Medicine
sb admin | May 29, 2008The fight against HIV occurs on several different levels: prevention of transmission and acquisition, treatment of the infection, and prevention and treatment of opportunistic illnesses.
Prevention has been addressed extensively (and perhaps will be again later), and opportunistic illnesses is a huge topic, so first I'll delve a bit into the origins and biology of the treatment of HIV infection (and of course the usual caveat; this is grossly oversimplified, and Abbie has a whole lot of good, ungrammatical science over at her place).
For better or worse, this requires another short biology…
sb admin | May 29, 2008by Susan F. Wood, PhD
Last year, Congress passed new legislation on the Food and Drug Administration, known as the FDA Amendments Act (FDAAA) of 2007.This legislation, while limited, made some significant steps forward, see here and here. It reauthorizes the user fee systems for drugs, biologics and medical devices, and expands FDAâs authority on labeling, requires new transparency for the Agency and establishes broader registries of clinical trials and requires results from clinical trials to be released to the public The public concern over the handling of medications like Vioxx and Ketek…
oracknows | May 29, 2008Sometimes I wonder if subjecting myself to all this woo is going to my head. Why do I worry that this might be the case? Recently, I made the mistake of getting involved in an e-mail exchange with a prominent antivaccinationist. Perhaps it was my eternal optimism that led me to do this, my inability to believe that any person in the thrall of pseudoscience, no matter how far gone and how active in harassing anyone who counters him, can't be somehow saved and brought around to understand the value of science and why their previous course was wrong. Such efforts on my part almost inevitably end…
mikethemadbiologist | May 28, 2008So argues a recent commentary in Science:
The pursuit of novel scientific interventions for AIDS, malaria, and tuberculosis has been supported for decades by the traditional public-sector research funding bodies, such as the U.S. National Institutes of Health, the U.K. Medical Research Council, the Agence nationale de recherches sur le sida, and the European and Developing Country Trial Partnership, with additional contributions from the private sector and charitable bodies. These major public-sector funding bodies are located in developed countries and, although the situation is changing,…
j7uy5 | May 28, 2008
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height="50" width="80">Just as
we learn of favorable studies about rTMS (see yesterday's post on this blog), studies that suggest
that ECT could be surpassed, the ECT camp fires again. A new
study by Sackeim indicates that a new form of ECT is highly effective,
with lower negative impact on cognition. The difference is in
the length of the electrical pulse. They use what they call
an ultrabrief pulse (0.3 millisecond), as…
oracknows | May 27, 2008As a physician and scientists who's dedicated his life to the application of science to the development of better medical treatments, I've often wondered how formerly admired scientists and physicians degenerate into out-and-out cranks. I'm talking about people like Peter Duesberg, who was once an admired scientist thought to be on track for a Nobel Prize; that is, until he became fixated on the idea that HIV does not cause AIDS. True, lately he's been trying to resurrect his scientific reputation with his chromosomal aneuploidy hypothesis of cancer, but, alas, true to form he's been doing it…
oracknows | May 24, 2008Damn Steve Novella.
Well, not really, but I always get annoyed when someone comes up with an analogy or description of a phenomenon that I should have thought of first. I don't really get annoyed at the person who came up with such ideas, but rather at myself for not thinking of something so obvious or precious first. Whether this self-criticism is a symptom of the megalomania or massive ego that I have been accused of having by some of my less--shall we say?--enamored readers or simply a personality quirk, I'll leave to the reader to decide.
Whatever the case, writing for Science-Based…
terrasig | May 22, 2008Well, things have changed in my life that have begun to impact my posting frequency so I really appreciate the support of readers when I last spoke of this change of life (no, not menopause).
I've even gotten so distracted that I have neglected to read the daily fishwrapper - that is until today's recycling when I stood outside on the street at 6 am rummaging through my blue bin to read Tuesday's paper (hell, it was news to me). At least I was courteous enough to the neighbors to throw on a pair of shorts.
In it, I learned that an academic physician settled with her employer for $200K after…
oracknows | May 22, 2008There's a new blog in town that I've been meaning to pimp. It's a blog by a retired epidemiologist who got things started looking at the role of diagnostic substitution in autism diagnoses and argued that the autism "epidemic" is an artifact of changing diagnostic criteria.
The blog is Epi Wonk, and it's a good one so far.
This week, I'm really glad Epi Wonk exists. The reason is that somehow, another Geier père et fils crapfest of dumpster-diving has somehow slimed its way into the medical literature, just in time to be used in the Autism Omnibus hearings no doubt. The "study" (if you can…
sb admin | May 14, 2008by David Egilman, MD, MPH
I just finished watching the Waxman hearings on FDA preemption and must comment on Christopher Shays' (R-CT) comments. Christopher Shays is the last remaining Republican congressman from New England. Hopefully the November elections will result in the extinction of this last remaining
remnant of the age of the dinosaurs.
He repeatedly stated that he "had no dog in this hunt" concerning the impact of preemption and torts suits on drug safety. This is a peculiar position for a Congressperson who must decide whether or not the FDA's actions are appropriate. It's…
oracknows | May 14, 2008Regular readers here are probably most familiar with the so-called "complementary and alternative medicine" therapy known as chelation therapy in the context of its use, or, more specifically, its misuse in "treating" autistic children, a misuse that has resulted in at least one death, a five-year-old autistic boy named Abubakar Tariq Nadama. However, before the profit potential of chelating nonexistent mercury in autistic children was even a gleam in Dr. Roy Kerry's eye, there was another equally dubious use of chelation therapy: to treat atherosclerotic coronary artery and peripheral…
clock | May 12, 2008The Case of Deborah Rice: Who Is the Environmental Protection Agency Protecting?:
For researchers who operate at the intersection of basic biology and toxicology, following the data where they take you--as any good scientist would--carries the risk that you will be publicly attacked as a crank, charged with scientific misconduct, or removed from a government scientific review panel. Such a fate may seem unthinkable to those involved in primary research, but it has increasingly become the norm for toxicologists and environmental investigators. If you find evidence that a compound worth…
signout | May 12, 2008"What I want you to do," I said, "is breathe in deep, then blow it all out like you're blowing out birthday candles."
He focused his eyes in concentration and blinked a few times, then did as I'd said, aiming for the finger I held in front of him.
I listened to his back with my stethoscope. "Again," I said. "Again. Again. Good job! Again."
His mother sat forward in her seat and breathed in sync with her boy, her face softened from the suspicious glare she'd trained on me a moment before. After I'd listened to every part of the kid's chest, I put my hand up for a high five, which he gave me…
revere | May 9, 2008Last October (2007) a 46 year old Minnesota man died of rabies, the only known victim in the US last year. Rabies is a rare disease in the US because we have good veterinary services. Most animals in routine and regular contact with humans are vaccinated against the disease. But bats have become a significant wild animal reservoir and the Minnesota case was a bat case:
Once rabies was suspected, the patient's family was interviewed on October 16 for a history of potential exposure. According to his family, the patient had handled a bat with his bare hands in a semi-open cabin porch in north-…
When medical experimental therapeutics gets co-opted as complementary and alternative medicine (CAM)
terrasig | May 8, 2008Sorry to get to this so late but I wanted to weigh on an excellent post from my cancer blogging colleague, Orac, the other day on the investigation of CAM therapies in cancer. The post covers a lot of ground, as expected from any of Orac's exhaustive missives, but I wanted to focus on the comparison and contracts between NIH's National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Cancer Complementary and Alternative Medicine within the National Cancer Institute (NCI-OCCAM).
I am on record as a strong critic of NCCAM but a supporter of NCI's OCCAM in that the…
oracknows | May 8, 2008In science- and evidence-based medicine, the evaluation of surgical procedures represents a unique challenge that is qualitatively different from the challenges in medical specialties. Perhaps the most daunting of these challenges is that it is often either logistically impossible or unethical to do the gold-standard clinical trial, a double-blind, randomized placebo trial, to test the efficacy of an operation. After all, the "placebo" in a surgical trial involves exposing patients to anaesthesia, making an incision or incisions like the ones used for the operation under study, and then…
revere | May 7, 2008Vaccination against most childhood diseases is important for the overall health of the community. I've said that many times here and most recently, along with my Sciblings, bemoaned an increasing trend to refusing vaccination. The health related reasons for refusing to be vaccinated are largely based on false information, but that doesn't mean that when millions of people are being vaccinated something untoward doesn't happen. Usually what happens is innocuous and self-limiting. The person (often an adolescent) faints. We don't know how often that happens, but a recent effort by CDC has tried…
signout | May 5, 2008A few months ago, a new patient walked into my clinic at four o'clock on a Friday afternoon. She was a fiftyish woman who had recently moved to the area from a different state. On the plane ride up, she had developed a fever and cough, and the day after arrival, had been admitted to the hospital with a huge, cavitating pneumonia. She was seeing me in follow up to her hospital stay.
Her hospital discharge, which I had skimmed earlier in the day, detailed an extensive past medical history including sarcoid disease and drug abuse. That afternoon, when I walked into the room where she waited for…
sb admin | May 4, 2008I'm not going to lie to you. This post contains some actual science. WAIT! Don't click away! I'll make it palatable, I promise!
It's just that this is such an interesting story, and I can't help sharing it. It is a shining example of one of the great successes of modern medical science, and stands in such stark contrast to the unfulfilled promises of the cult medicine crowd, with their colon cleanses and magic pills. This is the story of a real magic pill.
It starts back in 1960. A couple of researches at the University of Pennsylvania were looking at chromosomes in the blood cells of…
bioephemera | May 2, 2008This entry originally appeared November 24, 2007 on the old bioephemera. I was inspired to repost & update it after seeing this post over at Morbid Anatomy earlier this month.
Wounds (2007)
Nicole Natri
I ran across this collage by the talented Nicole Natri shortly after attending an interesting lecture, "When Sleeping Beauty Walked Out of the Anatomy Museum," by Kathryn Hoffmann, who is a professor of French at the University of Hawai'i at Manoa. The connection here is pretty cool, but it's roundabout, so bear with me.
Dr. Hoffmann's talk was my introduction to Pierre Spitzner's…