Medicine
oracknows | August 20, 2009One of the advantages of hanging out around home on the proverbial staycation is that, instead of actually paying more attention to the news, I've paid less attention to the news. That's why I didn't notice some stories from earlier this week about what the new director of the NIH, Francis Collins, plans to do.
Regular readers probably know that, other than the occasional snarky comment on other people's blogs, I haven't (much) engaged in the blogospheric kerfuffle over Collins' religion and the (in my opinion) vastly overblown fear in some quarters that he would inject his religion into his…
razib | August 17, 2009Fat Tax:
Which is why it is so striking to talk to Delos M. Cosgrove, the heart surgeon who is the clinic's chief executive, about the initiative. Cosgrove says that if it were up to him, if there weren't legal issues, he would not only stop hiring smokers. He would also stop hiring obese people. When he mentioned this to me during a recent phone conversation, I told him that I thought many people might consider it unfair. He was unapologetic.
"Why is it unfair?" he asked. "Has anyone ever shown the law of conservation of matter doesn't apply?" People's weight is a reflection of how much…
terrasig | August 16, 2009
Artemisinin is a natural product isolated from the leaves of the annual wormwood, Artemisia annua. Used originally in Chinese herbal medicine, the pure compound is employed in Africa as an inexpensive antimalarial drug. In April, 2009, the multinational pharmaceutical company Novartis received FDA approval for a combination drug called Coartem®, comprised of the semi-synthetic artemisinin analog, artemether, and another novel antimalarial, lumefantrine.
An herbal preparation of artemesinin has recently been associated with a single case of hepatic injury as reported in this week's issue of…
thusspakezuska | August 14, 2009As I recently reported, my mother's wallet was stolen last week, containing her bank card, driver's license, and insurance and Medicare cards. This has resulted in hours and hours of work for me to deal with replacing the cards, working with the bank to contest the fraudulent charges on her account, etc.
I'm going to tell you something the health insurance company probably won't, because I'm not sure that the people who answer the phones even understand that their system works like this.
When you call to report your lost or stolen insurance card, the insurance company will naturally want…
palmd | August 13, 2009There is no clear definition of "quackery". Stephen Barrett, founder of Quackwatch, discusses the slippery nature of the definition and the issues of intent and competence. Defining quackery of necessity involves some subjective judgment, but there are objective parameters we can apply. If someone is hyping a medical practice without adequate scientific evidence and is profiting from it, they are a quack.
Quackery differs from "fraud", which is a legal concept. In my state health care fraud is defined as:
Intentional deception or misrepresentation made by a person with the knowledge…
revere | August 13, 2009Science Based Medicine is a site we highly recommend with experienced scientists and practitioners in charge. In other words, it's run by adults. But scientists often disagree about things. This is apparently a secret to non-scientists and many reporters who assume that when two scientists disagree, one is lying or wrong. But it's true nonetheless. Whatever the subdiscipline, there are disagreements. If you pick up almost any issue of Science or Nature you will find plenty of them, usually (but not always) couched in polite language in the Introduction or Discussion section of a paper or in…
revere | August 11, 2009Yesterday (today as I am writing this) the British Medical Journal published another Cochrane meta-analysis on the efficacy of neurimminidase inhibitor antivirals (the only two in use now, being oseltamivir [Tamiflu] and zanimivir [Relenza]). Their conclusions have made the news, so I guess I should cast my baleful eye on their handiwork. I think there is less here than meets the eye, but first let's look at what meets the eye.
This is a meta-analysis, that is, an analysis of other analyses, the other analyses in this case being drug trials of Tamiflu or Relanza in children. So it's an…
oracknows | August 7, 2009Dr. Bob Sears is the bane of science- and evidence-based pediatricians everywhere. As pediatrician Dr. John Snyder relates, whenever he hears a parent say "I was reading Dr. Sears" or sees a patient in his office holding a copy of Dr. Sears' The Vaccine Book: Making the Right Choice for Your Child, he knows what's coming next: Resistance to vaccination. It would be one thing if this resistance were based on evidence or science-based concerns about the safety of vaccination, but it's not. As Dr. Snyder explains, while playing the "open-minded" "tell both sides" gambit, Dr. Sears credulously…
scientificactivist | August 6, 2009Mike Dunford tells a compelling story today at The Questionable Authority:
Yesterday, I took the kids to the doctor for their school physicals. I wouldn't normally subject you to an account of the day-to-day minutia of my personal life, but given the current debate about how we should handle health care in the United States, the details might be of interest.
We arrived - without an appointment - at a medical facility that we had not been to before. We did not have medical records with us, and the only paperwork of any kind that we had brought were the forms that needed to be filled out to…
tqa | August 6, 2009
Yesterday, I took the kids to the doctor for their school physicals. I wouldn't normally subject you to an account of the day-to-day minutia of my personal life, but given the current debate about how we should handle health care in the United States, the details might be of interest.
We arrived - without an appointment - at a medical facility that we had not been to before. We did not have medical records with us, and the only paperwork of any kind that we had brought were the forms that needed to be filled out to enroll the kids in sports programs. When we checked in, the only thing I…
oracknows | August 6, 2009There is no doubt that the infiltration of quackademic medicine into medical schools in this country represents a profound threat to science-based medicine. By mixing mysticism, non-science, and pseudoscience along with science-based medicine, medical schools are in essence endorsing quackery and elevating it to the same level as science-based and science-tested modalities. Worse, they're running the risk of training a generation of medical students accepting of this "integrating" woo with science, who can't recognize highly implausible treatments or recognize obvious quackery. By letting…
oracknows | August 4, 2009During the month of June on this blog, I got annoyed not once, but twice. First, I got annoyed at Sharon Begley for a truly annoying and evidence-free (other than cherry-picked anecdotes) broadside against the NIH for its "culture of caution" that, according to her, is largely responsible for the "lack of progress" against cancer over the last 38 years since President Richard Nixon declared "war on cancer." In essence, Begley blamed the need scientists have for publishing in the highest impact journals they can get their manuscripts into for "delaying" cures or, as I put it, "keeping teh…
oracknows | August 2, 2009Due to annoying stuff at work and good stuff personally, I didn't have time to grind out my usual bit of Insolence, either Respectful or not-so-Respectful, today. Fortunately, there is a long history on this blog, full of good stuff that I can repost. So, as I did when I went to TAM7, I'm picking a couple of posts for today that originally appeared in August. This one happens to have first appeared in August 2006; so if you haven't been reading at least three years, it's new to you (and if you have, I hope you enjoy it a second time).
I'll be back tomorrow.
So, after nearly two weeks of…
revere | July 26, 2009The Reveres have been around a long time and we know a lot of public health people in different states. Recently we were talking with a colleague about the problem of hospital surge capacity -- the ability to handle a sudden demand for services -- and she described her first job working for a state health department in the early 1980s. Her job was to compile a health resources report, essentially a yearly compilation of licensed and operating beds for all manner of health facilities, including hospitals, nursing homes, psychiatric facilities, outpatient clinics, rest homes, group homes and…
palmd | July 26, 2009Lawmakers and the public in general have no idea how the business and practice of medicine operates. None. When you read statements from many representatives, you see such simplistic, anhistoric thinking that pessimism about health care reform is the only logical response.
Or so it seems from media reports. The New York Times, whose quality seems to be dropping by the femtosecond, reported this week on salaried vs. traditionally paid physicians. This could have been a terrific article, if the reporter knew anything.
Let me catch you up a bit. Doctors are generally paid in one of two ways…
neurophilosophy | July 21, 2009
RESEARCHERS at the University of California, Berkeley have developed a microscope attachment which enables a standard mobile phone with a camera to be used for high-resolution clinical microscopy. Daniel Fletcher and his colleagues describe the CellScope in a paper published today in the open access journal PLoS One, and demonstrate that it can be used to capture high quality bright field images of the malaria parasite and sickle blood cells, as well as fluorescence images of cells infected with the bacterium that causes tuberculosis. The device could potentially become an important tool for…
sb admin | July 21, 2009by Erika Furlong
I recently attended the June 29th-30th FDA advisory committee meeting that voted for a reduction in the maximum daily over-the-counter (OTC) dose of acetaminophen and the âunbundlingâ of narcotic-acetaminophen prescription medications. While I agree ultimately with many of the recommendations that were made, I canât help but feel that there is a larger problem that remains unaddressed. There is a growing disparity between FDA expectations for prescription drugs and expectations for OTC drugs and dietary supplements. As requirements for prescription drugs increasingly reflect…
palmd | July 15, 2009I've frequently written that alternative medicine beliefs are much like religion, and often cult-like. When reading about alternative medicine, you'll often encounter charismatic leaders, faith in the unknowable, and conversion experiences. A fine example of the latter is currently up at the Huffington Post. It's written by "Dr" Patricia Fitzgerald, HuffPo's "wellness editor". Just to remind you of her credentials, she is a "Licensed Acupuncturist, Cert. Clinical Nutritionist, Homeopath, [and] Author." In other words, she's not a doctor in any well-recognized sense of the word.
Her…
revere | July 15, 2009I hate to take off on the press. I do it every once in a while, but not often. The slow and agonizing demise of the main stream press has major consequences for keeping the public informed about issues both big and small. It's also a personal tragedy for many dedicated professional journalists. Still, while newspapers-as-we-knew-them aren't dead yet, they are at least moribund, and like the famous definition of a statesman as a successful politician who is dead, there is more than a bit of a tendency to endow the working press with some virtues it doesn't have now and in general never did.…
sb admin | July 14, 2009Yesterday, President Obama announced his choice for the Surgeon General post: Regina Benjamin, a family doctor who built and repeatedly rebuilt a rural health clinic in Bayou La Batre, Alabama. She was the first African-American woman to be named to the American Medical Association's Board of Trustees, became President of Alabama's State Medical Association in 2002, and was named a MacArthur Fellow in 2008. In his remarks, though, Obama explained that itâs Benjaminâs experience delivering care in an underserved area that makes her such an appropriate choice at this particular moment:
For…