Medicine
oracknows | June 21, 2010Over the last few decades, there has been a veritable explosion in the quantity of scientific journals and published papers. It's a veritable avalanche. Some of the reason for this is simply the increase in the number of scientific researchers that has occurred over the last few decades. Another reason I'd suggest is that there are now numerous whole fields of science that didn't exist 30 years ago, fields such as genomics, HIV/AIDS, angiogenesis, and various technologies that have come into their own in the last decade or so. It's not surprising that these disciplines would spawn their own…
oracknows | June 18, 2010In the wake of President Obama's election, there was a great deal of hope that he would take science-based medicine seriously and, as he promised in his inaugural speech, "restore science to its rightful place." Shortly before Obama's inauguration, in fact, Steve Salzberg proposed that the Obama administration should defund the National Center for Complementary and Alternative Medicine (NCCAM).
NCCAM, as you may recall, is a center in the National Institutes of Health largely dedicated to funding pseudoscience. True, there is some legitimate research mixed in with the pseudoscience, but it's…
mmckenna | June 17, 2010A set of papers published this month in two journals provide an unsettling glimpse into the rocketing incidence and complex epidemiology of one really scary pathogen, Acinetobacter baumanii.
In the all-star annuals of resistant bugs, A. baumanii is an underappreciated player. If people -- other than, you know, disease geeks -- recognize it, that is because it's become known in the past few years for its propensity to attack wounded veterans shipped to military hospitals from Iraq and Afghanistan, earning it the nickname "Iraqibacter." (Important note: Steve Silberman of Wired magazine took an…
palmd | June 16, 2010I've been teaching internal medicine for a number of years now. The practice of internal medicine falls into two broad categories; inpatient medicine, and outpatient medicine. Because of certain historical imperatives, internal medicine training is heavily biased toward inpatient education, and these days, inpatients are sick. To qualify for hospital care a patient must be receiving care that cannot be given outside the hospital; they must meet criteria for intensity of service and severity of illness. Ask any old-timer doc and they will tell you that hospitalized patients are much sicker…
mmckenna | June 15, 2010Via the Journal of the American Medical Association, a report from Spain: the first recorded outbreak, in a Madrid hospital, of Staphylococcus aureus resistant to linezolid (Zyvox), one of only a few drugs still available to treat very serious infections of drug-resistant staph, MRSA. This is bad news.
Background: The M in MRSA stands for methicillin, the first of the semi-synthetic penicillins, created by Beecham Laboratories in 1960 in response to a worldwide 1950s outbreak of penicillin-resistant staph. The central feature of the chemical structure of both penicillin and methicillin is an…
egrossman | June 13, 2010by Elizabeth Grossman
"The biggest thing we're going to see in the next month or so is heat. The hottest months are ahead. There's no shade on the water, on the beach or in the marshes. We're going to see an increased amount of heat exhaustion and heatstroke," Dr. James Callaghan, emergency room physician and vice president of hospital staff at the West Jefferson Medical Center (WJMC) in Marrero, Louisiana told me on Saturday morning June 12.
The hospital has admitted eight spill response workers thus far but, said Callaghan, "There are triage centers before they get here, so very few…
dgmacarthur | June 11, 2010It looks as though the FDA is swooping down on the direct-to-consumer genetic testing industry in a serious way, sending formal letters to five companies informing them that their tests will be regulated as medical devices:
WASHINGTON -- The Food and Drug Administration is issuing regulatory letters to five genetic test makers, the first sign that the government is cracking down on companies that claim to use DNA samples to predict inheritable diseases.
The FDA letters notify each company that their tests are considered medical devices and therefore must be federally approved as safe and…
oracknows | June 10, 2010Let's see. Now that I'm back from Chicago, having recently attended a major cancer meeting, not to mention having already blogged about the meeting, what to do next? Sure, the whole thing about Andrew Wakefield finding himself just one step away from appearing on Jeff Rense's or Alex Jones's radio show was amusing in the extreme to me, and no doubt there will be much more blogging material to mine in that vein, but if you really want to bring home the crazy there's only one place shy of Whale.to to visit.
That's right, I'm talking about that wretched hive of medical scum and villainy, Mike…
oracknows | June 9, 2010Well, I'm home.
As I've mentioned before, I attended the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago. Although one of the problems with ASCO, at least for surgeons like me, is that it is a meeting completely dominated by medical oncology. Quite frankly, not that much of what is presented at ASCO has a lot of relevance to my surgical practice. There are exceptions, of course. In fact, Monday morning's sessions on breast cancer were the best of science-based medicine that will change practice. Perhaps I'll blog about that tomorrow or later in the week. As I…
oracknows | June 7, 2010Orac is currently away at the ASCO meeting in Chicago. Shockingly, he was so busy that he didn't bother to write anything last night. Fortunately, he found something from the archives that's perfect for this occasion. This was originally written in 2005 on the "old' Respectful Insolence blog and then reposted in 2006. That' means if you haven't been reading at least three and a half years, it's new to you. It's also related to scientific meetings. Hmmm. This reminds me. I really should update this or do more installations in the saga, even if five years late. If you have any ideas, leave 'em…
oracknows | June 6, 2010I forgot to mention on Friday that I'm currently in Chicago attending the ASCO meeting. It's a lot of fun seeing the latest that science-based medicine has to offer, although ASCO isn't always my cup of tea. The reason is that it's very heavily based in medical oncology and chemotherapy, and there aren't a lot of surgical talks. Another reason is that it's a clinical meeting; so there isn't a lot of basic science. Still, there's plenty to keep my busy, and my blogging may be irregular over the next couple of days. Worse comes to worst, I'll post a "best of Orac" or two. Nothing short of death…
dgmacarthur | June 3, 2010Jay Flatley, CEO of sequencing giant Illumina, announced at the Consumer Genetics Conference today that the company had reduced the price of its retail whole-genome sequencing service. At $19,500 this still isn't in the realm of an impulse buy for most of us, but it's a long way down from the $48,000 that Illumina offered at the launch of its service, and more than an order of magnitude below the $350,000 price paid for the first ever retail genome.
Illumina's press release notes that bulk orders of 5 or more genomes drop the price to $14,500 per genome, and "[i]ndividuals with serious…
clock | June 2, 2010Hi Café Friends,
Our June Science Café (description below) will be held on Tuesday 6/15 at the Irregardless Café on Morgan Street. Our café speaker for the evening will be Dr. Dianne Dunning from the NCSU School of Veterinary Medicine. Join us for a thought provoking discussion with Dr. Dunning about the relationships humans have with animals in our increasingly crowded world.
The Human-Animal Bond
Tuesday June 15, 2010
Time: 6:30 - 8:30 pm with discussions beginning at 7:00 followed by Q&A
Location: The Irregardless Café, 901 W. Morgan Street, Raleigh 833-8898
Animals touch our…
lborkowski | May 27, 2010A New York Times article by Jane Gross highlights a costly healthcare problem: avoidable hospital readmissions, which affect one in five patients and account for $17.4 billion of the current $102.6 billion Medicare budget. (When people talk about readmissions, they're generally referring to an admission within 30 days of the previous admission for the same condition.)
When patients end up back in the hospital, it's often because their care didn't continue appropriately when they were first discharged. Patients leaving the hospital should receive detailed instructions about what they need to…
palmd | May 26, 2010As my regular readers know, I'm not a big fan of our current health care system. Our bloated, industry-driven system manages to deliver less effective care at a higher cost than most other industrialized nations. The system is Byzantine, unnavigable, and dangerous, and is kept that way in the name of the Holy Market. But health care can benefit from practices that are decidedly un-capitalist, at least in the Milton Friendman or Ron Paul sense.
Like aviation, health care must apply risky and expensive practices to large numbers of people in dangerous situations. This process is made safer by…
oracknows | May 23, 2010
An old Chinese combined proverb and curse is said to be, "May you live in interesting times." Certainly, with respect to vaccines, the last few years have been "interesting times." Unfortunately, this week times are about to get a lot more "interesting" as the Autism One quackfest descends upon Chicago beginning today. Featuring prominently in this quackfest will be an anti-vaccine rally in Grant Park on Wednesday featuring some really bad, anti-vaccine fundamentalist Poe-worthy "music" and a keynote speech by Andrew Wakefield himself. If you want evidence that Andrew Wakefield is being…
oracknows | May 23, 2010Andrew Wakefield's back, and he's sure trying to come back big.
I knew when I last wrote about his utter humiliation and disrepute that he wouldn't stay away for long. In fact, he stayed away longer than I thought--a whole three months. Unfortunately, though, he appears to be on a full media blitz to try to rehabilitate his image in the wake of his having been found to have committed research misconduct, leading to The Lancet retracting his article that started the anti=vaccine MMR scare back in 1998, which further led to NeuroToxicology withdrawing his execrably bad "monkey business" study…
dgmacarthur | May 20, 2010The brief Golden Age of direct-to-consumer genetic testing - in which people could freely gain access to their own genetic information without a doctor's permission - may be about to draw to a close. In a dramatic week, announcements of investigations into direct-to-consumer genetic testing companies by both the FDA and the US Congress have sent the personal genomics industry into a spin, and it is still impossible to say exactly which way it will be pointing once the confusion passes.
I've been frustratingly unable to find the time to cover the developments as they happened due to other…
oracknows | May 20, 2010Around this time last year, the major topic of this blog was the case of a young teen named Daniel Hauser. In fact, right around this time last year, this particular case was approaching its climax. Hauser, as you may recall, was the 13-year-old Minnesota boy diagnosed with Hodgkin's lymphoma who refused chemotherapy. His stated reason was his religion, namely Nemenhah, a fake American Indian religion that his parents joined 18 years ago. However, I had my doubts that religion was the main reason why Hauser was refusing chemotherapy and his mother was supporting his decision to pursue "…
jgoldman | May 20, 2010[Below is a longer, less edited version of an article I wrote for my department newsletter this month.]
Is science blogging something that belongs to Science or to Journalism? Clearly more and more scientists are communicating online. In a time when mainstream media are obliterating their science departments, science blogging is growing, and the few science journalists left are increasingly turning to science blogs for story ideas. And so is the general public. A recent press release from ScienceBlogs indicated that the network, the top social media network in the science category, had…