medicine
denialism | July 26, 2007The Washington post reports on new efforts by insurance companies to rate doctors performance and their policies that penalize doctors for performing poorly according to their metrics.
After 26 years of a successful medical practice, Alan Berkenwald took for granted that he had a good reputation. But last month he was told he didn't measure up -- by a new computerized rating system.
A patient said an insurance company had added $10 to the cost of seeing Berkenwald instead of other physicians in his western Massachusetts town because the system had demoted him to its Tier 2 for quality.
...
In…
j7uy5 | July 25, 2007Infections
with
href="http://www.wpro.who.int/media_centre/fact_sheets/fs_20050802.htm"
rel="tag">Streptococcus suis
have been reported in a cluster in Viet Nam, plus one
apparently-isolated case in China. This is not the first
outbreak of the pig-borne illness. A
href="http://www.who.int/csr/don/2005_08_03/en/index.html">larger
outbreak occurred in 2005 in Sichuan, China. In
2005, there were 205 reported cases, with 36 fatalities.
Earlier, a 1998 outbreak involved 14 deaths out of 25
reported human cases. Cases have been recorded dating back to
the 1960's. No cases have been…
oracknows | July 25, 2007...At least, that's what I most definitely say after reading this account of The rise & fall of the prefrontal lobotomy.
One question that stands out: How could a stepmother force her stepson to get a lobotomy just because she didn't like his sullenness and defiance, even after being told by other doctors that there was nothing wrong with the boy? An observation that stands out is that medicine and surgery are periodically caught up in fads. That's why it's every bit as important to apply evidence-based medicine to the newest procedures and treatments as it is to apply it to alternative…
oracknows | July 25, 2007Yesterday, when I wrote about a death in Arizona caused by a homeopath doing liposuction, what amazed me the most was that homeopaths are licensed in Arizona. Although I alluded to it only briefly in yesterday's post, I was truly astounded at what homeopaths are allowed to do in Arizona. It piqued my curiosity--and horror. Consequently, I decided to delve a bit more deeply into the website of the Arizona Board of Homeopathic Medical Examiners.
There are more horrors in there than I thought. Those of you who live in Arizona should be afraid--very afraid!--about what these quacks are permitted…
jstemwedel | July 24, 2007Almost a year ago, I learned about the case of the Tripoli six, five Bulgarian nurses and a Palestinian physician in Libya sentenced to death for infecting hundreds of children with HIV despite the fact that the best scientific evidence indicated that the children were infected due to negligence in the hospital well before these health care workers even arrived in Libya.
I asked you to write letters on behalf of the Tripoli six, in the hopes that they might get another trial in which the scientific evidence mattered to the verdict. Good people that you are, I know that lots of you did write…
grrlscientist | July 24, 2007tags: Medicine, Grand Rounds, blog carnival
After being a regular contributor for over one year, I somehow stopped submitting entries to Grand Rounds, which was one of my favorite blog carnivals. But after a long (two year) absence, I am back because they included one of my entries in this week's issue, volume 3, number 44. As always, there are plenty of other great stories there as well for you to read and enjoy. I am especially interested to read this debate that they included; "Is mental illness adaptive?"
oracknows | July 24, 2007Normally, when I hear such a term as "homeopathic surgery" or of homeopaths doing surgery, I get the irresistable urge to make jokes about it, such as wondering if homeopathic surgery is surgery diluted down to the point where not a single cell in the body is injured or whether homeopathic surgeons make ultra-tiny incisions. Actually, that second quip risks confusing homeopathic surgeons with laparoscopic surgeons, and I'd never do that. I respect laparoscopic surgeons. Laparoscopic surgery is very difficult, and I have the utmost respect for my colleagues who can do complex operations…
j7uy5 | July 23, 2007I was
reading about the
href="http://www.medicalnewstoday.com/articles/24941.php">epidemic
of vitamin D deficiency, got curious
about albinism,
and ended up finding this picture of a white lion. It is
distributed under a
creative commons license, attribution required. The
photographer is
face="Helvetica, Arial, sans-serif">Stano Novak.
The original, in much higher resolution (and not compressed
for the web) is in
href="http://commons.wikimedia.org/wiki/Image:White_Lion.jpg"
rel="tag">Wikimedia.
This is not to be confused with the band named
href="http://www.…
j7uy5 | July 23, 2007
href="http://content.nejm.org/cgi/content/full/357/3/e3">
face="Helvetica, Arial, sans-serif">This image
shows what can happen to your retina from a sudden increase in venous
pressure. What could cause such a sudden increase?
Jumping straight down, followed by sudden upward
acceleration. The patient initially had 20/400 vision in the
affected eye. After surgery it stabilized at 20/25.
The image, by the way, can be viewed full-size at the
open-access NEJM article:
href="http://content.nejm.org/cgi/content/full/357/3/e3">Macular
Hemorrhage from Bungee Jumping.
See for…
oracknows | July 23, 2007The other day, Sid Schwab, surgeon blogger extraordinaire, brought up a question that, I'm guessing, most nonsurgeons wonder about from time to time when contemplating how it is that we surgeons do what we do.
What about bathroom breaks?
Given that most of the surgery that I do is breast surgery, my operations rarely take more than two or three hours. The only time a typical operation that I do takes longer than that is the uncommon times when I am doing a double mastectomy, and even then it's rarely more than a four hour affair. All I have to do is to make sure to hit the bathroom right…
oracknows | July 23, 2007After the invasion of the smoking cranks last week into the comments of the three posts I somehow ended up doing on the topic of secondhand smoke (SHS), the health dangers it poses, and some of the deceptive quote mining used in the service of trying to discredit studies demonstrating a moderate but real risk from SHS , I was ready to move on to other topics. I'll give these guys credit for one thing; they're almost as persistent as the antivaccinationists. Despite my flooding this blog with fluff unrelated to smoking and the hazards it causes (or even, for that matter, medicine or surgery),…
jstemwedel | July 22, 2007Orac's calculated value (if he shuffled off this mortal coil in his present state -- and I really hope he doesn't) piqued my curiosity and led me to calculate the value of my own potential cadaver. But the calculated value leaves me curious about the assumptions underpinning the calculation.
First, my results:
$4875.00The Cadaver Calculator - Find out how much your body is worth. From Mingle2 - Free Online Dating
(Hey, my corpse is worth more than Orac's, to the tune of $1285!)
Now, the questions:
Is the underlying assumption that the value of my cadaver would come primarily from…
oracknows | July 22, 2007I'm not sure whether this is reassuring or depressing.
$3590.00The Cadaver Calculator - Find out how much your body is worth. From Mingle2 - Free Online Dating
Mingle2 - Free Online Dating
So...how much is your cadaver worth?
(Found via Attuworld.)
scientificactivist | July 22, 2007Today's New York Times includes a profile of drug safety advocate Dr. Steven E. Nissen by medical business writer Stephanie Saul:
His questioning of the safety of the Avandia diabetes medication in late May, for example, prompted a federal safety alert and led to a sales decline of about 30 percent for the drug, which brought in $3.2 billion for GlaxoSmithKline last year. Now, with a federal panel soon to decide whether it can remain on the market, Avandia's future is uncertain.
The drug is the latest example of why Dr. Nissen, 58, whose day job is chairman of cardiovascular medicine at the…
j7uy5 | July 21, 2007The
href="http://www.sanofi-aventis.us/live/us/en/index.jsp">Sanofi-Aventis
obesity pill,
rel="tag">rimonabant, will be labeled with
stronger warnings as a result of
href="http://www.irishhealth.com/?level=4&id=11864">a review
by The European
Medicines Agency (EMEA).
According to the
href="http://www.emea.europa.eu/humandocs/PDFs/EPAR/acomplia/32982607en.pdf">EMEA
press release on Acomplia (31 KB PDF file):
The
European Medicines Agency (EMEA) today recommended contraindicating
Acomplia (rimonabant) from sanofi-aventis, in patients with ongoing
major…
oracknows | July 20, 2007It sure took the FDA long enough, nearly five months, but it finally acted. It finally shut Jim Tassano down, as this notice on TheDCASite.com states:
Two agents from the FDA visited us on Tuesday,July 17, 2007 and ordered that we stop making and selling DCA. Unfortunately, the site www.buydca.com will be shut down immediately.
It is against US government law to sell substances with the suggestion that they are cancer treatments unless they are approved by the FDA.
DCA can still be obtained from pharmacies with a prescription and from chemical companies.
To keep you informed and abreast of…
oracknows | July 20, 2007Here's a rather interesting wrinkle in the regulation of chiropractors. This time, it's New Jersey:
A recent state court decision has hundreds of chiropractors across the state bent out of shape because it sharply limits what they can legally do.
And while the decision is being appealed to the state Supreme Court and state legislators have proposed amending state law to return the field to where it was, changes are not expected for months.
In the meantime, the decision "definitely wiped out a source of income, because we were able to bill for the extremity adjustment before and now we can't…
oracknows | July 20, 2007After over a year of delving into the world of woo, I had been starting to think that my ability to be surprised had disappeared. I mean, just think about it. After dealing with things like DNA activation, quantum homeopathy, the Healing Broom, Healing Sounds, and, of course, colon cleansing and liver flushing, I thought I had seen it all. However, another thing I've learned is that the most amusing woo is not necessarily the battiest. Sure the DNA activation guy and Lionel Milgrom can put out some woo that is so unbelievably out there, so bizarre, so amazing over the top that rational,…
denialism | July 20, 2007Writing for HuffPo, Charlottesville's own Barbara Ehrenreich takes on positive psychology. I have to remember to drop by sometime with a cake and welcome her to the city, even if it is a year too late.
She addresses something very annoying about the belief that positive thinking is a universal good (and provides a backhanded slap to Depeak Chopra and "the Secret"), that there isn't much proof that it really works - at least not in situations of ongoing stress. Further, a more insidious aspect of the emphasis on positive thinking is a blame-the-victim mentality inherent in its proponents…
j7uy5 | July 19, 2007There
was an outbreak of botulism in the past several days in the
United States. The problem was traced to contaminated canned
chili sauce intended for use on hotdogs. Product from
Castleberry Food Company based in Augusta, Georgia is suspected.
But what is botulism, exactly, and how/why is it so lethal?
There
are actually three different ways to get botulism. The
most common occurs when a person eats improperly canned food, usually
food canned at home. It is also possible for human infants to
get botulism when they are fed something that contains live spores.
Most often, the…