Medicine
sb admin | September 26, 2008But apparently he'd rather have me fill it with coffee. Really...I mean it. I love coffee, but c'mon now! I can't stand that this idiot is given time on public television during pledge drives to peddle his woo...
I stumbled across a website that goes on and on about the supposed vast conspiracy of the medical community to...well, I'm not sure. Anyway, given that you have to buy Gary Null's quack tomes to get his advice, it's hard to know exactly what he is selling. The conspiracy theorist from the above-linked site was kind enough to share some of Null's secrets (at least they are cited that…
oracknows | September 24, 2008Here we go again.
Tuesday night and yesterday, you probably saw it, plastered all over the media, in the newspapers, on ABC, on the radio, in press releases, and around the blogosphere. Yes, it was another bit of science by press release, with news outlets practically falling all over themselves to hype the results of an acupuncture study reported earlier this week at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). Leading the pack was ABC News:
A new medical study finds that acupuncture, an ancient form of healing that has been around for thousands…
revere | September 24, 2008We don't post much about clinical topics here, mainly because we haven't done much practice since our medical training days. I'm primarily a researcher and professor. But every once in a while I see papers on subjects that strike a nostalgic chord from those days and yesterday was one of those once-in-a-whiles. This was a report of a paper (DOI: 10.3748/wjg.14.5282) about what we used to call "gall balls in the gall bag," that is, gall bladder disease from gallstones. My medical school was located at a gigantic hospital with a very famous surgical program. And the chief surgeon there was most…
oracknows | September 23, 2008If there is one difference that defines scientific medicine compared to "alternative medicine" it is the application of the scientific method to health claims. Science and the scientific method require transparency: transparency in methodology, transparency in results, transparency in data analysis. Because one of the most important aspects of science is the testing of new results by other investigators to see if they hold up, the diligent recording of scientific results is critical, but even more important is the publication of results. Indeed, the most important peer review is not the peer…
oracknows | September 22, 2008Oddly enough, I'm more tired this morning than I was on Friday.
That's the sort of thing that happens when I actually do as much work over the weekend as I often do on two typical weekdays. The reason is that I've suddenly found myself with an unexpected promotion, and--oh, by the way--there's stuff that needs to be done on Monday. Consequently, my originally intended topic for Monday will have to wait until Tuesday or Wednesday, mainly because it might require a bit of thought. That's OK. It'll wait. Besides, it'll be much more useful and educational if I have a little time to think about it…
oracknows | September 19, 2008As a cancer surgeon, I maintain a particularly intense contempt for peddlers of cancer quackery. Although I've been fortunate enough not to have had to see the end results of it more than a handful of times in my career, women with bleeding, stinking, fungating tumors with widespread metastases that could have been treated if they hadn't decided upon woo rather than good old-fashioned surgery, radiation, and chemotherapy, I've become aware of enough such cases and seen the dishonest marketing of quackery enough to drive me to maintain this blog and undertake other activities to promote…
oracknows | September 17, 2008Well, well, well, well.
Sometimes science and ethics do win out after all:
CHICAGO (AP) -- A government agency has dropped plans for a study of a controversial treatment for autism that critics had called an unethical experiment on children.
The National Institute of Mental Health said in a statement Wednesday that the study of the treatment -- called chelation -- has been abandoned. The agency decided the money would be better used testing other potential therapies for autism and related disorders, the statement said.
The study had been on hold because of safety concerns after another study…
revere | September 16, 2008As blogger Roy Poses at Health Care Renewal wrote, some things you can't make up. Trying to compete with the Department of Veterans Affairs in the "can you imagine what they did" sweepstakes i fruitless, as I have cause to know. They are perhaps the most dysfunctional federal agency I have ever encountered, although admittedly my experiences working for them predated the Department of Homeland Security, which from all evidence is the all time champion in incompetence and dysfunctionality. Back to the VA:
U.S. House members on Tuesday admonished Veterans Affairs officials from Pittsburgh for…
oracknows | September 16, 2008Dr. Paul Offit's book Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure has hit the bookstores, and, as predicted, the mercury militia is going into a frenzy of spin and smear. As is usual, because they have no science to support their viewpoint, they are reduced to extended ad hominem attacks. For example, the clueless wonder of a reporter who couldn't find the Clinic for Special Children and the autistic children treated there but nonetheless confidently exclaimed that he couldn't find any autistic Amish children, goes for a full frontal assault in a little…
terrasig | September 15, 2008The Japanese scientist who grew fascinated by fungi as a boy is one among five of this years' recipients of a Lasker Award. Endo was specifically given the Lasker~DeBakey Clinical Medical Research Award.
Dr Akira Endo first isolated the hypocholesterolemic compound, mevastatin or compactin, from Penicillium citrinum. Compactin was the forerunner to the 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG CoA reducatase) inhibitors. This fungal natural product gave rise to the cholesterol-lowering "statin" drugs. While not without risk of adverse events, this drug class is widely…
oracknows | September 13, 2008After yesterday's lovefest that really did go to my head. Really, when I wrote it I wasn't trolling for praise, although in retrospect it now does kind of look that way to me. I was simply expressing amazement that anyone would listen to a pseudonymous (although not really anonymous anymore) blogger. Fortunately for my ego, which threatens to expand until it pops like an overinflated balloon, there are are readers who aren't all that impressed by me. Heck, there's even a whole blog, every blogger of which really, really detests me. (I leave it as an exercise to the reader to guess to which…
sb admin | September 12, 2008One of our sciblings, Dr. Signout, is learning the ropes as she struggles (and presumably excels) through her medical residency. As her writing has picked back up, she has brought up some important questions about medical education and medical professionalism. I'm a little further along in my career than she, and I have some thoughts that may flesh out her experiences, and shed some light on the medical profession as a whole.
Her latest posts brought up two particularly important issues, one about how doctors are treated "without the white coat" and the other on what it means to put…
oracknows | September 12, 2008I've often written about the intersection of medicine and religion. Most commonly, I've lamented how the faithful advocate inappropriately injecting religion into the doctor-patient relationship in a manner that risks imposing the religion of the health care practitioner on the patient, sometimes through physicians feeling no obligation to inform patients of therapeutic options that violate their religious beliefs or pharmacists refusing to dispense medications that (they claim) violate their beliefs. Another common thread running through this blog is criticism of religion when it leads…
dgmacarthur | September 10, 2008
Yesterday I discussed the decision of personal genomics company 23andMe to slash its price for a genome scan by 60%, to under $400.
In the comments to that post, industry observer David Hamilton pointed me to an article he's written for BNET on the implications of 23andMe's price plunge, which (like everything he writes) is well worth a read.
Hamilton has long argued, quite compellingly, that the true business model of personal genomics companies relies only indirectly on selling genome scans to consumers:
...personal-genomics companies don't intend to make money by selling the tests.…
oracknows | September 9, 2008Well, here's a rare bit of good news in the endless tedium that has become the U.S. election. It appears that Barack Obama has ticked off the antivaccine contingent. I know, I know, I said I would try to lay off this topic for a few days, but this is just too amusing. Apparently, he's gone a long way towards redeeming himself for his previous gaffe when it came to vaccines and autism, and the antivaccine zealots over at Age of Autism are all in a tizzy over it:
Last Friday evening, September 5, 2008, I had the opportunity to ask Senator Barack Obama about childhood vaccine safety/choice. His…
oracknows | September 9, 2008If there's one thing I really detest, it's cancer quackery. Indeed, one of the very earliest posts on this blog was about this very topic, and applying science, skepticism, and critical thinking to extraordinary claims of cancer cures has remained a major theme of this blog ever since. Shortly after that, I described how, because of the variable course of cancer and the fact that many cancers are cured with surgery alone, "testimonials" for cancer quackery can sound very convincing. It's a topic I've covered several times over the three and a half year history of this blog. Whenever a high…
revere | September 9, 2008This week CDC's Morbidity and Mortality Weekly Reports (MMWR) has a quick statistical snapshot of the percent of adults (over the age of 18) who used Complementary and Alternative Medicine (CAM) by sex and selected conditions. CDC defines CAM as
A group of diverse health-care systems, practices, and products not presently considered to be part of conventional medicine. CAM includes acupuncture; ayurveda; homeopathic treatment; naturopathy; traditional healers; chelation therapy; nonvitamin, nonmineral, natural products; diet-based therapies; chiropractic or osteopathic manipulation; massage…
jstemwedel | September 8, 2008Back in July, Science ran an interesting news article about an on again, off again clinical trial of chelation therapy in the treatment of autistic children. I found the story fascinating because it highlights some of the challenges in setting up ethical research with human subjects -- not to mention some of the challenges inherent in trying to help humans to make good decisions grounded in the best available scientific knowledge.
From the Science article:
Believing that mercury in vaccines triggers autism, thousands of parents, often at the advice of their physicians, have given their…
oracknows | September 8, 2008If there's one thing that cancer researchers, indeed most biomedical researchers in the U.S., know today it's that the research funding climate sucks right now. Indeed, after the completion of the near-doubling of the NIH budget in 2003, during which time it was flying high, the NIH budget in essence crash landed--hard. Paylines, which had been well over the 20th percentile (meaning that over 20% of grant applications in any give deadline cycle were funded) plummeted to near single-digit ranges almost overnight. Indeed, I almost fell victim to this myself in 2004. The initial score on my R01…
dgmacarthur | September 5, 2008I have every intention of living forever, but I'm deeply aware of a number of factors that stand in my way. I'm not female, for a start; I wasn't born to a young mother; I enjoy my food far too much to ever consider caloric restriction; and I hate exercise with a passion. So right now my game plan is basically to rely on advances in medical science, and hope like hell that I have the right genes - bearing in mind that at least 25% of variation in life expectancy is genetically determined.
Finding the actual genes that influence longevity, however, has long proved problematic. In fact, the…