medicine
ddobbs | October 6, 2009A few years ago, a friend of mine gave birth to a daughter, her second child. A few weeks into the child's life, it became apparent she was suffering from cerebral palsy. Not long after, my friend, whom I'll call Carol, bumped into her ob/gyn doctor on the street and told him about her daughter's diagnosis. In a good world, the moral and legal context of such a conversation would encourage the doctor to express sympathy. But the doctor, looking stricken, and clearly terrified about being sued, immediately said, "Well I hope you don't think it was because of anything I did." Carol, who was…
palmd | October 5, 2009Last spring, when the flu season is usually winding down, we had a "second flu season" brought to us by the novel H1N1 ("swine") flu. After school let out for the summer, the numbers declined, but not to the usual low summer rate. Now, as fall begins, flu is picking up again---fast. Pandemic swine flu is hitting our naive population fiercely.
From the CDC Red is this year
This graph clearly illustrates the high baseline during what would normally not be flu season, and the early peak which we are (hopefully) approaching.
This correlates with my own clinical experience. It's gonna be a…
ddobbs | October 5, 2009I've wondered many times, including out loud in Slate, why it's not common in the U.S. to give flu vaccinations at schools, so they could efficiently be given to the population (children) whose inoculation most effectively prevents epidemics or pandemics, as well as to anyone else who wanted one. Same place, procedure, and personnel every year. It would simply and speed things immensely, and save scads of money?
This story in the Times has me asking the question anew. Instead of a single date (or a few dates) in which people can line up and get their shots in an orderly, efficient process,…
j7uy5 | October 5, 2009This is an odd one. A study of 5191 adults showed an
association between air pollution and attacks of acute appendicitis.
href="http://www.cmaj.ca/cgi/content/abstract/cmaj.082068v1">Effect
of ambient air pollution on the incidence of appendicitis
CMAJ 10.1503/cmaj.082068
Published online ahead of print October 5, 2009
Abstract
Background: The pathogenesis of appendicitis is
unclear. We evaluated whether exposure to air pollution was associated
with an increased incidence of appendicitis.
Methods: We identified 5191 adults who had been
admitted to hospital with…
ddobbs | October 5, 2009Never know what'll top the charts. Top post was a post I put up in January, "Pfizer takes $2.3 billion offl-label marketing fine." That post reported the news (via FiercePharma) that Pfizer had tucked away in its financial disclosure forms a $2.3 billion charge to end the federal investigation into allegations of off-label promotions of its Cox-2 painkillers, including Bextra. (Lot of money ... but it didn't quite wipe out the company's 2008 net income.) The company had set aside the money as part of a deal it was negotiating Justiice. Finalizing the deal, however, took until September. At…
palmd | October 5, 2009From time to time, my wife or one of our friends will forward one of the latest health rumors going through the email lists in our community. The usual email list is the one that goes out to moms of young kids living in our ethnic/geographic community. Usually I shrug it off, but every once in a while, my wife and I get fed up and try to spread the truth.
The latest was sent by a friend and colleague who took one look at it and thought, "I bet this'll piss off Pal." She was right. The email contained a link to a notorious anti-vaccination site, and to one post in particular that repeats…
ddobbs | October 5, 2009Lots of flu news out there. Here's my short list for the day:
Helen Branswell reports that WHO is unpersuaded by the unpublished paper showing seasonal flu vaccine may raise chance of getting swine flu. (Anomalies are usually anomalies.) Canada has been thrown into quite a bit of confusion by this report, with some provinces holding off on seasonal flu vaccines.
Meanwhile, an OB notes an extraordinary death toll of H5N1 among pregnant women.
Greg Laden has an extremely short post suggesting how difficult these two bits of news are when you (or your wife) are actually pregnant. The gist: The…
oracknows | October 4, 2009My first hometown, as many readers of this blog know, is Detroit, where I spent the first ten years or so of my life. My second hometown, as I pointed out a while back when a particularly loony city council candidate caught the eye of the skeptical blogosphere.
Unfortunately, I just found out that there's some more looniness going on there in a little more than a week. My cousin e-mailed me this notice:
Event: Mrs. Michigan Autism Lecture
Date: Thursday, October 15, 2009
Time: 6:30pm Location: Zerbo's Health Foods
Event Details:
Heidi Scheer is a national spokesperson for Autism Awareness…
oracknows | October 4, 2009I hadn't planned on writing much, if anything more, about the whole Bill Maher debacle, but PZ has shown up in my comments and graciously tried to explain what's going on at the AAI convention regarding the truly awful choice of Bill Maher for the Richard Dawkins Award:
Look, I don't know what else I can say. I didn't endorse Maher; if they'd run this decision by me months ago, I would have said, "Are you nuts?". But of course, I have no clout with the AAI. Dawkins consented to the award initially, because he didn't know much about the full views held by the crackpot; he would certainly have…
palmd | October 4, 2009The flu pandemic of 1918 was horrific. Millions of people died (by some estimates 4% of the world population), and the medical establishment worked feverishly to find a cause and a treatment. There were many dead-ends in the search for the cause of the flu. One of the most enduring errors was the attribution of the pandemic to a bacterium called Haemophilus influenzae. It turned out that the flu was actually caused by a virus rather than a bacterium, but H. flu is still an important discovery. The fight against influenza was in many ways successful (although too late for the 1918…
oracknows | October 3, 2009...from PZ Myers at the AAI Convention:
The good news for all the critics of this choice is that Dawkins pulled no punches. In his introduction, he praised Religulous and thanked Maher for his contributions to freethought, but he also very clearly and unambiguously stated that some of his beliefs about medicine were simply crazy. He did a good job of walking a difficult tightrope; he made it clear that the award was granted for some specific worthy matters, his humorous approach to religion, while carefully dissociating the AAI from any endorsement of crackpot medicine. It won't be enough, I…
oracknows | October 2, 2009...for Bill Maher to receive the Richard Dawkins Award. It was a huge mistake on the part of the Atheist Alliance International to award it, for the reasons I've repeated ad nauseam over the last couple of weeks; so I won't go there again.
What I really want to know is what happened. I can't be in L.A. this weekend. Actually, I'd much rather be in London for TAM London than in L.A. anyway. Unfortunately, I can't be in either place (although I will be going to Chicago next weekend for the American College of Surgeons Clinical Congress; keep that in mind if any of you Chicagoans wants to try a…
palmd | October 2, 2009In general, competent adults shouldn't be forced into any medical intervention, but taking on certain jobs comes at the cost of accepting certain responsibilities. As health care workers, we are given special access to people at their most vulnerable, and with this access comes a special responsibility. Most health care institutions require proof of vaccination or proof of immunity for several vaccine-preventable diseases, such as measles, mumps, rubella, and chicken pox. So why is influenza vaccination so controversial? Influenza vaccines are safe and effective. We accept that we must show…
oracknows | October 2, 2009And so it begins.
Well, it hasn't really just begun. In fact, it's been going on a long time. I'm talking about confusing correlation with causation when it comes to vaccines. For example, the "vaccines cause autism" variety of the anti-vaccine movement blatantly confuses the correlation with the beginning of the increase in autism diagnoses in the 1990s with the expansion of the vaccine schedule that occurred at roughly the same time. The same sort of thing is going on regarding the HPV vaccine. It began first with the credulous referring to reports of reactions to the Vaccine Adverse Events…
palmd | October 2, 2009Of course you know what my answer will be. It was predictable that the death of a girl shortly after receiving an HPV vaccine to prevent cervical cancer would attract the immoral agents of the anti-vaccine movement. Like zombies to brains, they descend on the tragedy, ready to consume it and gain strength. And just as zombies will eat anything cerebral, even Dana Ullman's brains, the fact that the vaccine didn't cause the death won't slow them down a bit. (Have I finished straining the zombie analogy? Maybe...)
The media certainly loves this story. What could be better than a poor,…
grrlscientist | October 2, 2009tags: physiology, The Bloodmobile, They might be Giants, music video, streaming video
Here's another fun music video; "The Bloodmobile" by the creative group, They Might be Giants. This song tells about the many functions of blood, from providing oxygen to tissues to helping transport hormones (well, hormones are generally transported in the plasma).
oracknows | October 1, 2009This two-part video trashes common antivaccine arguments better than any video I've seen in a long time:
That's right. Vaccines educate the immune system, and Generation Rescue is full of...well, you know what it's full of.
Now if only Bill Maher would watch these videos. Let's make 'em go viral!
oracknows | October 1, 2009...you'll know why.
I got my flu shot today! Yes, it had thimerosal and everything. Give me mercury, baby!
And, guess what? When our hospital gets its supply of H1N1 vaccine later this month, I'll be getting that one, too.
Take that, Doug Bremner! Oh, and you too, Bill Maher!
ddobbs | October 1, 2009You have to move fast these days to keep up with the flu. Or outrun it.
A quick roundup from the last 24:
From the invaluable H5N1:
Mexico: 4,000 H1N1 cases in 7 days
Spain: 31,322 cases and 6 deaths in one week
US: 15 states could run out of hospital beds
Scotland sees it Worst week yet for swine flu, with new cases running at 2,000 a day
Toronto catches the wave.
Meanwhile, Helen Branswell reports that Dutch researchers find mutation linked to greater virulence in swine flu virus -- but so far it doesn't appear to be the big upgrade in nasty we've been fearing. Effect Measure…
palmd | October 1, 2009Fever is a fascinating phenomenon. The biochemistry and physiology of it is fairly well understood (sort of), but historically and presently, it is endowed with great teleologic power. The nearly magical ability of the body to heat up dramatically was noted by the earliest physicians. In the Hippocratean school, fever was often viewed within the humoral framework as an excess of yellow bile and was seen to be beneficial, although it was also recognized that some fevers were a grave sign. Later in the history of medicine, fever was equated with infection as was thought to be "a bad thing"…