Wow. Hard as it is for me to believe, Rick and I focus our attention this week on PodMed on the subject of ear wax, or cerumen, as it's known among the medical tribe. Why is that? Because the American Academy of Otolaryngology has published new guidelines on the subject, and it's a lot more impactful (boo!) than we were aware.
Rick points out in the podcast that there are certain groups who are at high risk to have ear wax accumulate and become impacted in the ear canal, including the elderly, small children, those who wear hearing aids and those who live in nursing homes or have dementia. In fact one in ten people may suffer from such a condition. When cerumen becomes impacted hearing can clearly be affected, but a sensation of fullness and even infection can also result. Getting the stuff out is more problematic than you may think; the adage I heard many years ago about never inserting anything larger than your elbow in your ear is once again invoked. Cotton tipped swabs may actually make the problem worse and are not recommended. Folks are advised to see their primary care doc, who can first visualize whether there is a problem, and then use either mechanical means to remove it or chose among several agents to dissolve it. Even this choice may be complicated by whether someone is on a blood thinner or has other medical conditions. Who knew? Guess we're glad they stepped up to this.
Other topics this week include Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative CareA Randomized Clinical Trial in JAMA Internal Medicine, and two from Annals of Internal Medicine:
Firearm Acquisition Without Background Checks: Results of a National Survey and Clinical Outcomes of Metformin Use in Populations With Chronic Kidney Disease, Congestive Heart Failure, or Chronic Liver Disease: A Systematic Review. Until next week, y'all live well.