medicine
scientificactivist | April 29, 2009Yesterday, the Institute of Medicine released a report entitled "Conflict of Interest in Medical Research, Education, and Practice". As far as I can tell, the full report is only available for a fairly substantial charge, but these are some of the main recommendations summed up in the report's press release:
All academic medical centers, journals, professional societies, and other entities engaged in health research, education, clinical care, and development of practice guidelines should establish or strengthen conflict-of-interest policies, the report says. Disclosure by physicians and…
grrlscientist | April 29, 2009tags: Antigen Shift, Influenza Viruses, molecular biology, virology, microbiology, streaming video
This video discusses the process of antigen shift in influenza viruses, such as the H1N1 "swine flu" that has recently been identified in Mexico and in quite a few other countries, including in NYC [1:18]
palmd | April 29, 2009Here at ScienceBlogs we have a (very) informal agreement to try to avoid profanity-laden titles. Personally, they don't bother me at all, but I can see the point---there are lots of folks who probably don't want their feed reader to pop up with what I'm about to say.
What the FUCK hath swine flu wrought????
I warned you that swine flu would bring out the charlatans. In the course of hours to days, a virtual zombie army of immoral, idiotic, evil fucking quacks has risen to fan your fears and take you cash.
It's really hard to overstate this, but the people who engage in this fact- and…
jstemwedel | April 28, 2009In my last post, I looked at some of the ethical considerations an individual might make during a flu epidemic. My focus was squarely on the individual's decisions: whether to stay in bed or seek medical care, whether to seek aid from others, etc. This is the kind of everyday ethics that crops up for most of us as we try to get through our days.
If you're someone who is responsible for keeping health care infrastructure or other state resources in good working order, however, the ethical landscape of a major flu epidemic looks quite different.
On January 30, 2009, the Minnesota Pandemic…
oracknows | April 28, 2009No one brings home the stupid the way Michelle Bachmann does:
I find it interesting that it was back in the 1970s that the swine flu broke out then under another Democrat president Jimmy Carter. And I'm not blaming this on President Obama, I just think it's an interesting coincidence.
In just the same way that Kim Evans apparently doesn't know that there was no such thing as a flu vaccine during the 1918 pandemic, Michelle Bachman apparently doesn't know that the swine flu scare of 1976 occurred when Gerald Ford was President. In case Bachmann doesn't remember, Gerald Ford was a Republican.…
ddobbs | April 28, 2009Via emails, comments, and so on, quite a few people offered their own explanations for why mortality might be higher in Mexico (as of yesterday), the subject of my Slate piece.
First, though, a correction: I punched my numbers a bit too quickly in computing the flue's hypothetical kill ratios in Mexico, and had everything a decimal point over, and -- and therefore tenfold too understated.
Alert reader johnshade called this to my attention:
You'll want to fix your own "bad math":
"about 100 deaths?suggesting a mortality rate of 6 percent. This is
almost certainly bad math, as the total case…
oracknows | April 28, 2009I know I've been ragging on The Huffington Post a lot lately. Trust me, I take no great pleasure in doing so. Indeed, more than anything else, it's been a major frustration for me. It's bad enough that HuffPo has been a hotbed of anti-vaccine propaganda and pseudoscience ever since its very inception, continuing through to today. Ditto Deepak Chopra, who has had a home there for at least three years now. But 2009 has been especially bad, adding proponents of distant healing, detox quackery, and, worst of all, the stylings of Kim Evans, a detox maven who thinks that antibiotics cause cancer.…
palmd | April 28, 2009We have a lot to cover today, but first things first: the Big Question. If you'll cast your memory way back (thanks, Van) you'll remember that a good question to ask altmed followers is the one of abandonment: what would it take for them to abandon a modality? Well, the answers are in, and the one's who answered just didn't get it. For example:
[T]he question was: "Can you please give specific examples of alternative medicine theories and modalities that have been abandoned because they have been found to be ineffective?"
The short and honest answer to this is no-- I cant. But my reason…
ddobbs | April 28, 2009The excellent blog H5N1 (now covering H1N1 as well, and all over it), points us to the New York Times for an op-ed by John M. Barry, author of the definitive history of the Spanish flu in the US: Where Will the Swine Flu Go Next? Excerpt:
As the swine flu threatens to become the next pandemic, the biggest questions are whether its transmission from human to human will be sustained and, if so, how virulent it might become.
But even if this virus were to peter out soon, there is a strong possibility it would only go underground, quietly continuing to infect some people while becoming…
jstemwedel | April 27, 2009Like a lot of other people, I'm watching the swine flu outbreaks unfold with some interest. As they do, I can't help but think about the ethical dimensions of our interactions with other humans, since it's looking like any of us could become a vector of disease.
There are some fairly easy ethical calls here -- for example, if you're sick and can avoid spreading your germs, you should avoid spreading them. But there are some other questions whose answers are not as clear.
Stay in bed or seek medical care?
Currently public health officials in Mexico and the U.S. are scrambling to determine…
ddobbs | April 27, 2009I'm guessing most everyone interested in swine flu already reads Effect Measure (as well you should; it was an invaluable resource in my reporting for my Slate piece on the mystery of the virulence of the outbreak in Mexico). But in case you haven't or are not, today's primer there on case fatality rates, virulence, and mortality would make an excellent start.
One of the things we'd like to know about the swine flu virus is its Case Fatality Ratio (CFR, commonly called a case fatality rate, although it isn't technically a rate but a proportion). But what is a CFR? And how is it different…
amillikan | April 27, 2009
Correction appended: This post incorrectly stated the Center for Disease Control as the organization responsible for raising the pandemic threat level. This is the duty of the World Health Organization.
Swine flu outbreaks are raising alarm across the globe and prompting the World Health Organizationto consider raising the pandemic threat level. For the most current interpretations of what's happening from experts on the ScienceBlogs network, see the following category threads: "Pandemic-Preparedness" and "Swine Flu" from Revere at Effect Measure, and "Influenza" and "Outbreak" from Tara…
palmd | April 27, 2009I tuned into a CDC conference call this afternoon. It was interesting. As is often the case with emerging diseases, what we don't know vastly outweighs what we do. For the best public health information in the blogosphere, and the best flu updates, go to Effect Measure.
The CDC emphasized that it's quite early and things are changing by the hour. So far 40 cases have been identified in the U.S., all of them mild, with one requiring hospitalization because of underlying medical problems. It is assumed that many more cases will be identified, and it would be unusual if at least some were not…
ddobbs | April 27, 2009
"Swine Flu and the Mexico Mystery," my story on the swine-flu outbreak, is up at Slate. It looks at a question hotly pursued right now: Why does this flu seem to take a much deadlier course in Mexico than elsewhere so far? The answers will suggest much about what's to come.
Of the two two qualities vital to a nasty pandemicm-- to spread readily, and to be deadly, -- this flu,a brand-new strain of swine flu, or H1N1, seems to possess the first: Evidence is high that it spreads readily among humans. In that sense, it's an inversion of the bird flu. Bird flu terrifies infectious disease…
palmd | April 27, 2009It's going live shortly, the wifi gods willing.
Conference here.
Tweet at http://twitter.com/palmd
oracknows | April 27, 2009I've complained quite a bit about the news media in my hometown. Indeed, about a year ago, I was stunned at how utterly credulous one TV reporter was about--of all things--orbs. I mean, orbs! Even dedicated ghosthunters don't push orbs much anymore, realizing that they are nothing more than reflections or specks of dust reflecting lights in photographs. Then there's Steve Wilson and his forays into anti-vaccine nonsense, in which he recycles some of the oldest, most tired, most highly debunked canards. Lately, it's been some additional crappy reporting about Gardasil and a recent "autism"…
palmd | April 26, 2009With all the news abuzz about swine flu, it's important to remember a few things. Influenza can be very, very dangerous, but it's still just a virus, and one that we know quite well. There have been a number of flu pandemics in the last century, the most famous (and most deadly) being the "Spanish flu" of 1918-1919. That pandemic was a perfect storm. Soldiers moved back and forth between Europe and the U.S., and military bases in the U.S. weren't much better than the Western Front. Soldiers on U.S. bases lived in crowded, cold, wet conditions, and the flu moved through them rapidly,…
palmd | April 26, 2009So far, it looks like the US Gov't is on top of this one. If you're interested in following along with the story, I strongly suggest following the Effect Measure blog. The writers know their stuff, and so far, government websites aren't all that much health.
Some basics:
As you remember, the flu virus changes over time due to "antigenic drift" and we need to make new vaccines every year. Sometimes, often due to multiple strains co-infecting the same animal, the influenza genome undergoes a more dramatic change called "antigenic shift". Influenza A is commonly found in birds, pigs, and…
j7uy5 | April 26, 2009I had to look this up, so to save others the trouble of finding it,
here is the WHO
href="http://www.who.int/csr/disease/avian_influenza/phase/en/index.html">explanation
of pandemic alert levels:
In
nature, influenza viruses circulate continuously among
animals, especially birds. Even though such viruses might theoretically
develop into pandemic viruses, in Phase
1 no viruses circulating among animals have been reported to
cause infections in humans.
In Phase 2 an animal influenza
virus circulating among domesticated or wild animals is known to have
caused infection in humans, and is…