Shifting Paradigms in Evidence-Based Medicine: 15 Evolving Perspectives | May 26 2025, 01:16

I stumbled upon 15 examples where evidence-based medicine has shifted its stance over time. Truly intriguing; there was a lot I didn’t know.

1. Cholesterol: “bad vs “good

Originally, total cholesterol was considered the main risk. Nowadays, it’s more important to look at LDL (“bad) and HDL (“good) in the context of inflammation and overall metabolic state. High levels of LDL (“bad)—a confirmed risk factor for cardiovascular diseases, especially when HDL (“good cholesterol) levels are low.

2. Saturated Fats

Long considered a cause of cardiovascular diseases. Modern studies have proven: trans fats are indeed harmful, but natural saturated fats in moderate amounts are permissible. In the USA, as I understand, there has been a complete ban on adding artificial trans fats to food products since 2021, while in Russia, as I found, there is a limit of 2% trans fat content in certain products, but no total ban and less stringent control measures are in place.

3. Hormone Replacement Therapy (HRT)

HRT was long believed to protect against cardiovascular diseases in women. The WHI study (2002) showed an increased risk of heart attacks, strokes, and breast cancer with combined therapy.

4. Vioxx (rofecoxib)

This drug was heavily advertised as safe for joints. In 2004, it was withdrawn from the market due to an increased risk of heart attacks. It was found that the manufacturer had hidden side effects.

5. Antiarrhythmics Post-Heart Attack

Drugs like flecainide were used post-heart attack. The CAST study (1989) showed: such drugs increased mortality.

6. Low-Fat Diets

Fats were once considered the main culprits of obesity. Today, it’s clear that replacing fats with sugar and fast carbohydrates only intensified the epidemic of diabetes and metabolic syndrome.

7. Infant Weaning

Solid foods used to be introduced at 2–3 months. Today, WHO recommends exclusive breastfeeding until 6 months.

8. Stomach Ulcer and Helicobacter pylori

Ulcers were once linked to stress and diet. Now, it’s known that the main cause is H. pylori infection. Treatment involves antibiotics. Upon my arrival in the US, it was immediately detected and treated.

9. Antidepressants and the “Serotonin Theory

Depression was formerly explained by a lack of serotonin. Nowadays, this theory is not supported, and the effectiveness of antidepressants is critically assessed.

10. Omega-3

Omega-3 supplements were once regarded as a panacea for the heart. Major studies (e.g., VITAL, 2018) found no benefits in healthy individuals. Eating fish continues to be considered beneficial.

11. Vitamin D

Its deficiency was associated with many diseases. However, meta-analyses have shown: vitamin D supplements do not prevent cancer, diabetes, and heart attacks unless there is a deficiency.

12. Aspirin for Prevention

Aspirin used to be prescribed to many healthy individuals. Today, its use is limited to high cardiovascular risk due to the risk of bleeding.

13. Statins

Previously prescribed widely, including for moderately elevated cholesterol. Now prescribed selectively, based on overall risk assessment.

14. “Safe Opioids

In the 1990s, it was claimed that OxyContin did not cause addiction. This triggered the opioid crisis in the USA—one of the biggest challenges to the healthcare system.

15. PSA Testing for Prostate Cancer

Mass PSA screening led to overdiagnosis and unnecessary surgeries. Nowadays, its use is individualized, after discussion with the patient.

Navigating Tick Territory: A Cautionary Tale | May 25 2025, 22:49

Caught a tick with a surprise (LD), gobbling antibiotics. Around our parts, venturing into nature requires a spacesuit 😞 dogs have it good, pop a pill and all the ticks that bite you drop dead at the bite. Just in case, it’s probably not a good idea to kiss him on the nose now.

Exploring Pronunciations and the Curious Naming of Lululemon | May 25 2025, 21:23

Today I discovered an interesting story about the name of the brand Lululemon (see below) and it turns out, not only is `ballet` pronounced in English as bal-AY (it seems everyone knows this), but also `cabriolet` as ka-bree-ow-ley, `valet` as val-AY, and even `parquet` as paar-kay. `buffet` is also pronounced as buh-FAY, but there is also the verb `to buffet` which is pronounced as BUH-fit. and `sorbet` is pronounced as sor-BAY. They are all borrowings from French.

It also turned out that aborigine is pronounced as a·buh·ri·juh·nee. `apostrophe` and `catastrophe` are pronounced as uh·po·struh·fee and kuh·ta·struh·fee respectively. `coyote` is pronounced as `kai·ow·tee`. The word `dilettante` (did you know there are two t’s together?) is pronounced as di·luh·tan·tee. Well, about recipe (reh·suh·pe) and fiance (fee-ahn-say) everyone probably knows.

I also read an interesting story about why Lululemon is called just that. Lululemon Athletica founder, Chip Wilson, shared: “The reason the Japanese liked Homeless (his former skateboard brand) was that the name had the letter “L. A Japanese marketing agency would never come up with a brand name containing “L because it isn’t in their alphabet. They find it hard to pronounce. So I thought: next time I have a company, I’ll invent a name with three “Ls and see if I can make three times the money. It’s amusing to watch them try to pronounce it.” (2004 interview with National Post Business Magazine)

Lessons from a Tick-Infested Trail | May 25 2025, 11:34

Walking around the house with Yuka, it’s like a whole zoo here. But nature is treacherous indeed. Just the other day, one trail with ticks resulted in a vet visit, and now I’m off to the emergency room. We both got bitten, only Nadya got off lightly. One lesson shines through: in tick-infested places, you should march like she did with bare legs, so all those parasites are in plain sight during the assault on the fortress. I was in jeans, and they took full advantage of that.

Choosing the Tesla Model Y 2026: A Personal Review | May 24 2025, 18:53

Well, congratulate me 😉 I’ve finally picked the Tesla Model Y 2026, despite doubts about whether it’s worth paying Musk. I carefully analyzed all the alternatives to the “horrible Tesla,” but the new model beats all competitors, some by a significant margin. The only thing is I could have saved a bit. Tesla has finally made decent interior materials, and they and the exterior design finally match the price. And the AWD with a 4.5-second acceleration is hard to underestimate.

The level of automation from the buying process to driving is so advanced that, as an IT professional, I find it hard to rank anything above it.

I drove home for half an hour on full autopilot. Really cool, but after three months I won’t renew it; it’s pricey, although good. On some left turns, I would let more oncoming cars pass than it does, but, I must admit, it calculates very accurately.

Exploring the Forest Trail: Ticks, Trails, and Late-Night Returns | May 18 2025, 02:01

It turned out that there is a forest near the house and a 12-km trail runs through it, around the reservoir. We hadn’t even reached home yet, and I had already removed 20 ticks from myself (none had attached), about five from Nadya, and at least ten from Yuki.

We didn’t quite estimate the time well and ended up returning literally at night. What I like about American infrastructure is that it’s usual to find a restroom open at night by the parking area in the forest, with hot water, where Yuki could wash his paws before getting into the car.