medicine
palmd | January 28, 2009It's hard to hide severe back pain. When I stand up, I look like a question mark. The visibility of the problem, combined with the general goodness of my fellow human beings, leads to lots of unsolicited advice. Folks have given me great advice (take some NSAIDs, stretch, and don't lay in bed) and some questionable advice (go to the chiropractor, get some acupuncture). My colleagues and I have written a lot about acupuncture. It's sort of a "gateway CAM", in that it has a patina of plausibility. But the evidence of its efficacy has pointed toward it being an elaborate placebo.
To help…
oracknows | January 28, 2009...it smells like...fisking.
In this case, it's a fisking of a particularly annoyingly self-righteous and scientifically ignorant antivaccinationist by a medical student. The annoying drinker of the "vaccines cause autism" Kool Aid is Ginger Taylor. The medical student is Adina Cappell. The slapdown is utterly comprehensive, methodical, and ruthless, pummeling Ginger's panoply of pseudoscience, logical fallacies, defenses of Jenny McCarthy, and conspiracy mongering under a barrage of science, reason, and fact, leaving nothing but smoldering ruins of antivaccinationist misinformation.
Even…
oracknows | January 28, 2009
If you've browsed the redesigned front page of ScienceBlogs, you'll see that our benevolent ScienceBlogs Overlords at Seed Magazine have started a project that they have so humbly termed The Rightful Place Project: Reviving Science in America, which is described thusly:
In his first speech as President-elect last November, Barack Obama reminded us of the promise of "a world connected by our own science and imagination." He recently stated, "promoting science isn't just about providing Resources--it's about protecting free and open inquiry... It's about listening to what our scientists have…
palmd | January 27, 2009Now, both of my readers may note that: 1) the number "37" appears to be randomly assigned, and 2) "incoherent" would appear to be redundant. But let me explain.
Many, many years ago I injured my back. It got better. Until 3 a.m. this morning. Since then, I have been a walking question mark, except when I'm laying on the X-ray table or floor trying to find a flat surface from which I might just have a chance to get up again. It's both humiliating and humorous to hobble through an enormous American hospital holding onto the walls. Normally, I stride rapidly from room to room, down tunnels…
ddobbs | January 27, 2009
Close on the heels of Lilly's $1.42 billion penalty for off-label marketing comes the news that Pfizer paid out $2.3 billion to settle similar allegations.
From FiercePharma
News of the Pfizer-Wyeth merger this morning drowned out some not so good news for the company. Just after announcing its $68 billion buyout of Wyeth, Pfizer published its 2008 fourth quarter earnings report. In it, Pfizer reveals a $2.3 billion charge to end investigations into allegations of off-label promotions of the company's COX-2 meds, including Bextra. That settlement caused a 90 percent reduction in Pfizer's…
ddobbs | January 27, 2009CNN has a fascinating and rather frightening story about the toll football (or the concussions acquired playing it) take on the brain:
But today, using tissue from retired NFL athletes culled posthumously, the Center for the Study of Traumatic Encephalopathy (CSTE) is shedding light on what concussions look like in the brain. The findings are stunning. Far from innocuous, invisible injuries, concussions confer tremendous brain damage. That damage has a name: chronic traumatic encephalopathy (CTE).
CTE has thus far been found in the brains of five out of five former NFL players. On Tuesday…
oracknows | January 27, 2009It looks like I've been sucked into another streak again.
Regular readers know that examining the claims of the antivaccine movement with skepticism, science, and critical thinking has been a theme of this blog from the very beginning. If there's one thing I've learned over the last four years, it's that vaccine news seems to come in streaks. Often weeks will pass without much, and, because the antivaccine wingnuttery over at, for example, The Huffington Post and Age of Autism is such a constant that it blurs into background noise, provoking my attention only when someone really brings the…
oracknows | January 26, 2009
When I mentioned a while back that, although I like awards as much as the next guy, I don't go actively seeking them, I wasn't kidding. As evidence that I wasn't kidding, I point out that, until some of you started letting me know about it, I had no clue that I had actually won the 2008 Medical Weblog Award for Best Health Policies/Ethics Weblog of 2008. In fact, even though I do peruse Medgaget, the blog that hosts the competition, I had somehow missed the post last Friday announcing the winners.
Of course, it would have helped if the Medgadget guys would have shot me a quick e-mail.
In…
palmd | January 26, 2009Blog buddy and all-around great guy lucite box of diodes, Orac of Respectful Insolence, has won "Best Health Policies/Ethics Weblog of 2008", sponsored by MedGadget.com. According to the website:
Orac of Respectful Insolence has been chosen as the Best Health Policies/Ethics Weblog of 2008. As one of the members of Science Blogs, Orac attempts to bring sanity to the world full of medical quackery. His efforts at exposing the dangers of alternative medicine, pseudoscience, and evolution deniers have made Orac one of the most recognized online activists against medical fraud and pseudoscience…
palmd | January 26, 2009Morning report is a daily conference for medical residents. It is done differently at different institutions, but normally a case is presented, often by the post-call team, and discussed by the senior residents and an attending physician. Today's case will be the first in an occasional series. --PalMD
Case:
Mrs. M is an 89 year old woman who resides in a nursing home who was admitted with confusion and lethargy. She has a past medical history significant for stroke, coronary artery disease, depression in the distant past, and no history of dementia. She has lost significant weight over…
oracknows | January 26, 2009Remember the quack-friendly scammer Kevin Trudeau? Remember his book Natural Cures "They" Don't Want You To Know About? Back during the summer, he was fined $5 million and ordered not to produce or publish infomercials for products in which he had an interest. Given the huge profits he made from Natural Cures and his followup The Weight Loss Cure 'They' Don't Want You to Know About, unfortunately, $5 million was nothing more than the cost of doing business. It didn't do one thing to deter Trudeau.
Maybe this will:
A federal judge has ordered infomercial marketer Kevin Trudeau to pay more than…
palmd | January 26, 2009It's true that words matter, and that we who practice real medicine have often let cult medicine practitioners get the linguistic high ground. We've let them get away with calling non-science-based practices "alternative" and "complementary", without really asking, "alternative to what?" or "does it really "complement, or just distract?" We've often ignored language, and when we don't, we are accused of being pedantic, of focusing on "rhetoric" rather than "real" issues. Language is powerful. There is no such thing as "it's just a word".
Language is even more important in the fight…
oracknows | January 26, 2009Beginning on Friday after my post expressing amazement at something as rare as a 70° F temperature in January (at least around my neck of the woods), namely an actual provaccine article in the Huffington Post, a number of you began sending me links to a story that I find most disturbing, a mini-tsunami that continued all weekend. In fact, it's so disturbing that I kept procrastinating all weekend until I wasn't even sure I was going to write about it at all. But the comments kept coming, and I realized once again that, once one gains a reputation as a go-to blogger about a certain topic,…
palmd | January 25, 2009Sometimes I feel like I'm pounding my head against a wall. I've been wondering why the issue of so-called conscience clauses just won't die, why otherwise intelligent people can't just agree with me just don't get it.
Quick review: some health care professionals wish to be able to deny patients certain types of care, and want to be protected by law for imposing their own morals on others, in violation of basic medical ethics and human dignity (as you can see, I don't have a strong opinion about this one).
Ethical behavior is difficult. It requires empathy---but in a very particular sense…
oracknows | January 24, 2009It's no secret that I'm a Mac geek, at least not to any of my readers, family, or friends.
Neither is it a secret at my job that I'm a Mac geek, mainly because, although the university where I'm faculty is perfectly fine with Macs, the cancer center where my laboratory, clinic, and office are housed is not. Indeed, one might even say it goes beyond that in that it borders on being Mac-hostile. Oh, the IT department doesn't actually forbid Macs (although until a recent change in organization it was clear to me that they would clearly very much like to do so), but, until the recent hire of one…
palmd | January 24, 2009...or so goes the refrain of the addict. I was going to put up a more substantive, well-researched post, but I wanted to give you a few weekend thoughts to chew on.
I deal with addictions a lot, but the most common and deadly one is tobacco. Tobacco is responsible for millions of serious illness and deaths every year in the U.S., all of which are preventable. But, like other substance use disorders, we don't really know how to talk about tobacco addiction (which is more properly "nicotine addiction"). There is no doubt that nicotine is powerfully addictive, and the health and social…
palmd | January 24, 2009I don't have a lot of experience with small hospitals. My medical school's hospital was about two square blocks of buildings, all of them attached, ranging in age from 100 years to 10 years. The were connected by irregular bridges and linked (ex)-fire escapes, and by miles of dim tunnels.
During my residency, the campus covered several square blocks, with buildings linked by more airy bridges (a la Minneapolis) and "secret" tunnels that you could find if you just knew where to look---although getting lost underground was the rule.
My current hospital is---by number of admissions---one of…
oracknows | January 23, 2009When it comes to science, I've always detested The Huffington Post.
Nearly four years ago, when Arianna Huffington's vanity group political blog went live, I was the first one to notice a most disturbing trend about it. As far as I knew at the time (or know now), I was the only one to have noticed that The Huffington Post had become a hotbed of antivaccine propaganda a mere three weeks after its launch. It was home to David Kirby, author of that paean to the mercury militia Evidence of Harm: Mercury in Vaccines and the Autism Epidemic, A Medical Controversy and now antivaccine blogger on both…
oracknows | January 22, 2009The latest Change of Shift, the blog carnival for nursing, is up at Emergiblog. Be sure to check it out.
I've also been remiss in not mentioning that Dr. Val is hosting Grand Rounds. Enjoy that, too!
palmd | January 22, 2009I've written quite a bit of the need for good health reporting, and I've had the good fortune to talk to some terrific reporters. But bad reporters are easy to come by, which is kind of sad, especially since jobs are getting scarce.
When this article came across my browser, something looked familiar. The Stamford (CT) Advocate has shown up on my blog before. The last time, it was an article about a naturopath preying on immigrants. When I saw a new story pop up, I was sure it would be the same reporter. The article is locked in the archives, so it took some searching, but I eventually…