medicine
milhayser | December 17, 2009
As we shiver in the northern hemisphere, holiday cheer isn't the only thing in the air—there are also flu, cold, and other contenders just waiting to hit a mucous membrane. Revere questions H1N1 terminology on Effect Measure, citing "10,000 deaths, 47 million infections and over 200,000 hospitalizations" caused by the virus, with the "heart of flu season" still to come. On The White Coat Underground, PalMD reports more CDC data, revealing a "death rate from influenza in American Indians/Native Alaskans" that is almost four times the rate of other ethnicities. Rhinovira are also out in…
hrynyshyn | December 17, 2009I know we're just hours away from the nail-biting climax of the Copenhagen conference at which the fate of humanity hangs in the balance (or not), but a Daily Kos post explaining why efforts to reform health insurance in the U.S. have amounted to nothing has fallen into my "must read" category. One paragraph should be enough to whet your appetite for outrage/resignation:
So here's what you have to understand. If the health insurance and financial industries really felt scared by any particular politician or political party, or their lobbying efforts were inadequate, they could throw them out…
palmd | December 16, 2009C'mon, Times, it's not like you're some kind of penny-ante operation. You've got at least modest resources, you know like the internet and telephones to call up experts. Right?
I don't know whether it's a lack of resources, laziness, or ignorance that allows pieces like this one into the paper, but it doesn't change the craptastic nature of the piece.
The byline says:
Anahad O'Connor, who writes the Really? column for The New York Times, explores the claims and the science behind various alternative remedies that you may want to consider for your family medicine cabinet.
I also "explore…
oracknows | December 16, 2009Last week, I marked the occasion of my fifth anniversary in the blogosphere. Yesterday, my blog bud Abel Pharmboy marked his fourth anniversary in the blogosphere. Anyone who makes it past a year, as far as I'm concerned, has passed the test of time and shown himself (or herself) to be in this crazy thing for the long haul; people who have managed to pump out quality material for four years are exceedingly rare.
Like me, Abel has asked his readers to delurk. However, he has been disappointed by the results. Come on, people! Abel deserves more. If you're one of his readers and see this, do me…
oracknows | December 15, 2009There are times when I get really depressed writing this blog. It's not because I don't enjoy it, although like any long term hobby my blogging does occasionally feel like more of an obligation than a hobby. That's only part of the time, though. Most of the time I really do enjoy what I do. That doesn't mean that it doesn't get to me from time to time, however. After all, how much quackery, pseudoscience, and woo can a plastic box of blinking multicolored lights stand on a daily basis for five years. I would submit to you that Orac is made of quite stern stuff indeed. Still, it's depressing…
palmd | December 15, 2009One of my favorite publications is the Morbidity and Mortality Weekly Report (MMWR). It's put out weekly by the CDC and allows for rapid communication of emerging or interesting health trends. This week the CDC is reporting an extraordinary death rate from influenza in American Indians/Native Alaskans (AI/NA). Collecting data like this presents several challenges, including under-reporting of AI/NA ethnicity and under-reporting of H1N1 as a cause of death, which makes the data even more sobering.
The death rate from H1N1 among AI/NA is 3.7 per 100,000 population, compared with 0.9 per…
oracknows | December 15, 2009It would appear that during my mini-hiatus (indeed, a homeopathic hiatus, so to speak) to celebrate having passed the fifth anniversary of the start of this blog and being irritated by some of my colleagues enough to risk getting myself in a little trouble, I actually missed something that normally I'd leap on like a starving hyena. Normally, such woo would have been like waving the proverbial red cape in front of the bull, holding a slab or bloody red steak in front of a starving pit bull, or a rabbit zipping in front of my late lamented dog. The not-so-Respectful Insolence would have been…
jstemwedel | December 14, 2009One of the sprogs gave me a cold. There is nothing like being knocked on your butt by a cold to take all of the fun out of a weekend spent not-grading research projects.
Also, it seems to have filled my head with phlegm that then got ... phlegmatic. Not quite congealed, but on its way in that direction. Desperate for relief, this led me to try something new.
OK, a neti pot is actually a very old treatment, but its use is new to me. Also, it's apparently mainstream enough that you can find it in Walgreen's, and that the package insert claims that "it has been clinically proven to provide…
palmd | December 14, 2009After reading the Canadian Association of Naturopathic Physician's idiotic flu handout I decided to see what our American naturopaths had to say about flu. It's not good. The most effective way to prevent influenza is through vaccination. Good hand hygiene probably helps. Nothing else really does, but that has never stopped quacks from making wildly bogus claims.
The American Association of Naturopathic Physicians has a page on "preparing for flu season naturally" which of course fails to mention the most effective prophylactic treatment, presumably because it's "unnatural". I'm not…
palmd | December 14, 2009Over at Skeptic North there has been an ongoing discussion about naturopathy. Since it looks like naturopaths are going to get prescribing privileges in Ontario, it's reasonable to subject their practice to some pretty intense scrutiny. One naturopath left some interesting comments about treatment of heart disease, citing relevant literature, but failed to show an actual understanding of the clinical realities of treating heart disease. This is not surprising given that naturopaths aren't required to do residencies like real doctors are.
Another comment referenced the Canadian…
oracknows | December 14, 2009When the USPSTF issued new guidelines for who should undergo screening mammography, at what ages, and how often, it set off a firestorm of negative reactions. Some of this is not surprising, given that the reevaluation of the evidence for screening mammography led the USPSTF to recommend against its routine use in women between the ages of 40 and 50 who lack strong risk factors for breast cancer; i.e., who are at "average" risk. Add to that the recommendation that screening for women age 50 and older should only be every two years instead of every year plus the recommendation that women…
oracknows | December 12, 2009I've decided to chill this weekend after five years of insanity. However, while you anxiously await yet another hemidecade of Insolence, both Respectful and not-so-Respectful, what better way to do so than checking out the awesome Tim Minchin and his most excellent nine minute beat poem "Storm":
Who says skepticism and art don't mix?
bioephemera | December 11, 2009The National Library of Medicine's "Turning the Pages" gallery lets you turn the virtual pages of classic science/medicine manuscripts. Check out Hieronymus Brunschwig's Liber de Arte Distillandi de Compositis (1512):
Note that the NLM's copy is hand-colored; uncolored copies also exist, such as this copy at ECHO. Comparison with the images of the ECHO copy show that NLM has elided the boring, text-only pages from their animation.
I'm not usually a big fan of animations that try to replicate the tactile experience of books, but given that you aren't usually allowed to touch manuscripts of…
oracknows | December 11, 2009
Has it really been that long?
It was a dismally overcast Saturday five years ago when, on a whim after having read a TIME Magazine article about how 2004 was supposedly the Year of the Blogger, I sat down in front of my computer, found Blogspot, and the first incarnation of Respectful Insolence was born. If anyone is curious, this was my first test post, and this was my first substantive post (well, sort of). Every year (at least the ones where I remember my blogiversary, I find it particularly interesting to go back to the beginning and see how true to my original vision for this blog I've…
jstemwedel | December 10, 2009For those of you who have heard me issue calls for dialogue (not debate) on the subject of research with non-human animals -- especially if you're in the Los Angeles area -- I'm pleased to announce that there's an event coming up in February that's aimed at fostering just such a dialogue, in the three-dimensional world. Here's the announcement:
Save the date!
Perspectives on the Science and Ethics of Animal-Based Research
UCLA, Covel Commons, 6pm-8:30pm, February 16th, 2010
With the goal of opening an on-going dialogue between individuals who are in favor or opposed to the use of animals in…
palmd | December 10, 2009Human medicine advances in the way much of science does. People make systematic observations, form plausible hypotheses, and collect data. One of the more important questions in medicine is how people are affected by certain exposures. When that exposure is a medicine, we prefer data from double-blinded, randomized controlled trials. Other types of exposures (such as cigarette smoke) are less amenable to RCTs and we must rely on case-control, cohort, and other studies that examine correlation.
But before we can run RCTs on human subjects we need more than just a plausible hypothesis;…
oracknows | December 10, 2009Arguably, the genesis of the most recent iteration of the anti-vaccine movement dates back to 1998, when a remarkably incompetent researcher named Andrew Wakefield published a trial lawyer-funded "study" in the Lancet that purported to find a link between "autistic enterocolitis" and measles vaccination with the measles-mumps-rubella (MMR) trivalent vaccine. In the wake of that publication was born a scare over the MMR that persists to this day, 11 years later. Although peer reviewers forced the actual contents of the paper to be more circumspect, in the press Wakefield promoted the idea that…
oracknows | December 9, 2009A while back I wrote about really rethinking how we screen for breast cancer using mammography. Basically, the USPSTF, an independent panel of physicians and health experts that makes nonbinding recommendations for the government on various health issues, reevaluated the evidence for routine screening mammography and concluded that for women at normal risk for breast cancer, mammography before age 50 should not be recommended routinely and should be ordered on an individualized basis, and that routine formalized breast self-examination (BSE) should also not be routinely recommended. In…
palmd | December 8, 2009Some time ago I issued a naturopath challenge in which I invited naturopaths to analyse a typical primary care problem. Today, I'd like to issue a broader challenge.
With health care reform in the works, it would be wise to look north (or in my case, south) to our Canadian neighbo(u)rs, but not for the reason you think. Assuming we are able to extend health insurance coverage to millions of more Americans, we will need primary care practitioners (PCPs) who can care for these new medical consumers. In Canada, legislation to deal with a shortage of PCPs by giving modest new powers to other…
oracknows | December 8, 2009My irony meter exploded in a near-nuclear conflagration, leaving nothing but a sputtering, molten puff of plasma when I was referred to this gem from Kim Stagliano over at Age of Autism directed at the enemy of all anti-vaccine pseudoscience, that Dark Lord of Vaccination (to anti-vaccine loons) himself, Paul Offit:
You'll blame the "anti-vaxxers" for the public refusal of this vaccine. Spare me. We are a cap gun compared to your nuclear bomb when it comes to the media. We're ragtag colonials hiding behind trees as you Red Coats march in military precision with fine weapons. How much money…