medicine
oracknows | May 27, 2007Over the last couple of months, I've written periodically about cancer research and the complaints that the present system of funding grants and of peer review stifles innovation, as well as whether ideas for which there is some evidence but which fall out of the mainstream are given a fair shake. My overall take has been that, while the complaints have some merit, those making them tend to overstate their case dramatically. Either that, or their obvious agendas, such as making it easier to get funding for pseudoscience or rehabilitating the reputation of a crank, make it obvious that their…
oracknows | May 26, 2007Cicadas!
I don't think I'd have the self-control that the children pictured above do, though.
oracknows | May 26, 2007I had thought of featuring this little gem on Your Friday Dose of Woo before, but my Friday feature usually requires a bit more to go on. Well, not exactly. Rather, it requires a bit more quotable material, the better for hilarity to ensue, and this is just a book with a description and some comments, but it's a nice bit of bizarre bonus silliness to start out the long holiday weekend.
The title of the book?
How to Good-Bye Depression: If You Constrict Anus 100 Times Everyday. Malarkey? or Effective Way? by Hiroyuki Nishigaki
I kid you not. Thanks, Stupidity Tracker, for turning me on to this…
oracknows | May 25, 2007I've been meaning to go through the recent meta-analysis of Avandia published by the New England Journal of Medicine that purported to show major increase in the risk for cardiac events (myocardial infarctions and cardiac death) in patients who use Avandia, but somehow never got around to it. I'm not sure I need to now, given how, via Kevin, MD, I've found this rant byThe Angry Pharmacist, who has looked over the meta-analysis and found that there is considerably less there than meets the eye and that the value of the study is considerably different than what has been reported in the press.…
oracknows | May 25, 2007Hot on the heals of the loss of Flea and other medical bloggers, Dr. Hébert announces without explanation other than that "I've had enough" and "I'll be gone for a little while."
Cryptic indeed.
I can understand why someone might quit blogging or take a hiatus. However, if I were ever to decide to do either, I'd at least give you an explanation.
oracknows | May 25, 2007One of the banes of a physician's existence is not so much keeping up with changes in how medicine is practiced, studying new treatments, and following the medical literature. After all, that comes with the territory; it's part of the job. Failure to keep up is to become increasingly ineffective and even to risk malpractice lawsuits. No, what's a major bane is to document that you've kept up. In other words, it's to get enough continuing medical education (CME) credits to be able to renew your medical license. In my state, I have to get 100 CME credits in two years in order to renew my…
oracknows | May 24, 2007Our creationist neurosurgeon, Dr. Michael Egnor, isn't going to like this one bit. No doubt he'll try to call it "artificial selection" or a "tautology" when he finds out about it, if he doesn't just ignore it because he it doesn't fit in with his view that studying evolution is "of no value" in medicine. Too bad, because, via Derek Lowe at In the Pipeline, I've found a really cool application of evolutionary biology to the development of antibiotic resistance in response to vancomycin that sheds light on the molecular mechanisms behind the development of antibiotic resistance in…
oracknows | May 24, 2007A number of readers have mailed me links to this story, and, yes, it is right up my alley. In reading it, I fear that it's a vision of the future for two young cancer patients who are very unlikely to survive their cancers because their parents eschewed evidence-based medicine in favor of woo, Starchild Abraham Cherrix and Katie Wernecke, both of whom had relapsed when last I discussed them. The case is one with which I had not been familiar, namely that of Noah Maxin, of Canton, OH:
CANTON No one in the courtroom nearly five years ago wanted this day to come. Not Noah Maxin's parents. Not…
j7uy5 | May 23, 2007This
is in response to a
href="http://scienceblogs.com/corpuscallosum/2007/05/childhood_ptsd.php#comment-439606">comment
from a prior post. There are a few related questions here.
Can preemies develop PTSD, can
they be labeled with PTSD, if they can get PTSD is it fundamentally the
same as it is in adults, and if it is different, should we call it
something else????
The comment was left by Stacy, the author of a blog,
href="http://thepreemieexperiment.blogspot.com/">The Preemie
Experiment. I spent a bit of time on
href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi">Medline…
oracknows | May 22, 2007While I'm on the topic of alternative medicine and NCCAM again, I've said on many occasions that I reject the distinction between evidence-based medicine and "alternative medicine" as a false dichotomy. To me, the only dichotomy that matters is between medicine that has high quality scientific evidence showing that it works and medicine that does not, a category that includes plausible treatments that might work but have not yet been shown to work and treatments, implausible treatments with little or no evidence of efficacy (a category that includes the vast majority of what is lumped…
oracknows | May 22, 2007I've complained on multiple occasions about the infiltration of non-evidence-based "medicine" (a.k.a. woo) into every level of medicine in the U.S.. Worst of all, it's infiltrating medical education in a big way, starting with the pro-woo activism of the American Medical Student Association (AMSA), to various educational programs in various medical schools, to even the mandatory medical curriculum in at least one prestigious medical school. This is more than just teaching what various "alternative medical" therapies are, so that new physicians know what their patients are referring to or…
oracknows | May 21, 2007I would be remiss if I didn't mention that I recently noticed that one of my favorite medical bloggers, Flea, had completely deleted his blog. There's nothing there. It's gone, except for a blank Blogger blog. Apparently, too, Flea's not alone, as Kevin, MD points out.
I'm going to miss Flea, but I understand why he might have done it. As he had documented in the weeks leading up to the disappearance of his blog, he was being sued for malpractice. Indeed, I was amazed at how honest he had been about some of the pretrial preparations he was undergoing. It was great reading, but probably ill-…
oracknows | May 21, 2007I hadn't planned on revisiting this topic again quite so soon, but sometimes a piece of information comes up that's so disturbing that I can't ignore it and can't justify delaying blogging about it by very long. So it is yet again with the strange and disturbing saga of dichloroacetate (DCA), the small molecular chemotherapeutic drug with a novel and scientifically interesting mechanism of action that could lead to a whole new class of chemotherapeutic agents and that has shown considerable promise in rat tumor models but has not yet been tested in humans. Not to belabor the story, which has…
j7uy5 | May 21, 2007
One of the things that most consistently surprised me, when I was doing
the consultation-liaison rotation in residency, was how common delirium
was, and how frequently it was missed by the medical team.
Even since then, it has evolved into a pet peeve of mine. The
brain is a rather important organ, and when it shows acute signs of
dysfunction, you'd think doctors would notice and pay attention.
All too often, they do not.
Why is this so important?
A recent paper in the BMJ indicates:
Delayed
or missed diagnosis is an important issue — non-detection of
delirium in emergency…
oracknows | May 20, 2007It would appear that I must respectfully disagree (or be Respectfully Insolent, if you will) with fellow comic fan Scott over at Polite Dissent.
Two of my all-time favorite comics are Fantastic Four and (believe it or not, given my present day disdain for woo) Doctor Strange. Doctor Stephen Strange, for those of you not familiar with him, started out as an incredibly arrogant and greedy neurosurgeon who was involved in an auto accident in which he suffered nerve damage to his hands that impaired the fine motor control to the point where, while he could function normally in every day life, he…
oracknows | May 19, 2007Abel Pharmboy shows why I shouldn't have left my American Society of Clinical Oncology (ASCO) proceedings abstract sit on my desk unread for a week.
Damn. Talk about blowing an opportunity. Of course, given that I don't own any pharmaceutical stocks (making me a rather poor "tool of big pharma" indeed), it doesn't matter.
j7uy5 | May 19, 2007I
specifically remember a phrase from a handout I read in the second
year of med school, imploring us to not depersonalize patients by
referring to them, for example, as "the pancreas in room XXX."
That was the thought that I had when I saw a photo in the LA Times:
This
is only a part of the photo, the whole thing is unpleasnt to see.
It is from a 3-part feature on the treatment and fate of
soldiers wounded in Iraq.
I think it is a bad sign when someone writes a number on your chest
with a magic marker...
I
mean, I can see why they do it. It probably helps, in two
ways. One,…
scientificactivist | May 18, 2007On Tuesday, California governor Arnold Schwarzenegger released a revised lethal injection protocol in hopes of reversing a moratorium on capital punishment in the state put in place by a February 2006 federal court ruling. From the LA Times:
On Tuesday, Gov. Arnold Schwarzenegger's legal affairs secretary, Andrea L. Hoch, and James Tilton, director of the California Department of Corrections and Rehabilitation, said the new protocol addressed all the issues U.S. District Judge Jeremy Fogel raised in finding that the state's previous procedures violated the constitutional ban on cruel and…
grrlscientist | May 18, 2007tags: mosquito, DNA, Aedes
After recently mapping all the DNA, or genome, of the mosquito that spreads yellow and dengue fever, scientists were surprised to find it is more complex than the genome of the mosquito that carries malaria. Scientists plan to use this information to help them battle disease.
Researchers published the genome yesterday for the mosquito, Aedes aegypti, which spreads disease in tropical and sub-tropical locales worldwide as it feeds on human blood. The mosquito's genome could guide researchers' efforts to develop new insecticides or to create genetically engineered…