Medicine
oracknows | November 7, 2008As I've said before many times, herbal or plant-based medicines are about the only kind of "alternative" medicine that has significant prior scientific plausibility based on what we know about science. That's because plants often contain biologically active molecules; i.e., they often contain drugs. Of course, the problem with plant-based medicines is that they are, in essence, highly contaminated drugs, the predictability of whose responses is variable because the amount of active ingredient can vary widely.
There's also a problem when claims for a plant-based compound become grandiose. It…
sb admin | November 7, 2008When reporting on science, reporters and editors like sexy stories. Since most science isn't particularly sexy, there's usually a hook. If you can squeeze "risk" and "cancer" into a headline, an editor sees good headline. What I usually see is a sensationalist article that is going to get it very wrong.
One of the questions most often asked in the medical literature is "what is the risk of x?" It's a pretty important question. I'd like to be able to tell my patient with high blood pressure what their risk of heart attack is, both with and without treatment. And risk is a sexy topic---the…
oracknows | October 31, 2008I feel bad.
I realize that I've been completely neglecting my Academic Woo Aggregator. You remember my Academic Woo Aggregator, don't you? It was my attempt to compile a near-definitive list of academic medical centers that had "integrated" woo into their divisions or departments of "integrative medicine" (i.e., departments of academic-sounding quackery). Perusing it, I now realize that it's been over five months since I did a significant update to it. You just know that, given the rate of infiltration of unscientific medical practices into medical academia as seemingly respectable treatment…
oracknows | October 28, 2008The other day, I thought it was about time that I did some of that cool and fancy ResearchBlogging.org stuff, you know, to keep this blog from being nothing more than a collection of not-so-Respectfully Insolent spleen venting at generalized stupidity. I realize that those are some of the funnest posts here and that people like them, but a little variety is required. No study, however, had quite floated my boat, and I was almost to the point of being desperate enough for blog fodder that I considered perusing Age of Autism or even NaturalNews.com (maybe later in the week) in search of that…
oracknows | October 27, 2008Hot on the heals of my post earlier today about the flurry of misinformation-laden ads being aired in Michigan to try to prevent Proposition 2, the proposed amendment to the Michigan State Constitution that would allow embryonic stem cell research using embryos that would be discarded from fertility clinics, I've learned that my alma mater, the University of Michigan, where I did both my undergraduate and medical school training, has released a series of videos countering the dishonest propaganda of groups like MiCAUSE:
The truth about stem cell science
And there's more:
Where Do Embryonic…
oracknows | October 27, 2008Two years ago, there was a brouhaha in Missouri over a ballot proposal to allow state funding for embryonic stem cell research using discarded embryos from fertility clinics. The issue made national news, including some rather despicable rhetoric from Rush Limbaugh about Michael J. Fox, who made ads in support of the Missouri initiative, as well as deceptive ads against the proposal featuring Patricia Heaton and members of the St. Louis Cardinals. It was a big stink that drew national attention.
Fast forward to two years later and to my home state of Michigan, and history appears to be…
clock | October 25, 2008You have probably heard that Governor Palin, in a recent speech contradicted herself within a span of a couple of sentences. So, she said that "Early identification of a cognitive or other disorder, especially autism, can make a life-changing difference.", then in the next breath dissed that same research: "You've heard about some of these pet projects they really don't make a whole lot of sense and sometimes these dollars go to projects that have little or nothing to do with the public good. Things like fruit fly research in Paris, France. I kid you not." You can see that part here:
This…
terrasig | October 24, 2008"Prescribing 'placebo treatments': results of national survey of US internists and rheumatologists," is the title of a newly-published article in the 23 October issue of BMJ (British Medical Journal). The full text article and PDF are available for free at the time of this posting.
In this study of 679 US physicians, Tilburt et al. reveal that 46-58% of those responding report regularly using some sort of placebo in their practice. The reason for the range is that questions were asked in a manner that did not use the word, "placebo," but instead took into account:
"Placebo treatment" is an…
jstemwedel | October 24, 2008Jake has a great post up today about the frequency with which American internists and rheumatologists prescribe placebos and the ethical questions this raises. Jake writes:
For my part, I don't think I would be comfortable deceiving my patient under any circumstances. I see my role as a future physician partly as a healer but also as an educator. Patients -- particularly patients with intractable chronic illnesses -- want to understand what is happening to them. I almost feel like in deceiving them, I would be denying them that small measure of control -- that small measure of dignity --…
purepedantry | October 24, 2008A survey of American internists and rheumatologists has revealed that over 50% of them regularly prescribe placebos. Tilburt et al. surveyed internists and rheumatologists to see whether they were prescribing placebos, and if so how and what kind they were using. The study, published in BMJ, found the following:
679 physicians (57%) responded to the survey. About half of the surveyed internists and rheumatologists reported prescribing placebo treatments on a regular basis (46-58%, depending on how the question was phrased). Most physicians (399, 62%) believed the practice to be ethically…
bioephemera | October 24, 2008Today I encountered yet another example of the misleading language I see all too frequently in coverage of science news. I was browsing a health newsletter (the "Pink Sheet") when I saw this:
NeuroSearch pill doubles weight loss, study finds A Phase II trial of tesofensine found that the drug caused about 10% more weight loss in obese patients compared with placebo and diet. The finding indicates that the treatment, manufactured by Danish firm NeuroSearch, is twice as effective as existing obesity pills, which provide about 5% of weight loss.
Okay, how much weight loss does tesofensine…
purepedantry | October 23, 2008Whenever you are having a debate -- particularly a policy debate -- it is always important to check your premises. That is why I found this article in the Journal of the American Medical Association refreshing.
Emergency Department utilization is clearly on the rise in the US, and this rise in use is leading to longer wait times and diminished quality of care. One assumption that the cause of this problem are the uninsured, i.e. the uninsured are using the ED as an alternative to primary care and causing overcrowding.
However, Newton et al., in what will likely be a provocative article,…
oracknows | October 22, 2008I hate it when an article starts right out with a rather annoying usage of terminology, even when it provides information that interests me:
(AP) -- Nearly a fourth of widely used new-generation biological drugs that treat several common diseases produce serious side effects that lead to safety warnings soon after they go on the market, the first major study of its kind found.
Included in the report released Tuesday were the arthritis drugs Humira and Remicade, cancer drugs Rituxan and Erbitux, and the heart failure drug Natrecor. All wound up being flagged for safety.
That might surprise…
sb admin | October 20, 2008I took on the ScienceOnline09 anonymity panel because I thought it might be interesting, but the conversation that has developed has turned this into a much deeper issue than I had anticipated. I'm stepping into a big, brown pile of ethics here, and hopefully Janet won't make too much fun of me.
Abel over at TerraSig has a number of posts up already, and today DrugMonkey brought up a very interesting question.
The science blogosphere, being a new medium, is slowly developing a set of practical normative ethics (geez, I hope that's the right term), and that this is a critical time to start to…
oracknows | October 19, 2008Note: The following is a collaborative post between James (a.k.a. Dad of Cameron of Autism Street) and Orac. Feel free to tell which parts were written by whom.:-)
Jenny McCarthy's latest book, Mother Warriors: A Nation of Parents Healing Autism Against All Odds, contains a foreword penned by "pediatrician to the stars' children", Dr. Jay Gordon. Dr. Gordon (or, as he often refers to himself, Dr. Jay), is the pediatrician for Jenny McCarthy's son Evan, whose autism McCarthy blames on vaccines and whom she has also claimed to have "cured" of autism with so-called "biomedical interventions. Dr…
clock | October 19, 2008
Genes Hold Secret Of Survival Of Antarctic 'Antifreeze Fish':
A genetic study of a fish that lives in the icy waters off Antarctica sheds light on the adaptations that enable it to survive in one of the harshest environments on the planet. The study is the first to search the genome of an Antarctic notothenioid fish for clues to its astounding hardiness.
Physical Decline Caused By Slow Decay Of Brain's Myelin:
During this year's baseball playoffs, Chicago White Sox outfielder Ken Griffey Jr., 38, threw a picture-perfect strike from center field to home plate to stop an opposing player from…
oracknows | October 17, 2008It's time.
Well, it's sort of time, anyway.
As you know, it's been over three months since I last indulged in my little Friday exercise known as Your Friday Dose of Woo. At the time it was because I couldn't get myself into the appropriately light-hearted but nonetheless just vicious enough frame of mind to do the exercise after we had to have our dog put to sleep. In retrospect, however, it was clear to me that the whole feature had been running on fumes for a while before that. It had become a bit stale and, I thought, could benefit from a hiatus. At the time, I hadn't planned for the…
sb admin | October 16, 2008On call one night as a medical student, I was presenting a case to my intern. As I recounted the patient's ER course, the intern stopped me and said, "Pal --- trust no one."
That sounded a little harsh to me, but the intern was nice enough to explain further.
"Look, you're going to be taking calls from doctors and nurses the rest of your career. They are going to give you information about a patient, but it's you who will be responsible for everything that goes right and wrong. Do you want to hang yourself on someone else's evaluation?"
As any internist knows, there is a perpetual tension…
oracknows | October 16, 2008I thought I had seen it all.
Ever since I first discovered the antivaccination movement that is utterly convinced, despite all evidence to the contrary, that mercury from the thimerosal preservative that was in many vaccines until the end of 2001 or, more recently, vaccines themselves cause autism, I've been amazed at the panoply of dubious ideas proposed about how vaccines might bring this about. There is, of course, the claim of neurotoxicity from mercury, even though the symptoms of mercury toxicity do not come close to matching those of autism. Then, of course, there is the related claim…
oracknows | October 14, 2008Why, oh, why do I keep perusing NaturalNews.com?
Why do I subject myself to wave after wave of neuron-apoptosing stupidity of a magnitude that even activation of NF-kappaB, Akt, and neuronal cell survival signaling pathways can barely keep the killing stupidity at bay? I guess it's because it provides such good blog fodder for a skeptical blog dedicated to science- and evidence-based medicine. On the other hand, it often gives me a headache to read its contents. Really, it does. I mean, looking at how Mike Adams, the Woo-meister Supreme and Chief Tin Foil Hat responsible for the lunacy there…