medicine
oracknows | August 24, 2008You may recall that on Friday afternoon, I posted a bit of a rant about how a certain liberal blogger named Matt Stoller had disparagingly and contemptuously referred to Presidential Candidate John McCain as a "crazy, cancer-ridden dishonest madman." It turns out that Mr. Stoller was displeased by my much-justified rebuke. His response is an example of the most studiously, intentionally obtuse avoidance of answering what my real criticism was, including an elaborately constructed straw man, some quote mining, and one really dumb additional statement that reveals Mr. Stoller to be far more…
oracknows | August 23, 2008While, thanks to the recent CDC report documenting the resurgence of measles in the U.S., thanks to worrisome pockets of decreasing vaccine uptake that could portend a much wider resurgence if the antivaccine brigade, now led by Jenny McCarthy, has its way, I'm back on the topic of vaccines after having amazingly managed to stay away for an uncharacteristically long time, I thought that one last post for a while (I hope) is in order.
Yes, in September, there is reason for some optimism in the P.R. war, which the antivaccination forces have clearly winning in recent months. That's because a…
sb admin | August 23, 2008A number of us in the blogosphere have been outraged by Bush's Department of Health and Human Services' desire to put the arbitrary wants of doctors before the needs of patients. At first it was just a draft proposal, but now Mike Leavitt is pushing to implement the changes. Soon, it may be legally acceptable to deny you a needed health service because the health care provider thinks your decisions are immoral.
I've already written several times about why there can be no "conscientious objectors" in health care. This law would essentially allow doctors to ignore the standard of care set by…
sb admin | August 22, 2008I'm a little down today. I've told you before that I take care of my own patients in hospice. I've also told you about watching patients and friends lose their battles with disease.
This week I had serious talks with several people about end-of-life issues (the details of which I can't really share at the moment). I've also had to tell someone about an abnormal lab result (a very bad one). In fact, the best news I've delivered all week was telling someone they had mononucleosis (rather than something worse).
I've found, in my limited experience, that terrible illnesses don't change…
clock | August 22, 2008Vedran keeps cranking these at an incredible rate (the first numbers indicate these aggregators are quite comprehensive and the feedback is that they are useful) - here is the latest one: Aggregator of RSS feeds about Gynecology
oracknows | August 22, 2008I was disappointed to find an approving link from a fellow ScienceBlogger to this sort of rant by Matt Stoller:
We all know that winning this election is not enough. It's just not. It's not even close. This is the most unpopular President we've ever had and our opponent is a crazy cancer-ridden dishonest madman. Our nominee should crush this guy.
"Crazy cancer-ridden dishonest madman"? Nice. I wonder if Matt spit out the term "cancer-ridden" with the same amount of contempt and venom while typing as he did when he spit out the terms "crazy," "dishonest," and "madman." I wonder if he…
oracknows | August 22, 2008Since vaccines seem to be back in the news again, I would be remiss if I didn't mention a fantastic post that I saw the other day over at A Photon in the Darkness.
Read it. Read it now.
I've done fairly long posts about how pseudoscientists and antivaccine advocates are capitalizing on the case of Hannah Poling, who had a mitochondrial disorder that, the government conceded, may have been exacerbated by vaccines. Meanwhile, antivaccine mouthpiece David Kirby is shouting to the world that new findings that mitochondrial disorders are more common than previously thought is somehow vindication…
oracknows | August 22, 2008Regarding the recent antivaccinationist-fueled outbreak of measles reported yesterday, quoth J. B. Handley, founder of Generation Rescue, now arguably the most prominent antivaccine activist group in the U.S., given that its coffers are filled with money from celebrity and pro wrestling fundraisers:
Autism and antivaccines advocates are unapologetic about the return of measles.
"Most parents I know will take measles over autism," said J. B. Handley, co-founder of Generation Rescue, a parent-led organization that contends that autism is a treatable condition caused by vaccines.
Except that…
denialism | August 22, 2008Prometheus brings us the best article I've seen to date on why the new push for a mitochondrial basis for autism is total nonsense.
Once I saw this push from denialists like David Kirby towards a link between mitochondria and autism I knew we were in for a world of trouble. If only because mitochondrial diseases are a relatively new area of study and there are enough unknowns that they'll be able to milk this nonsense for a decade at least.
Prometheus, however, does an excellent job showing how the likelihood of a mitochondrial explanation for autism is prima facie absurd. This is not…
oracknows | August 21, 2008I realize that I've thanked Jenny McCarthy and Andrew Wakefield before for giving the U.S. the gift of a measles resurgence. Originally, when I started this sarcastic little exercise, I assumed that it would be 5-10 years before we in the States caught up with the level of endemic measles that has been resurgent in the U.K. in the decade since Andrew Wakefield published his shoddy, fraudulent, pseudoscientific, litigation-driven article in The Lancet claiming that the MMR vaccine was responsible for "autistic enterocolitis," leading to an anti-MMR hysteria that drove down vaccination rates…
oracknows | August 21, 2008I must be slipping.
Well, not really. It doesn't bother me that blog bud and fellow skeptical physician PalMD beat me to an important publication that came out a couple of days ago in the Annals of Internal Medicine. I'm a surgeon and a translational/basic scientist; so Annals is not usually one of the journals I read regularly. I usually read individual studies as I find out about them referenced elsewhere, usually Eureka Alert! or when an Annals study sufficiently interesting to motivate me to surf on over to the website and download the article. Be that as it may, this article is highly…
sb admin | August 20, 2008I've written a number of times about how a physician must be careful not impose his or her personal beliefs on patients.
Another interesting case has hit the news. The decision of the California Supreme Court hinged on interpretation of state non-discrimination law. I'm not a lawyer, but I do know a bit about medicine and medical ethics. Regardless of law, this doctor's behavior was wrong. The details are a little sketchy, but an unmarried lesbian woman was denied fertility treatments by a California doctor because the treatment conflicted with the doctor's faith.
Conflicted with the…
oracknows | August 20, 2008
My Academic Woo Aggregator has become even more out of date. You remember my Academic Woo Aggregator, don't you? It's my list of medical schools and major academic medical centers in North America that have adopted what Dr. R.W. once so famously dubbed "quackademic medicine" in that they've created divsions, centers, or departments of "complementary and alternative medicine" (CAM) or "integrative medicine" (IM), in which pseudoscientific or mystical woo is "integrated" with scientific medicine in the mistaken belief that it will somehow improve patient care. Whether it's for chasing money…
sb admin | August 20, 2008I've been having an internal debate about whether to write on this issue, not because it isn't interesting, not because it isn't important, but because it's getting so much coverage and I'm not sure how much I can add to the conversation.
But it so infuriated me that I must blog. Science-based medicine relies on medical evidence. It relies on being able to grade medical evidence by its quality and strength, and to do this, there must be a certain level of transparency.
I'm only a little bit idealistic. I know that drug companies must fund clinical trials if we ever want to see new drugs…
oracknows | August 19, 2008Late this afternoon, I happened to be sitting in my office perusing the websites for the latest batch of surgical journals, trying desperately to catch up on my reading, something that I, like most academic surgeons, am chronically behind in, when I happened upon the website of the Archives of Surgery. There, the lead article caught my eye, and I downloaded it for later reading. Then, as I perused a few news sites (yes, I was procrastinating; but who doesn't procrastinate from time to time?), and I came across a story about this very study:
CHICAGO - When it comes to saving lives, God trumps…
oracknows | August 18, 2008I've written about the ridiculousness of the Kinoki Detox Footpads before. While on the way home from work today, I happened to be listening to NPR, and--wonder of wonders!--I came across a skeptical story about the Kinoki Footpads. In the story, the reporter, Sarah Varney, took used footpads to a laboratory to have them tested. Surprise, surprise! There was no significant difference between the used and unused pads in chemical content, nor was there any evidence of elevated heavy metal content of the "used" pads. She then interviewed a doctor who explained just how ridiculous the concept of…
purepedantry | August 18, 2008The University of Georgia has started doing health screens to check their football players for possible arrhythmias or heart abnormalities:
Makiri Pugh is not your typical college freshman. At age 18, he knows more than most young adults about the structure and health of his heart, and it's not because he's sick.
Pugh, of Charlotte, North Carolina, was recruited to play football for the University of Georgia Bulldogs, ranked No. 1 in pre-season polls.
Like other elite athletes at the school in Athens, Georgia, he was required to undergo a battery of medical tests before he took the field.…
sb admin | August 18, 2008Over the last few decades, the nature of medical knowledge has changed significantly. Before the revolution in evidence-based medicine, clinical medicine was practiced as more of an art (in the "artisan" sense). Individuals were treated empirically with a strong knowledge of medical biology, and the guidance of "The Giants", or particularly skilled and respected practitioners. While the opinions of skilled practitioners is still valued, EBM adds a new value---one of "show me the evidence".
Evidence-based medicine refers to the entire practice of gathering and applying medical knowledge.…
oracknows | August 18, 2008In complaining about the infiltration of pseudoscience in the form of "complementary and alternative medicine" (CAM) into academic medicine, as I have many times, I've made the observation that three common modalities appear to function as "gateway woo, if you will, in that they are the tip of the wedge (not unlike the wedge strategy for "intelligent design" creationism, actually) that slip into any defect or crack it can find and widen it, allowing entrance of more hard core woo like homeopathy behind them.
All of these modalities fall under the rubric of "energy healing" in that the…
sb admin | August 16, 2008Look, whether you like it or not, you can't live forever. I bring this up because there is always a new book or new add purporting to have "the answer" to long life and good health, which never includes modern, evidence-based medicine. Still, perhaps some of these books contains good advice. Or not. Let me explain.
First let me disabuse some of you of the thought that doctors don't "do" nutrition and life-style advice. In fact, we do. And as attractive as the idea seems, life-style modification will never be the answer to all of (or even most of) our medical problems. Leaving aside the…