Politics, Science, and Other Assorted Musings

I love helping people understand issues and look at them from a different perspective. In this blog, I hope I can offer you some new insights—bridging the gap between basic science and your medicine chest—as I am still a practicing physician, as well as having had broad clinical research experience. I'm interested in developing new medicines and treatments, as well as caring for patients—and explaining these topics for you.

As medicine has evolved, so have my interests. I have also become increasingly interested in health disparities, social justice issues, and ethics. I invite you to join me as we explore a variety of territories. I hope that reading these posts will encourage you to learn, engage, and above all, work for the forces of good.

If there are topics you'd like to see me cover, please let me know—I welcome your input as to what you would like us to discuss in this column.

Will A Medicine Work For You? A Simple Test Might Tell – Pharmacogenetics

By Judy Stone | November 16, 2019 | 0 Comments

A simple test using a swab of cells from the inside of your cheek can dramatically improve your medical treatment. The test can predict whether a drug will help, if you need a different dosage, or if you are at risk of severe side effects. This testing is called pharmacogenetics or pharmacogenomics. This means studying the interactions of drugs (pharma-) and an individual’s genes (genom-). Genes control how drugs are metabolized and may be different in different people. Treatment can be personalized, or individualized for some classes of drugs. The test can help suggest dosing for some HIV medicines, psychiatric drugs, statins, opioids, cancer drugs, and anticoagulants, but not all medications. A swab of the inside of the mouth is used to obtain cheek cells. The DNA (genetic material) is then extracted from the cells. Then, the DNA is tested to examine specific enzymes that metabolize drugs, drug targets, or immune responses. Did you know that about one in ten people won’t get adequate pain relief from codeine? Many health care workers don’t realize what a poor pain reliever codeine is, unless combined with acetaminophen, nor that some people just don’t metabolize codeine into the active agent, morphine. This may lead to…

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Trade War With China Threatens To Make Problems With Generic Medicine Worse

By Judy Stone | September 29, 2019 | 2 Comments

Earlier in September, Reps. Eshoo and Adam Schiff had an op-ed in the Washington Post, “Opinion | China’s grip on pharmaceutical drugs is a national security issue.” I couldn’t have agreed more. I wrote a letter to the editor, “How a trade war could turn deadly,” published September 19. It was based on my detailed article below, which first appeared in Forbes, last spring: Do you know where your medicines are made? Have you been switched between different generic forms of your medicine, only to find that you responded differently? Ma’s pills in a ginger jar. – Judy Stone Two recent books have echoed my longstanding concern about America’s dependence on other countries for basic needs and the security of our supply chain for medicines. My concern has heightened with the news this week of a tightening trade war with China and saber rattling about Iran. Many of the key ingredients for antibiotics are produced only in China. These are called APIs, or Active pharmaceutical ingredients. Medicine and supply shortages As an infectious disease physician, I was regularly hampered by drug shortages. A global shortage of piperacillin-tazobactam, a critically important antibiotic, occurred because of an explosion at a Chinese factory which was the sole source…

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It’s Tick Season—Know Your Enemy

By Judy Stone | September 21, 2019 | 0 Comments

This post first appeared in Forbes last year. While we are thinking of fall and that we can relax our guard, this is your friendly reminder that ticks are still quite active–and will be any time there is not a freeze. It’s time to worry and ramp up your protective moves; tick season is getting more active. I can’t say it is just starting, as we found ticks on us and the dog in both January and February, most unexpectedly when we had unseasonably warm days. Any time it is above freezing is a risk, but April–September is prime time for the buggers. There are many different types of ticks, but the one we need to be most careful to avoid is the black-legged or deer tick, Ixodes scapularis (or Ixodes pacificus on the West Coast) because it transmits Lyme disease, often difficult to diagnose and treat, and a number of other infections. Deer ticks are most commonly confused with dog ticks, according to Dr. Tom Mather, director of the University of Rhode Island’s Center for Vector-Borne Disease and its TickEncounter Resource Center. Deer ticks and dog ticks are two of the three species most frequently submitted to TickEncounter. The distinction is important, as dog…

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Swimming Pools, Hot Tubs, and Other Summer Recreational Water Hazards

By Judy Stone | July 20, 2019 | 0 Comments

Is nothing safe anymore? Just in time for summer fun, the CDC announced an increase in infections from swimming pools and hot tubs. In their new Morbidity and Mortality Weekly Report (MMWR), the CDC announced that cases of a parasite, cryptosporidium, had increased approximately 13 percent each year between 2009–2017, with 444 outbreaks reported in total. Cryptosporidium is a single-celled organism, a protozoan. It causes diarrhea that often lasts for two to three weeks and is readily missed by the lab. This is because often only a stool culture is ordered, and the parasites are instead seen on direct examination of stool through a microscope. Many community hospitals don’t have techs skilled in this and have resorted to sending stool samples “for ova and parasites” to a reference lab, causing further diagnostic delays. Cryptosporidium is now the leading cause of water-borne outbreaks in the U.S. This parasite made a grand debut in 1993, sickening more than 400,000 people in Milwaukee, Wisconsin—a quarter of the city’s population—and killing sixty-nine, mostly immunocompromised hosts. As a result, many places now filter their water to remove the organism prior to chemical treatment. More recently, Cryptosporidium has been associated mostly with water parks and swimming pools. This is…

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Do You Know Which Mosquito Repellents Really Work? Most People Are Wrong

By Judy Stone | July 7, 2019 | 0 Comments

Being summer–and a wet one at that–it seems appropriate time to repost this favorite from Forbes: Many Americans surveyed in June on how to protect themselves from mosquito-borne diseases like Zika, dengue and Chikungunya are ill-prepared. The June survey by Spectrum Brands Holdings showed that respondents were extremely overconfident about their knowledge. While almost a quarter of participants could not name even one effective active ingredient in insect repellents, 82% incorrectly believed that specific products were effective.   Knowledge of insect repellents As explained in yesterday’s post about the survey results, many participants lacked even basic knowledge about what repellents are effective, although they were confident in their knowledge. Almost all were unfamiliar with some effective insect repellent ingredients, especially picaridin and IR3535, although most recognized DEET. More troubling is that “natural” ingredients, such as citronella, were believed to be effective by 73% of respondents, although they are not. Why the confusion? The topic is not easy to understand and, more importantly, marketing seems very misleading. Here’s what you need to know. What insect repellents are the most effective? Mosquitoes are attracted to people by the scent of several chemicals we produce: lactic acid and 1-octen-3-ol, two skin compounds produced by our…

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Ticked Off – What We Don’t Know About Lyme Disease

By Judy Stone | May 28, 2019 | 2 Comments

It’s tick season again, so I’m sharing this article that first appeared in Forbes in 2015 as a reminder of what to look for. Unfortunately, little has improved in our ability to diagnose Lyme since then. My best advice is to treat your clothes and shoes with Permethrin regularly and to do tick checks several times per day after being outside. The tiny ticks are easy to overlook. I didn’t see the tiny danger lurking in my own yard. Yet for Lyme disease awareness month, just ended, it seems I am learning experientially. I’ve had Lyme at least once before, and found three attached deer ticks on me just in 10 days. I may have had Lyme a second time, last year, but diagnostic tests are so poor that we don’t know. Here’s some of what I learned from my experience and for caring for others in my infectious disease practice. Lyme is increasing I was in disbelief the first time I had Lyme. We hadn’t had problems with it in western Maryland though it was a problem downstate. I didn’t realize that between 1992 and 2010, the number of reported Lyme cases doubled⁠, to about 23,000. In Maine, where I…

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