medicine
terrasig | November 20, 2009
Denise Gellene in the New York Times is reporting this morning that Scottish physician, Sir John Crofton, passed away on 3 November at age 97.
Crofton is best known for implementing a combination drug regimen to treat tuberculosis, the insidious lung infection with Mycobacterium tuberculosis which decimated the US early last century and still kills 2 million a year worldwide. The concept of using drug combinations to increase individual drug potency and slow the emergence of resistance is now a mainstay of therapeutic approaches for cancer, HIV, and other infectious diseases.
Gellene…
palmd | November 19, 2009In November, the citizens of my home state approved a medical marijuana law. The very next day, I started getting calls from patients (often not may own) asking how they could get it. I'm not fan of draconian laws that imprison people for getting stoned, but when it comes to medical interventions (rather than legal ones) I have an informed opinion. The new law allows Michigan residents to grow weed for their own consumption if they have approval. The law does not allow doctors to prescribe marijuana, rather it allows them to certify that the patient has a condition designated by statue as…
palmd | November 19, 2009Basing medical practice on science helps us avoid the pitfalls of relying on our own reasoning and experience. If I want to start a patient on a new medicine, the individual characteristics of the patient are important (Is the drug meant for their condition? Will it interact with other drugs they are on? Are they allergic to it? Can they tolerate it?) but at least as important is how the drug performs when used on large numbers of people. This attenuates the large differences that can be seen among individuals, and allows us to predict how in general the drug will act.
One of the metrics…
oracknows | November 19, 2009I knew when I first heard about them that the new United States Preventative Services Task Force (USPSTF) recommendations on breast cancer screening would be controversial. I tried to discuss these guidelines and the issues involved in a calm and rational way, relatively devoid of Insolence, Respectful or not-so-Respectful, yesterday, pointing out that screening guidelines were clearly due for revision but also recognizing the problems with the USPSTF recommendations and valid criticisms of them. In the end, I concluded that, among the critics, the ASCO discussion of the proposed guidelines…
palmd | November 18, 2009There are a couple of quotes circulating widely claiming that major players in flu vaccine development are "denouncing" the vaccine.
From (shudder!) mercola.com:
"Dr. Anthony Morris, a distinguished virologist and former Chief Vaccine Office at the U.S. Federal Drug Administration (FDA), states that "There is no evidence that any influenza vaccine thus far developed is effective in preventing or mitigating any attack of influenza" and that "The producers of these vaccines know they are worthless, but they go on selling them anyway."
And:
And in November 2007, the UK newspaper The Scotsman,…
oracknows | November 18, 2009"Early detection saves lives."
Remember how I started a post a year and a half ago saying just this? I did it because that is the default assumption and has been so for quite a while. It's an eminently reasonable-sounding concept that just makes sense. As I pointed out a year and a half ago, though, the question of the benefits of the early detection of cancer is more complicated than you think. Indeed, I've written several posts since then on the topic of mammography and breast cancer, the most recent of which I posted just last week. As studies have been released and my thinking on…
palmd | November 18, 2009In a piece written for health reporters, journalist Jane Allen gives some useful advice about covering alternative medicine, but there are some gaps that are are hard for a non-medical professional to recognize (and frankly, for many medical professionals as well). She quite rightly urges skepticism, but when looking into ideologic and muddled topic of alternative medicine, skepticism needs to be turned up to "11". A major complaint that doctors have about health coverage is not the objectivity, earnestness, or research abilities of the reporter but the lack of some of the fundamental…
oracknows | November 17, 2009If you want a dose of science and rationality about the H1N1 flu pandemic, and you need it now, check out The Skeptics' Guide to the Universe. Led by Steve Novella, the discussion involves more than one friend of the blog, if you know what I mean and can be downloaded here.
oracknows | November 17, 2009Just when I thought I was out, they pull me back in again.
Yes, I know I've used this clip before at least twice and the line in it several more times over the last couple of years. However, sometimes it's just so completely appropriate to how I'm feeling about a topic I'm about to write about that I just don't care and have to use it again. This is one of those times. The 2009 recipient of the Richard Dawkins Award bestowed upon him by the Atheist Alliance International (a.k.a. Bill Maher, anti-vaccine comedian and host of Real Time With Bill Maher, has decided, after an all too brief…
palmd | November 16, 2009Hat tip to the incomparable, contentious, pain-in-the-ass-who-we-are-all-better-for-having-around scienceblogs regular becca for pointing out this site (from google of course) that helps locate flu shots in your area (in my area, everyone is "temporarily out of stock"). While you're visiting, check out google's flu trends as well.
oracknows | November 16, 2009The New York Times has been periodically running a series about the "40 years' war" on cancer, with most articles by Gina Kolata. I've touched on this series before, liking some parts of it, while others not so much. In particular, I criticized an article one article that I thought to be so misguided about how the NIH grant system leads researchers to "play it safe" and how we could cure cancer if we could just fund "riskier" research that I had to write an extended screed about the misconceptions in the article. The latest installment, Medicines to Deter Some Cancers Are Not Taken, also by…
j7uy5 | November 14, 2009
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src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png"
style="border: 0pt none ;">Actually, this is only good news
for coffee drinkers who also have
late-stage hepatitis C. A recent study in Hepatology showed a
possible benefit to coffee consumption in patients with hepatitis C,
First I will show the treatment of the study as shown in the popular
press, then the actual journal article.
href="http://www.medpagetoday.com/Gastroenterology/GeneralHepatology/16539">Coffee
Could Stall Liver Disease Progression
By…
palmd | November 14, 2009An easy way to kill a debate on health care policy is to use the "R" word. We saw this early in the HCR debate with overheated talk of "death panels" and other nonsense. But we ignore the real issue of rationing at our own peril. Those of us who favor real HCR must embrace rationing, coopt it, show our opponents how it is inevitable.
Nowhere is the the Right more hypocritical than the issue of health care rationing (OK, maybe with sex stuff, but...). Everyone who studies American health care knows that we already ration; we just do it irrationally. Current rationing allocates resources…
oracknows | November 13, 2009Remember how I proudly proclaimed the other day that I gotten my H1N1 flu vaccine? Maybe I shouldn't have been so happy. After all, if Eric is right, then the H1N1 vaccination program is nothing more than a socialist plot by Obama-Hitler to poison Wall Street executives, and I fell for it!
The shame. The shame.
palmd | November 13, 2009The resurgence of vaccine-preventable diseases is a fascinating, if unwanted, phenomenon. Pertussis, measles, and now mumps are cropping up after long periods of quiescence. Mumps has been generally very well-controlled since the adoption of wide-spread vaccination, with no nation-wide outbreaks, but there have been a number of regional outbreaks, most notably in 2006 and now again in 2009. Since the widespread use of two-dose vaccines, mumps cases in the US have dropped by more than 99%.
In an analysis of the 2006 outbreak the authors noted a three year periodicity to wide-spread mumps…
jstemwedel | November 13, 2009Dr. Free-Ride: Do you know what a placebo is?
Elder offspring: A placebo is something that you think works but doesn't really work.
Dr. Free-Ride: Sometimes when people are not feeling well, like, if you're sick and bed and want some medicine -- you've asked me for medicine before when you were sick. Why do you ask for medicine?
Younger offspring: Because I think it will make me better.
Dr. Free-Ride: You think it will make you not sick anymore.
Younger offspring: Mmm-hmm.
Dr. Free-Ride: And sometimes you get the medicine and almost immediately you think maybe you feel better. Although I…
oracknows | November 13, 2009
Things have been getting a bit serious around here. Of course, there's been a lot to get serious about, what with Suzanne Somers promoting cancer quackery, Generation Rescue exploiting a young woman with problems in order to promote its anti-vaccine agenda (leading to my "friend" J.B. Handley launching yet another hilariously off-base love letter to me), and my ruminations on the disappointment of cancer screening, things have gotten heavy to the point where they may be a bit of a downer. Add to that the fact that over the last week we've had one of the most persistent and annoying…
palmd | November 12, 2009There's a number of dangers in carrying an analogy too far. One situation may be analogous to another without being identical, or they may not in fact be analogous at all. Forgetting this principle can get you into a wee bit of trouble.
To formalize it a bit, just because you think "A" resembles "B", and "B" has property "P" does not mean that "A" also has property "P". It may be that "A" is not quite enough like "B" to share all of its properties.
But a weak analogy can't stop a weak but persistent mind. Dana Ullman, Hahnemann's cognitively-impaired bulldog, has given us a…
oracknows | November 12, 2009Over two weeks ago, I wrote a rather withering assessment of a truly bad article published by one of my favorite magazines, a magazine to which I've subscribed continuously since the mid-1980s. I'm referring, of course, to Shannon Brownlee's and Jeanne Lenzer's execrable article about the H1N1 vaccine entitled Does the vaccine matter?
I have been surpassed.
I say that because Mark Crislip has written what is to my mind the very best fisking of Brownlee and Lenzer's article I have yet come across, entitled Yes, But. The Annotated Atlantic. Stick a fork in Brownlee and Lenzer. They're done.
jstemwedel | November 12, 2009There is a story posted at ProPublica (and co-published with the Chicago Tribune) that examines a particular psychiatrist who was paid by a pharmaceutical company to travel around the U.S. to promote one of that company's antipsychotic drugs. Meanwhile, the psychiatrist was writing thousands of prescriptions for that same antipsychotic drug for his patients on Medicaid.
You might think that there would be at least the appearance of a conflict of interest here. However, the psychiatrist in question seems certain that there is not:
In an interview and in response to written questions, […