medicine
oracknows | March 19, 2009Given that I'm the proverbial lapsed Catholic cum agnostic, religion just doesn't play that large a role in my life and hasn't since around six years ago. I don't know if I'll ever discuss or explain on this blog what the last straw resulting in that transformation was (it's too personal), but a couple of years ago I did go through a period where I became hostile to religion, perhaps spurred on by PZ and the whole anti-religion gestalt of the ScienceBlogs Collective here. That lasted maybe a year or two, during which time I did what every new disillusioned ex-religious person seems to do (…
clock | March 18, 2009Tomorrow's Nature has a nice, long article about the plight of science journalism and the potential role of science blogs in filling the void as science journalists are laid off and the news-media are going bankrupt and shutting down.
No commentary for me about it yet today - I hope others will start first.
The introductory editorial is here: Filling the void: As science journalism declines, scientists must rise up and reach out.
The main article is here: Science journalism: Supplanting the old media? (allows comments)
The PDF is really pretty (and has additional images and boxes in the…
terrasig | March 18, 2009I just had a chance to check in on a triad of posts by Prof Janet Stemwedel at Adventures in Ethics and Science (1, 2, 3) on the ethical issues of the conduct of studies, particularly clinical trials, supported by the US NIH's National Center for Complementary and Alternative Medicine (NCCAM).
For background, NCCAM was originally established for political, not scientific reasons, as the NIH Office of Alternative Medicine in October 1991. It received a token budget of $2 million at the time. They still only get $120-ish million; modest by NIH standards as compared, say, with the 2007 NCI…
tqa | March 18, 2009
One of the pictures in a Walter Reed Army Medical Center collection of historic photographs is a simple, black-background shot of what we can only assume is some sort of scientific equipment:
The question is, what is it? According to the caption, it's a 1984 picture of a "mouse-tail wash table". My guess is that it was used to wash the tails of mice used in scientific experiments, presumably after said tails had been removed from their original owners. Exactly which lab used the device, and for what sort of research, is not so clear.
(HT: Wired Science)
palmd | March 18, 2009I often write about "cult medicine", that is, medical practices that share many characteristics of cults: they are based on faith, they follow charismatic leaders, they separate people from their money---you know, like The Church of Scientology. The COS has everything going for it---a religious arm, a health care arm (the Citizens Commission on Human Rights), and an educational arm. In fact, the more I learn about these wackos, the scarier (and funnier) they seem. You see, it turns out that these folks have a lot of front organizations. Unlike more traditional religions, that are happy to…
palmd | March 18, 2009How can a seemingly trivial head injury kill you?
To answer this, you need a little anatomy.
Your brain is a pretty important organ, and is well protected. It sits inside a thick armor (the skull) and floats cushioned in a bath of cerebral-spinal fluid. It's surrounded by several layers of tissue, and its blood supply is kept relatively separate from the rest of the body (the "blood-brain barrier"). This separation helps keep out toxins and micro-organisms (but is imperfect). Just beneath the skull is a tough, leathery layer called the dura mater. This picture shows the skull cut…
oracknows | March 18, 2009Two days ago, I deconstructed Andrew Wakefield's clumsy attack on Brian Deer, the investigative journalist whose investigations uncovered Wakefield's massive conflicts of interest and, most recently, his scientific fraud. Now, right here in the very comments of this blog, Brian Deer has responded:
Obviously, because Our Andy's statement purports to be a complaint to the UK Press Complaints Commission, I can't yet comment on the substance (although I have mentioned just a couple of generic Wakefield claims right up at the top, here: http://briandeer.com/solved/wakefield-veracity.htm).
But, in…
jstemwedel | March 18, 2009Orac takes issue with a pair of posts I wrote yesterday about the National Center on Complementary and Alternative Medicine (NCCAM). I gather he thinks I've been far too trusting as far as the information provided on the NCCAM website, and that I'm misrepresenting the issues the critics of NCCAM have with the center. If my posts communicated that they were giving the straight dope on NCCAM and the objections to it, then I blew it; that wasn't at all what was intended. Rather, I wanted to have a look at the ethical issues that arise from such an official effort to examine medical treatments…
ddobbs | March 18, 2009It didn't take long for my Scientific American story on PTSD to draw the sort of fire I expected. A doctor blogging as "egalwan" at Follow Me Here writes
[Dobbs] is critical of a culture which "seemed reflexively to view bad memories, nightmares and any other sign of distress as an indicator of PTSD." To critics like this, the overwhelming incidence of PTSD diagnoses in returning Iraqi veterans is not a reflection of the brutal meaningless horror to which many of the combatants were exposed but of a sissy culture that can no longer suck it up.
Doctor or not, he's seeing politics where my…
j7uy5 | March 18, 2009Today's edition of the Journal of the American Medical Association
contains a study that employed PET scans to determine the effect of
modafinil upon dopamine concentration and reuptake in the human central
nervous system. They conclude with a caution that clinicians
should be mindful of the potential for abuse and dependence in persons
taking modafinil.
The problem with the study is that it adds very little, if anything, to
clinical practice.
href="http://jama.ama-assn.org/cgi/content/short/301/11/1148">Effects
of Modafinil on Dopamine and Dopamine Transporters in the Male Human…
palmd | March 18, 2009A frequent commenter on the conscience issue has raised a lot of questions on an recent post. He seems somewhat frustrated that I don't understand his point. What I think he doesn't realize is that I do understand his point all too well---he is just wrong. Here is an example:
You also still haven't cleared up that little inconsistency regarding the matter of whether or not there is a professional obligation to provide elective services. Or is it just physicians, but not pharmacists or other healthcare professionals, who have rights of conscience?
OK, I'll clarify it for you. It's not that…
oracknows | March 18, 2009It's probably an understatement to say that I've been critical of the National Center for Complementary and Alternative Medicine (NCCAM). Indeed, I consider it not only to be a boondoggle that wastes the taxpayers' money funding pseudoscience, but a key promoter of quackery. Worse, its promotion of highly implausible (one might even say magical) modalities gives these modalities a patina of scientific respectability that they do not deserve, especially given that, even under the most favorable conditions possible, they routinely fail to demonstrate any efficacy above and beyond that of a…
jstemwedel | March 17, 2009In my last post, I started wading into the question of what kinds of ethical questions arise from clinical trials on "alternative" medical treatments, especially clinical trials supported by the National Center on Complementary and Alternative Medicine (NCCAM). The ethical questions include whether alternative treatments expose human subjects to direct harm, or to indirect harm (by precluding a more effective treatment), not to mention whether the money spent to research alternative modalities would be better spent on other lines of research. I think it's worthwhile to dip into the NCCAM…
tfk | March 17, 2009Via ObWi, we learn that the Pope took time out of his busy schedule to extend the AIDS crisis in Africa:
While medical workers advocate the use of condoms to help prevent the spread of AIDS, the Church insists on fidelity within heterosexual marriage, chastity and abstinence.
"The problem cannot be overcome by distributing condoms. It only increases the problem," the pontiff told reporters on board the plane headed for Africa.
While in Cameroon, he will visit charities, meet Muslim leaders and attend a gathering of bishops trying to chart the Church's role in bettering Africans' lives.
If…
oracknows | March 17, 2009Yet another reason why I love The Onion:
Because giant, highly intelligent, acid-spitting crabs pose no danger to society.
Of course, certain antivaccine advocates seem to think that this parody has something to do with vaccines, which just goes to show how far down the rabbit hole they've gone when they think that a parody like this speaks to the truth of their cause. It also reveals a bit of their mentality in that they so easily liken life-saving vaccines to giant, acid-spitting, highly intelligent crabs.
jstemwedel | March 17, 2009A little while ago, PalMD put up a post at Whitecoat Underground about the current state of the National Center on Complementary and Alternative Medicine (NCCAM), especially at a moment in history when the federal government is spending loads of money (and thus maybe should be on the lookout for expenditures that might not be necessary) and when health care reform might actually happen. Pal wrote:
The whole idea of setting up such an agency is a bit quixotic---after all, the National Institutes of Health already study health science. .... Many, many studies have been funded which fail basic…
palmd | March 17, 2009I've written a number of times how blindingly stupid and irresponsible Deirdre Imus has been. Now, Don Imus has revealed he has prostate cancer, and he is apparently surprised. According to ABC News, "he was surprised by the diagnosis because he had been following a healthy diet for the last decade." He also stated that, "... it was all the stress that caused this."
I'm not nearly as surprised as Mr. Imus. Prostate cancer is the malignancy most closely correlated with age (and of course, gender) and estimates are that between 14-70 % of men his age may have prostate cancer (occult or…
oracknows | March 17, 2009Until recently, most of my research was laboratory-based. It included cell culture, biochemical assays, molecular biology, and experiments using mouse tumor models. However, one of the reasons that I got both an MD and a PhD was so that I could ultimately test ideas for new treatments on patients and, if I'm good enough and lucky enough, ultimately improve the care for cancer patients. If there's one thing, though, that I've learned in my nearly nine years in academic surgery, it's that far fewer patients end up enrolled on clinical trials than are eligible to participate in them. Every…
j7uy5 | March 17, 2009Dr. Richard
Friedman, professor of psychiatry at Weill Medical College of
Cornell University, has an article in the New York Times. In it,
he claims that reforms in medical residency training may be leaving
young doctors "a little more hesitant and uncertain than you might
like."
At first I was hesitant to write about it, because I was uncertain as
to what point he is trying to make. But then I decided to go
ahead.
href="http://www.nytimes.com/2009/03/17/health/17mind.html?pagewanted=print">Accepting
the Risks in Creating Confident Doctors
By RICHARD A. FRIEDMAN, M.D.
Published:…
palmd | March 16, 2009Over at Neurotopia, Scicurious has been doing some terrific writing about depression. Mental illness is a topic I've written about many times, so I was inspired to look into the vault and see what kind of goodies I had back there. Well, since I truly loathe people who dole out dangerous medical lies, I figured it was time to dust off this little bit on Scientology and mental illness, rework them a bit, and share them with you again.
The problem
Depression, in the medical sense, is not a mood...it is a severe
disorder originating in the brain, and affecting the entire body. Major…