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BLOG: On Ebola, aspirin and other medical mysteries
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In this issue of Ocular Surgery News, our cover story focuses on a newly discovered uveitis entity — that occurring in the post-acute phase of Ebola infection. It seems trouble is not over for patients afflicted with this life-threatening virus once they heal from the initial respiratory assault. Months later, aggressive uveitis can permanently destroy vision if aggressive and timely therapy is not instituted.
In other medical news, in mid-September, the U.S. Preventive Services Task Force released new recommendations for patients aged 50 to 59 years: These patients should take low-dose aspirin daily if they have a 10% risk of stroke or cardiac event within the next 10 years. Previous analyses for this large risk group have been more conservative on recommending aspirin, citing the risk of bleeding as outweighing the putative cardiovascular benefit. For patients younger than 50 years, the task force concluded, the risk may not justify the use of aspirin, and for those older than 60 years, there’s likely benefit, but consultation with a physician was recommended. Interestingly, although the task force’s conclusions are being heralded as “life-saving” by some, many prominent cardiologists contest the benefits of low-dose aspirin as a purely preventive measure.
A friend of mine used to quip, “Smoking is the No. 1 cause of statistics.” It’s truly amazing with all the investment in clinical research how few true conclusions are agreed upon for fundamental questions in medicine. While our response to the new entity of Ebola is understandably parallel to the knowledge we had of polio in the 1930s, our prevention of cardiovascular disease — two leading killers of Americans that have been the subject of billions of dollars in research — is still very much guesswork. To us as physicians, this lack of “truth” might be disheartening. And yet, rather than being frustrated, we physicians should maybe rather embrace it as another reason why sound medical judgment provided by individual practitioners still reigns as the most vital component in medical care. The thoughtful observation of those clinicians who first discovered the relationship between uveitis and Ebola has changed medicine forever. And whether we’re treating Ebola or cardiovascular disease, what we lack in collective knowledge we can certainly try to overcome by listening to our patients and offering them our best efforts.
Disclosure: Hovanesian reports no relevant financial disclosures.