Clinical trials
oracknows | October 30, 2006Institutional review boards (IRBs) are the cornerstone of the protection of human subjects in modern biomedical research. Mandated by the federal government in the 1970's in the wake of research abuses of the 20th century, in particular the the horrors of the infamous Nazi biomedical experiments during World War II that were documented in during the Nuremberg trials and the Tuskegee syphilis experiment in which black men with syphilis in rural Alabama were followed without treatment in order to study the natural course of the disease, a study that lasted into the early 1970's. In the wake of…
tsmith | October 25, 2006I previously blogged an editorial by NBC medical correspondent Robert Bazell, where he told scientists to "quit whining" about intelligent design and instead work on teaching "values." While I agreed with him there on the science (he made it clear he gave no respect to "intelligent design" and other types of creationism), his suggestion that teachers and scientists spend more time worrying (and teaching) about more "practical" things such as biotechnology and medical ethics was just, in my opinion, wrong. Luckily, his new editorial on alternative medicine contains no such red herrings.…
oracknows | September 5, 2006I was perusing some articles that had accumulated while I was away, looking for ones that I wouldn't want to have missed and also looking for blog fodder (sometimes my day job and my blogging job actually mesh quite well, at least when it comes to discussing biomedical studies), and then I found an article that I had to discuss. Somehow I had missed it in the week leading up to my departure; how that happened I don't know, but it's time to make up for it. In any case, when I saw this article over the weekend, I knew I'd better comment on it, because, mark my words, it will soon be showing up…
oracknows | August 23, 2006Note: One year ago today, an autistic boy, Abubakar Tariq Nadama, died of a cardiac arrest while undergoing chelation therapy to try to "cure" his autism. Today, as I am on vacation, I have scheduled several of my old posts on the topic to appear.The investigation into his death is ongoing regarding whether to file criminal charges against the doctor, although it irritates the hell out of me that they are arguing over whether Tariq was given the "right" agent when in fact there is no "right" agent for chelation therapy for autism. The boy should never have been getting chelation to "cure"…
tsmith | August 19, 2006One catchphrase that permeated the conference this past week was "scaling up." I just want to wrap up my posting here with a brief discussion of what that is, and what that means as far as HIV/AIDS prevention and treatment.
Readers who are scientists or who have some kind of science background will probably be famililar with the concept of a "pilot study." This is a study, generally small in scale, where new ideas are tested, and preliminary data are gathered. For example, a pilot study looking at how the ABCs of prevention work may take 100 individuals and split them into two groups: 50…
oracknows | August 15, 2006Damn you PZ!
(Heh, I haven't gotten to say that since he shamed my profession by showing us an example of a certifiably loony young earth creationist physician running for Lt. Governor of South Carolina.)
This time around, I'm annoyed at PZ for pointing me in the direction of an article so absurd, so ridiculous, so full of postmodernistic appeals to other ways of knowing with respect to science that at first I thought that it had to be a parody of postmodernism in the form of, as PZ put it, suggesting that Foucault or Derrida should have as much value treating your cancer as evidence-based…
tsmith | July 11, 2006If you're a parent, I'm sure you've had all kinds of people give you advice in myriad different areas. Many of them may be in-laws or friends or relatives with children themselves; or they might be strangers in the street with brilliant (or, not-so-intelligent) ideas on how to get your kid to stop throwing a temper tantrum (phrased a bit less politely, "shut that freakin' kid up!"). Or, they may be Evil Monkeys trying to get you to dose your kids with Benadryl to get them to sleep. However, Evil Monkey owns up to his wrong-headed acceptance of folk medicine, linking an article showing that…
tsmith | June 26, 2006...according to a new Nature News story.
Migraine sufferers might soon be able to block an imminent attack using a device that targets the brain with a powerful magnetic field.
The technique, called transcranial magnetic stimulation (TMS), triggers activity in the brain's nerve cells and is already being tested as a way to treat depression. Two small clinical trials have now shown that delivering TMS to the brain in the early stages of a migraine seems to halt it in its tracks.
Since I've dealt with migraines for a long time, this sounds great (though I'll note that the research hasn't yet…
oracknows | May 23, 2006It seems a reasonable question to ask, given my propensity for it.
Unfortunately that's not what our Seed overlords asked this week. This week, they ask:
If you could shake the public and make them understand one scientific idea, what would it be?
Predictably, some ScienceBloggers answered: evolution and what it really means, not the parody of evolution presented by creationists or the simplistic version of it that is often taught in school or discussed in the mainstream media. I can't argue with that answer, but I'm a physician; so my answer will be different:
If I could get the public to…
oracknows | April 11, 2006OK, I've been prodded enough!
Yes, I've been aware of the study purporting to present good anecdotal case reports showing that there might be something to the hypothesis that megadoses of vitamin C can cure cancer where other therapies fail. I've also been aware of an in vitro study that suggested selective toxicity of vitamin C to tumor cells compared to normal cells. I've even been meaning to write about since I first saw it a couple of weeks ago, but the AACR intervened, as did a number of other topics, and, like so many other topics that I want to write about but somehow never find the…
tsmith | March 18, 2006 I discussed the so-called "cervical cancer vaccine," a multivalent vaccine protective against several strains of the human papilloma virus previously here. In the new issue of the New England Journal of Medicine, there's a
perspective on the vaccine, and issues surrounding it:
Genital HPV infection is common, with an estimated 6.2 million new infections each year in the United States. Although most infections are asymptomatic and transient, persistent infection with oncogenic HPV types is a serious health issue. Cervical cancer is the 11th most common cancer among women in the United States…
oracknows | February 24, 2006One of the greatest challenges in medicine can sometimes be to convince a patient that the results of scientific and medical research apply to them, or, at the very least, to explain how such results apply. A couple of days ago, in an article the New York Times, Dr. Abigail Zuker, proposed one reason why this might be, beginning with a discussion with her mother in which she tries to convince her of the benefit of exercise, even in the elderly, a concept that her mother would have none of:
"Studies," she says, dripping scorn. "Don't give me studies. Look at Tee. Look at all the exercise she…
tsmith | January 19, 2006 You just never know where the next insight is going to come from. An observation that surfers with cystic fibrosis (a genetic disease that results in mucus build-up in the lungs leading to an increased susceptibility to infection) reported breathing easier after spending time out on the water led researchers to test salt water as a treatment for the disease. A new study inThe New England Journal of Medicine shows that it worked in their pilot studies.
Patients were given either a 7% or a .9% saline solution to inhale twice a day for 48 weeks. A number of outcomes were measured,…
tsmith | October 31, 2005 As mentioned in the comments to this post, there is a brewing controversy over upcoming guidelines outlining who should receive the "cervical cancer vaccine," a vaccine against the human papilloma virus (HPV). Briefly, the HPV vaccine is a highly effective (100% in a 2-year clinical trial) vaccine which is targeted against two specific serotypes of the human papilloma virus: HPV 16 and HPV 18. Together, these types cause about 70% of cervical cancers in the United States. Previously, Bridget Maher of the Family Research Council, a leading Christian lobby group, has said this about the HPV…