Medicine
oracknows | February 12, 2007I've written about the corrosive effect that religion can have on medical care when it is allowed to become too pervasive. One example where the intersection of religion and medicine concerns me is when various religious doctors insist on very dubious evidence that religiosity is good for a patient's health and that physicians should therefore take a "spiritual history" of all of their patients, with one even going so far as to claim that "excluding God from a consultation should be grounds for malpractice." I've also critically discussed studies that purport to show various benefits of…
j7uy5 | February 10, 2007Many ScienceBloggers, and some science bloggers, are writing posts
about basic concepts. I thought that was a good idea, but could
not think of one that would be interesting and that I felt like writing
about and that I was particularly well-suited to write.
Psychiatry is not a basic science. It is a medical practice that
is derived from several basic sciences: psychology, pharmacology,
physiology, anatomy, epidemiology, and so forth. So this is not
really a basic concept, in the sense of explaining something
fundamental about nature. Rather, it explains something that is
fundamental in…
oracknows | February 9, 2007Apparently, while I've been at this meeting, Mayo Clinics Proceedings has published this systematic review of the scientific literature on the "efficacy" of homeopathy. Its conclusion:
The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.
Actually, it would have been more accurate to say "not convincing at all." It's inevitably smaller, more poorly designed or non-randomized studies that purport to show treatment effects, which…
clock | February 7, 2007Just got this exciting news by e-mail:
Data on Equine Genome Freely Available to Researchers Worldwide
BETHESDA, Md., Wed., Feb. 7, 2007 - The first draft of the horse genome sequence has been deposited in public databases and is freely available for use by biomedical and veterinary researchers around the globe, leaders of the international Horse Genome Sequencing Project announced today.
The $15 million effort to sequence the approximately 2.7 billion DNA base pairs in the genome of the horse (Equus caballus) was funded by the National Human Genome Research Institute (NHGRI), one…
oracknows | February 7, 2007I happen to be in Phoenix today, attending the Academic Surgical Congress, where I actually have to present one of my abstracts. That means, between flying to Phoenix last night and preparing for my talk, I didn't have time to serve up a heapin' helping of that Respectful Insolence⢠you know and (hopefully) love. Fortunately, there's still a lot of stuff in the vaults of the old blog begging to be moved over to the new blog; so that's what I'll do today. I'll probably be back tomorrow with new material, given that the conference will likely produce blog fodder. (Conferences usually do.) And…
oracknows | February 6, 2007I've written a lot about alternative medicine, much of which I consider to be woo; i.e., treatments for which there is no medical efficacy and the belief in which often requires magical thinking. I've expressed my disappointment in medical physicians who fall prey to and become purveyors or woo, doctors such as Dr. Deepak Chopra, Dr. Joseph Mercola, those pushing to "integrate" woo into medical school curricula, and physicians who sell expensive "screening tests" such as breast MRI whose value has not been shown in valid, well-designed clinical trials. All of these activities represent, to me…
mementomori | February 5, 2007Ever wonder what happens when you live in a parsimonious country that isn't willing to spend any money on new treatments against cancer?
"Cancer patients having to dig deep for new drugs"
TORONTO -- Whether patients survive cancer increasingly depends on where they live and how much of their own money they can afford to spend on the latest drugs, an advocacy group reported Monday. "Essentially, we will continue to ration life-saving cancer treatment, and some Canadians will live and some will die simply because of where they live," said the Cancer Advocacy Coalition of Canada report.
Ever…
signout | February 2, 2007A few days ago, I posted here about a recent ICU admission of a patient with pancreatic cancer. Her admitting diagnosis was septic shock, and I'd initially included some detail about septic shock to help illustrate a clinical dilemma in her treatment. Although that portion was ultimately edited out, this is how a snippet of it read:
In septic shock, the blood itself is infected, and byproducts made by the infectious organisms cause the blood vessels to become dilated and leaky. The danger of septic shock is poor perfusion of important organs, like the brain, the heart, the kidneys, and the…
tsmith | February 2, 2007It's been awhile since I've written about HIV/AIDS denial on here. To be honest, the whole area has just burned me out a bit; it gets tiresome to even discuss issues with people who so fundamentally deny the basic tenets of microbiology and infectious disease epidemiology. But in my absence, there's been quite a bit going on, much of it collected here at the AIDStruth website. However, I have to draw your attention to a notable story today.
The first is like something out of "Law and Order." An HIV-positive man is appealing his conviction in Australia of endangering the lives of three…
sb admin | February 1, 2007By Liz BorkowskiÂ
Last week, Revere at Effect Measure used extremely drug-resistant tuberculosis (XDR TB) as an example of why the world needs a resilient and robust public health infrastructure (and just a few days later, an article on an XDR outbreak in South Africa made it to the New York Timesâ list of the 10 most e-mailed articles). Earlier this month, Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, published an article in Foreign Affairs (subscription only) in which she listed TB as one of the diseases thatâs been getting more money and…
oracknows | February 1, 2007It's things like this over at Over My Med Body! that show our friend Graham really knows how to make a humble guy like Orac feel the love:
Big name bloggers like Orac and Dr. RW and KevinMD are all up in arms about how "medical schools are going the wrong way" and asking "Does anyone in academic medicine care about the integrity of medical education?" They like to talk about the fluffy "woo" of medical school, as if we're all hippies out in our commune who have sacrilegiously sacrificed our Evidence and Data to a golden cow.
Give. Me. A. Break.
They're whining as if this is the most…
j7uy5 | January 30, 2007And what an unflattering light it is.
It occurs to me that often, when I write about the pharmaceutical
industry, I have something negative to say. Really, my thoughts
are not all negative. It's just that it is easier to come up with
criticisms when responding to news items.
Anyway, this one (from Washington Post) deserves comment:
href="http://blog.washingtonpost.com/thecheckout/2007/01/drug_ads_taking_medicine_never.html">Drug
Ads: Taking Medicine Never Looked So Good
Remember all those tricks drugmakers used to get you to take medicine
as a kid? They made cough syrup sweet…
mikethemadbiologist | January 29, 2007I write often about irresponsible antibiotic use. But I want to make one thing clear: antibiotics are critical, life-saving and health-improving drugs. In the U.S., every year roughly two million people contract hospital-acquired infections (this ignores infections contracted outside the hospital). Roughly 96% don't die. Antibiotics are a major reason, if not the major reason, for why the mortality rate is so low. I'm pointing out the obvious because of an email I received (I've 'de-identified' all of the personal information):
hi, mike. i've been reading your blog on triclosan and…
oracknows | January 29, 2007Critics who don't like my insistence on applying the scientific method to the claims of alternative medicine sometimes accuse me of unrelenting hostility towards alternative medicine, as though no amount of evidence would ever convince me of the efficacy of various alternative medicine therapies. Nothing could be further from the truth; I merely insist, as I have from the very beginning, that, at the very least, the claims of alternative medicine should be subject to the same testing by the scientific method that "conventional" or "scientific" medical treatments (a.k.a. evidence-based…
oracknows | January 28, 2007Everyone who reads this blog regularly knows my dismay at the infiltration of the curriculum of American medical schools with increasing amounts of non-evidence-based woo. It's even gotten to the point where one medical school (Georgetown University) has is integrating alternative medicine into the mandatory curriculum during all four years, even though these modalities are not based in convincing scientific evidence and therefore are not considered standard of care. Well, this distressing trend just gets more and more disturbing. Now, it seems, you can do a residency or fellowship in "…
grrlscientist | January 27, 2007Yesterday, I received a rejection letter from the clinic I was trying to set up "after care" with -- so .. not only do I receive rejection letters from every job I've applied for, but now I am receiving rejection letters from shrinks! This means that I have no way to obtain the meds that I am supposed to take, which means I get to go through some really serious withdrawal symptoms or I can set out on a special adventure to the ER obtain a few days of these drugs. Going to a city hospital ER means I get to;
spend 26 hours in the psych ER
be strip-searched
be searched with a metal detector…
apalazzo | January 27, 2007Yeah, it's going to happen.
From Corie Lok's blog:
The 69-page report - PDF, submitted [Jan 11th] to the Boston Redevelopment Authority for review, proposes some pretty big changes to the Allston landscape. Here are the highlights:
-putting part of Soldier's Field Road, the road that snakes alongside the river on the Boston side, underground
-building a new footbridge
-rebuilding and widening the existing Weeks pedestrian bridge to make room for bicycles and shuttles between the campuses
-creating a new Harvard Square-like Barry's Corner at the corner of North Harvard Street and Western Ave…
j7uy5 | January 26, 2007Fibromyalgia
is a disorder of chronic generalized muscle pain and joint stiffness
with the presence on physical exam of at least 11/18 designated tender
points. (The formal definition is a bit more involved.)
Interestingly, the term was not accepted by the AMA until
1987; the formal definition was not developed until 1990(1).
Prior to that, it was widely assumed to have a psychological
basis.
In fact, there still is a tendency in some medical circles, and in some
persons in the general population, to attribute fibromyalgia
Despite a substantial research effort (see
href="http://fm-…
terrasig | January 24, 2007I don't even know where to begin with this beautifully-crafted but very sad article in today's Wall Street Journal (sub req'd..sorry) by Suzanne Sataline.
This has all the features that are sure to send PZ Myers and Orac convulsing in a corner somewhere. As detailed in FDA allegations from an ongoing investigation as reported by Sataline:
A Pentacostal minister physician touting cancer cure rates of 60% or better, without chemotherapy
The sale/promotion of dietary supplements and herbal formulas, sometimes along with diets inspired by Biblical descriptions, at hundreds to thousands of…
mikethemadbiologist | January 24, 2007Well, kinda sorta. I'm mentioned in a UPI article about rapid diagnosis of influenza and antibiotic use. Rather than repeat the UPI story, here's the abstract (don't worry, I'll translate):
Background: Rapid influenza testing decreases antibiotic and ancillary test use in febrile children, yet its effect on the care of hospitalized adults is unexplored.We compared the clinical management of patients with influenza whose rapid antigen test result was positive (Ag+) with the management of those whose rapid antigen test result was negative or the test was not performed (Ag0).
Methods: Medical…