Medicine
revere | May 23, 2009Queens, a borough of the city of New York, seems to be a hotspot for swine flu and a New York Times reporter on the city beat, Anemona Hartocollis, has been writing very astute and perceptive pieces from there. Yesterday she had one on the problem posed by the "worried well" who are flooding Emergency Rooms in quest of reassurance. Articles about worried parents who bring relatively well kids to the Emergency Room (ER) are not uncommon. They usually include interviews with harassed and overburdened emergency room doctors and nurses dismayed at the unnecessary demand and its consequences for…
palmd | May 22, 2009You don't have to be a parent to care about the welfare of children---but it does bring things into a sharp, personal light. I recently wrote about Daniel Hauser, a child likely to die of Hodgkin's disease due to his parents' cult medicine beliefs. Cases like his are aberrations---they stand out for their rarity, but also for their horror. Still, the horror is mitigated somewhat by the rarity.
More frightening are systemic abuses of children via cult medicine beliefs, ones that affect dozens or hundreds of kids at a time. One of the most egregious of these is Lupron therapy for autism.…
denialism | May 22, 2009A dishonest campaign has started against healthcare reform in this country and the first shot has come from Conservatives for Patients Rights (CPR), a group purporting to show that patients in universal health systems suffer from government interference in health care. To bolster their argument, they have a pile of anecdotes from people around the world who have suffered at the hands of evil government-run systems. The problem, of course, is that anecdotes are not data, it is impossible to determine the veracity or reasonableness of these claims, and there is no way, ethically or…
j7uy5 | May 21, 2009Traumatic Brain Injury
href="http://scienceblogs.com/neurophilosophy/2007/08/traumatic_brain_injury_on_the.php">has
been called the "signature injury" of the Iraq War, due to the
reported high prevalence of the injury there. This is in contrast
to previous wars. It's not that head injury is necessarily more
common; what is more common is for soldiers to sustain such injuries
and survive.
The Pentagon has recognized this, and (
href="http://scienceblogs.com/effectmeasure/2007/05/signing_a_check_for_iraqs_sign.php">reportedly)
is addressing it. But now, a paper published in NEJM…
oracknows | May 21, 2009I know I've been very, very harsh on Jenny McCarthy. After all, she has become the face of the anti-vaccine movement in America, and her activities are directly endangering children. Let's take a look back, oh, a few days to a video that she made in which she decried all manner of "toxins" in vaccines as the cause of autism, including aluminum (which is not toxic at the doses used in vaccines), mercury (which is no longer in most childhood vaccines other than in trace amounts), antifreeze (there is no antifreeze in vaccines), and ether (again, there is no ether in vaccines). Then look back a…
oracknows | May 20, 2009Over the last couple of weeks, I've been blogging regularly about the case of Daniel Hauser, the 13-year-old boy with stage 2B Hodgkin's lymphoma who, after one course of chemotherapy in January, refused to undergo any more, citing a faux religion run by a woo-meister naturopath and Native American wannabe called "Chief" Cloudpiler. In reality, it probably wasn't so much belief in this fake religion, which is really no more than an excuse to use laws guaranteeing Native Americans freedom to practice their religions as justification for using peyote and various quackery for disease, but rather…
j7uy5 | May 18, 2009This is a continuation from
href="http://scienceblogs.com/corpuscallosum/2009/05/peak_oil_imminent_public_healt.php">last
time. Sort of. Last time I wrote about some things from
a recent program at the Johns Hopkins University Bloomberg School of
Public Health, in conjunction with the Centers for Disease Control and
Prevention. I took the material from one of the many
presentations. since then, I have looked thought the slides from
the other presentations. It turns out that the majority of the
material relates more to Peak Oil than to Public Health. Perhaps
that is because most of…
oracknows | May 18, 2009You knew it was just a matter of time. At least I did. Let me back up a minute and tell you what I mean.
Over the last week, I've done three posts about a chemotherapy refusenik (as some oncologists I've worked with tend to refer to them as) named Daniel Hauser. Hauser is a 13-year-old boy with Hodgkin's lymphoma who, after having undergone one course of chemotherapy for his disease, decided that he didn't want anymore. He and his mother justified his refusal using the teachings of a faux Native American cultish religious group but in reality are probably only using religion as a convenient…
revere | May 17, 2009At Friday's press briefing on the swine flu outbreak, Canadian Press's Helen Branswell twice asked whether CDC's weekly flu surveillance data showing the uptick in swine flu but also an unexpected prevalence in seasonal influenza was an artifact of increased testing or something new and unusual. CDC's Dan Jernigan was not especially clear, but seemed to acknowledge there was a lot of seasonal flu around:
The CDC said part of the increase is certainly due to the fact that much more influenza testing is going on these days, because of concerns about swine flu. But the agency said it seems that…
revere | May 15, 2009It is clear that if you want to get a so-so paper published in a top tier journal, the best way to do it is to write about a breaking medical news event and get there first. We saw this with avian influenza and SARS and now it's being repeated with swine flu. The Scientist had a story yesterday about how The New England Journal of Medicine (NEJM) and Science, two of the highest profile science journals in the world, pushed through some swine flu papers at record speed last week:
An international research team led by Neil Ferguson of Imperial College London published a report online today (May…
oracknows | May 14, 2009I have a bit of a love-hate relationship with the antivaccine propaganda blog Age of Autism.
The reason for the hate part should be obvious. AoA is, without a doubt, a cesspool of pseudoscience and anti-vaccine propaganda. All while oh-so-self-righteously denying that its agenda is "anti-vaccine," AoA on a daily basis lays down articles blaming vaccines for autism, while setting up websites attacking vaccine science, taking out full page ads attacking vaccines as causing autism, gloating when learning of declining vaccination rates in the Ukraine, and high-fiving (blogospherically speaking)…
oracknows | May 13, 2009I have to hand it to acupuncture mavens. They are persistent. Despite numerous studies failing to find any evidence that acupuncture is anything more than an elaborate placebo whose effects, such as they are, derive from nonspecifice mechanisms having nothing to do with meridians, qi, or "unblocking" qi. Moreover, consistent with the contention that acupuncture is no more than an elaborate placebo, various forms of "sham" acupuncture (needles that appear to insert but don't or acupuncture in the "wrong" locations, for example) produce results indistinguishable from "real" acupuncture.
That…
oracknows | May 12, 2009Yesterday, I wrote about Daniel Hauser, a 13-year-old boy with Hodgkin's lymphoma who, with the support of his parents, has refused conventional therapy for his cancer, which would normally consist of chemotherapy and radiation. Given his stage and type of tumor, he could normally expect at least an 85% chance of surviving and perhaps even greater than 90%, wherea without therapy he is certain to die of his disease, barring a rare spontaneous remission. The reason given by his Daniel and his mother Colleen is that they belong to a highly dubious-sounding American Indian religion called…
oracknows | May 10, 2009Regular readers here know that I really hate to see stories like the one I'm about to discuss, specifically that of 13-year-old Daniel Hauser, a boy with Hodgkin's lymphoma who is refusing chemotherapy based on religion and his preference for "alternative" therapy, whose parents are also supporting his decision.
Since I'm a bit behind on this story, its having percolated through the blogosphere for the last three or four days, let me start with a bit of context. If there is one theme that I've emphasized time and time again here, it's science- and evidence-based medicine. That means…
revere | May 9, 2009Maryn McKenna has a great piece at CIDRAP News today about something that should worry all of us as we wait to see if the other shoe drops with swine flu. Our acute care health services system is so brittle it won't take much to break it:.
With the global outbreak of novel H1N1 influenza (swine flu) entering its fourth week, physicians at emergency rooms, clinics, and hospitals around the United States say they are overwhelmed with "worried well" who have as much as doubled their patient loads.
All the clinicians work at medical centers that have planned and practiced for pandemics and…
palmd | May 9, 2009I had this great idea for my PalCast today, but I have a cold and my voice is squeaking like a twelve-year-old boy, so I'm just going to have to write. I woke up a little early---I love mornings. I opened up the back door to listen to the wind blowing through the new leaves, to the birds, and to my coffee maker. It was perfect peace---until the game started up at the nearby high school. The PA carries right into my family room. That's what happens when you don't get up early enough. You start with being able to imagine you are sitting alone in a meadow and rapidly find you are actually…
revere | May 8, 2009Late yesterday The New England Journal of Medicine published a number of papers on the recent swine flu outbreak. The first paper, "Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans" by large federal-state team of epidemiologists describes 642 confirmed cases in 41 states as of May 5, 2009, two days before publication. What I find remarkable is the speed the problem was recognized -- literally days. Identification of the virus was first made in the CDC laboratory on April 15, just 3 weeks ago. Now we are already reading scientific papers providing a wealth of detail.
Among…
jstemwedel | May 7, 2009At White Coat Underground, PalMD considers an article from the Journal of Medical Ethics. The article (L. Johnson, R. B. Stricker, "Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process," Journal of Medical Ethics 2009; 35: 283-288. doi:10.1136/jme.2008.026526) is behind a paywall, but Pal was kind enough to send me a copy.
Pal writes:
I have a strong interest in medical ethics, although I'm not an ethicist myself. Still, I'm generally familiar with the jargon and the writing styles. This piece reads like no ethics article I…
jstemwedel | May 6, 2009In the wake of some recent deaths in Edmonton of teenagers who took Ecstasy, DrugMonkey gets irritated with a doctor who made some proclamation to the press:
I'm particularly exercised over an article which quotes Charles Grob, M.D. (UCLA page):
Charles Grob believes there is a strong chance that a deadly batch of adulterated pills is making the rounds in and around Edmonton, though health officials and law-enforcement groups have issued no such public warning.
Dr. Grob, a professor of psychiatry at UCLA, was the first U. S. researcher to conduct human tests of methylenedioxymethamphetamine…
oracknows | May 5, 2009Homeopathy is water.
Homeopaths will tell you otherwise. They will tell you that water "memory," which, the way they describe it is some mystical property whereby it "remembers" the remedy with which it's been in contact, even though the substance (whatever it was) has been diluted far beyond the point where there's likely to be even one molecule of it left. Not only that, but they will, in all seriousness, tell you that dilution is not enough. They will insist that, at each serial dilution, the remedy must be vigorously shaken (or, as they call it, "succussed") in order to imbue it with its…