Medicine
thusspakezuska | December 22, 2008I don't particularly enjoy having needles poked into my scalp and neck and shoulders and temples and I especially don't like having them poked into my forehead just above my eyebrows. Yet I allow my neurologist to turn me into a pincushion every three months because regular botox treatments subdue my migraines, and nothing else does. I like my neurologist; I trust him, and we have a good doctor-patient relationship. On this last visit we discussed my current medications and how they're working, and agreed that I could probably start scaling back one of them. My neurologist is at a…
oracknows | December 22, 2008Why does anyone listen to actors when they pontificate about health and medical issues?
Think about it. What is it that actors do? They read lines given to them. True, some have a talent that goes beyond that; they can actually write or direct. But few of them have any more abilities when it comes to science than the average populace. Indeed, arguably, they have less knowledge of science than average. Witness, for instance, Jenny McCarthy and her crusade against vaccines. Yes, I realize that she claims not to be "antivaccine," but her actions and words say otherwise. She's also managed to…
nisbetmc | December 21, 2008
The latest issue of the American Journal of Bioethics features an important study on the effects of viewing medical dramas on the ethical reasoning of medical and nursing students. From the abstract for the study by researchers at Johns Hopkins:
Television medical dramas frequently depict the practice of medicine and bioethical issues in a strikingly realistic but sometimes inaccurate fashion. Because these shows depict medicine so vividly and are so relevant to the career interests of medical and nursing students, they may affect these students' beliefs, attitudes, and perceptions…
ddobbs | December 18, 2008As Obama solidifies his teams on science, education, and environment, attention -- and not a little worry from the drug industry -- is turning toward his hunt for a new FDA commissioner. The WSJ Health Blog reports that the FDA Commissioner Coalition, which is heavy with groups financed by the drug industry, appears increasingly concerned that Obama will appoint outspoken critics of drugmakers and the FDA, such as Cleveland Clinic cardiologist Steven Nissen or Baltimore health commissioner Joshua Sharfstein, who is heading Obama's FDA assessment team.
While the coalition prominently talks…
dgmacarthur | December 18, 2008Nature has a list of the top news stories of 2008, and "Personal genomics goes mainstream" comes up second:
In January, an international consortium announced the launch of the 1,000 Genomes Project, which aims to provide a catalogue of human genetic variation. In October, the Personal Genome Project, which hopes to sequence and publish the genomes of as many people as possible, released initial data for ten participants. Meanwhile, as researchers wondered what they could glean from the results coming from personal-genomics companies, the prices of such services dropped. The firm 23andMe,…
oracknows | December 17, 2008Having been sucked into the blogosphere for over four years now and having gotten the majority of my news online or from newsmagazines or the New York Times, I frequently forget that I'm not like the vast majority of people. Neither, I daresay, are my fellow ScienceBloggers or my readers. We don't get our information from the same sources, and we tend towards a lot more scientific sophistication than the average American. This is not to brag or to claim superiority; it is simply an observation that may help explain to some extent why those of us in the science blogosphere have a hard time…
oracknows | December 15, 2008Several months ago, I wrote a post about the experimentation with acupuncture by an Air Force physician, Col. Robert Niemtzow. In the post, I started with an admittedly exaggerated vignette--a story, if you will--of a soldier whose leg was shredded by a mortar in battle. When the medic came to treat his wounds and get him ready for transport, this soldier was in for a surprise, because after applying a tourniquet to his leg, this medic offered him not morphine for his pain but acupuncture. At the time, the military acupuncture program spearheaded by Col. Niemtzow was not proposing anything…
oracknows | December 12, 2008It figures.
Right around the time of my blogiversary yesterday, when I had intended nothing more than a brief by characteristically self-indulgent bit of navel-gazing twaddle (at which, I succeeded brilliantly, I might add; no one--and I mean no one--does self-indulgent navel-gazing twaddle better than I do), what should be there tempting me from my intended day off? Lots of news stories about a report published by the Centers for Disease Control about a yearly survey regarding the usage of so-called complementary and alternative medicine (CAM) therapies in the U.S. Predictably, headlines in…
denialism | December 12, 2008Aside from taking 4th year medical school classes it's also the time of year that medical students who plan to graduate in 2009 (like me) are applying to residency programs across the country. This is an interesting process and one that many people outside of medicine are unfamiliar with, and quite surprised by. For one, did you know that we don't have final say on where we train in residency but that the decision is made by a computer?
It's true. The process is called "the Match" and it's a time of great excitement and anxiety for 4th year medical students. For one, there are far more…
dgmacarthur | December 10, 2008Pharmacogenomics Reporter has a fascinating article (subscription only, I think) on the impact of individual gene patents granted by the US patenting system on the future of personal genomics. Essentially, the issue for companies conducting genome-wide analysis (including SNP chips or whole-genome sequencing) is that setting up licensing deals for each individual gene makes business complex and expensive - potentially discouraging investment in the field.
On their website, personal genomics company Navigenics explains the problem:
For example, if we obtain licenses from third parties to 10…
sb admin | December 10, 2008In Brooklyn, a bus driver refused to give a transfer to a man who hadnât paid â and the man responded by stabbing the bus driver to death. Edwin Thomas, 46, had an 18-year-old son and a 16-year-old daughter. He was driving the B46 route when he was killed. In the New York Times, Robert D. McFadden says this about violence against New York bus drivers:
Howard H. Roberts Jr., the president of New York City Transit, said it was the first killing of a city bus driver since Oct. 10, 1981, when Harvey Shild, 28, operating a B44 bus in Brooklyn, was shot to death under remarkably similar…
terrasig | December 10, 2008I have something like ten posts already started and none of them done due to that silly work thing. I don't know how the other people around ScienceBlogs actually get posts up with such frequency.
In the meantime, I had a thought while conversing with Alice Pawley and Suzanne Franks about their session at the upcoming ScienceOnline'09 unconference on gender issues in science where I, brave one that I am, will represent all men and discuss how we all think we boys can be allies.
In the meantime, please re-read Alice's post on the recent anniversary of the Montreal Massacre:
On December 6,…
jstemwedel | December 9, 2008Back in November, at the Philosophy of Science Association meeting in Pittsburgh, I heard a really interesting talk by Jeremy Howick of the Centre for Evidence-Based Medicine at Oxford University about the challenges of double-blind trials in medical research. I'm not going to reconstruct his talk here (since it's his research, not mine), but I wanted to give him the credit for bringing some tantalizing details to my attention before I share them with you here.
First, he noted that "blinding" might not be as apt a description of what actually happens in medical trials as "masking". A double…
ddobbs | December 8, 2008This time had to come: A group that includes some serious neuro-heavyweights, such as neuroscientists Michael Gazzaniga and Ronald Kessler and the highly prominent and influential neuroethicists Hank Greely and Martha Farah, has published in Nature an essay "Towards responsible use of cognitive-enhancing drugs by the healthy."
In this article, we propose actions that will help society accept the benefits of enhancement, given appropriate research and evolved regulation. Prescription drugs are regulated as such not for their enhancing properties but primarily for considerations of safety and…
sb admin | December 8, 2008The CDC has declared this week to be National Influenza Vaccination Week, and is working to raise awareness about the seriousness of influenza and the importance of vaccination. The agency reminds us that each year in the U.S., 5-20 %of the population gets the flu, and approximately 36,000 people die from it. Many of these deaths occur among young children and the elderly, so if youâre in one of those groups or come into contact with those who are, itâs a good idea to get yourself vaccinated.
The idea behind flu vaccination isnât just to avoid getting a virus thatâll make you miserable for a…
oracknows | December 8, 2008In 2007, I wrote a series of posts about what I found to be a fascinating yet at the same time disturbing phenomenon, specifically self-experimentation by cancer patients using an as yet unapproved drug called dichloroacetate. If you'll recall, DCA is a small molecule drug that was used to treat congenital lactic acidosis in children through its inhibition of the enzyme pyruvate dehydrogenase kinase. This inhibition shifts the metabolism of glucose towards oxidative metabolism in the mitochondria and away from glycolysis, the product of which is lactic acid. In January 2007, Dr. Evangelos…
j7uy5 | December 8, 2008
Tapentadol
is a drug for pain. It was approved by the US FDA for the
treatment of moderate to severe pain. The
href="http://www.fda.gov/bbs/topics/NEWS/2008/NEW01916.html">FDA
news release was dated 24 November 2008, although the actual
approval was a few days earlier.
Tapentadol acts on μ-opioid receptors, making it similar to
morphine
and its ilk. Do we need another opioid agonist? And
if so,
why? Suspicions deepen because it was produced by the same
company that makes tramadol. Indeed, it is similar to
tramadol in
many ways. Tramadol is the active ingredient in
Ultram®, now…
sb admin | December 4, 2008Anyone who works with the mentally ill knows that they smoke more than other people. In fact, people with mental illness (hereafter, MI, not to be confused with myocardial infarction) are about twice as likely to smoke as people without mental illness, with smoking rates of 60-90%. One of my favorite stats is that "44% of the cigarettes smoked in the United States are by individuals with a psychiatric or substance-abuse disorder." People with MI are also heavier smokers, and may even be better at extracting nicotine from the cigs that they smoke.
Studies have shown that people with MI can…
revere | December 4, 2008The 53 year old South African businessman arrived in Rio de Janeiro on November 23. Two days later he began to feel unwell. Today he was returning to South Africa -- in a zinc lined coffin:
Brazilian media reported officials as saying he may have been infected when he was a patient at a hospital in South Africa where four people died from a new strain of arenavirus, which also includes the germ that causes Lassa fever.
The health ministry said it had not confirmed that information, but said one of the suspected causes of death was the arenavirus, which is spread through the excrement or blood…
oracknows | December 3, 2008Ever since I started paying attention to it, acupuncture has, at least until recently, inspired ambivalence more than anything else in me. As a skeptic and science-based physician, I found it very easy to dismiss utter quackery like homeopathy or the various "energy healing" modalities, such as reiki or therapeutic touch strictly on the science alone. After all, homeopathy is based on magical thinking more than anything else, specifically the concepts of "like cures like," the concept that dilution with vigorous shaking can make a remedy stronger, and the idea that water has "memory" all are…