palmd | July 2, 2009In case you hadn't noticed, the advertising present on the top and right of the blog has been a bit odd lately. Dr. Oz's smiling face has been showing up above mine, you may have just won $59, your teeth can be whiter than white, and last but not least human trafficking in "Russian brides".
First, might I point out that I have nothing to do with the ads other than appearing on the same page as them.
Wait, that's stupid. I might not choose the ads, but I choose to write for ScienceBlogs, so I am culpable. Normally, I don't care much about ads that show up on my page. After all, someone…
palmd | July 1, 2009The medical education calendar begins and ends on the first of July each year, and in the hospital, that means a brand spanking new crop of young doctors. While this may sound a bit scary, the facts are a bit subtle (and not terrifying). Some of the questions regarding the so-called July Phenomenon are:
Are hospitals more dangerous in July?
Is care more expensive in July?
Are hospital stays longer in July?
The data show that there does not appear to be an increase in poor outcomes in July vs. other months, but in some fields hospital stays may be longer and care may be more expensive due…
palmd | June 30, 2009Major depressive disorder (hereafter referred to as "depression") is a prevalent and disabling illness. According to the National Institute of Mental Health:
Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44...[and]...affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.
There's been some terrific writing on depression around ScienceBlogs this year. I've written a few pieces touching on mental illness in the past, but never anything explicitly about depression. Given the…
palmd | June 29, 2009A long while back, at the original wordpress incarnation of this blog, I wrote a piece on the reasons that chiropractic is unscientific nonsense. Because it was popular, I moved it over here. Well, a chiropractor has come to bravely defend his field and left us a comment.
A study in the May 2007 issue of the Journal of Manipulative and Physiological Therapeutics reports health plans that use Chiropractors as Primary Care Providers (PCPs) reduce their health care utilization costs significantly.
The study covers the seven-year period from 1999 to 2005. Researchers compared costs and…
palmd | June 28, 2009(NB: as is usual with my more "science-y" posts, oversimplification is the rule. --PalMD)
It's been a very long while since I've updated my series on cancer. I keep meaning to, but you know how things go. Lately, though, I've been curious about radiation oncology, the use of ionizing radiation to treat cancers. What set me off was a recent Times article about some pretty crappy practices. Radiation oncology requires a very thorough education in physics and medicine and the field attracts some of the best minds, but no field is immune to unethical behavior (which in this case I feel is…
palmd | June 27, 2009PalCast 12 is up.
Some relevant links:
Anal Cancer
HPV and cancer
Simon Singh and chiroquacktic
A blogospheric proposal
Bad medical ideas
Crazy new autism ideas
palmd | June 25, 2009Medical science rarely undergoes revolutionary changes. Progress tends to be slow and steady, with new ideas undergoing extensive investigation before being implemented. This pace can be frustrating and every once in a while, someone comes along who thinks they have discovered The Secret to It All. Despite the apparent insanity of such grandiosity (or perhaps because if it), you can always rely on the Huffington Post to give it a platform. (Interestingly, most of these Ideas can't be simultaneously correct, but that doesn't seem to bother HuffPo).
The latest Revolutionary Thinker is Dr…
palmd | June 24, 2009Everyone who uses the internet leaves some sort of footprint, even if it's just a string of visited addresses. This presence is magnified if you've ever been in the news, been listed on a website (e.g., as faculty), or if you write a blog. Social networking sites such as facebook and Twitter add a whole new dimension of online presence. Everyone should be concerned about what their online presence says about them (if your public Amazon wish list is full of sex toys, for example...) but physicians should have special concerns which fall into some broad categories. First, we'll briefly…
palmd | June 19, 2009I've been a bit remiss in my coverage of the Simon Singh case, reviewed in detail by Phil Plait, among others. As many of my readers already know, respected science writer Simon Singh is being sued for libel in England by the British Chiroquacktic Association (BCA) because he described some of their treatments as "bogus". Despite the fact that he underplayed his hand, he is still getting his legal ass whooped over in the motherland, thanks to their idiotic libel laws.
Be that as it may, the BCA wasn't complaining about Singh being wrong, but about him being mean. You see, "bogus" seemed to…
palmd | June 18, 2009When I look at my daughter, what do I see? There is so much in every glance. Usually, she's moving too fast to pin down, running at me yelling, "Daddy!!!" I don't know how anyone even looks at their kids without tearing up, even a little. There is of course a narcissistic joy in having someone around who (for now) loves you unconditionally. But there's more.
When my daughter was a baby, she had the biggest eyes, like out of a Japanese cartoon. They were what everyone noticed. One day when I was pulling into the hospital I looked into the rear view mirror and I saw her eyes looking back…
palmd | June 17, 2009I'd like to direct your attention toward an excellent discussion of today's news about the cold "remedy" Zicam. Dr. Novella and the commenters have hit on all the major points; I can't improve on it.
I would, however, like to give you a personal look at anosmia, or the absence of a sense of smell. It is not at all OK. I have rather nasty seasonal allergies and I also get a lot of upper respiratory tract infections (presumably due to my constant exposure). Several years ago, I came home from the hospital with a nasty cold, had some soup, and went to bed. The next morning I got up and made…
palmd | June 16, 2009The last month has been pretty busy at the office, with lots of H1N1 influenza. I've been quite lucky, but the last couple of days I've had some pretty close exposures. The other day I gave a nebulizer treatment to a patient with wheezing who turned out to have the flu (I was not wearing a mask), and I've seen about a half-dozen others with it.
So today I'm off to the pharmacy to pick up my prophylactic course of oseltamivir. Whoopie!
palmd | June 15, 2009It's just disgusting. Autism spectrum disorders are an important health problem (although not the "epidemic" claimed by some). While real scientists and clinicians (and parents) are looking for causes and treatments based on evidence, fake experts are pulling "answers" out of their backsides. Studies of families with autism have shown specific genetic defects associated with autism, and while this applies only to a small percentage of cases, it is an example of a good lead. Even if a minority of people with autism have similar genetic defects, these findings can lead to more generalizable…
palmd | June 13, 2009People in my profession are at increased risk for acquiring certain diseases: tuberculosis, HIV, hepatitis B and C, and some others. We vaccinate against the ones we can (primarily hepatitis B) and exercise universal precautions, which involves careful attention to bodily fluids and other infectious tissue. The basic rule is, "assume everyone has a blood-borne infection." We don't make the same assumptions for other illnesses such as tuberculosis as these usually have symptoms when they are infectious, as opposed to HIV and hepatitis. Even with these precautions, health care workers are…
palmd | June 12, 2009We already know the hate-filled bag of right-wing goatfuckery, Rush Limbaugh, wants the head of state of the USA to "fail". There was a lot of argument from idiots about what that meant. The excuses were flying: "fail" meant his "socialist agenda", not his goal of saving the US from this recession, and other such nonsense. But the meaning was clear. If we are to climb out of this recession, Rush very much cares how we do it, and would rather we fail as a nation rather than have his putative anti-Christ carry the mantle of success. But he never said he wanted Obama to drop dead.
That honor…
palmd | June 11, 2009I know, I know, I don't usually do politics, but Rush is really chapping my ass right about now. His comments are always outrageously hate-filled diatribes, and he's getting harder to ignore every day. What's worse, his followers eagerly suckle at the teat intolerance, finding solace in his affirmation of their own bigotry. And finally, he is cynical beyond any hope of redemption.
First, he is virtually a Holocaust denier, and as we know, Holocaust denial is always a manifestation of hatred of Jews.
"He [Obama] is beating Germany up. He is ripping them to shreds over something they did…
palmd | June 11, 2009
"Whosoever saves a single life, saves an entire universe"
In Memoriam Stephen T. Johns, Righteous Among Nations
palmd | June 10, 2009The Huffington Post put up a good piece about vaccination. It's by Dr. Harvey Karp, and he does an especially nice job looking at some of the "scary numbers" used by the infectious disease promoters.
He's also getting swamped with wackaloon comments, so if you don't mind giving HuffPo your clicks, you might want to check it out.
BTW, JB Handley has written that Karp is, "a completely arrogant asshole with little grasp of the facts," so you know his creds are legit.
Addendum:
Holy Karp! My head re-asploded! Thanks to our alert reader below, I see that Karp only made a little sense. I…
palmd | June 9, 2009One of the concepts we often discuss around here is "what is disease?" As we've seen in the discussion of Lyme disease and so-called Morgellons syndrome, this is not always an easy question to answer. Knowing what states are disease states does not always yield a black-or-white answer. The first step is usually to define what a disease is. The next problem is to decide who in fact has that disease. The first question is hard enough, especially in disease states that we don't understand too well. The second question can be equally tricky. To explore the scientific and philosophical…