Medicine
purepedantry | December 18, 2006Yet again, a drug company is playing damage control for failing to come clean about a drug's side effects. It makes me so mad when companies do stuff like this because it is such a preventable problem. In this case, the drug in question is Zyprexa (olanzapine) -- presently one of the go-to drugs for the treatment of schizophrenia -- and the company in question is Eli Lilly:
The drug maker Eli Lilly has engaged in a decade-long effort to play down the health risks of Zyprexa, its best-selling medication for schizophrenia, according to hundreds of internal Lilly documents and e-mail messages…
clock | December 18, 2006Just How Useful Are Animal Studies To Human Health?:
Animal studies are of limited usefulness to human health because they are of poor quality and their results often conflict with human trials, argue researchers in a study online in the British Medical Journal.
Before clinical trials are carried out, the safety and effectiveness of new drugs are usually tested in animal models. Some believe, however, that the results from animal trials are not applicable to humans because of biological differences between the species.
So researchers compared treatment effects in animal models with human…
oracknows | December 15, 2006This week sucked.
OK, it was the last two or three days that sucked, but they were bad enough to ruin the whole week. The only reason my blogging didn't reflect this is because most of the posts over the last couple of days were actually written earlier this week, and the true magnitude of this week's suckitude didn't hit me until yesterday. Suffice it to say that my lab minions have caused me considerable aggravation and angst this week by doing something really, really dumb, a problem whose effect was amplified by the response of a colleague. (That's all I'm going to say about it.) To top…
revere | December 15, 2006There are many local stories about pandemic flu planning and they all sound pretty much the same. Local officials saying they are making good progress but there's still much left to do and if a pandemic struck they'd be in trouble. Yawn. But every once in a while you read one where you say to yourself, "Some of this has sunk in. They're asking the right questions." Not often, or at least not often enough, but when we started talking about this no one was asking questions like this:
Meals on Wheels delivers 850 meals a day in Rockingham County [New Hampshire], relying on 35-40 drivers and…
terrasig | December 14, 2006Following from my previous post about the JCO paper on the medical ethics of managing pediatric cancer cases where parents refuse standard-of-care therapies, I wanted to discuss an accompanying review on complementary and alternative therapies for cancer-related pain. Unlike the previous article, this one is subscription-only but I'll provide the highlights.
Cancer-related pain is serious business and is experienced by 75% of cancer patients. Opiates remain the most effective drugs for severe cancer pain, but they are underprescribed due to the convergence of regulatory and liability issues…
oracknows | December 14, 2006It appears that I'm even further behind in my reading than Abel Pharmboy, because he pointed me to a couple of articles in an issue of the Journal of Clinical Oncology that I haven't even cracked open yet. It's probably still sitting in the pile of journals on my desk that haven't been touched yet because I haven't gotten around to them. The issue contains two articles of interest, but I think I'll only touch on one of them for now because it's highly relevant to my previous posts about Abraham Cherrix, the 16 year old with relapsed Hodgkin's disease and refused additional chemotherapy in…
oracknows | December 13, 2006Believe it or not, I missed my own blogiversary.
It's true. It was two days ago. For some reason, as the date approached I got the idea that it was the 13th, when in fact this blog was born on December 11, 2004 on a dreary Saturday afternoon when, after reading the TIME Magazine story about how 2004 was supposedly the "year of the blog" and, given my long history on Usenet pontificating on various topics, on a whim, I decided that I'd dip my toe into this thing called the blogosphere.
Thus was Respectful Insolence⢠born, and I've never looked back since.
Since then, this thing has grown…
terrasig | December 12, 2006I finally just got around to reading the 1 Dec issue of the Journal of Clinical Oncology and was struck by two, back-to-back articles that address two interesting aspects of alternative medicine in cancer treatment. Mind you, I'm a basic scientist but I find the struggles that oncologists face to be quite interesting in this regard.
First is an article (free full text here) from a feature called, The Art of Oncology: When the Tumor is not the Target. The title alludes to some high-profile legal cases that arose over the summer, but does not discuss specifically the Cherrix case:
Do…
mementomori | December 12, 2006Study: Long hospital shifts, sleep deprivation can kill
We in the healing arts have waited a long time for a headline like this. It seems that someone has finally acknowledged what we knew all along: working long hours is dangerous to the health and life of young doctors-in-training. Hurrah for research! Let's celebrate by knocking off early, before we get hurt.
A study from the U.S. of doctors in their first postgraduate year (interns) has showed that working extended shifts is associated with increased reporting by the doctors of medical errors, adverse patient events and attentional…
drorzel | December 12, 2006Surprising approximately no-one outside the medical profession, Eurekalert today features a press release about a paper showing that doctors on long shifts make more mistakes:
The study, published in PLoS Medicine, which was led by Charles Czeisler and Laura Barger from Brigham and Women's Hospital and Harvard Medical School, included 2737 medical residents, who completed 17,003 monthly reports. In months in which residents worked even one long shift-of 24 hours or more -they were three times more likely to report a fatigue-related significant medical error compared with months in which they…
oracknows | December 11, 2006It's that time of year again. Nominations are open for the best medical blogging:
Welcome to the third annual Medical Weblog Awards! These awards are designed to honor the very best in the medical blogosphere, and to highlight the diverse world of medical blogs.
The categories for this year's awards will be:
-- Best Medical Weblog
-- Best New Medical Weblog (established in 2006)
-- Best Literary Medical Weblog
-- Best Clinical Sciences Weblog
-- Best Health Policies/Ethics Weblog
-- Best Medical Technologies/Informatics Weblog
-- Best Patient's Blog (a new category this year)
Nominations are…
j7uy5 | December 11, 2006According to a study published in the medical journal, Pediatrics,
girls and young women who visit eating disorder oriented websites may
be harmed by the activity. The funny thing is, is does not
matter if the sites encourage eating disorder behavior, or discourage
it. Persons who visit such sites are more likely to end up in
the hospital for treatment of their disorder, and are more likely to
have along duration of active illness. Furthermore, they are
likely to spend less time on schoolwork.
Although it is not possible to say that the use of such sites
exacerbated the disorders, persons…
signout | December 10, 2006Today, in another of her cantankerous and directionless "interviews," Deborah Solomon of the New York Times at least got something right. This time, the subject of her bullying is Louann Brizendine, a professor of neuropsychiatry at the University of California, San Francisco (UCSF). Brizendine, who in her picture insists on the heeled ankle bootie, just came out with a book about why all women are catty bitches. (Finally!)
Near the end of the interview, Solomon notes that while Brizendine draws on other scientists' research in writing her book, she hasn't done any research herself. In…
cortex | December 9, 2006The scientific process is famously conservative. On the one hand, this is a necessary flaw: empiricism requires reproduction, and it's never fun when our view of reality is jolted by some revolutionary new fact. The reputation of science in large part depends upon not endorsing charlatans.
On the other hand, it often seems as if science is excessively conservative. The peer-review process is an essential element of science, but it also discourages original ideas. If you want to publish a bold new paper on, say, the function of the Golgi bodies, then your paper is sent for review to all the…
terrasig | December 8, 2006As Dave Barry would say, I am not making this up.
In yesterday's Wall Street Journal (sub req'd, but I'll quote extensively), Stacy Meichtry wrote on an Italian Roman Catholic religious order whose cancer research laboratory, owned formerly by Pfizer, has recently entered partnerships with this and other major international pharmaceutical companies.
But two years ago, Father Decaminada, a priest and chief financial officer of the Roman Catholic religious order Congregation of the Children of the Immaculate Conception, engineered the acquisition from Pfizer Inc. of a leading Italian…
j7uy5 | December 6, 2006Usually, doctors post radiology quizzes with odd clinical findings, or
sometimes odd things that people have swallowed, or gotten into their
bodies through other means.
But this particular image has nothing to do with medicine, or even
traditional radiology. Rather, it pertains to astronomy and
archeology.
This is the famous
href="http://en.wikipedia.org/wiki/Antikythera_Mechanism"
rel="tag">Antikythera mechanism, found in the
Mediterranean Sea, discovered in a shipwreck in 1901, off the coast of
the Greek island,
rel="tag">Antikythera. That's the origin
of the name of the…
oracknows | December 6, 2006The Cheerful Oncologist posts a nice piece about When Is No Treatment the Right Treatment? It's a difficult question that surgical oncologists have to face as well. His example is a man with lung cancer who has recently rapidly deteriorated with little hope for long-term survival. Should he get chemotherapy? Are the risks (immunosuppression, etc.) worth the rather meager benefit?
It's a really, really tough question.
We surgeons face this question as well, although probably much less frequently than medical oncologists do (another reason I don't think I could do medical oncology). One of the…
oracknows | December 6, 2006Although I've mentioned before that I am a surgical oncologist, but I recently noticed that, in nearly five months of blogging, I've yet to explain exactly what that is or what it means. I've written about all sorts of things, ranging from alternative medicine, to the evolution-creationism conflict, to the Holocaust, to even trying my hand at reviewing music.
True, I've discussed a fair number of anecdotes based on patient stories. Certainly those stories can give a feel for what I do in the clinical part of my duties, but they don't really explain what my specialty is. I've also spoken about…
purepedantry | December 4, 2006Totally effective, side-effect free treatment of Parkinson's continues to elude physicians, but a study by Deuschl et al in the NEJM shows that we are definitely making progress.
Deuschl et al performed a randomized study that assigned patients into one of two groups. The control group recieved the standard treatment for Parkinson's -- which right now is pharmaceuticals like the drug L-dopa. The experimental group had stimulating electrodes implanted into the subthalamic nuclei (STN) of their brain in addition to treatment with L-dopa. The study shows that the individuals in the…
terrasig | December 3, 2006Yesterday, Revere (Effect Measure) threw down the gauntlet challenging those critical of alternative medicine to examine work done at the University of Nebraska Medical Center in 2000 on the medicinal properties of chicken soup.
The news release cites work that a chicken/vegetable soup, but not simple chicken broth, inhibits in vitro neutrophil migration, or chemotaxis. Inhibiting the migration of this class of white blood cells might reduce the nasopharyngeal symptoms of the common cold, thereby providing some evidence that grandma's chicken soup might very well help one feel better during…