About John Staples

John Staples

All posts by John Staples

Initial Antibiotic Choice for Community Acquired Pneumonia

• April 2nd, 2015

The basic symptoms which occur in pneumonia … are as follows: acute fever, sticking pain in the side, short rapid breaths, serrated pulse and cough.   – Maimonides (1138–1204 AD) Antibiotic treatment of community-acquired pneumonia (CAP) is one of the most remarkable medical developments of the 20th century, yet the choice of initial antibiotics is not… Read More…


Eliminating Barriers to Teen Contraception

• October 1st, 2014

Unplanned pregnancy can be a lucrative topic for Hollywood, with movies like Precious, Boyhood, Juno and Knocked Up collectively making hundreds of millions of dollars. Yet what’s profitable for producers comes at great socioeconomic cost to teen mothers and their children. Watching a movie about this public health problem isn’t likely to help. Is there… Read More…


Naloxegol for Opioid-Induced Constipation

• June 18th, 2014

Did opioid-induced constipation contribute to Elvis Presley’s death? Would he still be making music today if he’d won the battle with his bowels? Though many disagree, Elvis’ former personal physician thinks that a cure for the King’s constipation might have spared his life. If this kind of conjecture from suspicious minds leaves you all shook up… Read More…


Sepsis, Albumin, and the Therapeutic Potential of Improving Oncotic Pressure

• April 9th, 2014

In physiology, as in all other sciences, no discovery is useless … we may be certain that every advance achieved in the quest of pure knowledge will sooner or later play its part in the service of man. —    Dr Ernest Henry Starling, The Linacre Lecture on the Law of the Heart (1915) Modern sepsis treatment owes a… Read More…


Tuberculosis Control in the Gold Mines of South Africa

• January 22nd, 2014

It’s a clinical trialist’s dream: A prevalent disease, an effective intervention, and an implementation strategy that’s practical in a community setting. How could the result be anything but dramatically positive? In this week’s NEJM, the Thibela TB study investigators report on a cluster-randomized trial with a setting precisely this promising – and discuss their unexpected results…. Read More…


Test-tubes and Tumors: Cancer Risk in Children Born after Assisted Conception

• November 6th, 2013

When Louise Brown was born at Oldham General Hospital in 1978, her arrival brought even more excitement than your average infant. Her birth prompted a flurry of media attention, commentary from the man who would soon become Pope John Paul I, and a Nobel Prize for physiologist Sir Robert Edwards. Why all the fuss? Louise… Read More…


Worrisome or not? Lung nodules identified on initial LDCT lung cancer screening

• September 4th, 2013

Long the domain of astrologers and tarot card readers, prediction has recently become downright fashionable. While quant-minded individuals like Billy Beane and Nate Silver have achieved fame and fortune using probabilistic forecasting, dozens of smartphone apps deliver the predictive insight of clinical risk scores to doctors’ fingertips. Why all the enthusiasm? Accurate predictions allow us… Read More…


Does Serotype Replacement Erode the Benefits of Pneumococcal Vaccination?

• July 10th, 2013

Picture this: You’re in your primary care office trying to convince a young mother to bring in her newborn for vaccinations in his second month. Sleep deprived and stressed, she says: “I know I should do it, doctor, but if it’s not one thing, it’s another. My eldest got the pneumonia vaccine a few years… Read More…


The Truth Behind the Lie: Prone Positioning in Severe Acute Respiratory Distress Syndrome

• June 5th, 2013

Physicians have long realized that a little change in position can go a long way. Is Mr. X’s peripheral arterial disease causing him ischemic rest pain? Keep those legs dependant. Is Mrs. Y getting orthopnea from uncontrolled heat failure? Sit her up and she might get some relief. Is the sight of blood making your… Read More…


PREDIMED: Supplemented Mediterranean Diets and the Prevention of Cardiovascular Events

• April 3rd, 2013

Mr. Smith decided to get serious about his cardiovascular health when he turned sixty. He comes to your clinic one day to tell you that he’s stopped smoking and that he’s been more attentive to the treatment of his hypertension and dyslipidemia over the last few months. “I’m really turning things around, Doc,” he tells you,… Read More…