Medicine
oracknows | January 10, 2008The other day, I mentioned what Prometheus termed the "arrogance of ignorance," in which people with no training in a complex, scientific issue have the hubris to think that they know enough to be able to lecture medical scientists on shortcomings of their research. Here's another example of just such arrogance by antivaccinationist Barbara Loe Fisher:
As usual, it is not the M.D. or Ph.D. "experts" but parents of vaccine injured children, who understand the bigger picture involving accumulating clinical evidence that many children are regressing and becoming chronically ill after receiving…
oracknows | January 9, 2008(NOTE ADDED 12/7/2010: Kim Tinkham has died of what was almost certainly metastatic breast cancer.)
Cancer is scary. It's very, very scary, even when it is a cancer that is treatable and potentially curable. It's such a common disease that, by the time we reach a certain age, the vast majority of us have seen at least one friend or loved one die of some form of cancer. All too often, that death is horrific, and even when it is not the wasting and weakness that is often seen before the end provokes a visceral reaction matched by few diseases. Moreover, the treatments of cancer can be toxic.…
mementomori | January 8, 2008A study from Duke University reveals that oncologists who hear an expression of emotional concern from their patients respond with an empathic statement only 22% of the time. In other words, patients who share feelings of distress such as anger, discouragement or fear with their doctors are likely to receive no recognition of their suffering nor any emotional support in return. As a medical oncologist I find this embarrassing.
By identifying how seldom oncologists provide empathic support to patients, the study illuminates the potential benefit of teaching such skills to doctors. Previous…
revere | January 7, 2008Hospitals are dangerous places, but sometimes you have to be there. If you are a child in the developing world sick with pneumonia, the World Health Organization (WHO) thinks that's one of the times. Pneumonia is the big killer of children globally, so WHO guidelines call for children with severe pneumonia to be treated with intravenous antibiotics in the hospital. Now a landmark clinical trial from a team at the Boston University School of Public Health and published this week in The Lancet (January 4 issue), says these seriously ill children will do just as well at home on antibiotic syrup…
denialism | January 6, 2008This new year is shaping up to be pretty exciting, and part of the changes in my life will be reflected in what I write about on the blog. First let me explain how the MD/PhD program I'm in works, and where I am in it.
The Medical Science Training Program (MSTP) or MD/PhD program is designed to promote bench-to-bedside or translational research. The idea is that if you take medical students and give them a PhD as part of their education they will be more likely to take science from the basic literature (bench research) and translate it to medical care (bedside research) or at least do…
cortex | January 3, 2008Phantom limb syndrome has always been intertwined with war. It was first discovered by Silas Weir Mitchell after the Battle of Gettysburg, when the hospitals of Philadelphia were overwhelmed by soldiers with amputated limbs. Many of these soldiers said that they still felt their missing arms and legs, even though they were clearly gone. As Weir Mitchell put it, the soldiers were afflicted with "sensory ghosts".*
After the Civil War, Weir Mitchell's clinical observations fell into obscurity. Because phantom limbs had no material explanation, medical science continued to ignore the phenomenon.…
oracknows | January 2, 2008Although this may be more up Abel Pharmboy's alley than mine, there was an article in the New York Times yesterday that indirectly demolished one of the favorite claims of advocates of "natural" medicines and cures. Appropriately enough, it appeared in the Business section. It also demonstrated just what a big business finding natural compounds with therapeutic properties.
The story opens with a description of Chris Kilham, ethnobotanist, a man who's searched the world for medicinal plants:
Part David Attenborough, part Indiana Jones, Mr. Kilham, an ethnobotanist from Massachusetts who calls…
scientificactivist | December 31, 2007An individual cell inside the human body is in a dynamic environment: it not only has to anchor itself to its surroundings but also be able to communicate with them and respond as appropriate. One group of proteins--the integrins--play a central role in all of these tasks. The integrins are large (about 200,000 Da) membrane-spanning proteins, and each integrin consists of two subunits (alpha and beta). The vast majority of the integrin is located on the exterior of the cell, where it anchors the cell to the extracellular matrix. Each subunit has a short tail inside of the cell, and the…
tsmith | December 30, 2007 As another Ebola outbreak simmers in Uganda (and appears to be increasing), I recently was in touch with Zoe Young, a water and sanitation expert with Médecins Sans Frontières (MSF*, known in the US as Doctors without Borders), who was working in the Democratic Republic of Congo during the DRC Ebola outbreak earlier this fall (and blogging it!)
Regular readers know of my interest in this virus, but I'm obviously geographically removed from any of the outbreaks. As such, Zoe and her colleague, physician Armand Sprecher, were generous enough to answer my questions about their work with…
oracknows | December 27, 2007It figures.
Some of the most interesting questions and posts showed up right before Christmas, just the time when I didn't have time to discuss and (hopefully) expand upon them. Neither, I'm guessing, did anyone else, which is unfortunate because this post was about an issue worth further discussion in the skeptical blogosphere. I'm talking about a post in which fellow ScienceBlogger Martin Rundkvist made this rather provocative observation about skepticism:
A discussion in the comments section of the recent Skeptics' Circle reminded me of something I learned only after years in the skeptical…
oracknows | December 21, 2007
People never cease to amaze me.
Sometimes it's in a good way, when a person whom I would least expect to be capable of it does something really kind or brilliant. Sometimes it's in a bad way. One of the bad ways people never cease to amaze me is how someone can continue down a path that has obviously caused them harm. I was reminded by this by a news story that's been making the rounds of the media. I first saw it a couple of days ago on the local ABC affiliate, and it seems to be making the rounds of many affiliates nationwide. It's the story of Paul Karason.
Paul Karason is blue, and an…
oracknows | December 21, 2007
As hard as it is to believe, yet another Christmas is fast approaching. I can feel it in the blogosphere. Heck, I can feel it here on the ol' blog. Once garrulous commenters here have gone strangely silent for the most part (at least in comparison to their usual prodigious output), and traffic has already begun to plummet in anticipation of the even bigger plunge that it usually takes during that dead week between Christmas and New Years. It's almost enough to make me wonder whether I should just put the blog on hiatus until after the 1st.
Almost.
I might slow down a bit and throw a few…
denialism | December 20, 2007Except this time it's from the right! Richard Dolinar of the Heartland Institute (a crank tank) writes in TCS Daily that evidence-based medicine (EBM) is bad for patients.
A new buzzword entered the medical lexicon in 1992 when the Evidence-Based Medicine Working Group published one of the first articles on the phenomenon in the Journal of the American Medical Association (JAMA). In the years since, the role that evidence-based medicine (EBM) plays in medical care has increased exponentially. Some now question whether it should play such a prominent role.
"[EBM is not] medicine based on…
mementomori | December 20, 2007Here's more discouraging news about the consequences of living without health insurance:
Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.
In this study done by the American Cancer Society, researchers looked at a database of 600,000 cancer patients from 1500 different hospitals and documented the percentage alive five years after their diagnosis. The patients were all under age 65 and were separated into three different…
oracknows | December 20, 2007Evidence-based medicine is not perfect.
There, I've said it. Like anything else humans do in science or any other endeavor, evidence-based medicine (EBM) has its strengths and its weaknesses. On the whole, I consider it to be potentially vastly superior to the way that medicine was practiced in the past, bringing a systematic, scientific rigor to how we practice to replace parts of medicine that tended to be based as much (or more) on tradition or dogma as on evidence. Naturally, a common source of attacks on EBM is advocates of "alternative medicine," who often appeal to "different ways of…
oracknows | December 19, 2007I used to be of the opinion that there might just be something to acupuncture. No, I never thought there was anything to the notion that acupuncture "works" by somehow rerouting the flow of a magical life force (qi) that no scientific instrument can detect and that no practitioner of acupuncture (or other practioners "healing arts" that invoke qi or something like it as the reason that they can heal) can detect either, even as they claim to "release blockages" of or somehow improve its flow. Rather, I wondered whether the simple act of sticking needles into the skin might release some hormone…
terrasig | December 15, 2007On this day in 2005 we first signed on to the blogosphere on the original Terra Sigillata at Blogger. I had spent over six months reading the blogs of other in the areas of medicine and science and wondered if there was any need for yet another blog from another frustrated scientist. But I'm an academician stuck in a position where I don't teach full-time. I really used to enjoy beginning my pharmacology lectures with little vignettes about the latest drug news or some information about an herb or dietary supplement. I've also been fortunate to have a lot of clinical colleagues who would…
tfk | December 13, 2007Philll Kline to investigate AG Morrison's alleged improprieties.
I must say that I don't see Kline's logic here. Morrison may well have done something wrong, and if so, his enemies' best move would be to sit back and let him fall apart on his own, and to force the Democratic governor to follow through with an investigation of the Democratic AG. Either way, the allegations will tarnish Morrison's reputation, and if a fair investigation turns up nothing, his enemies won't look bad as a result. On the other hand, no one will take the result of Kline's investigation seriously. Morrison…
gregladen | December 13, 2007 173 medical staff from the emergency department of a Turkish university hospital responded to a questionnaire about domestic violence. 69.0% of the female and 84.7% of the male respondents declared that they agreed or partially agreed to at least one reason to justify physical violence.
[source]
This research is published in an open access paper on BMC Public Health. From the paper:
Violence against females is a widespread public health problem in Turkey and the lifetime prevalence of IPV ranges between 34 and 58.7%. Health care workers (HCW) sometimes have the unique opportunity and…
oracknows | December 13, 2007Oh, no, not again.
Respectful Insolence⢠has been invaded over the last few days by a particularly idiotic and clueless homeopath named Sunil Sharma, who's infested the comments of a post about how U.K. homeopaths are complaining about all of us mean skeptics who have the temerity to point out the mind-numbingly obvious about homeopathy, namely that it is based on magical thinking, goes against huge swaths of well-understood science and thus would require some very compelling evidence indeed to be worth being taken seriously by scientists (evidence that homeopaths have been thus far unable…