medicine
palmd | March 16, 2009Thankfully, I don't receive all that much blog-related mail. But this weekend I received several communications about a piece in popular liberal blog. The piece is (ostensibly) about Lyme disease, which coincidentally happens to be one of the topics of my first post here at SBM. In fact, I've written about Lyme disease a number of times, and Dr. Novella has a very good summary of the controversy at one of his other blogs. Since we've discussed this so many times, I won't be reviewing the entire controversy, but looking at this particular blog post to examine how our personal experiences…
oracknows | March 16, 2009By way of badscience.net:
Speak it, brother Ben!
Oh, and don't be too hard on your hairstyle and clothing in that one. I could totally picture you as an incarnation of The Doctor in that getup. That sweater vest does look a bit Peter Davison-ish, although the curly locks do rather echo Tom Baker.
oracknows | March 16, 2009The antivaccine counterattack against Brian Deer continues.
As you recall, about a month ago British reporter Brian Deer published an exposé, a tour de force of investigative journalism that led him to discover that Andre Wakefield had not only had incredibly blatant undisclosed conflicts of interest (his having been in the pocket of trial lawyers suing vaccine manufacturers and his forgetting to mention the little fact that he had been developing a competing version of a measles vaccine that he had been hoping to market) when he published his infamous 1998 Lancet paper linking MMR to…
clock | March 15, 2009From SCONC:
Wednesday, March 25
7 p.m.
"Something for the Pain: One Doctor's Account of Life and Death in the ER," a book reading and discussion by author Paul Austin, MD hosted by the American Medical Writers Association, Carolinas Chapter. Austin, a former firefighter who is now an emergency room physician at Durham Regional Hospital, has written "a relentlessly honest look at modern emergency medicine," in the words of Publisher's Weekly. At the Friday Center, UNC-Chapel Hill. Please RSVP by March 18 to Ellen Stoltzfus (estoltzfus@nc.rr.com).
ddobbs | March 14, 2009
My story in the April 2009 Scientific American story, "The Post-Traumatic Stress Trap", just went online. Here's the opening:
In 2006, soon after returning from military service in Ramadi, Iraq, during the bloodiest
period of the war, Captain Matt Stevens of the Vermont National Guard began to have a problem with PTSD, or post-traumatic stress disorder. Stevens's problem was not that he had PTSD. It was that he began to have doubts about PTSD: the condition was real enough, but as a diagnosis he saw it being wildly, even dangerously, overextended.
[snip]
"Clinicians aren't separating the…
oracknows | March 14, 2009I love it when someone does something like this, namely pwning an antivaccine video like The Truth About Vaccines:
It's not perfect, but I love it. Now if only more people would do something similar on YouTube. I'm tired of seeing titles like VACCINES KILL INNOCENT CHILDREN! - Hundreds and More Likely Thousands of Children are Murdered Each Year by Vaccines. Vaccinations Are Part of A Hidden Crime Against Our Children. Vaccines Do NOT Prevent Disease - They Are The Disease.
Hmmm. Maybe Lu could take that one on next...
palmd | March 13, 2009I hate this topic. I really do. But Abel started it this time. Over at Terra Sig, the good pharmacologist brought up the issue of pharmacists behaving badly. I've dealt with the ethical implications of conscience clauses ad nauseum but Abel's discussion raised some important points.
A brief recap: a patient with a valid prescription for morphine was denied her medication by a pharmacist. The reason given was "that [the patient] should find some alternative pain relief", presumably one that does not involve opioid analgesics. I won't bother with my usual rant about the responsibility…
purepedantry | March 13, 2009This is just unbelievable. At a day care center in Arkansas, 10 kids were accidentally given windshield wiper fluid instead of Kool-Aid:
Child welfare investigators plan to talk to the owner of an Arkansas daycare center where 10 children were sickened after they were given windshield wiper fluid to drink.
"They'll go out, they'll get an explanation and they'll try to sort (it) out preliminarily," said Julie Munsell, spokeswoman for the state Department of Human Services.
Hospital officials say a staffer mistakenly put the blue liquid in the refrigerator after shopping and later served it…
oracknows | March 13, 2009Khaaaaan!
No, wait a minute. I mean: Nooooooo!
No place is safe from the invasion of quackademic medicine. No place. As you will soon see.
As you know, I've documented the infiltration of pseudoscientific and outright antiscientific woo into institutions that really should know better, namely academic medical institutions. Specifically, over a year ago, I created the Academic Woo Aggregator, a list of medical schools and academic medical centers that have embraced "complementary and alternative medicine" (CAM) or, as it's more commonly known these days, "integrative medicine" (IM). Of course…
clock | March 12, 2009Wow! This is massive!
From Anesthesiology News:
Scott S. Reuben, MD, of Baystate Medical Center in Springfield, Mass., a pioneer in the area of multimodal analgesia, is said to have fabricated his results in at least 21, and perhaps many more, articles dating back to 1996. The confirmed articles were published in Anesthesiology, Anesthesia and Analgesia, the Journal of Clinical Anesthesia and other titles, which have retracted the papers or will soon do so, according to people familiar with the scandal (see list). The journals stressed that Dr. Reuben's co-authors on those papers have not…
palmd | March 12, 2009An interesting article was recently published in the Annals of Internal Medicine, the journal of the American College of Physicians (my professional organization). It has been noted in previous studies that there are differences in outcomes between African Americans and whites who are diagnosed with a heart attack. What hasn't been clear is the reason for these differences.
There are known disparities in access to health care, and there is sometimes a stated distrust in the medical system by minorities (not just due to such atrocities as the Tuskegee Syphilis Study). Many of us who…
jstemwedel | March 12, 2009The headlines bring news of another scientist (this time a physician-scientist) caught committing fraud, rather than science. This story is of interest in part because of the scale of the deception -- not a paper or two, but perhaps dozens -- and in part because the scientist's area of research, the treatment of pain, strikes a nerve with many non-scientists whose medical treatment may have been (mis-)informed by the fraudulent results.
From Anesthesiology News:
Scott S. Reuben, MD, of Baystate Medical Center in Springfield, Mass., a pioneer in the area of multimodal analgesia, is said to…
tqa | March 12, 2009
Several news agencies are reporting that a massive academic fraud case has surfaced. A single researcher apparently fabricated data used in the publication of at least 21 journal articles published over a 12-year period.
After an internal reviewer raised concerns, Baystate Medical Center conducted an investigation into research conducted by Dr. Scott S. Reuben, who was - at that time - the chief of their acute pain service. As the phrase "at that time" suggests, the results of the investigation did not exonerate Dr. Reuben. Anything but, in fact. In late January, Baystate sent out a letter…
oracknows | March 12, 2009Science as it is practiced today relies on a fair measure of trust. Part of the reason is that the culture of science values openness, hypothesis testing, and vigorous debate. The general assumption is that most scientists are honest and, although we all generally try to present our data in the most favorable light possible, we do not blatantly lie about it or make it up. Of course, we are also all human, and none of us is immune to the temptation to leave out that inconvenient bit of data that doesn't fit with our hypothesis or to cherry pick the absolutely best-looking blot for use in our…
razib | March 11, 2009A few years ago I pointed to a paper which surveyed variation in health across the United States as a function of geography. Today Andrew Gelman points to a new map put out by the heath insurance industry. I've placed the two maps side by side below.
palmd | March 11, 2009It's not like we haven't had this discussion before. I have, on previous blogs, written about the fantasy that is reiki, as have my colleagues. In fact, the very same colleague turned me on to a recent news piece out of Cleveland. Here's my problem with reiki---it's bullshit, pure and simple.
"But how can you be so dismissive?," a credulous reader might ask. My answer comes in two parts.
Absurdist ridiculousity
OK, so I made up that phrase---which is exactly what I have in common with the founder of reiki. In 1922 Mikao Usui (JSG) fasted on a mountaintop in Japan and "received" the…
palmd | March 11, 2009This is a piece from last year that is kinda resonating today, so I'm gonna share it with you. --PalMD
As
I've written before, I love my work. You really have to love medicine
to do it, because, contrary to popular belief, it's a lousy way to get
rich. I'm not starving or anything, but there are dozens of easier ways
to make a much better living...
I'm sitting here in my robe, drinking coffee, getting ready to go
out for a birthday party. I'm drinking coffee because at 2:38 a.m., the
E.R. called me to tell me a patient of mine was being admitted--to
oncology.
"So, why are you calling me?" I…
oracknows | March 11, 2009I know I've been hard on a lot of legislators, including woo-friendly clods such as Tom Harkin, Ron Paul, and Dan Burton. Occasionally, though, a legislator will show that he "gets it" (or at least hasn't drunk the Kool Aid). Forwarded to me was a letter sent from Representative John Linder (R-GA) in response to a letter from the Autism Action Network, apparently upset over the IACC's not being as excited about throwing good money after bad studying the scientifically discredited notion that vaccines cause autism. Here is Mr. Linder's response, and it's a good one (for a politician, anyway):…
clock | March 11, 2009From Sigma Xi:
NCSU molecular biologist Jorge Piedrahita has cloned pigs and explored why they are not carbon copies despite sharing the same DNA. Now he is trying to crack puzzles that could result in transgenic animals useful in human and veterinary medicine. His studies in cloned pigs led him to an unusual family of genes called imprinted genes, involved in placental function and fetal development. Recently he found they are implicated in human diseases too and is developing stem cell technologies in swine to try to speed up clinical applications in people.
To learn more, come hear…
oracknows | March 11, 2009Advocates of so-called "complementary and alternative medicine" (CAM) frequently make the claim that they are the victims of a "double standard," in which (or so they claim) they are subjected to harsher standards than what they often refer to as "conventional" or "orthodox" medicine, usually because, don't you know, big pharma controls everything and rigs the game. Whatever the sins of big pharma (and they are legion), this claim is, of course, a whole lot of hooey. If there is a double standard (and, indeed there is), it favors CAM. Indeed, CAM itself is a "wedge strategy" to apply a…