medicine
oracknows | November 22, 2006A few days ago, I posted a response to another physician who was not happy with me, no, not happy with me at all. What made him unhappy was the vociferousness with which I criticized the creeping infiltration of woo that is insinuating itself into medical school curricula and expressed dismay at the threat that I see to evidence-based medicine (EBM) from it. He interpreted this vociferousness as "anger," but in reality it is more frustration, a dismay that was exacerbated by his defense of including unproven therapies in his practice. I did not respond so harshly somuch because I think that…
moleculeoftheday | November 21, 2006Happy Thanksgiving week to the American readers! In celebration, let's talk gout!
Uric acid is the final product of purine (the bases that comprise exactly half of your DNA) catabolism in humans. Normally, you urinate it out with no problems. Below are guanine and adenine (the two purines that are found the vast majority of the time in vivo) and their metabolite, uric acid:
However, it's rather insoluble, so if you've got too much hanging around, problems arise. It can deposit in various parts of the body, notably (in most first attacks) in the big toe.
Gout is as puzzling as the rest of…
oracknows | November 20, 2006The latest Pediatric Grand Rounds has been posted, and this time it's being hosted by fellow ScienceBlogger Tara Smith at Aetiology. Check it out.
purepedantry | November 20, 2006Women are more susceptible to Post-traumatic Stress Disorder (PTSD) even when the type of the stressful event is controlled for:
Males experience more traumatic events on average than do females, yet females are more likely to meet diagnostic criteria for Posttraumatic Stress Disorder (PTSD), according to a review of 25 years of research reported in the November issue of Psychological Bulletin, published by the American Psychological Association (APA).
The authors reviewed 290 studies conducted between 1980 and 2005 to determine who is more at risk for potentially traumatic events (PTE) and…
oracknows | November 20, 2006I don't know about you, but I was getting a little tired of writing so often about the same topic last week, namely the insinuation of unscientific and unproven "alternative medicine" into the medical school curriculum and its promotion by the American Medical Student Association (AMSA). I had planned on giving the topic a rest for a while, but then on a mailing list to which I subscribe, an example came up of something so outrageously egregious that I had to post just one more time. (Dr. R. W., as usual, has beaten me to it, but I plan on going into it in a little more detail.) It's a…
oracknows | November 19, 2006A couple of days ago, I wrote a criticism of the increasing tendency to teach woo in American medical schools and then later followed up with a post questioning the contention that teaching woo has the benefit of improving the doctor-patient relationship. A physician going by the 'nym Solo Practitioner took umbrage:
As a physician, I find the anger with which this blog is written disturbing. The National Center for Complementary and Alternative Medicine was created by the NIH to provide grant money and motivation for research to be performed in these fields in order to apply evidence-based…
oracknows | November 18, 2006Fellow ScienceBlogger (I'm not all that enamored of the term "SciBling") Abel Pharmboy has finally weighed in on the issue of alternative medicine woo finding its way into medical school curricula and its promotion by the American Medical Student Association, which Dr. RW, Joseph, and I have been discussing the last few days.
Besides using his experience in natural products medicine to discuss this issue, Abel asks a very pointed question from a patient's perspective:
So, someone like me who feels a doctor doesn't have time for them might approach any one of the growing number of integrative…
purepedantry | November 17, 2006The most commonly cited causes of the obesity epidemic over the last 30 years are decreases in physical activity and increased consumption of unhealthy foods: the Big Two. For these as causes, we have what can only be described as an overwhelming quantity of evidence.
However, many other causes of increased obesity have been suggested such as environmental endocrine disruptors or chronic sleep deprivation. In an editorial in the International Journal of Obesity, Keith et al. argue that for some of them the evidence is quite solid -- meriting further study and possibly public health…
oracknows | November 16, 2006My recent post (coupled with similar posts by Dr. R. W. and Abel Pharmboy) about the American Medical Student Association (AMSA) and its credulous promotion of non-evidence-based alternative medicine while posing as being "skeptical" of big pharma brought this rejoinder from Joseph of Corpus Callosum, in which he took issue with one aspect of my suspicion of the promotion of woo in medical schools by AMSA. I have to strenuously disagree with nearly all of his points. Here's the first, and most easily dismissed:
They [Dr. R.W., Abel, and I] raise some valid points, although I would not be…
moleculeoftheday | November 16, 2006The urea entry ended up with a discussion in the comments I encourage you to read about early organic chemists, one of whom was Kolbe, who first prepared acetic acid (an indisputably organic and biologically relevant molecule) from inorganic compounds. He worked with Wohler (mentioned in the urea entry) as well as Robert Bunsen (of burner fame). From the ACS bulletin above:
In the course of work on chlorinated ethanes Kolbe effected the first complete synthesis of an organic compound, acetic acid, from inorganic precursors. His carbon source was carbon disulfide, chlorination of which gave…
oracknows | November 15, 2006Change of Shift, the blog carnival for nursing, comes to us from the U.K. at Life in the NHS.
purepedantry | November 15, 2006On The Colbert Report last night, Stephen Colbert talked about an article about uterine transplants for The Word. Scientists now claim that there is nothing technically to prevent us from performing a womb transplant, even to the point that you could put a uterus in a man:
Scientists claim that the first human baby could be born from a transplanted womb within three years.
Animal experiments have dismissed many of the concerns that womb transplants could not produce healthy babies.
The Swedish expert behind the research says that one of the best candidates to be an organ donor would be the…
purepedantry | November 15, 2006The answer is that it increases lymphocyte motility, helping to fight the infection:
Nobody likes coming down with a fever, but feeling hot may do a body good. Researchers report online 5 November in Nature Immunology that a fever in mice revs up the immune response by helping white blood cells enter lymph nodes, where they join the battle against microbial invaders.
All mammals can develop fever when they're sick enough, and even cold-blooded animals with infections, such as fish and lizards, will seek warmth to raise their body temperatures. This suggests that fever somehow helps the body…
j7uy5 | November 15, 2006I've quietly worried about this for a few years, but now I have
company. Increased temperatures, combined with increased
climate variability, could have a significant effect on human health
worldwide.
href="http://hosted.ap.org/dynamic/stories/C/CLIMATE_HEALTH">Diseases
Appear on Rise With Temperature
Nov 14, 5:51 PM EST
By CHARLES J. HANLEY
AP Special Correspondent
NAIROBI, Kenya (AP) -- A warmer world already seems to be producing a
sicker world, health experts reported Tuesday, citing surges in Kenya,
China and Europe of such diseases as malaria, heart ailments and dengue…
j7uy5 | November 15, 2006The Union of Concerned Scientists is concerned again. This
time,
they are concerned the possibility that a fourth-generation
cephalosporin,
href="http://www.intervet.co.uk/Products_Public/Cephaguard_Injection/090_Product_Datasheet.asp">cefquinome,
could be approved for use in animal feed.
It seems obvious that this could lead to more problems with antibiotic
resistance. If bacteria are exposed to these antibiotics in
sublethal amounts, in animals, those bacteria probably would develop
resistance to the antibiotics. If those same bacteria later
cause
infection in humans, the…
oracknows | November 15, 2006Effect Measure has a good post about the NIH granting process. I'm not going to rehash what revere said, as far as the description of what happens once a grant application arrives at the NIH and how it winds its way through the Initial Review Group to one of many study sections through programmatic review. In any case, I agree that it's a crappy system--except for all the others. Certainly it has much to recommend it. Junior scientists compete for funds with more senior scientists on a more equal footing than perhaps any other nation in the world, and almost anyone can get a grant if they…
j7uy5 | November 15, 2006First there was Alternative Medicine, then there was Complimentary and
Alternative Medicine, and now there is Integrative, Complimentary and
Alternative Medicine.
I guess the natural cynic in me becomes suspicious when I see acronyms
undergoing hypertrophy.
So is this growing collection of concepts worthwhile? Do we
really need to create a terminology? Or does the acronym
creep indicate that the concepts are to vague, too ill-defined, to
merit the creation of a term?
href="http://scienceblogs.com/insolence/2006/11/the_future_of_american_medicine_woo_1.php">Orac,
href="http://…
oracknows | November 14, 2006Monty Python invades Grand Rounds over at the rumors were true.
Read it, or we shall be forced to say "Ni!" to you.
purepedantry | November 14, 2006We're mad as hell, and we are not going to take it anymore:
In recent years, women's health has been a national priority. Pink ribbons warn of breast cancer. Pins shaped like red dresses raise awareness about heart disease. Offices of women's health have sprung up at every level of government to offer information and free screenings, and one of the largest government studies on hormones and diet in aging focused entirely on older women.
Yet statistics show that men are more likely than women to suffer an early death.
Now some advocates and medical scientists are beginning to ask a question…