. Pesticides on crops often run-off into streams and rivers, interfering and even hurting local wildlife, but with organic pesticides, the chemicals decompose faster before they can cause massive change to their environment. There may be other potential benefits, but to feed the immense population that exists on earth, many debate whether organic farming is truly sustainable. </p>\n\n<p><strong>\"Healthier\" depends on the context of the food:</strong> </p>\n\n<p>How much pesticide is being used? How much exposure becomes a detriment? Does it have long-term consequences? What are the loopholes that producers are using?</p>\n\n<p>So when you say \"organic\" and \"conventional\" it really depends on the process, producer, and product- all of which need to be studied in more detail to develop solid claims. </p>\n\n<p><strong>Citations:</strong></p>\n\n<p>History of Pesticides:</p>\n\n<ul>\n<li><p><a href=\";sobi2Task=sobi2Details&amp;catid=3&amp;sobi2Id=31\">IUPAC - History of Pesticide Use</a></p></li>\n<li><p><a href=\"\">Oregon State - History of Pesticide Use</a></p></li>\n<li><p><a href=\"\">Pesticide Usage in the United States: History, Benefits, Risks, and Trends</a></p></li>\n<li><p><a href=\"\">Toxipedia - DDT</a></p></li>\n</ul>\n\n<p>GMOs</p>\n\n<ul>\n<li><a href=\"\">Wikipedia - Genetically Modified Organism</a></li>\n</ul>\n\n<p>Secondary Effects of Organic Farming:</p>\n\n<ul>\n<li><a href=\"\">FAO - What are the environmental benefits of organic agriculture?</a></li>\n</ul>\n\n<p>Modern Pesticide Usage:</p>\n\n<ul>\n<li><p><a href=\"\">Stanford Researchers - Are Organic Foods Safer or Healthier Than Conventional Alternatives?: A Systematic Review</a></p></li>\n<li><p><a href=\"\">Harvard - Organic food no more nutritious than conventionally grown food</a></p></li>\n<li><p><a href=\"\">Stanford - Little evidence of health benefits from organic foods, study finds</a></p></li>\n<li><p><a href=\"\">Pesticide Use Regulations on ORGANIC Fruit and Vegetable Farms</a></p></li>\n<li><p><a href=\"\">Pesticide Politics</a></p></li>\n<li><p><a href=\"\">Science 20 - The Muddled Debate About Pesticide and GM Crops</a></p></li>\n</ul>\n", "score": 28 }, { "answer_id": 609, "body": "<p>In Mathematics, the <em>Annals of Mathematics</em> is the most sought after journal to have your research accept to. The article of research on this topic I am presenting was published in the <em>Annals of Internal Medicine</em>. However, I don't know if it carries the same weight. If it does, then we can rest assure that this research was meticulously scrutinized and still was able to earn a spot in the journal.</p>\n\n<p>Dr.s Crystal Smith-Spangler, Margaret L. Brandeau, Hau Lui, Patricia Schirmer, Ingram Olkin, and Dean Bravata along with Grace E. Hunter, Clay Bavinger, Maren Pearson, Vandana Sundaram, and Christopher came to the conclusion that </p>\n\n<blockquote>\n <p>Published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods. Consumption of organic foods may reduce exposure to pesticides residues and antibiotic-resistant bacteria [<a href=\"\">1</a>].</p>\n</blockquote>\n\n<p>in Are Organic Foods Safer or Healthier Than Conventional Alternatives? A Systematic Review. </p>\n\n<p>This was a non-funded study so sponsorship bias shouldn't play a role in the outcome of their work. The researchers collected data from MEDLINE, EMBASE, CAD Direct, Agricola, TOXNET, Cochrane Library, and bibliographies of retrieved articles from 1966 to 2011.</p>\n\n<p>The studies findings on Vitamin and Nutrient Levels by Food Origin:</p>\n\n<ul>\n<li>Vitamins\n<ul>\n<li>They did not find significant differences in the vitamin content of organic and conventional plant of animal products</li>\n</ul></li>\n<li>Nutrients\n<ul>\n<li>Out of the 11 nutrients reported only 2 were significantly higher in organic compared to conventional.\n<ul>\n<li>Phosphorous but the removal of one study rendered the effect size insignificant.</li>\n<li>Omega-3 fatty acids in milk and chicken</li>\n</ul></li>\n</ul></li>\n</ul>\n\n<hr>\n\n<ul>\n<li>Contaminants\n<ul>\n<li>Pesticides: detectable pesticides residues were found in 7% of organic produces and 38% of conventional produces. Organic was 30% less likely to have pesticide residue but the results statistically heterogeneous due variable levels of detection in the studies. Additionally, only three studies reported contamination exceeding maximum allowed limits.</li>\n<li>Bacterial\n<ul>\n<li>E. Coli: 7% organic; 6% conventional which is not a statistically significant difference</li>\n<li>Campylobacter in chicken: 67% organic; 64% conventional</li>\n<li>Salmonella in chicken: 35% organic; 34% conventional</li>\n<li>E. Coli in pork: 65% organic; 49% conventional</li>\n<li>Listeria monocytogenes: 3% organic; 4% conventional</li>\n</ul></li>\n</ul></li>\n<li>Antibiotic Resistance: the risk of isolating bacteria resistant to three or more antibiotics was 33% higher in conventional chicken and pork. Bacteria from retail chicken and pork had a 35% lower risk of resistance to ampicillin but the removal of one study rendered it statistically insignificant. However, of the remaining bacteria, greater resistance among bacteria from conventional methods was statistically insignificant.</li>\n<li>Fungal Toxin and Heavy Metal\n<ul>\n<li>Ochratoxin: no difference</li>\n<li>Deoxynivalenol: lower risk in organic</li>\n<li>Cadmium or lead: no difference</li>\n</ul></li>\n</ul>\n\n<p>Moreover, the researchers found publication bias in many of the articles over the 45 year period. In the discussion, the researchers write:</p>\n\n<blockquote>\n <p>Consumers purchase organic foods for many reasons. Despite the widespread perception that organically produced foods are more nutritious than conventional alternatives, we did not find robust evidence to support this perception. Only phosphorous demonstrated superiority in organic foods... although it is unlikely to be clinically significant because near-total starvation is needed to produce dietary phosphorous deficiency.</p>\n</blockquote>\n\n<p>The researchers also admit to their own publication bias:</p>\n\n<blockquote>\n <p>Studies were heterogeneous and limited in number, and publication bias may be present. </p>\n</blockquote>\n\n<p>Finally, the Mayo Clinic appears to stand by the research given in this article [<a href=\";pg=1\">2</a>].</p>\n\n<h2>Definitions</h2>\n\n<ol>\n<li>Statistically heterogeneous: the ideals were not fully met</li>\n</ol>\n", "score": 9 }, { "answer_id": 591, "body": "<p>The more healthy can be defined in terms of nutritional value, sensory quality, and food safety.</p>\n\n<p>As we know the potential long-term health effects of exposure to pesticides can include: cancer, neurotoxic effects and many more<sup><a href=\"\" rel=\"nofollow noreferrer\">wiki</a></sup>, because the pesticides needs to be toxic to kill pests. However under the FQPA, EPA has the authority to ensure that all pesticides meet the safety standards by setting permittable <em>tolerance</em> levels and it's testing carcinogenicity of chemicals as part of <a href=\"\" rel=\"nofollow noreferrer\">the Carcinogenic Potency Project</a>.</p>\n\n<p>Washing and peeling conventional fruits and vegetables has only limited effect by reducing the levels of pesticides only from the surface as per USDA test data<sup><a href=\"\" rel=\"nofollow noreferrer\">1999</a></sup>, but some plants can absorb pesticides systemically<sup><a href=\"\" rel=\"nofollow noreferrer\">EWG</a></sup>.</p>\n\n<p>Older studies comparing different type of foods were inconsistent. For example <a href=\"\" rel=\"nofollow noreferrer\">study from 2002</a> showed no strong evidence that organic and conventional foods differ in concentrations of various nutrients and microbiological contamination.</p>\n\n<p>The more recent study from 2006 of comparison of chemical composition and nutritional value of organically and conventionally grown plant showed that <strong>organic crops contain a significantly higher amount of certain antioxidants</strong> (vitamin C, polyphenols and flavonoids), higher dry matter content and minerals with lower level of pesticide residues, nitrate and some heavy metal contaminations. Therefore there is is a relationship between these two plant production systems and the nutritional composition of crops<sup><a href=\"\" rel=\"nofollow noreferrer\">2006</a></sup>.</p>\n\n<blockquote>\n <p>Consequently, it can be concluded that organically produced plant derived food products have <strong>a higher nutritional value, including antioxidants than conventional ones</strong>. Furthermore, due to the fact that there is a <strong>lower level of contamination</strong> in organic crops, the risk of diseases caused by contaminated food is significantly reduced.</p>\n</blockquote>\n\n<p>This was confirmed by <a href=\"\" rel=\"nofollow noreferrer\">meta-analysis of 343 studies in 2014</a>.</p>\n\n<blockquote>\n <p>In conclusion, <strong>organic crops, on average, have higher concentrations of antioxidants, lower concentrations of Cd and a lower incidence of pesticide residues</strong> than the non-organic comparators across regions and production seasons.</p>\n \n <p>Additionally, the frequency of occurrence of pesticide residues was found to be four times higher in conventional crops, which also contained significantly higher concentrations of the toxic metal Cd.</p>\n</blockquote>\n\n<p>The summary of this meta-study and antioxidant activity in ORG/CONV food can be shown in the following figures:</p>\n\n<p><img src=\"\" alt=\"Results of the standard unweighted and weighted meta-analyses for antioxidant activity\"></p>\n\n<p><img src=\"\" alt=\"Results of the standard unweighted and weighted meta-analyses for different crop types/products for antioxidant activity\"></p>\n\n<p><sup>Image source: Br J Nutr. 2014 Sep 14; 112(5): 794–811, <a href=\"\" rel=\"nofollow noreferrer\">Fig. 3</a> &amp; <a href=\"\" rel=\"nofollow noreferrer\">Fig. 4</a></sup></p>\n\n<hr>\n\n<p>Based on above we can say that organic foods are more healthy than the conventional ones, because of:</p>\n\n<ul>\n<li><p>significant differences of minerals and vitamins:</p>\n\n<ul>\n<li>a higher nutritional value,</li>\n<li>higher antioxidant concentrations (vitamin C, polyphenols and flavonoids),</li>\n</ul></li>\n<li>lower incidence of pesticide residues,</li>\n<li>lower concentration of toxic/heavy metals (around 4 times less).</li>\n</ul>\n\n<p>However it can vary on agronomic practices/protocols and <a href=\"\" rel=\"nofollow noreferrer\">soil pollution</a> which can affect crop composition.</p>\n\n<p><sup>See also: <a href=\"\" rel=\"nofollow noreferrer\">Organic food: Chemical composition</a> &amp; <a href=\"\" rel=\"nofollow noreferrer\">Pesticide residue</a> at Wikipedia</sup></p>\n", "score": 4 } ]
<p>It seems the question of vaccine harm has been around at least as long as vaccines<sup><a href="">1</a></sup>. Specifically, the claim that vaccines can cause or contribute to autism has been hotly debated in the last decade. Many claim that there is a dangerous (possibly hidden) link.</p> <p>What is the current state of medical research on this topic? Could there be a conspiracy in the pharmaceutical industry to cover up a link?</p>
Do vaccines cause autism?
[ "vaccination", "autism" ]
CC BY-SA 3.0
[ { "answer_id": 361, "body": "<p>This has been a controversial dispute for a long time and it can involve a lot of personal opinion, but I will try to answer this as scientifically as possible.</p>\n<p>There hasn't been any viable evidence that vaccines do cause autism. Several different theories have been proposed on why vaccines could cause autism, such as the ingredient in some vaccines thimerosal being harmful, but these have all been disproved by many different experiments.</p>\n<p>Many reliable sources such as the <a href=\"\" rel=\"noreferrer\">CDC<sup>1</sup></a> says that there is no link between autism an vaccines. A <a href=\"\" rel=\"noreferrer\">2011 report<sup>2</sup></a> from the Institute of Medicine that tested 8 different vaccines on both adults and children showed that the vaccines are very safe.</p>\n<blockquote>\n<p>A <a href=\"\" rel=\"noreferrer\">2013 CDC study<sup>3</sup></a> added to the research showing that vaccines do not cause ASD. The study looked at the number of antigens (substances in vaccines that cause the body’s immune system to produce disease-fighting antibodies) from vaccines during the first two years of life. The results showed that the total amount of antigen from vaccines received was the same between children with ASD and those that did not have ASD.</p>\n</blockquote>\n<p>The CDC has also funded many other studies on vaccine ingredients and their links to autism, especially <a href=\"\" rel=\"noreferrer\">thimerosal<sup>4</sup></a>, a mercury-based ingredient used in some vaccines. These studies have shown &quot;no link between thimerosal-containing vaccines and ASD, as well as no link between the measles, mumps, and rubella (MMR) vaccine and ASD in children.&quot;</p>\n<p><a href=\"\" rel=\"noreferrer\">Full list of CDC studies on the link between vaccines and autism<sup>5</sup></a></p>\n<p>These are pretty convincing, but you can't just rely on one source, right?</p>\n<hr />\n<p><a href=\"\" rel=\"noreferrer\">An issue in the Oxford Journal<sup>6</sup></a> also shows how even though there have been many claims that vaccines do cause autism, there aren't any studies that help support this claim.</p>\n<blockquote>\n<p>A worldwide increase in the rate of autism diagnoses—likely driven by broadened diagnostic criteria and increased awareness—has fueled concerns that an environmental exposure like vaccines might cause autism. Theories for this putative association have centered on the measles-mumps-rubella (MMR) vaccine, thimerosal, and the large number of vaccines currently administered. However, both epidemiological and biological studies fail to support these claims.</p>\n</blockquote>\n<p><a href=\"\" rel=\"noreferrer\">One study that took place in the UK from 1979-1992<sup>7</sup></a> found that even though there was an increase in cases of autism, there was no jump in the amount of cases when the measles-mumps-rubella (MMR) vaccine, another controversial vaccine, was introduced in 1988.</p>\n<p><a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">A 2003 study in metropolitan Atlanta<sup>8</sup></a>, Georgia compared the ages that the MMR vaccine was given in children with autism against the age that children without autism received it. The results were that the proportion of time that children were vaccinated in both control groups was similar.</p>\n<p>The Oxford Journal entry mentioned many other studies that tested the link between MMR vaccines and autism and there has been no plausible evidence.</p>\n<p>The other vaccine ingredient that is also said to cause autism is thimerosal, which I mentioned before. The Oxford Journal issue also shows studies about this link.</p>\n<p><a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">A study in Finland<sup>9</sup></a> helped show that there wasn't a link between thimerosal and autism. In fact, cases of autism increased in 1992 after thimerosal-containing vaccines were discontinued.</p>\n<p><a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">Another study in the UK<sup>10</sup></a> also disproved the theory that thimerosal causes autism. They actually found that thimerosal-containing vaccines might even have a beneficial effect in children.</p>\n<p>There have also been many other studies that invalidate the link between thimerosal and autism.</p>\n<p>One last theory that has been proposed is that multiple vaccines being administered to a child simultaneously can weaken their immune system and cause autism. This theory is flawed for several reasons.</p>\n<p><a href=\"\" rel=\"noreferrer\">This article<sup>11</sup></a> used data from many studies and found that vaccines do not overwhelm and weaken an infant's immune system. Infants are able to respond well to the many vaccines that are given to them.</p>\n<p><a href=\"\" rel=\"noreferrer\">Another study<sup>12</sup></a> found that vaccines did not weaken the immune system to any diseases. They were unable to find consistent relationship between infectious diseases and immunization.</p>\n<hr />\n<p>All of this scientific evidence leaves one question left to be answered.</p>\n<p><strong>Why do any people believe that vaccines cause autism?</strong> (this part will get some more opinion then you may like, but it is necessary)</p>\n<p><a href=\"\" rel=\"noreferrer\">A fraudulent 1998 study<sup>13</sup></a> by Andrew Wakefield and colleagues was one of the main reasons that this controversy over vaccines and autism began. It <a href=\"\" rel=\"noreferrer\">used falsified data<sup>14</sup></a> to support their claim that the MMR vaccine caused developmental problems and other autism symptoms. This study has since been retracted as it was demonstrated to be false. Dr. Wakefield, a physician in the UK, was struck off the Medical Registry due to his participation in this fraud.</p>\n<p><a href=\"\" rel=\"noreferrer\">WebMD<sup>15</sup></a> also talks about why there are still some people that believe that vaccines are the cause of autism.</p>\n<blockquote>\n<p>And when something bad happens to a child, people demand to know what or whom is to blame. &quot;Parents are clamoring for a cause,&quot; says David Tayloe, MD, a pediatrician in Greensboro, N.C., and president-elect of the American Academy of Pediatrics (AAP).</p>\n<p>&quot;It's a terrible condition. It upsets families, and it upsets me.&quot; But all the fear and anger about vaccines is misplaced, he says. &quot;There's just nothing there.&quot;</p>\n</blockquote>\n<p>It seems most people who claim that vaccines cause autism are just looking for something to blame for what is happening to children. Many parents may become angry when they find out their child has autism, and they put that anger against vaccines.</p>\n<p>There are some logical arguments that people may present, such as changing of their child's behavior after receiving vaccines. This is mostly coincidence, as most children are vaccinated around the same time autism symptoms begin to appear (usually 12-18 months)<sup><a href=\"\" rel=\"noreferrer\">16</a></sup>. Other than this and some of the arguments mentioned earlier, there is almost no reason to believe that vaccines cause autism.</p>\n<hr />\n<p><sup>[<a href=\"\" rel=\"noreferrer\">1</a>] <a href=\"\" rel=\"noreferrer\">CDC - Vaccines Do Not Cause Autism</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">2</a>] <a href=\"\" rel=\"noreferrer\">Adverse Effects of Vaccines: Evidence and Causality</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">3</a>] <a href=\"\" rel=\"noreferrer\">Increasing Exposure to Antibody-Stimulating Proteins and Polysaccharides in Vaccines Is Not Associated with Risk of Autism</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">4</a>] <a href=\"\" rel=\"noreferrer\">CDC - Frequently Asked Questions About Thimerosal</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">5</a>] <a href=\"\" rel=\"noreferrer\">CDC - Vaccines and Autism: A Summary of CDC Conducted or Sponsored Studies</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">6</a>] <a href=\"\" rel=\"noreferrer\">Vaccines and Autism: A Tale of Shifting Hypotheses</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">7</a>] <a href=\"\" rel=\"noreferrer\">Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association</a></sup></p>\n<p><sup>[<a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">8</a>] <a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta</a></sup></p>\n<p><sup>[<a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">9</a>] <a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data</a></sup></p>\n<p><sup>[<a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">10</a>] <a href=\";keytype2=tf_ipsecsha\" rel=\"noreferrer\">Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">11</a>] <a href=\"\" rel=\"noreferrer\">Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">12</a>] <a href=\"\" rel=\"noreferrer\">DTP Immunization and Susceptibility to Infectious Diseases</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">13</a>] <a href=\"\" rel=\"noreferrer\">RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">14</a>] <a href=\"\" rel=\"noreferrer\">The MMR vaccine and autism: Sensation, refutation, retraction, and fraud</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">15</a>] <a href=\"\" rel=\"noreferrer\">WebMD - Autism-Vaccine Link: Evidence Doesn't Dispel Doubts</a></sup></p>\n<p><sup>[<a href=\"\" rel=\"noreferrer\">16</a>] <a href=\"\" rel=\"noreferrer\">When do children usually show symptoms of autism spectrum disorder (ASD)?</a></sup></p>\n", "score": 60 }, { "answer_id": 565, "body": "<p>You have already gotten an excellent answer on the scientific evidence for the autism-vaccination link (namely, that there isn't one). I would however like to address this part of your question directly, as an academic epidemiologist:</p>\n\n<blockquote>\n <p>Could there be a conspiracy in the pharmaceutical industry to cover up\n a link?</p>\n</blockquote>\n\n<p>No.</p>\n\n<p>It is a relatively common tactic in the various denial communities (vaccines, HIV, climate change, etc.) to posit that a major conspiracy exists to hide the truth, and thus explain away the utter lack of evidence for their position. But one should consider what that kind of conspiracy would actually entail.</p>\n\n<p>First, a number of researchers into vaccine safety are <em>not</em> paid by pharmaceutical companies. Which means they don't particularly have any financial incentive to play along.</p>\n\n<p>Second, some of the scientific evidence for the lack of a link between autism and vaccines emerges from birth cohorts in countries with a national health registry, <a href=\"\">such as this study</a>. The authors report no pharmaceutical funding (nor would they need it for a registry study), so for this study a conspiracy would not only have to involve researchers who are not compensated, but the suborning of an entire national health registry.</p>\n\n<p>Finally, even absent financial incentives, a conspiracy to hide the truth is actively counter to the incentives that researchers <em>do</em> have. Null results, like \"nope, vaccines still not associated with autism...\" are not exactly amazing results. Controversial ideas that turn out to be true, like the link between HPV and cancer, even if they're an uphill battle, win people <a href=\"\">Nobel Prizes</a>. Actually figuring out the causal mechanism of autism? That's a potentially career changing result. Getting an entire <em>field</em> and the healthcare systems of entire countries to take a pass in favor of pharmaceutical profits that those researchers don't get a share in? That's well outside the realm of possibility.</p>\n", "score": 29 }, { "answer_id": 15728, "body": "<p>Perhaps the question should be asked, <strong><em>can vaccines prevent autism?</em></strong></p>\n\n<blockquote>\n <p>One fact of note is that postnatal infections with the vaccine-targeted infectious agents, including measles, mumps, and rubella, are not known to cause autism, although autistic features have been reported in children with congenital rubella syndrome (Chess, 1971); one study reported the use of mathematical modeling and epidemiological data to conclude that MMR immunization had been associated with prevention of substantial numbers of cases of congenital rubella syndrome and associated autism in the period 2001–2010 in the United States (Berger et al., 2011). </p>\n</blockquote>\n\n<p><em>Adverse Effects of Vaccines: Evidence and Causality.</em> <a href=\"\" rel=\"noreferrer\"></a></p>\n", "score": 11 } ]
<p>Suppose that a dentist is doing a standard dental procedure, e.g. drilling out decay, on me, and I start feeling pain as he does it. Assuming that I can handle the pain silently, so I don't <em>need</em> to report it for my own sake, is it at all helpful to the dentist's work for me to report it? Is this feedback that the dentist can use to detect issues with the actual work as he goes along, or would the only purpose of reporting it be to try to get him to do something to mitigate it, for the sake of my immediate experience?</p> <p>(Note: I'm using "me" as a stand-in for a typical patient.) </p>
Is it helpful to a dentist to report pain during a procedure?
[ "pain", "dentistry" ]
CC BY-SA 3.0
[ { "answer_id": 736, "body": "<p>Most dentists - for <em>most</em> procedures - aim for a <em>painless</em> experience. If there is reason to keep some pain sensation intact, the dentist will inform you, and ask at appropriate intervals if you can feel pain.</p>\n\n<p>The efficacy of lidocaine and other local anesthetics depends on how closely your nerve distribution comes to the norm (they will inject the environs of the \"normal\" anatomical position of the nerve), how much anesthetic is injected, whether there are local factors which alter the local tissue pH (e.g. presence of an abscess or infection), how quickly it is removed from the site, etc.</p>\n\n<blockquote>\n <p>Is this feedback that the dentist can use to detect issues with the actual work as he goes along, or would the only purpose of reporting it be to try to get him to do something to mitigate it, for the sake of my immediate experience?</p>\n</blockquote>\n\n<p>Local anesthetics prevent pain sensation, but not vibration or pressure, which themselves can be unpleasant. Hypothetically, a dental procedure which should be painless with anesthesia can be carried out equally well whether the patient feels pain or not, so if you are stoic, feeling pain and not telling your dentist will not likely affect the outcome of that procedure. However, informing the dentist helps them to know if your anatomy is different (valuable information for the next time they need to do a similar local or regional block, your response to the anesthetic used (they might try another anesthetic or approach in the future), or if there might be an unseen infection altering the pH (and efficacy) of the anesthetic. Therefore it is probably wise to let your dentist know what you're feeling. They can reassess the situation, then offer you relief of some kind: a painless injection (the second injection into an already partially anesthetized region is truly painless), nitrous oxide (a gas), or other.</p>\n\n<p>I would liken this for most instances to suturing a laceration. There is <em>never</em> a time when I wish the patient to feel pain while I'm addressing the repair. I address what I see. If a patient feels pain, I want to know that and address the situation.</p>\n\n<p><sub><a href=\"\">An Update on Local Anesthetics in Dentistry</a></sub> </p>\n", "score": 33 }, { "answer_id": 1569, "body": "<p>It can absolutely give the dentist information which will help him identity potential problems. I recently had a root canal. It was a two-visit procedure, and on the first day, he drilled out the nerve fibers, tissue, and pulp, then placed a temporary crown over the tooth. </p>\n\n<p>The second visit was supposed to be a simple matter of removing the temporary crown, filling the tooth, and inserting the permanent crown. When he began to work, it was quite painful. He was shocked, and immediately set about trying to determine the cause of the problem. </p>\n\n<p>He spotted a bit of nerve fiber he had missed the first time, then completed the procedure. </p>\n\n<p>In this case, the fact I was even able to feel pain was an indication that he had overlooked something earlier in the process. If I hadn't told him about the pain, another procedure would have been necessary.</p>\n", "score": 8 } ]
<p>I regularly donate blood, however, I am curious as to what happens to my blood after I donate. Obviously some of it will go to people in emergency medical situations, as I intend. However, I have never heard of situations where someone died because we didn't have blood to donate to them; which makes it sound as if we don't have a blood deficit. That in turn makes me wonder what the excess blood is used for.</p> <p>So I have two related questions. First, do we ever <em>have</em> a blood deficit, situations where someone who could have been saved in a hospital dies because there wasn't blood to treat them? Or specifically situations like that caused by a lack of donors, not some logistical issue getting it where it needs to be. I have had the red cross call me and tell me that they have a 'deficit' many times, but frankly I hear it so often it leaves me questioning their definition of deficit. How often do we really run out?</p> <p>Related, if we don't run a deficit then what happens to my excess blood? I assume that some blood is regularly thrown out, but they figure it's better to have extra and risk it expiring then to run out during an emergency. However, if we have a high enough surplus do they do something else with it? For instance is it used for medical research? If we had say 5% fewer donors would it be our medical research which suffered, but not patients in the hospital?</p> <p>I will continue donating blood regardless of the answer here. I'm simply curious as to the result. Well that and it informs this discussion: <a href=""></a></p>
What is excess blood from blood donations used for, and do we ever run out?
[ "blood" ]
CC BY-SA 3.0
[ { "answer_id": 1278, "body": "<p>Great question! I think it's answerable as an overview, but please know this is only the tip of the iceberg.*</p>\n\n<p><strong>Summary</strong>: Yes, we have deficits of certain blood products in certain locations at certain times that affect patient care. However, a small percentage of blood product does expire unused (because it wasn't the <em>right</em> product [see background] in the <em>right</em> place at the <em>right</em> time).</p>\n\n<p><strong>A little background</strong> </p>\n\n<p>Donated blood is not usually transfused into a patient as whole blood. Instead, it's broken down into several components which are transfused in different clinical scenarios. The issues of storage and supply are different for each component. The components are:</p>\n\n<ul>\n<li>Plasma, and derivatives</li>\n<li>Red Blood Cells (RBCs)</li>\n<li>Platelets</li>\n<li>Granulocytes (rarely transfused)</li>\n</ul>\n\n<p>These different components require different storage conditions, so they are separated as soon as possible after donation.</p>\n\n<p><strong>OP's first question</strong>:</p>\n\n<blockquote>\n <p>First, do we ever have a blood deficit, situations where someone who could have been saved in a hospital dies because there wasn't blood to treat them?</p>\n</blockquote>\n\n<p>Yes. Well, actually your question is impossible to answer. :-) We could never know whether someone could-have-been-saved with a transfusion nor whether someone who received a transfusion would-have-died. Those are hypothetical constructs that are interesting to think about but are not compatible with research. </p>\n\n<p>However, we <em>can</em> ask whether there is evidence that blood supply on a clinical level is limited, for instance: </p>\n\n<ul>\n<li>doctors are requesting products that aren't available for patients; </li>\n<li>doctors are requesting fewer products than they think would be ideal for a particular patient because of a blood bank shortage; </li>\n<li>elective surgeries are being postponed; or </li>\n<li>blood banks are substituting products that may have a slightly increased risk of complications due to less-than-ideal immune compatibility.</li>\n</ul>\n\n<p>All of these are more nuanced than they seem, but to some degree all do occur. </p>\n\n<p>Quoting from a <a href=\"\">paper in the journal Transfusion entitled <em>How do I manage a blood shortage in a transfusion service?</em></a>:</p>\n\n<blockquote>\n <p>Although there are more than 16 million blood donations per year provided to more than 4 million recipients, blood shortages have recurred for decades [...] twice every year. Anyone with any experience at blood centers or transfusion services is quite accustomed to these expected shortages.</p>\n</blockquote>\n\n<p>He further notes that this problem is likely to worsen because the requirement for transfusions (all types) is increasing at a rate of 5-7% per year while donations are not matching that increase.</p>\n\n<p>The first thing that happens when there is a blood bank shortage usually involves the Transfusion Medicine specialist in the blood bank having a conversation with every doctor who orders the blood product that is limited. Together they determine whether a smaller amount of product or a deferment in transfusion might be clinically appropriate/acceptable. </p>\n\n<p>The distinction between those last two words &mdash; <code>appropriate|accetable</code> &mdash; is the key to whether clinical care is actually being compromised. In many cases, <a href=\"\">clinicians indeed are requesting product beyond what is recommended in published guidelines</a>, because they feel that the patient's condition warrants it due to some special circumstance. It seems likely that at least a small percentage of the time, the clinician was right, but this can never be proven.</p>\n\n<p>It is also the case that <a href=\"\">elective surgeries are sometimes postponed for this reason</a> (see chart 8-1, p 43), although it's rare. </p>\n\n<p><strong>Another question</strong></p>\n\n<blockquote>\n <p>Related, if we don't run a deficit then what happens to my excess blood?... is it used for medical research?</p>\n</blockquote>\n\n<p>Although localized shortages of particular products do occur and are disruptive, it is true that a small percentage of the products expire unused. In the U.S., this was estimated at 14% of supply in 1989 and had fallen to 5.2% in 2011, per <a href=\"\">a report from the US Dept Health and Human Services</a>, the most recent data available I've found. These are complicated and nuanced data that this format does not allow complete explanation of (and I myself am not completely familiar with), but please read <a href=\"\">the linked HHS report</a> if interested.</p>\n\n<p>As for what happens to the excess - it's probably discarded, although I can't prove that. Regarding your question about research: In addition to being sub-optimal because it's old, the blood was originally collected from human donors. Such research would be subjected to IRB requirements for protection of human subjects. This would likely require researchers to obtain permission from donors (/subjects) at the time of donation to use the product for research. This may happen in localized settings, but I know of no large-scale project.</p>\n\n<hr>\n\n<p><sub>\n* I limit this discussion to the U.S. While I realize the weaknesses &mdash; inadequacy, really &mdash; of that approach, this is the healthcare system where I was able to locate data, the O.P. is apparently asking about the U.S. situation (Red Cross), and I am most familiar with the clinical situation here. If another answer can offer a more global perspective, please do.\n</sub></p>\n", "score": 31 } ]
<p>In the past month, I've been really busy with the university and stuff, and I don't sleep as much as I used to. I usually sleep 4-5 hours a night.</p> <p>I haven't been doing that extensively ( I always kept a good sleeping routine), but can the lack of sleep affect my health on the long term ?</p>
Does the lack of sleep affect my health?
[ "sleep" ]
CC BY-SA 3.0
[ { "answer_id": 138, "body": "<p>In short, and according to <a href=\"\">the WGBH Educational Foundation and the Harvard Medical School Division of Sleep Medicine</a>:</p>\n\n<ul>\n<li><p>Lack of sleep can, in the short term, \"affect judgment, mood, ability to learn and retain information, and may increase the risk of serious accidents and injury\"</p></li>\n<li><p>In the long term, it may \"lead to a host of health problems including obesity, diabetes, cardiovascular disease, and even early mortality\". (We are speaking about an actual sleep deprivation here)</p></li>\n</ul>\n\n<p>They have published a complete set of articles about that, <a href=\"\">the entry point is here</a>.</p>\n", "score": 28 }, { "answer_id": 332, "body": "<p>I would also add that if you're consistently getting 4-5 hours of sleep (instead of about 8) then it's counterproductive for studying. Aside from affecting your ability to concentrate, there's also the effect on memory, especially memory consolidation for instance. </p>\n\n<p>As a grad student, I know that it's a constant challenge balancing sleep and studying, but I would still urge you to consider this.</p>\n\n<p>See a review here for example</p>\n\n<p>Rasch, Björn and Jan Born. <a href=\"\">About Sleep's Role in Memory.</a> Physiol Rev. 2013 Apr; 93(2): 681–766.\ndoi: 10.1152/physrev.00032.2012</p>\n", "score": 15 } ]
<p>According to the data on the <a href="" rel="nofollow noreferrer">Johns Hopkins Coronavirus Tracker</a>, as of 3rd February 2020 there were 17491 confirmed cases of COVID-19 globally, 536 total recoveries and 362 deaths. From my non-expert calculation this implies a mortality rate of:</p> <p><code>(Nd / (Nd + Nr)) * 100 = 41%</code></p> <p>where:</p> <p>Nd is the total number of deaths, Nr is the total number of full recoveries.</p> <p>This leaves 16593 people still suffering from the disease who have neither recovered or died.</p> <p>This is in stark contrast to the publicly disseminated value of ~2% mortality, so have I made a mistake in my calculation or assumptions, or is COVID-19 much more dangerous than commonly claimed? </p> <p><strong>[After a helpful discussion in the comments, 'mortality rate' is not the correct term to use here, instead I should say '<a href="" rel="nofollow noreferrer">Case Fatality Ratio</a>'.]</strong></p>
Does COVID-19 have a case fatality rate of 41%? Is this formula correct?
[ "virus", "infectious-diseases", "death", "covid-19" ]
CC BY-SA 4.0
[ { "answer_id": 20980, "body": "<p>The definition of mortality rate that you've given does not match any practical definition I'm familiar with.*</p>\n\n<p>When people talk about the mortality rate of a disease, what they <em>usually</em> mean is the <a href=\"\" rel=\"noreferrer\">case fatality rate</a> or the <a href=\"\" rel=\"noreferrer\">death-to-case ratio</a>, which is simply defined as <em>N</em><sub>d</sub> / <em>N</em><sub>i</sub>, where <em>N</em><sub>d</sub> is the number of deaths attributed to the disease over a given time period and <em>N</em><sub>i</sub> is the total number of new cases of the disease observed during the same time period. By this definition, the current case fatality rate of 2019-nCov according to your quoted figures is 362 / 17491 ≈ 2.07%.</p>\n\n<p>(The <a href=\"\" rel=\"noreferrer\">tracker</a> seems to have been updated since you asked your question, and now lists a total of 20679 confirmed cases and 427 deaths, for a CFR of 427 / 20679 ≈ 2.06%.)</p>\n\n<p><sup>*) As a theoretical definition of the mortality rate <em>in the long run</em>, when all infected patients have either died or recovered, it can sort of make sense. But then it becomes equivalent to the usual definition of the case fatality rate.</sup></p>\n\n<hr>\n\n<p>To compare this with your definition of \"mortality rate\" (as <em>N</em><sub>d</sub> / (<em>N</em><sub>d</sub> + <em>N</em><sub>r</sub>), where <em>N</em><sub>r</sub> is the number of individuals who have recovered from the disease), we need to start by observing that there's no single universal and unambiguous definition of what \"recovering from a disease\" means. Commonly used definitions tend to be something like \"no symptoms for <em>X</em> days\" and/or \"viral load below <em>N</em> particles per mL for <em>X</em> days\" or simply \"whenever a doctor declares that you're healthy again and lets you out of the hospital\".</p>\n\n<p>Now, let's say that we're using a (somewhat) objective definition of recovery like \"no detectable symptoms for two days\". The first observation is that any epidemic first observed less than two days ago would, according to your definition, inevitably have a mortality rate of 100% simply because none of the people infected so far would have had time to be considered definitely recovered yet. (That is assuming that at least one person had died from the infection; otherwise both the numerator and the denominator would be zero, and the rate thus undefined.)</p>\n\n<p>Further, even after some of the earliest cases have been symptom-free long enough to be counted as recovered, your definition would still yield a highly upwards biased estimate of the \"true\" long-term fatality rate during the early phase of the epidemic, when the number of new cases per day is still increasing. This is because, for most infectious diseases, any deaths typically occur when the disease is at its most severe state, whereas those who survive the disease will then experience a gradual decline in symptoms as their immune system succeeds in halting and reversing the progress of the infection.</p>\n\n<hr>\n\n<p>For an illustrative example, let's consider a hypothetical disease with a theoretical 1% long-term average CFR — that is to say, exactly 1% of all (recognizably) infected patients will die of the disease. Let's further assume that this disease typically takes two days to progress from the initial onset of recognizable symptoms to the state of maximum severity, which is when most of the deaths occur. After this, assuming that the patient survives, the symptoms gradually decline over the following three days. As remission is possible (but rare), doctors will generally consider a patient recovered only after showing no symptoms for at least two days. Thus, a typical case would progress as follows:</p>\n\n<blockquote>\n <p>onset of symptoms → increasing symptoms (2 days) → peak severity → declining symptoms (3 days) → no symptoms → observation (2 days) → officially recovered (total time: approx. 7 days from onset)</p>\n</blockquote>\n\n<p>or, for the 1% of patients for whom the disease is fatal:</p>\n\n<blockquote>\n <p>onset of symptoms → increasing symptoms (2 days) → death (total time: approx. 2 days from onset)</p>\n</blockquote>\n\n<p>Now, let's assume that, during the early period of an epidemic when the infection is still spreading exponentially, the number of new cases increases by a factor of 10 every three days. Thus, during this period, the number of new cases, recoveries and deaths per day might grow approximately as follows (assuming for the sake of the example that exactly 1%, rounded down, of the patients diagnosed on each day will die two days later):</p>\n\n<pre><code> | cases | recovered | deaths | | | \nday | new | total | new | total | new | total | Nd / Ni | Nd/(Nd+Nr) |\n----+-------+-------+-------+-------+-------+-------+---------+------------+\n 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 2 | 2 | 3 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 3 | 5 | 8 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 4 | 10 | 18 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 5 | 20 | 38 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 6 | 50 | 88 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 7 | 100 | 188 | 0 | 0 | 0 | 0 | 0.00% | N/A |\n 8 | 200 | 388 | 1 | 1 | 0 | 0 | 0.00% | 0.0% |\n 9 | 500 | 888 | 2 | 3 | 1 | 1 | 0.11% | 25.0% |\n 10 | 1000 | 1888 | 5 | 8 | 2 | 3 | 0.16% | 27.3% |\n 11 | 2000 | 3888 | 10 | 18 | 5 | 8 | 0.21% | 30.8% |\n 12 | 5000 | 8888 | 20 | 38 | 10 | 18 | 0.20% | 32.1% |\n</code></pre>\n\n<p>As you can see from the table above, naïvely calculating the case fatality rate as (total number of deaths) / (total number of cases) during this exponential growth period does underestimate the true long-term CFR by a factor of (in this case) about 5 due to the two-day lag time between infection and death. On the other hand, using your formula of (total deaths) / (total deaths + recovered) would <em>overestimate</em> the true CFR by a factor of about 30!</p>\n\n<p>Meanwhile, let's assume that, after the first 12 days, the growth of the epidemic saturates at 10,000 new cases per day. Now the total numbers will look like this:</p>\n\n<pre><code> | cases | recovered | deaths | | | \nday | new | total | new | total | new | total | Nd / Ni | Nd/(Nd+Nr) |\n----+-------+-------+-------+-------+-------+-------+---------+------------+\n 13 | 10000 | 18888 | 50 | 88 | 20 | 38 | 0.20% | 30.2% |\n 14 | 10000 | 28888 | 99 | 187 | 50 | 88 | 0.30% | 32.0% |\n 15 | 10000 | 38888 | 198 | 385 | 100 | 188 | 0.48% | 32.8% |\n 16 | 10000 | 48888 | 495 | 880 | 100 | 288 | 0.59% | 24.7% |\n 17 | 10000 | 58888 | 990 | 1870 | 100 | 388 | 0.66% | 17.2% |\n 18 | 10000 | 68888 | 1980 | 3850 | 100 | 488 | 0.71% | 11.2% |\n 19 | 10000 | 78888 | 4950 | 8800 | 100 | 588 | 0.74% | 6.3% |\n 20 | 10000 | 88888 | 9900 | 18700 | 100 | 688 | 0.77% | 3.5% |\n 21 | 10000 | 98888 | 9900 | 28600 | 100 | 788 | 0.80% | 2.7% |\n</code></pre>\n\n<p>As you can see, the two measures of mortality rate do eventually start converging as the growth of the epidemic slows down. In fact, in the long run, as the majority of patients either recover or die, they do both end up converging to the \"true\" long-term case fatality rate of 1%. But by then, the epidemic will be basically over.</p>\n\n<p>There are various ways to obtain a more accurate estimate of the long-term fatality rate even during the early exponential growth phase of an epidemic. One such method would be to look at the outcomes of a single cohort of patients diagnosed at the same time. For our hypothetical example epidemic, looking e.g. at just the 1000 patients diagnosed on day 10, we could get an accurate estimate of the CFR by day 12 simply by dividing the 10 deaths <em>within that cohort</em> by the total number of patients in the cohort. Furthermore, observing multiple cohorts would give us a pretty good idea of how long after diagnosis we would need to wait before the estimated case fatality rate for each cohort gets close to its final true value.</p>\n\n<p>Unfortunately carrying out this kind of cohort analysis for 2019-nCov would require more detailed information than the tracker you've linked to provides. Even the <a href=\"\" rel=\"noreferrer\">time series spreadsheet</a> the tracker links to doesn't directly provide such detailed cohort data, although it might be possible to obtain better estimates from it by making some more or less reasonable assumptions about the typical progress of the disease.</p>\n\n<hr>\n\n<p><strong>Addendum:</strong> A few preliminary cohort studies of the kind I describe above do appear to have already been published for 2019-nCoV.</p>\n\n<p>In particular, <a href=\"\" rel=\"noreferrer\">\"A novel coronavirus outbreak of global health concern\"</a> by Wang <em>et al.</em> and <a href=\"\" rel=\"noreferrer\">\"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China\"</a> by Huang <em>et al.</em>, both published on January 24 in <em>The Lancet</em>, note that, out of the first 41 patients diagnosed with 2019-nCoV before Jan 2, 2020 in Wuhan, six had died (and 28 had been discharged, leaving seven hospitalized) by Jan 22, giving a case fatality rate of 14.6% in this cohort.</p>\n\n<p>However, they do advise treating this figure with due caution, noting a number of reasons (besides just the small number of cases examined) why it may not fully reflect the eventual long-term CFR:</p>\n\n<blockquote>\n <p>\"<em>However, both of these</em> [CFR] <em>estimates</em> [of 14.6% from the 41 patient cohort and of 2.9% from all 835 cases confirmed at the time of writing] <em>should be treated with great caution because not all patients have concluded their illness (ie, recovered or died) and the true number of infections and full disease spectrum are unknown. Importantly, in emerging viral infection outbreaks the case-fatality ratio is often overestimated in the early stages because case detection is highly biased towards the more severe cases. As further data on the spectrum of mild or asymptomatic infection becomes available, one case of which was documented by Chan and colleagues, the case-fatality ratio is likely to decrease.</em>\"</p>\n</blockquote>\n\n<p>There's also a later paper titled <a href=\"\" rel=\"noreferrer\">\"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study\"</a> by Chen <em>et al.</em>, published on Jan 30, that examines a cohort of 99 patients diagnosed between Jan 1 to Jan 20 and reports a CFR of 11% within this cohort. However, the study only followed these patients up to Jan 25, by which time more than half of them (57 out of 99) still remained hospitalized.</p>\n", "score": 47 }, { "answer_id": 20972, "body": "<p>The equation you use for mortality is only really useful in the very long term for a known disease, when most cases have resolved.</p>\n\n<p>It's not very informative in the short-term, when the vast majority of total cases are neither deaths nor recoveries.</p>\n\n<p>Right now, the vast majority of people diagnosed have a mild illness and are very unlikely to die, but it takes a long time for them to be considered in the \"recovered\" category. Additionally, many of those who have died are particularly vulnerable. From WHO:</p>\n\n<blockquote>\n <p>As with other respiratory illnesses, infection with 2019-nCoV can cause mild symptoms including a runny nose, sore throat, cough, and fever. It can be more severe for some persons and can lead to pneumonia or breathing difficulties. More rarely, the disease can be fatal. Older people, and people with pre-existing medical conditions (such as, diabetes and heart disease) appear to be more vulnerable to becoming severely ill with the virus.</p>\n</blockquote>\n\n<p>Estimates for mortality that you see in the news might instead be based on deaths/cases, or are based on expert comparisons to past epidemic coronavirus strains and knowledge of the typical course of the illness.</p>\n\n<p>Additionally, we don't know how accurate the numbers are, especially for cases. There may be many more mild cases that go unreported.</p>\n\n<p>There won't be good estimates of the actual mortality rate until more time has passed, and even in that case it is unlikely that a single number will be very informative. Instead, the risk will vary by age and other factors. Good sources for information, like the WHO, don't report mortality rates: they are only reporting cases and deaths at this time.</p>\n\n<p>Some good sources for further information:</p>\n\n<p><a href=\"\" rel=\"noreferrer\"></a></p>\n\n<p><a href=\"\" rel=\"noreferrer\"></a></p>\n\n<p><a href=\"\" rel=\"noreferrer\"></a></p>\n", "score": 20 }, { "answer_id": 20977, "body": "<p>I'd like to chime in with an explanation of <em>what exactly</em> is wrong with the calculation offered in the question, rather than just saying \"it's a wrong formula\". Understanding the \"whys\" of the fallacy is important. So I'll try to answer your question from the math point of view.</p>\n\n<p><strong>TL;DR: The root cause of the fallacy is that recovery takes much longer that death.</strong></p>\n\n<blockquote>\n <p><code>(Nd / (Nd + Nr)) * 100 = 41%</code><br>\n where: Nd is the total number of deaths,<br>\n Nr is the total number of full recoveries.</p>\n</blockquote>\n\n<p>That formula (and the logic behind it) is correct as long as <code>Nd</code> and <code>Nr</code> both refer to <strong>the same fixed group of people</strong>. That is, if we had picked <code>N</code> infected people, waited for them <em>all</em> to reach the final state (recovery or death), and put those <code>Nr</code> and <code>Nd</code> to that formula above - then yes, it would give the statistical mortality rate in that group.</p>\n\n<p>However, the current counts of recovery/death outcomes do not refer to <em>the same group</em>. <code>Nd</code> in each WHO report refers to the group of all people infected thus far since the start of the outbreak. But the final outcome of <em>all</em> people in that group is yet unknown. Daily <code>Nr</code> refers only to a subgroup of all those infected (excluding those unknowns), see? So you can't take <code>Nd</code> and <code>Nr</code> from a WHO report and put those numbers to that formula - that would be apples and oranges...</p>\n\n<p>To illustrate this point, consider a grossly simplified imaginary situation:<br>\nthere's a disease which may lead to death on the 3rd day, while the rest of infected people will fully recover on the 15th day. In that case, <code>Nd</code> in the official report would encompass all people infected 3 days ago and before, while <code>Nr</code> would encompass all people infected 15 days ago and before. Given the high flow of new confirmed cases coming each day, the difference between those two groups is huge: it is all those people infected in 12 days!</p>\n\n<p>In our real case that difference is far greater than <code>Nr</code> and <code>Nd</code> combined, which means the error from ignoring that difference renders the calculation totally useless. (Well, it's useful as an absolute upper limit, but no more).</p>\n", "score": 14 }, { "answer_id": 21002, "body": "<p>According to earlier answers, in this early phase of 2019-nCoV, Nd/(Nd+Nr) is an overestimator, and Nd/Nc is an underestimator. </p>\n\n<p>Since the currently bantered about rate matches the underwestimator Nd/Nc, you are correct that 2019-nCoV is more 'dangerous' than commonly claimed. I used quotes because dangerous a squirmy term.</p>\n\n<p>Noting that Nd/Nc equals Nd/(Nd+Nr) after the epidemic is over, a better estimate would be to track the two quotients over time, and extrapolate their curves to the point they meet. That would still be a biased estimator, but less so than either on it's own. I'm guessing there are more sophisticated estimators with less bias, and I've posted that question here:</p>\n\n<p><a href=\"\">What is a sophisticated estimate of the 2019-nCoV fatality rate?</a></p>\n", "score": 4 }, { "answer_id": 21771, "body": "<p>I understand what you're trying/hoping to do here, but the correction method you try to apply is unsuitable. You need to explicitly account for the time delays to deaths <em>and</em> consider a confined population of cases <em>or</em> try to infer from a closed sample a correction factor to apply to the open-ended/ongoing epidemic. Such a study was recently <a href=\"\" rel=\"nofollow noreferrer\">published</a> <em>based</em> on the Diamond Princess (cruise ship) cases, using the information collected therein to correct (in this paper) the data on China.</p>\n\n<blockquote>\n <p>In real time, estimates of the case fatality ratio (CFR) and infection fatality ratio (IFR) can be biased upwards by under-reporting of cases and downwards by failure to account for the delay from confirmation to death. Collecting detailed epidemiological information from a closed population such as the quarantined Diamond Princess cruise ship in Japan can produce a more comprehensive description of asymptomatic and symptomatic cases and their subsequent outcomes. Our aim was to estimate the IFR and CFR of coronavirus disease (COVID-19) in China, using data from passengers of the Diamond Princess while correcting for delays between confirmation and death and for the age structure of the population.</p>\n</blockquote>\n\n<p><a href=\"\" rel=\"nofollow noreferrer\"><img src=\"\" alt=\"enter image description here\"></a></p>\n\n<blockquote>\n <p>During an outbreak, the so-called naive CFR (nCFR), i.e. the ratio of reported deaths date to reported cases to date, will underestimate the true CFR because the outcome (recovery or death) is not known for all cases, assuming all cases are detected. We can estimate the true denominator for the CFR (i.e. the number of cases with known outcomes) by accounting for the delay from confirmation to death. We assumed that the delay from confirmation to death followed the same distribution as the estimated time from hospitalisation to death, based on data from the COVID-19 outbreak in Wuhan, China, between 17 December 2019 and 22 January 2020, accounting for underestimation in the data as a result of as-yet-unknown disease outcomes [...]</p>\n \n <p>To adjust the CFR to account for delay to outcome, we use the method developed in <a href=\"\" rel=\"nofollow noreferrer\">Nishiura et. al (2009)</a> where case and death incidence data are used to estimate the number of cases with known outcomes, i.e. cases where the resolution, death or recovery, is known to have occurred:</p>\n</blockquote>\n\n<p><a href=\"\" rel=\"nofollow noreferrer\"><img src=\"\" alt=\"enter image description here\"></a></p>\n\n<blockquote>\n <p>where <em>c<sub>t</sub></em> is the daily case incidence at time <em>t</em>, (with time measured in calendar days), <em>f<sub>t</sub></em> is the proportion of cases with delay <em>t</em> between onset or hospitalisation and death; <em>u<sub>t</sub></em> represents the underestimation of the known outcomes and is used to scale the value of the cumulative number of cases in the denominator in the calculation of the cCFR. Given that asymptomatic infections are typically not reported, especially during an ongoing outbreak of a novel infection, this correction is normally used to calculate the cCFR. However, because of the high level of testing on the cruise ship, we were able to use this correction to calculate the corrected IFR (cIFR). After that, we used the measured proportions of asymptomatic to symptomatic cases on the Diamond Princess to scale the cIFR to estimate the cCFR. [...]</p>\n \n <p><strong>We estimated that the all-age cIFR on the Diamond Princess was 1.3% (95% confidence interval (CI): 0.38–3.6) and the cCFR was 2.6% (95% CI: 0.89–6.7).</strong> However, as the age distribution on the ship was skewed towards older individuals (mean age: 58 years), we also report age-stratified estimates. Using the age distribution of cases and deaths on the ship to estimate for only individuals 70 years and older, the cIFR was 6.4% (95% CI: 2.6–13) and the cCFR was 13% (95% CI: 5.2–26). The 95% CI were calculated with an exact binomial test, with death count and either cases or known outcomes (depending on whether it was an interval for the naive or corrected estimate).</p>\n \n <p>Using an approach similar to <a href=\"\" rel=\"nofollow noreferrer\">indirect standardisation</a>, we used the age-stratified nCFR estimates reported in a large study in China to calculate the expected number of deaths of people on board the ship in each age group, (assuming this nCFR estimate in the standard population was accurate). This produced a total of 15.15 expected deaths, which corresponds to a nCFR estimate of 5% (15.15/301) for the Diamond Princess, which falls within the top end of our 95% CI. As our cCFR for Diamond Princess was 2.6% (95% CI: 0.89–6.7), this suggests we need to multiply the nCFR estimates in China by a factor 52% (95% CI: 14–100) to obtain the correct value. <strong>As the raw overall nCFR reported in the data from China was 2.3%, this suggests the cCFR in China during that period was 1.2% (95% CI: 0.3–3.1) and the IFR was 0.6% (95% CI: 0.2–1.7)</strong>. Based on cases and deaths reported in China up to 4 March 2020, the nCFR calculation was considerably higher than the cCFR we estimate here (based on data taken from [8], nCFR = 2,984/80,422 = 3.71% (95% CI: 3.58–3.84)). The confidence intervals calculated for China using an indirect standardisation method reflect the uncertainty in the Diamond Princess estimates, as it is carried forward in the scaling.</p>\n</blockquote>\n\n<p>As you can see, if one does this correction properly, the \"death rate\" (cCFR) for Covid-19 is actually lower (than the nCFR).</p>\n\n<p>If the above is too dense/technical of an explanation, the <em>Nature</em> news <a href=\"\" rel=\"nofollow noreferrer\">coverage of it</a>:</p>\n\n<blockquote>\n <p>Another team used data from the ship to estimate that the proportion of deaths among confirmed cases in China, the case fatality rate (CFR), was around 1.1% — much lower than the 3.8% estimated by the World Health Organization (WHO).</p>\n \n <p><strong>The WHO simply divided China’s total number of deaths by the total number of confirmed infections</strong>, says Timothy Russell, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine. <strong>That method does not take into account that only a fraction of infected people are actually tested, and so it makes the disease seem more deadly than it is</strong>, he says.</p>\n \n <p>By contrast, Russell and his colleagues used data from the ship — where almost everyone was tested, and all seven deaths recorded — and combined it with more than 72,000 confirmed cases in China, making their CFR estimate more robust. [...]</p>\n \n <p>The group also estimates that the infection fatality rate (IFR) in China — the proportion of all infections, including asymptomatic ones, that result in death — is even lower, at roughly 0.5%. The IFR is especially tricky to calculate in the population, because some deaths go undetected if the person didn’t show symptoms or get tested.</p>\n</blockquote>\n\n<p>(Nature news says the [latter] paper had not been peer-reviewed/published, but in the meantime it has been published by <em>Eurosurveillance</em>, the same journal that had published the 1st Diamond Princess paper.)</p>\n\n<p>I should also noted that an 8th death was reported <a href=\"\" rel=\"nofollow noreferrer\">much later</a> (March 20) in relation to the Diamond Princess. It probably doesn't substantially change the conclusions of that paper (which included only the 7 reported deaths you see in the graph.)</p>\n", "score": 1 } ]
<p>In most countries, there is a legal drinking age: 21 in the U.S., 18 in most European countries. I've always been told that legal drinking age is in place because alcohol has harmful effects on underage people. I've never been told what these harmful effects are, though. I've also questioned sometimes if this is true or not.</p> <p><strong>Does alcohol have harmful effects on underage (say under 18) children? If so, what are the effects?</strong></p>
What effects does alcohol have on underage children?
[ "side-effects", "alcohol", "pediatrics" ]
CC BY-SA 3.0
[ { "answer_id": 447, "body": "<p>Alcohol is a psychoactive drug that acts as a central nervous system depressant.</p>\n\n<p>Drinking under-age increases alcohol risks in later life. Research shows the brain keeps developing well into the twenties, during which time it continues to establish important communication connections and further refines its function and studies show that young people who drink heavily may put themselves at risk for a range of potential health problems.</p>\n\n<p>Extreme alcohol consumption can cause memory loss, loss of coordination and <a href=\"\" rel=\"noreferrer\">alcohol poisoning</a>, in some cases can be fatal.</p>\n\n<p>Health risks associated with drinking include:</p>\n\n<ul>\n<li><p>brain effects,</p>\n\n<p>Alcohol interferes with communication between nerve cells and all other cells limiting the ability to think clearly.</p>\n\n<p>First alcohol affects the forebrain responsible for motor coordination and decision making. Secondly it knocks out the midbrain, so you lose control over emotions and you've more chances of black outs.</p>\n\n<p><img src=\"\" alt=\"How alcohol attacks the brain\"></p>\n\n<p><sup>Image credits: <a href=\"\" rel=\"noreferrer\">The Immortal Alcoholic</a></sup></p>\n\n<blockquote>\n <p>Research has shown that animals fed alcohol during this critical developmental stage continue to show long-lasting impairment from alcohol as they age<sup><a href=\"\" rel=\"noreferrer\">2002</a></sup>. Subtle changes in the brain may be difficult to detect but still have a significant impact on long-term thinking and memory skills.<sup><a href=\"\" rel=\"noreferrer\">NIH</a></sup></p>\n</blockquote></li>\n<li><p>liver effects,</p>\n\n<p>Every time you drink, your liver has to filter it out of your blood and a lot of alcohol over a short period of time (<a href=\"\" rel=\"noreferrer\">BAC</a>) won't give enough time for the body to process it all.</p>\n\n<p>In addition persons below the age of 25 and women may process alcohol more slowly<sup><a href=\"\" rel=\"noreferrer\">wiki</a></sup>.</p>\n\n<blockquote>\n <p>Elevated liver enzymes, indicating some degree of liver damage, have been found in some adolescents who drink alcohol<sup><a href=\"\" rel=\"noreferrer\">2001</a></sup>.</p>\n \n <p>Young drinkers who are overweight or obese showed elevated liver enzymes even with only moderate levels of drinking<sup><a href=\"\" rel=\"noreferrer\">2000</a></sup>.</p>\n</blockquote></li>\n<li><p>growth and endocrine effects,</p>\n\n<p>Consuming alcohol largely affects the body's endocrine system resulting in changes of various hormone levels which can disrupt a normal growth.</p>\n\n<blockquote>\n <p>Drinking alcohol during puberty period of rapid growth and development may upset the critical hormonal balance necessary for normal development of organs, muscles, and bones. Studies in animals also show that consuming alcohol during puberty adversely affects the maturation of the reproductive system<sup><a href=\"\" rel=\"noreferrer\">2001</a></sup>.</p>\n</blockquote>\n\n<p>See: <a href=\"\" rel=\"noreferrer\">Alcohol and cortisol</a> at Wikipedia</p></li>\n</ul>\n\n<p><sup>Source: <a href=\"\" rel=\"noreferrer\">Underage Drinking at NIAAA</a></sup></p>\n", "score": 20 } ]
<p>I'm sure this question is asked a lot. I asked it of two different doctors myself recently, one of them a diabetes specialist. They both said that causing too much sugar did increase the risk. Neither offered any actual evidence. The specialist gave a rather strange reason, which now escapes me.</p> <p>This idea has inherent plausibility, because eating a lot of sugar could be assumed to stress the body mechanisms that keep sugar level in the blood under control. Too much stress could cause these mechanisms to break down. This is, however, not the reason the specialist gave.</p> <p>A confounding factor could be that eating too much sugar might cause weight gain, which might increase the risk of diabetes for different reasons.</p> <p>There are (at least) two kinds of answers that would be useful here.</p> <ol> <li>Actual clinical trials/studies attempting to address this question.</li> <li>Descriptions of medical research which suggest mechanisms by which excessive sugar consumption could increase the likelihood of diabetes.</li> </ol> <p>The term "too much", of course, is ill-defined. An answer could attempt to quantify this.</p>
Is there evidence that eating too much sugar can increase the risk of diabetes?
[ "diabetes", "sugar" ]
CC BY-SA 3.0
[ { "answer_id": 60, "body": "<p>High consumption of sugar can up the risk of diabetes, but it is not the only contributing factor. There have been studies that have shown that sugar-sweetened drinks (mainly soda) have increased the probability of type 2 diabetes.<a href=\"\"><sup>1</sup></a> There is a less subtle way that sugar can cause diabetes, which is by weight gain.<a href=\"\"><sup>2</sup></a> Obesity has been shown to cause diabetes<a href=\"\"><sup>3</sup></a> and too much sugar can cause obesity, so technically sugar can cause obesity.</p>\n\n<p>In conclusion, sugar is fine in moderation (as most things are) and usually it won't cause diabetes. There are some links between the two though.</p>\n\n<hr>\n\n<p><sup>[<a href=\"\">1</a>] <a href=\"\">Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct.</a></sup></p>\n\n<p><sup>[<a href=\"\">2</a>] <a href=\"\">Fructose, weight gain, and the insulin resistance syndrome</a></sup></p>\n\n<p><sup>[<a href=\"\">3</a>] <a href=\"\">Why Does Obesity Causes Diabetes?</a></sup></p>\n", "score": 22 }, { "answer_id": 12754, "body": "<p>Consumption of carbohydrates is necessary to sustain life and mental health. Eating or drinking carbs stresses the body both when consuming too much or too little. Today's diabetic diet do include carbohydrates. </p>\n\n<p>For a little background, the pancreas serves two functional purposes. It provides the endocrine hormones that balance the sugar available in the blood stream. For the endocrine function, it produces insulin and glucagon from the Beta cells. Insulin is the catalyst for cells to pull in sugar from the blood. Glucagon tells the liver to dump glycogen to raise up blood sugar. The glucagon is dumped when the pituitary signals the adrenal glands to go into fight-or-flight mode. It boosts the available energy. Drinking simple sugars like the ones in soft drinks is an easily metabolized sugar, and it makes the pancreas work extra hard. At the same time, if the person has insulin resistance, the pancreas has to pump out even more to get the sugar from the blood into cells. Eventually the pancreas just stops functioning when it is worked too hard.</p>\n\n<p>The second function of the pancreas is exocrine, and it produces enzymes to help the body digest food and absorb vitamins. One of the enzymes also aids in the digestion of carbohydrates. </p>\n\n<p>So to make a long story short, yes, consuming high amounts of sugar may increase your risk of diabetes, especially type 2. However, the bigger risks factors, for diabetes and the potential of pancreatic cancer, are stress, alcohol consumption and eating red meats. </p>\n\n<p>Here is a link to the American Diabetes Association answering your very <a href=\"\" rel=\"nofollow noreferrer\">question</a>. Here is more information about how to treat your pancreas with <a href=\"\" rel=\"nofollow noreferrer\">respect</a>. The pancreas will demand respect eventually, and working with it helps to ease many complications of disease.</p>\n", "score": 4 } ]
<p>One of the most often-cited facts about human life, compared to those of other animals, is that the main reason we live so much longer is modern medicine. Because we can treat illnesses that would previously affect lifespan, we are far more likely to live greatly extended lifespans. However, this leads to two possible (conflicting) logical conclusions:</p> <ol> <li>People who by chance didn't get deadly diseases before modern medicine would live as long as people today, meaning the ability for any <em>individual</em> to survive ninety or more years, far longer than nearly all animals, is unrelated to modern medicine.</li> <li>Every illness one experiences weakens the body in some way, robbing it of future years. This would mean the role of modern medicine in extending lifespan is treating these illnesses to prevent the gradual reduction in lifespan.</li> </ol> <p>If the first is true, then lifespan itself isn't influenced by modern medicine unless it prevents death as the direct result of a disease, and only <em>average</em> lifespan is affected. In other words, if nine in ten dies at age thirty due to a deadly disease, and one in ten dies at age eighty by avoiding disease, the average life expectancy is thirty five, even though an individual could by living an extremely careful life survive to reach eighty.</p> <p>If the second is true, then short periods of non-deadly illnesses experienced by everyone each shorten life expectancy by a tiny amount, together decreasing <em>everyone's</em> lifespan to the same thirty five, rather than the effect being a result of averages.</p> <p><strong>So does each illness shorten lifespan, or is it only a result of averages that lifespan was so low pre-modern medicine, and humans always had the capacity for exceptionally-long lives?</strong></p>
If human life is so long largely due to modern medicine, does every illness shorten lifespan?
[ "life-expectancy", "disease", "statistics" ]
CC BY-SA 3.0
[ { "answer_id": 10, "body": "<p>Both. Human cells largely exhibit a phenomenon called <em>senescence</em> - they just give up and die after they reach a certain age via a biochemical mechanism called <em><a href=\"\">apoptosis</a></em>. The outer limit of survivability for human cells is generally understood to be in the 100-120 year range. One of the things that makes a cancer cell cancerous is the deactivation of the signals for apoptosis, making the cell effectively immortal.</p>\n\n<p>At the same time, most illnesses, particularly the \"lifestyle illnesses\" (diabetes, hypertension, hypercholesterolemia) so common today, do induce some changes which shorten lifespan.</p>\n\n<p>The most significant changes which extended human life were the development of (a) sanitation and (b) antibiotics. These together dramatically reduced death by infectious disease. Removal of early death from infection exposed these diseases of late-life and lifestyle.</p>\n", "score": 25 }, { "answer_id": 1056, "body": "<p>The claim of modern medicine being responsible for longer lifespans is of course a statistical claim, i.e. the average/net effect. Thus your second assertion does not follow logically. Though it is an interesting point.</p>\n\n<p>Diseases, both now and in the past, do not have 100% mortality rates. If you followed the ebola outbreak you'd have heard stories of survivors are quite common. The same is true with measles, the common cold, lung infections, etc. When we find a cure for a disease the lifespan statistic increases. This is because those people who would have died survive instead, NOT because infected people avoid long-term collateral damage that would have taken a few years of their 'original' lifespan. At least that is the current predominant view of things.</p>\n\n<p>Consider the following:</p>\n\n<ul>\n<li>Diabetes decreases individual lifespan, ergo the average lifespan also decreases if enough people get diabetes.</li>\n<li>The common cold does not decrease individual lifespan, yet it still contributes to a lower average lifespan because it may be fatal in weak individuals.</li>\n</ul>\n\n<p>So we could say (almost) every illness shortens the <em>average</em> lifespan, but not every illness shortens <em>individual</em> lifespan.</p>\n", "score": 12 } ]
<p>I have to attend classes at the university, band rehearsals, I live with my family, so I come close with many people during the day. I have to meet most of these people on a daily basis, even when I have the (common) cold.</p> <p>How can I prevent it from spreading to the people around me? </p>
How can I prevent a cold from spreading to the people around me?
[ "common-cold" ]
CC BY-SA 3.0
[ { "answer_id": 366, "body": "<p>There are lots of things you can do to be a responsible and considerate individual. Props for even asking this question!</p>\n\n<ol>\n<li><p>Cover your cough to prevent air-borne transmission with the inner part of your arm or your shoulder- whichever come into contact with other people less.</p></li>\n<li><p>Wash your hands with water and soap regularly for at least 20 seconds. That means before every meal and bathroom trip at least! Try as hot as you can bare so that it kills the bacteria. Carry hand sanitizer or some antibiotic wipes in case you don't have access to a sink or water.</p></li>\n<li><p>Rest and recovery (refer to anongoodnurse below) will build up antibodies. Try to get some sleep on your own and hold back on curling up with another person to avoid getting them sick too. <a href=\"\" rel=\"nofollow\">Be sure to change your sheets regularly as well</a>.</p></li>\n<li><p>Don't touch your face. Take caution to avoid eyes, nose, mouth, particularly.</p></li>\n<li><p>Use and carry tissues or napkins. Discard after use, wipe, or even just dabs. If you keep dabbing and leaving them on a surface, you'll risk contamination.</p></li>\n<li><p>Take a hot shower after you get home everyday. Doing so minimizes any other threatening particles that you may have acquired throughout the day.</p></li>\n<li><p>Don't share food or drinks with anyone. Anything your mouth touches will be contaminated and may sicken others.</p></li>\n<li><p>If you play a woodwind, try a decongestant so that you don't accidentally sneeze on a fellow band member and so that you can properly channel your breath.</p></li>\n</ol>\n\n<p>Side notes- \nIf the hot water starts drying out your skin, use a moisturizer.</p>\n\n<p>Feel better soon!</p>\n\n<p><a href=\"\" rel=\"nofollow\"></a></p>\n", "score": 9 }, { "answer_id": 449, "body": "<p>I'd like to offer a different perspective.</p>\n\n<p><strong>DaveL's answer is helpful if</strong> you absolutely have to carry on being a \"productive\" person and attend critical events for your career or life in general, all those recommendations DaveL offered will <em>reduce</em> the amount of people you'll infect, but chances are <em>you'll infect people anyway</em> because many diseases are infectious since before you show symptoms and you don't need to sneeze to spread it, talking can spread some viruses too, (e.g. the seasonal influenza is contagious since before you even know you are infected<a href=\"\" rel=\"noreferrer\">⁽¹⁾</a>). </p>\n\n<blockquote>\n <p>[...] flu viruses are spread mainly by droplets made when people with flu cough, sneeze <strong>or talk</strong>.\n [...] Most healthy adults may be able to infect other people beginning <strong>1 day before symptoms develop</strong> and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. <strong>Some people can be infected with the flu virus but have no symptoms</strong>. During this time, those persons may still spread the virus to others.</p>\n</blockquote>\n\n<p>The <strong>social aspect</strong> is why people are <em>thanking you for even asking</em>. So from a social perspective, DaveL's recommendations are also helpful if you want others to <em>perceive</em> you're <em>trying</em> not to get them infected, but in reality some people will know you should have stayed home because many people around you <em>will</em> get infected<a href=\"\" rel=\"noreferrer\">⁽¹⁾</a> (but most importantly, you should stay home to get better). </p>\n\n<blockquote>\n <p>People with flu can spread it to others up to about 6 feet away.</p>\n</blockquote>\n\n<h3>First of all, you need the assistance of a professional to get properly diagnosed.</h3>\n\n<p>You need to know why you have this \"common cold\" symptoms, so your treatment is adequate for just having a common cold or something a bit more serious or a lot more dangerous, many illnesses display symptoms of the common cold (e.g. the flu, but the list is big).<a href=\"\" rel=\"noreferrer\">⁽²⁾</a></p>\n\n<blockquote>\n <p>Several hundred different viruses may cause your cold symptoms.</p>\n</blockquote>\n\n<p>In the mean time and while you get properly diagnosed, IMHO any disease that has the potential to be airborne infectious can be somewhat mitigated and contained following the procedures, precautions and advice given by CDC to contain and deal with the flu. So I will elaborate on that particular case (again, I can't stress this enough, <strong>ask for professional advice</strong>, this answer should only broaden your general sense of how to avoid contagion for you and for others to some degree).</p>\n\n<h3>Stay home if sick, or get vaccinated every season before you get sick (flu only).</h3>\n\n<ol>\n<li>People will appreciate that you stood home <strong>better</strong> than sneezing or coughing \"with the inner part of your arm\" (which by the way is more ritual than safe practice, it is better to fully cover your mouth and nose<a href=\"\" rel=\"noreferrer\">⁽³⁾</a>). </li>\n<li>If you are the type of person who can't afford to stay home if you catch the flu, then <strong>the more reason</strong> you should get vaccinated every season<a href=\"\" rel=\"noreferrer\">⁽⁴⁾</a> (Getting vaccinated won't protect you against anything and everything but it will protect you from a broad range of flu type viruses). </li>\n</ol>\n\n<h3>1. About Staying home.<a href=\"\" rel=\"noreferrer\">⁽⁵⁾</a></h3>\n\n<p>You don't <strong>\"have to\"</strong> attend anything that's not critical, attend your health and well being, that is critical. Staying home will dramatically reduce the amount of possible subjects to be infected, in this case your family, so stay home and follow all hygienic recommendations.</p>\n\n<ul>\n<li>Ventilate your house and specially your room, if you have a window to\nthe street, open that (unless it is raining outside).</li>\n<li>Change your sheets and blankets as regular as possible (every 2-3\ndays until 5 days after you recovered, 7 days for children). Do it\nwhen you're alone and everyone else went to work/school. If you have\nboth washing and drying machines, great, if not, at least take them\nout to the sun, <em>do not</em> keep infected used blankets inside your\nhome.</li>\n</ul>\n\n<blockquote>\n <p>If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.</p>\n</blockquote>\n\n<h3>2. About Getting Vaccinated.<a href=\"\" rel=\"noreferrer\">⁽⁶⁾</a> (flu only)</h3>\n\n<p>The best prevention is not to get sick at all.\nIf you're not sick then you're not contagious.</p>\n\n<blockquote>\n <p>The single best way to prevent the flu is to get a flu vaccine each season. The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. There are several flu vaccine options for the 2014-2015 flu season. </p>\n</blockquote>\n\n<h3>Some additional info.</h3>\n\n<p>Virus that are so commonly transmitted like the flu are not going away anytime soon. Unless all potential hots/carriers get vaccinated at the same time repeatedly season after season until all types (A, B &amp; C types)<a href=\"\" rel=\"noreferrer\">⁽⁷⁾</a> of influenza viruses die with no viable hosts to replicate and evolve on. </p>\n\n<blockquote>\n <p>There are three types of influenza viruses: A, B and C. Human influenza A and B viruses cause seasonal epidemics of disease almost every winter in the United States. The emergence of a new and very different influenza virus to infect people can cause an influenza pandemic. Influenza type C infections cause a mild respiratory illness and are not thought to cause epidemics.</p>\n</blockquote>\n\n<p>Those viable hosts include more than 7 billion human beings and who knows how many animals that can carry along the virus and help it keep evolving<a href=\"\" rel=\"noreferrer\">⁽⁸⁾</a></p>\n\n<p><img src=\"\" alt=\"a graphic table depicting the kind of animals affected by different strands of influenza; which include humans, poultry, pigs, and to less degree other animals including bats \"></p>\n\n<h3>And most importantly, consult your GP.</h3>\n\nReference index.\n\n<p><sub>\n1. <a href=\"\" rel=\"noreferrer\">How Flu Spreads</a>\n2. <a href=\"\" rel=\"noreferrer\">Flu or Cold Symptoms?</a>\n3. <a href=\"\" rel=\"noreferrer\">Cover Your Cough</a>\n4. <a href=\"\" rel=\"noreferrer\">Preventing Seasonal Flu With Vaccination</a>\n5. <a href=\"\" rel=\"noreferrer\">Stopping the Spread of Germs at Home, Work &amp; School</a>\n6. <a href=\"\" rel=\"noreferrer\">Key Facts About Seasonal Flu Vaccine</a>\n7. <a href=\"\" rel=\"noreferrer\">Types of Influenza Viruses</a>\n8. <a href=\"\" rel=\"noreferrer\">Transmission of Influenza Viruses from Animals to People</a>\n</sub></p>\n", "score": 5 }, { "answer_id": 367, "body": "<p>A cold can be spread through:</p>\n\n<ul>\n<li>direct contact (via airborne droplets) – if you sneeze or cough, tiny droplets of fluid containing the cold virus are launched into the air and can be breathed in by others</li>\n<li>indirect contact – if you sneeze onto a door handle and someone else touches the handle a few minutes later, they may catch the cold virus if they then touch their mouth or nose.</li>\n</ul>\n\n<p>These things can help you to prevent it from spreading:</p>\n\n<ul>\n<li><strong>wash your hands regularly</strong> and properly, particularly after touching your nose or mouth and before handling food,</li>\n<li><strong>always sneeze and cough into tissues</strong> as this will help to prevent the virus-containing droplets from your nose and mouth entering the air where they can infect others; throw away used tissues immediately and wash your hands,</li>\n<li><strong>clean surfaces regularly</strong> to keep them free of germs,</li>\n<li><strong>use your own cup</strong>, plates, cutlery and kitchen utensils,</li>\n<li><strong>use disposable paper towels</strong> to dry your hands and face, rather than shared towels and always dispose of the paper towels after you have finished using them,</li>\n<li>use disposable devices that <strong>cover your mouth</strong> and nose with scarf, veil, face shields or surgical mask while sitting with people which will provide minimal protection from viruses for other people around.</li>\n</ul>\n\n<p><sup>Source: <a href=\"\" rel=\"nofollow noreferrer\">Cold, common: Introduction</a> and <a href=\"\" rel=\"nofollow noreferrer\">Preventing a common cold</a> at NHS</sup></p>\n\n<p>See also:</p>\n\n<ul>\n<li><a href=\"\">How long is someone infectious after a cold?</a></li>\n<li><a href=\"\">Effect of the common cold on the immune system</a></li>\n</ul>\n", "score": 3 } ]
<p>I have read several web pages that mention the potential benefits of sleeping without a pillow.</p> <p>Examples:</p> <p><a href="" rel="noreferrer"></a></p> <blockquote> <p>Is Sleeping Without a Pillow a Good Choice? Yes, it is. Not only will sleeping with no pillow save your money, but it will also lead to less neck, back, and shoulder pain, higher quality sleep, and even fewer wrinkles! When you were a child, you could fall asleep anywhere without a pillow. The body is resilient and adaptable when we're young. Even as we age, our body, including heads and necks, is able to rest comfortably without the support of a pillow.</p> </blockquote> <p><a href="" rel="noreferrer"></a></p> <blockquote> <p>While sleeping with or without a pillow is a personal preference, there are some medical experts that believe there are real benefits of sleeping without a pillow.</p> <ul> <li>Spinal benefits: Some argue that sleeping without a pillow is the healthiest method of sleeping as it greatly benefits the spine. Sleeping on your back without a pillow allows the spine to rest fully with the natural curves of the body. When you sleep with a thick pillow it can displace the spine.</li> <li>Facial benefits: Others argue that sleeping without pillows can help reduce wrinkles and other often considered unappealing facial features. This can be attributed to the fact that the face is not being squished against a pillow.</li> <li>Sleep benefits: Some argue that pillows interfere with quality sleep, especially when people use the wrong pillow. Sleeping without a pillow helps ensure quality sleep because the body is allowed to be at a normal level and not elevated like with a pillow.</li> <li>Neck benefits: The people that believe sleeping without a pillow is best for you, argue that sleeping with a pillow can be the main source of shoulder and neck pain. It is still good to do stretches and use heat packs, but they say that the best way to alleviate neck pain is to sleep without a pillow.</li> </ul> </blockquote> <p>Is there any scientific study confirming or infirming the claim?</p>
Is it better to sleep without a pillow?
[ "sleep", "spine", "position" ]
CC BY-SA 4.0
[ { "answer_id": 7673, "body": "<p>For most people, it is better to sleep <em>with</em> a pillow according to the latest research.</p>\n\n<ul>\n<li>Sleeping without a pillow <a href=\"\" rel=\"noreferrer\">increases interocular pressure</a> which is considered a risk for glaucoma patients. </li>\n<li>Sleeping on your side without a pillow increases your risk of osteoarthritis in the neck. If you sleep on your side, your cervical spine bends to the bed. This pinches the openings of the spine (the foramina) and causes bones to push and rub against each other. That friction and pressure causes bone to erode and grow which can create the bone spurs you can often see on cervical x-rays of patients. A pillow raises the head and straightens the spine. <a href=\"\" rel=\"noreferrer\"><img src=\"\" alt=\"cervical spine with a pillow\"></a></li>\n<li>Sleeping on your back without a pillow changes your neck angle from its normal daily position. When standing, your neck also has a certain curve to it. If you sleep on your back, that curve is also distorted. To simulate the natural curve of the neck, researchers found that about <a href=\"\" rel=\"noreferrer\">10cm of pillow is needed</a>. </li>\n</ul>\n\n<p>In general, studies suggest that sleeping with a pillow improves sleep quality and fits more physiologically and mechanically with the natural curve of the cervical spine. Even the Egyptians over 3,000 years ago used pillows. Here is King Tutankhamen's headrest around which his pillow linens were wrapped.</p>\n\n<p><a href=\"\" rel=\"noreferrer\"><img src=\"\" alt=\"Tut&#39;s pillow\"></a></p>\n\n<p>You can read additional <a href=\"\" rel=\"noreferrer\">studies here through PubMed</a>.</p>\n", "score": 16 } ]
<p>I like coffee, but caffeine seems to 'wire' me much more extremely than most other people. I feel energized or even shaky after less than half a normal cup, and a whole 8 ounces will usually cause me to sweat or make my heart race uncomfortably. </p> <p>Even decaffeinated coffee seems to have this effect, which seems strange to me (although I am aware that it still contains a small amount of caffeine). I typically drink green tea instead of coffee, since the effect is more mild.</p> <p>Is this an indication that my body metabolizes caffeine faster (or slower?) than normal? What else can cause caffeine sensitivity?</p>
Why do I feel shaky after only a small amount of caffeine?
[ "caffeine", "drug-metabolism", "energy", "shake-tremble-fidget" ]
CC BY-SA 3.0
[ { "answer_id": 76, "body": "<p>Caffeine metabolism has to do with your genetic makeup. The slower you metabolize caffeine, the more effect it will have on you. The cause for the differences that people have in how fast they metabolize caffeine has to depend on the CYP1A2 gene. Variants of this gene can cause you to metabolize faster or slower. The C allele variant in the AHR gene, which controls the turning on and off the the CYP1A2 gene, is common in people who have a high metabolism for caffeine. You probably do not have this variant. That with a few other factors that depend on variants in your DNA are the reason that caffeine has a strong effect on you.</p>\n\n<hr>\n\n<p><sup><a href=\"\">Caffeine Consumption</a></sup></p>\n", "score": 19 }, { "answer_id": 231, "body": "<p>All caffeinated beverages like coffee (even decaffeinated) and soft drinks give short bursts of energy, temporarily raise blood pressure, and reduces blood flow to inactive limbs.</p>\n\n<p>Soon after you drink coffee (containing caffeine), it’s absorbed through the small intestine and dissolved into the bloodstream and it’s able to penetrate the blood-brain barrier and enter the brain.</p>\n\n<p>Your sensitivity really depends on your body tolerance threshold (e.g. renal threshold for blood) and your average daily intake, in other words it's determined by the efficiency of the human body to process and metabolize caffeine. It's usually to do with person’s unique DNA which determines to what degree a given amount of caffeine will affect a person (as described in the other answer).</p>\n\n<p>See also: <a href=\"\">What are the side effects of drinking too much coffee?</a></p>\n", "score": 5 } ]
<p>Sometimes doctors prescribe steroid tablets to suppress pain for diseases, such as <a href="">arthritis</a>. Why do they prescribe it even though they know the side effects? </p>
Why do doctors prescribe steroid tablets even though they know the side effects?
[ "medications", "steroids", "side-effects" ]
CC BY-SA 3.0
[ { "answer_id": 307, "body": "<p>I think a missing bit of information that might help you get a better sense of this practice is: <strong>steroids are miracle drugs.</strong> </p>\n\n<p>OK, that was in jest - no miracles here. Truth be told, though, if there is a single class of drugs that has added more <a href=\"\">quality-adjusted life-years</a> to human history than any other, steroids must be competing with just a few antibiotic classes for that title.</p>\n\n<p>To make clear what we’re talking about, the term “steroid” as a label for drugs generally refers to <a href=\"\">glucocorticoids</a> (GCs) - drugs that act like cortisol, an endogenous steroid hormone. Commonly used GCs include:</p>\n\n<ul>\n<li><strong>Short acting</strong>: hydrocortisone, cortisone</li>\n<li><strong>Intermediate-acting</strong>: prednisone, prednisolone, mehthylprednisolone, triamcinolone</li>\n<li><strong>Long-acting</strong>: betamethasone, dexamethasone, paramethasone</li>\n</ul>\n\n<p>Your question poses a specific example of one indication for steroids but seems to be asking about the use of these drugs more generally. As others have brought up, any decision about drug treatment involves weighing the <a href=\"\"><strong>risk-benefit ratio</strong></a>.</p>\n\n<h2>Benefits</h2>\n\n<p>Although going through the efficacy data for various conditions is beyond the scope of this answer, I list a sampling of the common indications for GC treatment, and in the concluding paragraph I will provide specific efficacy data for arthritis. </p>\n\n<ul>\n<li><p><strong>Replacement therapy</strong>: due to either primary adrenal insufficiency (<a href=\"\">Addison’s disease</a>) or secondary/tertiary insufficiency (at the level of the hypothalamus or pituitary. </p></li>\n<li><p><strong>Inflammatory conditions</strong> (deep breath in): asthma, eczema, inflammatory bowel disease, allergic rhinitis/sinusitis, eosinophilic anything, inflammatory arthritis, anaphylaxis, septic shock (in very specific circumstances), polymyalgia rheumatica, polyarteritis nodosa, temporal arteritis, minimal change glomerulonephritis, autoimmune hemolytic anemia, urticaria, autoimmune hepatitis</p></li>\n<li><p><strong>Other things that aren’t (necessarily) obviously inflammatory</strong>: increased intracranial pressure, intractable nausea, acute leukemia, sarcoidosis, cluster headaches, dermatomyositis</p></li>\n</ul>\n\n<h2>Risks</h2>\n\n<p>First, please note that a few of the indications for GC require only a very brief burst of high-dose GC. In this time course, these drugs actually very few serious side effects (psychiatric effects and hyperglycemia are exceptions, but rarely outweigh the benefit). Over the longer term, however, supra-physiologic doses of GC have an array of adverse effects that fall into a few categories:</p>\n\n<ul>\n<li><p><strong>Suppression of the hypothalamus-pituitary-adrenal (HPA) axis</strong>: Exogenous GCs suppress the hypothalamic pathway that stimulates the adrenal gland, resulting in adrenal atrophy. This means that if the exogenous GC is abruptly discontinued, <a href=\"\">adrenal crisis</a> can ensue. The rule of thumb I learned was that >3 weeks treatment with >10 mg prednisone (or equivalent) can cause HPA suppression. As a result, GC treatment that meets these criteria is generally ended with a taper, allowing the adrenal to regenerate, whereupon it can resume normal function.<br><br>\nThis side effect is usually a non-issue if the medication is tapered correctly. Therefore, the benefits of treatment will generally outweigh the risks.</p></li>\n<li><p><strong>Cushing’s syndrome</strong>: This term is generally applied to the constellation of symptoms occuring with chronic administration of supra-physiologic doses of GC. <br> </p>\n\n<ul>\n<li>Hyperglycemia </li>\n<li>Hypertension </li>\n<li>Psychiatric effects: insomnia, precipitation of mania or psychosis in susceptible individuals</li>\n<li>Salt retention<sup>1</sup></li>\n<li>Decreased bone mineral density</li>\n<li>Weight gain: generally in a pattern characterized by central adiposity and peripheral muscle atrophy</li>\n<li>Increased intra-ocular pressure</li>\n</ul></li>\n</ul>\n\n<p>So, after all that:</p>\n\n<blockquote>\n <p>Why do doctors prescribe steroid tablets though they knew the side effect?</p>\n</blockquote>\n\n<p>Because the benefit outweighs the risk.<sup>2</sup> For the example you gave &mdash; arthritis<sup>3</sup> &mdash; the best paper I found was a <a href=\"\">meta-analysis</a> that used a statistical method that compares the <a href=\"\">number needed to treat</a> (NNT) with the <a href=\"\">number needed to harm</a> (NNH) for long-term (>1 year) treatment of rheumatoid arthritis. The ratio there NNH/NNT was 0.25, which is considered “good.” I’ll let you read their methods if you’d like the details. For further reading on this methodology and insights into how we quantitatively assess the comparison between risks and benefits, <a href=\"\">this article by Guo et al.</a> provides some good bedtime reading.</p>\n\n<hr>\n\n<p><sub>\n<strong>Notes</strong>:\n</sub><br>\n<sub>\n1. This is actually a mineralocoricoid rather than a GC effect, only present for those GCs whose receptor specificity overlaps, most prominently the short-acting agents hydrocortisone and cortisone.\n</sub> </p>\n\n<p><sub>\n2. Usually. Steroids are probably over-used in some settings because most people know that steroids tend to “make everybody feel better.” They can be an easy way to make patients happy if the side effects aren’t fully appreciated. Thus (in case you needed me to tell you!), your question is a valid one.\n</sub><br><br>\n<sub>\n3. I’m assuming here rheumatoid arthritis, because this is the most common type of arthritis for which steroids are appropriate. For the more common osteo-“arthritis” &mdash; a.k.a. degenerative joint disease &mdash; I’m sure steroids would make patients feel better, but the benefit there <em>rarely</em> outweighs the risk.</p>\n\n<h2></sub></h2>\n\n<p><sub>\n<strong>References:</strong>\n</sub> <br>\n<sub>\nGuo JJ, Pandey S, Doyle J, Bian B, Lis Y, Raisch DW. <a href=\"\"><em>A review of quantitative risk-benefit methodologies for assessing drug safety and efficacy-report of the ISPOR risk-benefit management working group.</em></a> Value Health. 2010 Aug;13(5):657-66.\n</sub> </p>\n\n<p><sub>\nLiu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcorn ED, Leigh R, Brown JP, Cohen A, Kim H. <a href=\"\"><em>A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy.</em></a> Allergy Asthma Clin Immunol. 2013 Aug 15;9(1):30.\n</sub> </p>\n\n<p><sub>\nMycek RJ, Harvey RA, Champe PC. <em>Pharmacology</em>. Lippincotts’s Illustrated Reviews, 2nd Ed. Lippincott, 1997: 272-276.\n</sub> </p>\n\n<p><sub>\nRavindran V, Rachapalli S, Choy EH.Rheumatology (Oxford). <a href=\"\">Safety of medium- to long-term glucocorticoid therapy in rheumatoid arthritis: a meta-analysis.</a> 2009 Jul;48(7):807-11.\n</sub></p>\n\n<hr>\n", "score": 30 }, { "answer_id": 151, "body": "<p>This is a very good question.</p>\n\n<p>Simply put: among doctors we call them <em>wonder drugs</em> or <em>life saving drugs</em>. In a number of emergencies, such as severe drug reactions, life-threatening asthma or allergies, or inflammatory conditions (such as your example of arthritis), no other drugs act like steroids. They act quickly and effectively, reducing inflammation and decreasing allergic responses, opening swollen airways, etc. They are used because they are so effective.</p>\n\n<p>Steroids do have side effects; they can cause kidney stones, decrease bone density, may cause diabetes, nervous system related diseases and many more, but only when used continuously for more than 3 to 6 months or so. Usually, however, steroids are only used until the patient is out of danger or experiences relief of their sudden severe pain. </p>\n\n<p>Steroids are not alien to our bodies; they are naturally produced by the adrenal gland, which lies above kidney. Therefore they are unlike paracetamol (which we take for fever) and other drugs which are synthetic (not natural). By giving steroids to patients, we are just strengthening a natural response our bodies attempt to mount. </p>\n\n<p>I suggest you not take any steroid for more than 3 months, and only under a doctor's supervision. Your doctor can advise you of any alternatives to steroids if available.</p>\n", "score": 6 }, { "answer_id": 190, "body": "<p>The reason drugs with adverse side effects are prescribed are </p>\n\n<ol>\n<li>Generally the benefits outweigh the risk,</li>\n<li>Every side effect that was discovered during trials, no matter how rare, must be listed, and</li>\n<li>Hopefully the FDA in the US or the similar administration in the other countries did their due diligence in order to protect consumers from drug companies.</li>\n</ol>\n\n<p>Doctors only prescribe untested drugs to terminal ill patients who sign numerous waivers in order to take them. So on average, a patient should only rarely experience the side effects and usually the milder ones will present; however, some people will present with the more serious adverse reactions. </p>\n\n<p>Additionally, if any side effect does present itself, the patient should consult their physician since alternatives may be available.</p>\n", "score": 2 } ]

All StackExchange questions and their answers from the Medical Sciences site, up to 14 August 2023. The repository includes a notebook for the process using the official StackExchange API.

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