Medicine
denialism | May 23, 2007Seed magazine profiles the recent work from John Ioannidis, author of the groundbreaking article "Why most published research findings are false".
I've written about him before in several contexts and the importance of understanding this research. The counter-intuitive thing is how much his research redeems science as an enterprise and emphasizes how denialists can abuse our literature.
I recommend that scientists take a chance to read some of his work, and ideally watch this video (it's a lot more approachable) I uploaded to google a few months ago. It is a bit long - it's the grand…
oracknows | May 21, 2007I hadn't planned on revisiting this topic again quite so soon, but sometimes a piece of information comes up that's so disturbing that I can't ignore it and can't justify delaying blogging about it by very long. So it is yet again with the strange and disturbing saga of dichloroacetate (DCA), the small molecular chemotherapeutic drug with a novel and scientifically interesting mechanism of action that could lead to a whole new class of chemotherapeutic agents and that has shown considerable promise in rat tumor models but has not yet been tested in humans. Not to belabor the story, which has…
j7uy5 | May 21, 2007
One of the things that most consistently surprised me, when I was doing
the consultation-liaison rotation in residency, was how common delirium
was, and how frequently it was missed by the medical team.
Even since then, it has evolved into a pet peeve of mine. The
brain is a rather important organ, and when it shows acute signs of
dysfunction, you'd think doctors would notice and pay attention.
All too often, they do not.
Why is this so important?
A recent paper in the BMJ indicates:
Delayed
or missed diagnosis is an important issue — non-detection of
delirium in emergency…
pharyngula | May 19, 2007South Dakota: very conservative, very Republican, very concerned with women's reproduction, and none of it in a good way. This story just personifies the worst of South Dakota's repressive residents perfectly.
A former South Dakota lawmaker is accused of molesting his own foster children and legislative pages.
Ted Klaudt, 49, a Republican rancher from Walker, faces a long list of charges: eight counts of rape, two counts of sexual exploitation of a minor, two counts of witness tampering, sexual contact with a person under 16, and stalking.
Court documents mention five possible victims. Three…
purepedantry | May 18, 2007A new journal for case reports only, The Journal of Medical Case Reports, has spawned an discussion at The Scientist about whether we should even have case reports in journals:
Does the medical literature need more case studies? A new journal is betting it does, even as editors at other journals say the answer is no.
Historically, case reports have proven extremely valuable to clinicians faced with diseases they knew little about. But in an age where countries spend more on research than ever before investigating both rare and common diseases, some experts argue that the obscure nature of…
mikethemadbiologist | May 16, 2007
The 'godly' singing "The Old Rugged Cross." Or something
The last thing most people in the Coalition of the Sane want when they are being treated for a serious illness in the hospital to have the staff try to convert you to another religion. And when you force a sick patient to choose between following the dictates of his religion or not eating in an effort to convert him, that is not 'godly', that is inhumane. It's also par for the course for Christopathic Uruk-hai.
From the Des Moines Register (italics mine):
U.S. Navy veteran David Miller said that when he checked into the Veterans…
j7uy5 | May 15, 2007Often,
on this blog, I've ranted about the risks that our government, and our
corporate citizens, e.g. pharmaceutical companies, expose us to on a
daily basis.
Perhaps it would be good to put some of those risks in perspective.
That is, to compare the risks of various medications to
others risks that we take on a routine basis. In the May/June
issue of the journal, Health Affairs, there is an article on the
subject. The full thing is behind a pay wall, but we'll get
to the heart of the matter anyway.
href="http://content.healthaffairs.org/cgi/content/abstract/26/3/636">What's…
mementomori | May 10, 2007I've been thinking a lot about Ms. Melanson, the woman from Alberta who died after receiving the correct dose of infusional fluorouracil chemotherapy in an fatally incorrect short time. Cancer care professionals take their responsibilities seriously and are not known to be infiltrated with ignoramuses or reprobates. This doesn't guarantee that a mistake will never be made; in fact this Canadian tragedy is all the more painful because according to the reports the nurses involved were well-trained. Writing chemotherapy orders is a task that requires the highest degree of concentration. It…
sb admin | May 9, 2007New reports on past disasters are in the news this week. Today, the Mine Safety and Health Administration released its report on the Sago Mine Disaster, which killed 12 mine workers; the report cites lightning for sparking the explosion that trapped the miners underground. A clinical study clearly linking World Trade Center dust to serious diseases - including sarcoidosis, a rare lung-scarring condition - was published in the medical journal Chest. And an internal report by BP about the deadly 2005 blast at its Texas City refinery recommends that four executives and managers be fired for…
mementomori | May 9, 2007Yesterday the results of two separate investigations into the death of a Canadian cancer patient were released. Both reports documented the mistakes made in the programming of a chemotherapy pump that was supposed to deliver a controlled infusion of fluorouracil over 96 hours:
On Tuesday, the Institute for Safe Medication Practices Canada released its independent report on the death of 43-year-old Denise Melanson last summer at Edmonton's Cross Cancer Institute.
A pump was supposed to deliver fluorouracil, a drug used to treat tumours, over four days, but it was given to Melanson over four…
revere | May 3, 2007Sometimes it can be hard to read the scientific literature without peering through the lens of one's own prejudices. That said, I must agree with this:
Malaysian doctors have declared neckties a health hazard and called on the heath ministry to stop insisting that physicians wear them.
Citing studies that show ties are unhygienic and can spread infection, the Malaysian Medical Association says they are not often washed and carry germs that can cause pneumonia and blood infections, the Star newspaper said on Tuesday.
"And when doctors are doing their clinical rounds, they dangle all over the…
grrlscientist | May 2, 2007tags: tainted pet food, melamine, Food and Drug Administration, FDA, Andrew von Eschenbach, politics
In view of the current problems with melamine-tainted pet foods, and the fact that these foods escaped detection by the Food and Drug Administration (FDA) for so long, a growing number of people are concerned about the safety of human foods as well. Obviously, based on this tainted pet food fiasco, the FDA is ill-equipped to test imported foods for safety and as a result, who is to say that these poisoned pet foods are not a "trial run" for something bigger, something that can cause wholesale…
oracknows | May 2, 2007I had come across a rather amusing mea culpa by GruntDoc in which, while discussing an amazingly inappropriate notice regarding guidelines for emergency room chiropractic reimbursement, he admits to having in the past referred our best and bravest to chiropractors. I can understand why he did it, given the circumstances he described. However, what bothered me was this statement:
In my six-plus years of being on-call in the hospital emergency department (ED), I have seen numerous ED physicians gain familiarity with the indications for chiropractic consultation. I have enjoyed seeing the…
oracknows | May 1, 2007There are times when, as a scientist, I look at an idea and its execution and simply stand in awe. It's particularly satisfying when it's a relatively simple idea that could conceivably do a lot of good for a lot of patients. Oddly enough, whether it's because I've been out of the loop or because it hasn't garnered that much attention in the blogosphere (not even here in ScienceBlogs), but I only just heard of it now. It's a new drug in phase II clinical trials that has the potential to obviate or reverse the effects of a wide variety of genetic mutations that cause human disease:
A pill that…
terrasig | May 1, 2007A few weeks ago, I commented on the increased action by the US FDA against unapproved drugs that have been used for decades but were never subjected to today's formal framework of preclinical and clinical safety and efficacy trials (most recent action here).
Over the last couple of months, FDA has been creating a bit of anxiety amongst herbal medicine stakeholders over their document entitled, "Guidance for Industry: Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration." (PDF here, html here). The term, CAM product, refers to any of the…
terrasig | April 29, 2007This sad story harkens back to my days as a pharmacy prof when students would argue for points on an incorrect pharmaceutical calculations exam by saying, "well, only the decimal point was off."
A pharmacy erroneously made a drug 10 times more potent than intended, which killed three people who received it at an Oregon clinic, the state medical examiner said Friday.
ApotheCure Inc., a drug compounding pharmacy company in Texas, said an employee made a weighing error in the creation of the drug colchicine.
Drug compounding pharmacies have often attracted controversy. While they fulfill the…
sciencetolife | April 28, 2007 The latest issue of the New England Journal of Medicine reports that 94% of physicians in the U.S. receive gifts and benefits from pharmaceutical companies in the form of free food, drug samples and sports tickets, to name a few. Despite efforts by several organizations to regulate these relationships they appear to be quite common and may underscore doctors' professional decisions.
The authors of the study sent out a survey to which over 1500 physicians responded.
Most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships…
oracknows | April 27, 2007I've said it once before, but this week's woo compels me to say it again: I happen to love gadgets.
I've been a bit of a technogeek since very early on in my life, with a lot of the things that go along with it, including a major interest in science fiction, awkwardness around the opposite sex, When at their best, gadgets can do things that need to be done and, if well designed, can do them with panache, making drudgery almost fun Then of course, there's the almost Dilbert-like joy males into technogeekery have in one-upping each other, almost like the surgeons I described yesterday one-…
mementomori | April 26, 2007A physician survey published in The New England Journal of Medicine this week reveals that 94% of the respondents from six different specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics) "reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%)."
This is news? Doctors have been receiving free items from Big Pharma (hereafter referred to as BP) for decades; why are these researchers wasting our precious natural…
oracknows | April 26, 2007Just when I start to think that maybe, just maybe, I could stop worrying and learn to love the National Center for Complementary and Alternative Medicine (NCCAM, with apologies to Stanley Kubrick and Peter Sellers), damn if it doesn't go and do something that renews my cynicism about the entire Center. This time around, Dr. RW has turned me on to a proposed project that leaves me scratching my head, Omics and Variable Responses to CAM: Secondary Analysis of CAM Clinical Trials.
Given the nature of the woo to be studied, my first inclination was to start making light of the whole "oooommmmm"-…