medicine
oracknows | June 19, 2009With Homeopathy Awareness Week rapidly approaching its end, I wondered just what I could do to bring further "awareness" of just how bogus and full of woo the concepts of homeopathy are. True, discussing homeopathic plutonium as a remedy and how homeopaths did "provings" of it the other day was fun, but surely there's more. What other homeopathic "remedies" (quotation marks used because of a complaint about my having actually used the term "remedy" to describe homeopathy, given that any true homeopathic remedy is diluted so much that there's nothing left but water--or alcohol, if that is what…
ddobbs | June 18, 2009
A key component of health-care reform -- and saving our ass from going bankrupt and sick from spending too much on lousy treatments -- is establishing comparative effectiveness measures, otherwise known as "actually knowing WTF works and what doesn't."
This idea terrifies companies who don't want such objective measures. It also generates a lot of fear, partly via confusing or intentionally frightening arguments. Yet making sure we don't pay for stuff that doesn't work is key to reform -- a point made in this Times op-ed from libertarian economist Tyler Cohen, keeper of the blog Marginal…
bioephemera | June 18, 2009
Joanna of Morbid Anatomy is on a quest to locate private collections of medical oddities. She's already sussed out fourteen such hidden wunderkammern and photographed their treasures, but she wants to find more:
"Who are these private collectors, and what sort of treasures do they possess? How might their methods of displaying collections differ from institutional approaches? Are we reaching a historical moment similar to the pre-museum era of private cabinets, in which the most interesting artifacts are now in private rather than public hands?"
It's a really interesting question.…
oracknows | June 17, 2009Will wonders never cease? A recent story about how "homeopathic" Zicam managed to slide through a loophole in which the FDA doesn't require evidence of efficacy or safety for medicines labeled as homeopathic has been percolating through the blogosphere based on a recent warning that the FDA issued. It turns out that the zinc in Zicam can mess up your sense of smell, causing a loss of the sense called anosmia. Steve Novella has already done an excellent job of discussing the issues involved with this loophole, which is big enough to pilot the proverbial Death Star through.
However, a followup…
ddobbs | June 17, 2009Big psych news of the day is that a big JAMA study debunked the "depression gene" -- that is, this big new study (by Risch et alia, in JAMA, today) found that, contrary to a famous earlier big study (Caspi et alia, in Science, 2003), the short ("bad") form of a particular gene called 5-HTT does NOT make a person more vulnerable to depression. Or, to flip it:: Caspi 2003 had found that having a short version of 5-HTT, which affects processing of serotonin, put someone at more risk of depression if they experienced (as adults) repeated stressful life events. Risch 2009, crunching data from a…
j7uy5 | June 17, 2009When I first heard about the American Medical Association (AMA)
opposing Obama's health care reform, I was troubled. I almost
wrote a post about it, but by the time I got home, I found that others
had beaten me to it.
href="http://scienceblogs.com/effectmeasure/2009/06/revolutionary_medicine.php">Revere,
for example, appears to have written before work,
posting at 6:46AM. That's dedication.
But it the interim, I've come up with a different angle. Part
of it comes from an article on Medpage Today (free registration):
href="http://www.medpagetoday.com/MeetingCoverage/AMA/14691"…
oracknows | June 17, 2009In keeping with Homeopathy Awareness Week (which still runs until June 21), I can't resist commenting on this gem of a story that was sent to me the other day. I mean, we're talking super duper heaving shopping in the very heart of London. It turns out that the Helios Homeopathy Shop right in Covent Garden will fix you up with homeopathic plutonium if you need it:
Dr Fiona Barclay, a chemist at RGB Research in west London, made this discovery. Her company specialises in selling collections of the periodic table elements (with the exception of those elements that are illegal or are so very…
grrlscientist | June 17, 2009tags: Shawn Johnson, gymnastics, sports, humor, satire, Onion News, streaming video
Gymnast Shawn Johnson euthanized after breaking leg. After gym doctors confirmed the her injuries were career-ending, Johnson's trainers said there was no reason to keep her alive. [2:28]
oracknows | June 16, 2009When it comes to antivaccinationists, The Onion, as for most things, nails it.
Don't vaccinate not because science shows no link between vaccines and autism but rather because, you know, Jenny McCarthy has some really convincing anecdotes.
When antivaccine loons are the butt of jokes on The Onion saying that they're endangering children, they should beware. Few things cut as deep as an Onion parody.
ddobbs | June 16, 2009Neuroskeptic offers an elegant unpeeling of a study seeming specifically designed to find a marketing-friendly distinction for a drug -- Abilify -- otherwise undistinguished.
Suppose you were a drug company, and you've invented a new drug. It's OK, but it's no better than the competition. How do you convince people to buy it?
You need a selling point - something that sets your product apart. Fortunately, with drugs, you have plenty of options. You could look into the pharmacology - the chemistry of how your drug works in the body - and find something unique there. Then, all you need to do is…
jstemwedel | June 16, 2009A day later than promised, let's kick off our discussion of "Research Rashomon: Lessons from the Cameroon Pre-exposure Prophylaxis Trial Site" (PDF). The case study concerns a clinical trial of whether tenofovir, an antiretroviral drug, could prevent HIV infection. Before it was halted in the face of concerns raised by activists and the media, the particular clinical trial discussed in this case was conducted in Cameroon. Indeed, one of the big questions the activists raised about the trial was whether it was ethical to site it in Cameroon.
From the case study:
Tenofovir was first…
oracknows | June 16, 2009Here we go again.
You may have noticed that I've been laying off that repository of quackery, autism pseudoscience, and anti-vaccine nonsense, The Huffington Post. I assure you, it's not because things have gotten much better there. Oh, sure, occasionally someone will try to post something resembling science and rationality, but it's impossible for so few to overcome so much history and so much woo. Indeed, even when someone tries, he can't help but be sucked into the morass of pseudoscience that is HuffPo. For example, Dr. Harvey Karp (the same guy who went toe-to-toe with Dr. Jay Gordon--…
palmd | June 16, 2009The last month has been pretty busy at the office, with lots of H1N1 influenza. I've been quite lucky, but the last couple of days I've had some pretty close exposures. The other day I gave a nebulizer treatment to a patient with wheezing who turned out to have the flu (I was not wearing a mask), and I've seen about a half-dozen others with it.
So today I'm off to the pharmacy to pick up my prophylactic course of oseltamivir. Whoopie!
palmd | June 15, 2009It's just disgusting. Autism spectrum disorders are an important health problem (although not the "epidemic" claimed by some). While real scientists and clinicians (and parents) are looking for causes and treatments based on evidence, fake experts are pulling "answers" out of their backsides. Studies of families with autism have shown specific genetic defects associated with autism, and while this applies only to a small percentage of cases, it is an example of a good lead. Even if a minority of people with autism have similar genetic defects, these findings can lead to more generalizable…
oracknows | June 15, 2009On Friday, I expressed my irritation at the misunderstanding of science by NEWSWEEK's science columnist Sharon Begley, in which she opines that it is those nasty basic scientists who insist on learning new science and new physiological mechanisms of disease that are devaluing translational and clinical research, in effect ghettoizing them in low impact journals, and, as I sarcastically put it, "keeping teh curez from sick babiez!!!!!"
It turns out that both Steve Novella, Mike the Mad Biologist, and Tim Kreider have also weighed in. All are worth reading.
I also thought of another thing…
oracknows | June 14, 2009Last month, a frequent topic of this blog was the case of Daniel Hauser, the 13-year-old boy from Minnesota with Hodgkin's lymphoma who made the national news for his refusal (and his mother's support of that refusal) to undergo a second round of chemotherapy. Instead, he wanted to pursue "natural" therapy, including what sounded like alkalinization quackery. What was especially disturbing about this case was that he had a highly treatable form of cancer with close to a 90% expectation of long term survival with conventional treatment with chemotherapy and radiation. As with the cases of…
oracknows | June 14, 2009I bet you didn't know this (maybe because of homeopathic publicity), but today is the first day of Homeopathy Awareness Week, which runs from June 14 to 21.
It turns out that I'm torn over whether to mention or do much about this. On the one hand, publicizing the magical, mystical thinking that is homeopathy serves a purpose in emphasizing time and time again just how utterly implausible from a scientific standpoint homeopathy is, how most studies showing and "effect" from homeopathy are seriously flawed, and how the best quality studies of homeopathy show it to be no more effective than a…
palmd | June 13, 2009People in my profession are at increased risk for acquiring certain diseases: tuberculosis, HIV, hepatitis B and C, and some others. We vaccinate against the ones we can (primarily hepatitis B) and exercise universal precautions, which involves careful attention to bodily fluids and other infectious tissue. The basic rule is, "assume everyone has a blood-borne infection." We don't make the same assumptions for other illnesses such as tuberculosis as these usually have symptoms when they are infectious, as opposed to HIV and hepatitis. Even with these precautions, health care workers are…
oracknows | June 13, 2009What should a doctor recommend for a 90 year old man with pancreatic cancer and liver metastases? Palliative care? Hospice? Those would seem to be the most reasonable options. If I were that 90 year old man, that's what I'd recommend. Unfortunately, I know from experience that that is all too often not what happens. I know and have seen the ordering of many invasive tests that won't change the outcome.
So does Buckeye Surgeon.
American medicine, as it is practiced now, all too often takes on a momentum that is very difficult to stop, a momentum demanding more, more, more, more, even in the…
oracknows | June 12, 2009I was very happy with NEWSWEEK recently, specifically because of its lengthy expose of Oprah Winfrey and her promotion of pseudoscience, mysticism, and quackery on her talk show. However, I haven't always been that thrilled with NEWSWEEK's coverage of medicine and science. For example, NEWSWEEK's science columnist Sharon Begley has gotten on my nerves on more than one occasion, most recently when she castigated doctors for not enthusiastically embracing comparative effectiveness research, making the unjustified slur against physicians that they "hate science." Indeed, she even managed to…