Medicine
oracknows | January 8, 2007It was just last week that I was made aware of the sad news that Katie Wernecke, the 14-year-old girl with Hodgkin's lymphoma whose parents' battle to reject radiation therapy and additional chemotherapy made national news in 2005 and who ultimately went for high dose vitamin C therapy at an altie clinic in Kansas, had relapsed. (Even now, altie vultures are advertising their wares in the comments of the post in which Katie's father announced her relapse, and chastising a lone MD who posted a comment begging the family to try conventional medicine while there's still a chance.) As regular…
evolgen | January 6, 2007
There is currently much debate over the ethics of chimeras -- organisms that are partially one species and partially another. This debate is especially heated when humans are one of the species involved. Nature has published an editorial on the controversy. I don't intend to comment on the position of the editorial, but rather on the sloppy use of language by the unattributed author.
I don't know enough about the research and clinical applications of chimeras involving humans to make any claims about the ethics of such creations, but I do know enough about biology to get all hot under the…
oracknows | January 2, 2007Believe it or not, there are times when I really, really wish I weren't right.
No, I'm not implying that I'm right so much of the time that I wish I were wrong more often. I'm human and therefore perfectly capable of being wrong, sometimes spectacularly so. (Of course, as we all know, that sort of thing rarely happens on this blog, right? Right?) But sometimes, even as I know I'm right about something, deep down I hope that I'm not. Usually such cases involve watching patients choosing alternative medicine reach the point where they have to the consequences of their choice. Despite all my…
oracknows | December 30, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts, most of which are more than a year old.) These posts will be interspersed with occasional fresh material. This post originally appeared on November 30, 2005 and is the followup to the first article I did (reposted earlier today). I debated whether to repost…
oracknows | December 30, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts, most of which are more than a year old.) These posts will be interspersed with occasional fresh material. This post originally appeared on November 21, 2005 and is the first of a two-part discussion of what has come to be known as the Al-Bayati Report. Part 2…
oracknows | December 29, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts, most of which are more than a year old.) These posts will be interspersed with occasional fresh material. This post originally appeared on January 9, 2006 and seems to fit in with the whole "Friday Dose of Woo" thing; so I'll repost it as such. Enjoy!.
I was…
oracknows | December 28, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts, most of which are more than a year old.) These posts will be interspersed with occasional fresh material. This post originally appeared on November 22, 2005.
A couple of months ago, there was a minor dust-up here regarding an unfortunate autistic boy who died…
oracknows | December 27, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts, most of which are more than a year old.) These posts will be interspersed with occasional fresh material. This post originally appeared on January 26, 2006, which means that more of you are likely to remember it. However, given the discussion from last week, I…
cortex | December 27, 2006The Times has a story today on the recent boom in "brain health" programs:
From "brain gyms" on the Internet to "brain-healthy" foods and activities at assisted living centers, the programs are aimed at baby boomers anxious about entering their golden years and at their parents trying to stave off memory loss or dementia.
The most popular of these programs (by far) is Nintendo's Brain Age. The game is a slickly marketed confection of shareware - you do everything from play Sudoku to read Dickens out loud - that pretends to measure the age of your brain. Of course, all they're really doing is…
mikethemadbiologist | December 26, 2006From the archives, I'm reposting this article about MRSA and VRSA. I've made some changes because the science and medical practice have changed.
The Chicago Tribune reports that three children died from toxic shock syndrome caused by methicillin resistant Staphylococcus aureus ("MRSA"). Toxic shock syndrome is not typically associated with MRSA. What's worse is that these infections were "community-acquired" (CA-MRSA) In other words, the kids were not infected in the hospital-many staph infections are hospital acquired due to puncturing the skin barrier (e.g., catheters, IVs, surgery).…
oracknows | December 26, 2006While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts.) These posts will be interspersed with occasional fresh material. This post originally appeared on March 7, 2005 after I arrived home from a meeting.
I'm back at home. The meeting went fairly well and my talk was well-received.
Surgical meetings are odd beasts.…
revere | December 25, 2006Measles is now uncommon in the US, thanks to vaccination. Last year there were only 66 cases. But half of them came from a single, unvaccinated 17 year old who traveled to Romania on a church mission that visited an orphanage. The next day she returned to the US and attended a gathering of other church members, 33 from Indiana and one from Illinois. Three wound up in the hospital.
Measles vaccination is not 100% effective but it is estimated to be over 90% in pre-school and school aged children. In this instance, 32 of the 34 cases were unvaccinated:
"The outbreak occurred because measles was…
mementomori | December 22, 2006"Subcutaneous inflammation mimicking metastatic malignancy induced by injection of mistletoe extract"
"At the risk of upsetting many proponents of alternative medicine, I also contend that intuition is no substitute for evidence."
-Edzard Ernst, professor of complementary medicine, Department of Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter
Holy Nostrums, Batman! Someone is actually criticizing one of the most popular anti-cancer treatments on the shelf of the corner store with the sign Natural Cures Only hanging above it. Professor Edzard…
signout | December 22, 2006Yesterday, I discharged 5 patients from the hospital. Today, I feel dead inside.
For patients, hospital discharge is a happy moment. Leaving the hospital means leaving behind the unflattering gown, the interrupted sleep, the food that does not resemble itself, and the constant parade of people poking and sticking and looking at your business. Most inpatients eagerly anticipate discharge from the moment they are admitted.
For residents, hospital discharges are a little different. Patients leaving the hospital require instructions, follow-up appointments, outpatient testing, prescriptions, and…
terrasig | December 21, 2006As we discussed briefly on Tuesday, trial results published in the Annals of Internal Medicine revealed that alternative botanical supplements containing black cohosh were without benefit relative to placebo in treating the vasomotor symptoms (e.g., hot flashes, night sweats) of peri- and postmenopausal women.
The Cheerful Oncologist followed up with a post entitled, "Oh M'Gosh! Black Cohosh Squashed and That's No Bosh!, where Doc Hildreth cited another 2006 study from Mayo Clinic investigators demonstrating lack of efficacy of black cohosh extracts against hot flashes. (He noted later that…
revere | December 21, 2006This week President Bush signed the Pandemic and All-Hazards Preparedness Act (S. 3678). It has generally gotten favorable reviews from public health professionals concerned with preparedness, including the Clinicians Biosecurity Network and The Trust for America's Health. We've taken a look, too, and find much to like, but whether this will indeed be useful will depend on how it's implemented. We have a few observations of our own, as well.
The law has four Titles, each dealing with a separate but related topic. Title I. pertains to " National Preparedness and Response, Leadership,…
ddobbs | December 20, 2006
I try to keep on top of controversies about drug companies, but lately it's hard to keep up with all the latest revelations and laundry spills -- and to wrap your head around the variations. Today the New York Times reports that Eli Lilly mounted an organized effort to convince doctors to prescribe its powerful schizophrenia and bipolar-disorder drug Zyprexa for elderly patients with symptoms of dementia -- despite that dementia in the elderly rises from causes quite different than those of schizophrenia or bipolar disorder, is far less serious problem than schizophrenia, and that Zyprexa…
bushwells | December 20, 2006With the latest Big Pharma debacle ("Hey, let's shoot ourselves in the other foot") from the Prozacasaurus' overmarketing of Zyprexa (see Grrl's, Jake's, and David's (addendum, 12/21) blog entries on the subject), this recent (and free access) article from PLoS Medicine: Educating Health Professionals about Drug and Device Promotion: Advocates' Recommendations seems particularly relevant.
Nephrology News and Issues provided a good summary of the PLoS article:
A group of physicians and advocacy groups is taking on pharmaceutical promotions, calling in a journal article for an overhaul of…
mikethemadbiologist | December 19, 2006...or at least, I was mentioned in Cell. Currently, we have very few new antibiotics in the pipeline, particularly for Gram-negative bacteria such as Acinetobacter. One of the things I'm involved with is a project to develop a not-for-profit screening library to find new antibiotics. From Cell:
Resistance of microbial pathogens to an increasing number of antibiotics is a serious problem. In the US alone, 90,000 people die every year from infections acquired while in the hospital. According to the Infectious Disease Society of America (IDSA), 70% of these deaths have been attributed to…
oracknows | December 18, 2006I don't think I could have done it much better, if at all.
Dr. R.W. presents, in FAQ-form, a primer on the difference between woo and conventional medicine, even conventional modalities that are weakly grounded in evidence.
A couple of examples:
Many of mainstream medicine's conventional treatments are not evidence based. Aren't they a form of woo?
No. Although some conventional methods fail to measure up to best evidence they are at least based on known anatomy and physiology. They have some plausibility in the observable biophysical model in contrast to the "vital forces", nebulous "energy…