medicine
oracknows | August 1, 2008For those out there who think it was "beneath" me to have responded to PhysioProf's rants about doctors and medical students last week, I present to you Steve Novella's take on the matter. Leave it to Steve to generalize the issue beyond my relatively narrow take on the matter. I also point out that Steve is nowhere near as--shall we say?--insolent as I am. If he's bugged enough to post a rant, it reassures me that I wasn't as off the mark as I feared I might have been.
One thing that came out in my post was an observation that skeptics, including those attending TAM 6, share in these…
oracknows | August 1, 2008Remember how on Monday I posted a dissection of some truly execrable reporting on vaccines and potential conflicts of interest (COIs) by Sharyl Attkisson of CBS News that aired one week ago today? As you may recall, my main point was that Attkisson's reporting was lazy, describing nothing that couldn't be found from public sources, and biased in that it intentionally used inflammatory language in order to bias the reader/audience against Dr. Paul Offit and the American Academy of Pediatrics right off the bat before even describing the supposed COI. I further made the point that it's rather…
tqa | July 31, 2008
Apparently, the Bush administration has come up with another way to attack reproductive rights. The department of Health and Human Services has come up with a draft regulation that changes a number of definitions in an effort to make it easier for people to refuse to provide people with abortions, or birth control, or even with a referral to another provider who would be willing to provide these services.
The regulation is ostensibly intended to ensure that federally funded programs do not discriminate against people or institutions that have religious objections to abortion. This is a…
sb admin | July 31, 2008My recent post on tobacco poisoning focused on chronic obstructive pulmonary disease, the cause of about one-third of smoking related deaths. Let's move on to cardiovascular disease (CVD), which accounts for another third.
When we talk about CVD, what are we taking about? The pathophysiology is very interesting...go and read.
Heart disease, which includes heart attacks and heart failure, kills about 100K smokers yearly. This includes people who have a heart attack and die suddenly, but also people who develop heart failure and linger on swollen and breathless.
Strokes kill about 16.5K…
oracknows | July 31, 2008Has it really been a whole year? The longer I blog, the faster time seems to fly. Or maybe it's just because I'm getting older. Whatever the case, you may (or may not) recall that about a year ago I got into a little tussle with a certain Libertarian comic and some smoking cranks over the issue of whether secondhand smoke is a health threat. The discussion escalated a bit, and some serious smoking cranks entered the fray, complete with quote-mining. I ended up discussing a couple of studies that claimed to have found a decrease in hospital admissions for acute coronary syndrome (colloquially…
sb admin | July 31, 2008This is one of those topics I've always sort of avoided, and I'm still avoiding it for now. But that doesn't mean you have to remain silent. Here's the reader comment/question:
This is off-topic, but I wanted some doctorly input to a discussion that I am having over at another blog.
This lady is hyperventillating about the "sinister" (her word) policy of the Oregon Public Health Plan.
They won't cover curative treatment for people who have a "less than 5% chance of surviving five or more years"
Instead, they cover palliative treatment, hospice, and Doctor-Assisted suicide.
This lady is…
sb admin | July 30, 2008Every once in a while I like to do a piece on how real science works. The New England Journal of Medicine was kind enough to serve up a nice example for us this week.
Real science is hard. It's time-consuming, expensive, and leads down many blind alleys. That's one of the reasons pseudoscience is so alluring---anyone can do it. It doesn't require an education, an R01 grant, or really even a grasp of reality.
So on to the current article. Heart disease is a big killer. Over half-a-million people yearly have the worst type of heart attack, called an ST-segment elevation myocardial…
oracknows | July 30, 2008I've been a bit remiss in my duty toward a fellow ScienceBlogger.
No doubt a few were wondering (or maybe not), why I, as the resident breast cancer expert here, didn't point out that my fellow ScienceBlogger Janet live-blogged her very first screening mammogram last week. Truth be told, I had meant to mention it a day or two after she first posted it, but it plumb slipped my mind. Maybe it's early stage Alzheimer's disease. Whatever the case, I had meant to use her post to point out that, as a breast cancer surgeon, I sometimes forget just how annoying and cumbersome getting a mammogram can…
oracknows | July 30, 2008With all the negativity around this blog lately, thanks to the continued moronic antics of the anti-vaccine contingent, which have irritated me more than they do usually, so much so that I can't recall a time since Jenny McCarthy's "Green Our Vaccine" anti-vaccination-fest nearly two months ago that they've been so flagrant in their lies, I thought it was time for some good news for a change. Fortunately, by way of the latest issue of The Lancet, some good news showed up in the form of a study. This study, reported late last week by the Antiretroviral Therapy Cohort Collaboration, a…
j7uy5 | July 29, 2008This is a nice little case report from the European Journal
of Psychiatry. The translation is a little rough,
but the information is good.
href="http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632007000400006&lng=es&nrm=iso&tlng=en">
href="http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632007000400006&lng=es&nrm=iso&tlng=en">Neuroleptic
malignant syndrome: Possible relationship between Neuroleptic Treatment
And Smoking Cessation
Mª José MartÃn Vázquez PhD MPsych*, Teresa Jimeno
Beltrán MD**
Eur. J.…
oracknows | July 29, 2008I just can't escape them. Even when I want to, even when I'd like to take a break, they're there.
The anti-vaccine nutcases.
This time around, they showed up at, of all places, Netroots Nation, where the deceptively named National Vaccine Information Center, an explicitly antivaccination group that spreads nothing but lies, set up a booth. Fortunately, the reaction to this incursion was not positive, but it just goes to show that these groups are trying to insinuate themselves anywhere they can.
sb admin | July 29, 2008I frequently get questions by email or by comment. If it's simple, I might fire off an answer. If it's about a personal medical problem, I either don't answer, or send a standard disclaimer to seek medical care. If it's a really interesting question, I blog. Today, I blog.
The question regarded the ubiquitous commercials for erectile dysfunction treatments (see this excellent post for an overview of the topic of ED drugs). As anyone who has a TV knows, the commercials always have the pleasant warning of "if you have an erection lasting more than four hours, seek immediate medical help…
oracknows | July 29, 2008The stupid continues to metastasize.
I wrote yesterday about a truly bad and irresponsible hit piece on Paul Offit and the American Academy of Pediatrics written by the anti-vaccinationist sympathizer Sharyl Attkisson of CBS News. Since I've already rehashed what was so bad about it, I won't go on about it. However, it appears that Alicia Mundy at the Wall Street Journal's Health Blog picked up the story yesterday and ran with it--stupidly, as demonstrated by this passage:
Drugmakers have given millions in grants and other kinds of payments to the AAP and helped build its headquarters, CBS…
clock | July 28, 2008The Health Blogosphere: What It Means for Policy Debates and Journalism:
The Kaiser Family Foundation is sponsoring a discussion about the growing influence of blogs on health news and policy debates. Only in the past few years has the blogosphere become mainstream. In the health policy arena, we now see policymakers, journalists, researchers and interest groups utilizing this new media tool to deliver information to their audiences. The briefing will highlight how the traditional health policy world has embraced blogging and will feature a keynote address by U.S. Department of Health and…
sb admin | July 28, 2008This comes up every day. Everyone's afraid of the big "C", and they should be. Smoking increases a person's risk of dying of lung cancer by about 12-20 times (whatever that means, but it's significant).
And while cancer may be scary, other diseases are just as bad. Lung cancers attributable to smoking cause about 125K deaths per year (all numbers US). Add in head and neck cancers, and the number goes up to about 133K. Add in cancers with less clear causative associations and we're up to 160K.
In contrast, there are about 130K cardiovascular deaths yearly attributable to smoking, and…
purepedantry | July 28, 2008Carlos Sastre won the Tour de France yesterday, but the whole race has been marred by incidents of sports doping. First, Riccardo Ricco was caught using a form of Epo called CERA. Now another biker named Dmitriy Fofonov tested positive for a drug called heptaminol.
Heptaminol made me raise an eyebrow, primarily because I had never heard of it before. I am beginning to wonder where these bikers even find this stuff. I kid you not: it took me a while to even find information on it. Most drug databases I checked don't even have an entry for it.
It is on the list of WADA prohibited…
oracknows | July 28, 2008You know, I think I've found a bride for Steve Wilson.
You remember Steve Wilson, don't you? He's the local "investigative reporter" in my hometown who recently did a truly awful "report" (it actually makes me cringe to call it a "report," but I couldn't think of anything else to call it) a couple of weeks ago, in which he regurgitated just about every anti-vaccine talking point about mercury and thimerosal there is out there. I hadn't seen anything like it, ever (at least not that I can recall). So bad was it that I feared the hyperconcentrated stupid might lower my blog bud PalMD's IQ by a…
sb admin | July 27, 2008What could be more important than a good old-fashioned flame war? I'll get to that in a moment, so please stick with me.
The recent imbroglio between some of our doctor bloggers and non-physician scientists got me thinking (so it couldn't be all bad).
As a quick summary, PhysioProf of the DrugMonkey blog used an incident of a doctor committing battery on a patient as a generalization regarding surgeons, all doctors, and medical education. Many of us who are actually doctors and physician educators took issue with that. PhysioProf apologized, but made it clear that s/he still feels that…
oracknows | July 26, 2008Late Thursday night, I posted a full-out rant about what I considered to be an incredibly unfair and stupid generalization of the bad behavior of a single surgeon to an overblown and hysterical indictment of medical students, doctors, and surgeons by a fellow ScienceBlogger, posted on his own blog and on Feministe. Fellow ScienceBloggers Mark Hoofnagle and PalMD posted similar criticism, all of which, in my humble opinion (or IMHO, in Internet-speak) were justified. One thing I didn't mention was that I debated for a while whether or not to post my criticism, because the reputation and…
oracknows | July 25, 2008I'm very puzzled.
Now, I know that my being puzzled isn't particularly unusual. I'm frequently puzzled. I can't figure out how, for example, anyone with the slightest bit of reasoning ability can do anything other than laugh when informed what homeopathy is and how it supposedly "works." I can't figure out why American Idol or Survivor is so amazingly popular.
And I can't figure out why the University of Pittsburgh Cancer Center released this warning about cell phones:
PITTSBURGH July 24, 2008, 07:13 am ET · The head of a prominent cancer research institute issued an unprecedented warning to…