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Cake day: July 6th, 2023

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  • This article leaves me with a lot of questions. As I understand it, SPF labels in the US have to apply to both UVA and UVB. They tried labels specific to each but decided that they were too confusing. Next, you don’t need more than about SPF 35 to get appropriate protection from skin cancer. SPF rating higher than that offer only marginally more protection. Lastly, how are these “chemical” sun screens blocking UV. If it’s not physically blocking the light, are they somehow changing the spectrum of the light so that it is not harmful? So, other than this guy who has spent $18B to try to sell his product in the US gunning for it, what is the advantage of the newer “chemical”? Do they last longer, cost less, have other functions for health and beauty? Are they generally easier to use?









  • I see this in my office constantly and there are lots of reasons surrounding it. All of my patients get a mini mental status exam (MMSE) with their yearly physical after age 65.The ones with any impairment tend to deny it as real. If there is impairment, I try to work it up with labs and then a brain MRI. Insurance won’t cover a brain MRI for MCI, so it has to be coded as “memory loss”. Memantine and donepizil are not indicated for MCI, just dementia, so we don’t prescribe them that early. We wait until it progresses. Also, I’ve seen a ton of patients over the years who have “microvasular changes” on brain imaging done for other reasons that no one has discussed with them, much less actually done an appropriate cognitive assessment and further workup. I don’t know why I am such an outlier in these areas, because I’m not doing things that aren’t indicated by specialty recommendation. I think it’s just another sign of our broken system.