Katie Suleta

Review of Superfoods, Silkworms, and Spandex by Joe Schwarcz

Recent headlines claiming a “cure” for autism and a complete reversal of symptoms were inspired by a case report published in June of 2024. However, with dubious methodology and potential serious conflicts of interest, there is reason to doubt these conclusions.

The popularity of health coaching continues to grow. The appeal is understandable with the promise of more one-on-one time with a person specifically hired to support your health. AI has blossomed in the 2020s, and creating calendars, training plans, answering questions, and more have never been easier. The combination of these two is obviously appealing but warrants caution.

Discussions about eating disorders and dietary supplements have been gaining traction, both on the internet and among policymakers. Last year, a review published in a peer-reviewed journal made the rounds among supplement makers and lobbyists. Since the article is being touted as evidence that supplements don’t contribute to eating disorders, a dive into the article is warranted.

Influencers are not new, but their popularity has exploded since the advent of social media. They have become an easy place to go for health advice and recommendations, but that’s not necessarily good.

It’s final exam time, which means all manner of study hacks are making their semi-annual resurgence amongst students across the country. Among those hacks, nootropics – substances ostensibly increasing cognitive function. What’s behind these brain-boosting products?

Lifestyle Medicine may become a new medical specialty. It claims to focus on prevention and lifestyle factors as treatment for chronic conditions. A review of the tenets of Lifestyle Medicine reveals old ideas repackaged for a new age.

Will Cole, an alternative healthcare provider with a massive social media following, sells wellness and scary-sounding pseudo-diseases. His empire, like other functional medicine hucksters, sells supplements and aligns with celebrities for promotion and legitimacy. Let’s tease apart the hype from the hyperbole.

Doulas acting as patient advocates during pregnancy, birth, and postpartum care may be a way to address poor health outcomes and health disparities. The evidence is compelling enough to warrant a closer look.

In the crowded market of wellness supplements, ARMRA Colostrum claims to offer a scientifically backed solution. However, a closer look reveals a familiar pattern of marketing tactics using buzzwords and bold claims. Despite touting transparency and scientific rigor, the evidence, as usual, falls short.

The Glucose Goddess is a prominent Instagram health influencer. Her real name is Jessie Inchauspe, and she has a master’s degree in biochemistry. She’s made her fame on social media by preaching about blood sugar and health. She’s the quintessential social media influencer: she sells books, courses, and recipes. Basically, everything except supplements…until now!

The myriad potential harms of these products are wide-ranging.

Every January, we cycle through the usual New Year’s resolutions tied to weight loss, exercise, and drugs, especially nicotine and alcohol. This year is no different; everything old is new again. My resolution is to begin a new January tradition of picking my favorite fad detox, cleanse, or diet and debunking it. This year, we’re tackling Dr. Josh Axe’s Detox Your Liver: A 6-Step Liver Cleanse.

Interest in our evolving understanding of the interstitium has led proponents of alternative medicine to take a victory lap. However, the evidence for these modalities (i.e., chiropractic, osteopathic manipulation, and Rolfing’s structural integration) remains unchanged and still unconvincing.

The wellness world loves science washing. By using technical-sounding jargon, it’s easy to add a sheen of legitimacy to an otherwise nonsensical product or offering. One of the most recent examples is Functional Blood Chemistry Analysis, or FBCA.

Article in Careers section about credentialism.

The Washington Post and an investigative journalism outlet called The Examination have partnered to investigate nutrition influencers on social media. Their investigation is ongoing, so we can expect more from them. While I think this work is important, there are some red flags in this investigation worthy of discussion.

Quick how-to guide for consuming scientific writing.

Evidence-based medicine specifically seeks evidence for treatments, recommendations, and practice guidelines. However, while the spirit of evidence-based medicine is to be based on ethical and scientifically rigorous research, in practice, it is often simply shortened to “Is there any evidence at all?”

Background

Chromobacterium haemolyticum is a gram-negative anaerobic sporulated rod and was only first identified in 2008. It is very rare in people with only a handful of cases having been diagnosed around the world.

Case presentation

After suffering a fall near Yellowstone National Park, a white male patient in his 50 s presented to a hospital in Eastern Idaho. With many unexplained symptoms, several changes in patient stability and recovery, over a course of 18 days in… Show more

Background

Chromobacterium haemolyticum is a gram-negative anaerobic sporulated rod and was only first identified in 2008. It is very rare in people with only a handful of cases having been diagnosed around the world.

Case presentation

After suffering a fall near Yellowstone National Park, a white male patient in his 50 s presented to a hospital in Eastern Idaho. With many unexplained symptoms, several changes in patient stability and recovery, over a course of 18 days in the hospital, the infecting organism could not be easily identified. Labs in the hospital, state, and eventually outside of the state were consulted for pathogen identification, which was only accomplished after the patient was discharged.

Conclusions

To our knowledge, this is only the seven reported human infection with Chromobacterium haemolyticum. This bacterium is difficult to identify and may be occur in rural areas without the proper testing facilities to quickly identify the pathogen, which is essential to timely treatment. Show less

Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal… Show more

Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine. Show less

Discussing the burgeoning field of health coaching and what you need to know about it.

Both depression and anxiety claims follow a seasonal
pattern where peaks were detected during winter
months and weekly claim volumes were lowest
during summer months.
• Steep declines in the frequency of in-office
and community mental health center (i.e.,
non-telehealth) visit types for both depression
and anxiety were evident beginning with the
implementation of COVID-19 stay-at-home orders
in the Denver metropolitan area. At the same time,
telehealth… Show more

Both depression and anxiety claims follow a seasonal
pattern where peaks were detected during winter
months and weekly claim volumes were lowest
during summer months.
• Steep declines in the frequency of in-office
and community mental health center (i.e.,
non-telehealth) visit types for both depression
and anxiety were evident beginning with the
implementation of COVID-19 stay-at-home orders
in the Denver metropolitan area. At the same time,
telehealth visits began to increase markedly as inoffice
visits decreased.
• Depression claim counts did not increase over
time prior to COVID-19 stay-at-home orders, but
increased 0.65% for each additional week following
the implementation of stay-at-home orders. Despite
an increasing weekly trend post-COVID-19 stay-athome
orders, depression claims on average decreased
9.5% following stay at home orders in the time
period analyzed.
• Anxiety claim counts increased weekly over time
during the period prior to COVID-19 stay-at-home
orders, and then increased 0.47% per week over and
above their previous trend post-COVID-19 stay-athome
orders.
• Detected increases in weekly trends of claims
coinciding with dramatic changes to the number
of services billable through telehealth suggest that
virtual care delivery is able to meet a large portion
of depression and anxiety health care needs for those who sought care during the COVID-19 pandemic.
• The overall decrease detected in depression claims following COVID-19 stay-at-home orders (despite an
increasing trend) may suggest that individuals with depression prefered in-person treatment or that telehealth
may have opportunities for improvement in depression treatment. Show less

Predicting future costs in a Medicaid population
could help with the management of high utilizing
members and has been a goal in numerous projects.
• Here we develop a machine learning approach,
extreme gradient boosting (XGBoost), using
approximately 3,700 claims-based predictors as
well as additional membership characteristics and
demographics. We use utilization history over three
quarters to predict costs incurred in a fifth quarter.
• The algorithm… Show more

Predicting future costs in a Medicaid population
could help with the management of high utilizing
members and has been a goal in numerous projects.
• Here we develop a machine learning approach,
extreme gradient boosting (XGBoost), using
approximately 3,700 claims-based predictors as
well as additional membership characteristics and
demographics. We use utilization history over three
quarters to predict costs incurred in a fifth quarter.
• The algorithm performs well with an R2
value of
0.786 in a population of consistent utilizers. A
robust Shapley additive explanation importance
analysis suggests that previous costs are far more
important to predicting future costs than other
claims-based information in these data. Show less

All measured forms of dental care were associated with reduced emergency department (ED) visits for uncontrolled diabetes after accounting for numerous other claims-based indicators of diabetes
management and comorbidities (e.g., chronic obstructive pulmonary disease, congestive heart failure, hypertension, etc.).
In those members with two or more diagnostic dental visits, the hazard of an ED visit is reduced nearly 60% (p < 0.0001). Additionally, there may be a potential dosage… Show more

All measured forms of dental care were associated with reduced emergency department (ED) visits for uncontrolled diabetes after accounting for numerous other claims-based indicators of diabetes
management and comorbidities (e.g., chronic obstructive pulmonary disease, congestive heart failure, hypertension, etc.).
In those members with two or more diagnostic dental visits, the hazard of an ED visit is reduced nearly 60% (p < 0.0001). Additionally, there may be a potential dosage effect where individuals with two or more periodontal treatments had a 59% (p = 0.004) reduced hazard, where individuals with one periodontal treatment (after adjustment) did not have a reduced hazard over those who had no dental claims.
Show less

Education as a risk factor for not receiving prenatal care has been overlooked. Providers and health plans should focus on those women with a high school education or less as they are less likely to engage in prenatal care.

This partnership and type of partnership seem
beneficial to all involved: the psychiatric emergency
services unit, the entity providing the care
coordinator, and the members.
• Although data were incomplete for instances when
a care coordinator was unable to see a patient
face-to-face, those who did receive face-to-face care
coordination services potentially had a 50% (52%
vs. 2%) higher frequency of assistance and 31%
(55% vs. 24%) higher frequency of follow… Show more

This partnership and type of partnership seem
beneficial to all involved: the psychiatric emergency
services unit, the entity providing the care
coordinator, and the members.
• Although data were incomplete for instances when
a care coordinator was unable to see a patient
face-to-face, those who did receive face-to-face care
coordination services potentially had a 50% (52%
vs. 2%) higher frequency of assistance and 31%
(55% vs. 24%) higher frequency of follow up care
scheduled. Show less

BACKGROUND: During April 2011 and April 2012 the Get Yourself Tested campaign was launched throughout the Cook County Health and Hospitals System to promote testing of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) among 15-25-year-olds in a high-prevalence urban community.
METHODS: Retrospective data were collected and analysed. Demographic differences by CT and GC positivity were evaluated along with factors associated with CT and GC status.
RESULTS: A total of 2853 tests… Show more

BACKGROUND: During April 2011 and April 2012 the Get Yourself Tested campaign was launched throughout the Cook County Health and Hospitals System to promote testing of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) among 15-25-year-olds in a high-prevalence urban community.
METHODS: Retrospective data were collected and analysed. Demographic differences by CT and GC positivity were evaluated along with factors associated with CT and GC status.
RESULTS: A total of 2853 tests were conducted among individuals 15-25 years. A total of 2060 (72%) females and 793 (28%) males were tested. Of those tested, 488 (17%) individuals tested positive for either CT or GC or both, 400 (14%) were positive for CT, 139 (5%) were positive for GC. The prevalence for GC was 8.8% (n = 70) in males compared to 3.3% (n = 69) in females (p < 0.001) and the prevalence of CT was 16% (n = 127) for males compared to 13.3% (n = 273) for women (p = 0.057).
CONCLUSIONS: Women in a high-risk population are more likely to get tested for STIs; however, men are more likely to test positive for CT and GC. Get Yourself Tested is an important campaign to encourage wider spread testing among populations at risk in Cook County. Show less

With young men who have sex with men (YMSM) continuing to be disproportionately affected by the HIV/AIDS epidemic in the U.S. , secondary prevention efforts with this population take on increasing significance. We surveyed 200 HIV-positive YMSM (ages 16-24, 66% Black, 18% Latino, 7% White, 7% Multiracial/Other) recruited from 14 HIV primary care sites to examine associations of unprotected anal intercourse (UAI) and partner HIV status with endorsement of serosorting, sexual positioning and… Show more

With young men who have sex with men (YMSM) continuing to be disproportionately affected by the HIV/AIDS epidemic in the U.S. , secondary prevention efforts with this population take on increasing significance. We surveyed 200 HIV-positive YMSM (ages 16-24, 66% Black, 18% Latino, 7% White, 7% Multiracial/Other) recruited from 14 HIV primary care sites to examine associations of unprotected anal intercourse (UAI) and partner HIV status with endorsement of serosorting, sexual positioning and viral load beliefs. Proportions of participants engaging in UAI one or more times during the past three months were consistent across type of UAI (insertive or receptive) and partner status. Belief that an undetectable viral load reduces infectiousness was significantly associated with insertive UAI (p<.05) and receptive UAI (p<.05) with HIV-negative or unknown-status partners and receptive UAI with HIV-positive partners (p<.05). Endorsement of belief in serosorting was significantly associated with receptive UAI (p<.01) and insertive UAI (p<.01) with HIV-positive male partners. Implications for sexual behavior and risk reduction beliefs in this population are discussed. Show less