Friday, March 31, 2006

Hilarious Journal Articles #47: Scent of Fear Improves Cognitive Performance

Chemosignals of Fear Enhance Cognitive Performance in Humans -- Chen et al., 10.1093/chemse/bjj046 -- Chemical Senses:
It is well documented across phyla that animals experiencing stress and fear produce chemical warning signals that can lead to behavioral, endocrinological, and immunological changes in the recipient animals of the same species. Humans distinguish between fear and other emotional chemosignals based on olfactory cues. Here, we study the effect of human fear chemosignals on the speed and accuracy of cognitive performance. In a double-blind experiment, female participants performed a word-association task while smelling one of the three types of olfactory stimuli: fear sweat, neutral sweat, and control odor carrier. We found that the participants exposed to the fear condition performed more accurately and yet with no sacrifice for speed on meaningful word conditions than those under either the neutral or the control condition. At the same time, they performed slower on tasks that contained ambiguous content. Possible factors that could introduce bias, such as individual differences due to anxiety, verbal skills, and perceived qualities of the smells, were ruled out. Our results demonstrate that human fear chemosignals enhance cognitive performances in the recipient. We suggest that this effect originates from learned associations, including greater cautiousness and concomitant changes in cognitive strategies.
Via EurekAlert:
For the study, Chen collected samples of sweat from research volunteers who kept gauze pads in their armpits while they watched videos of horror movies and nonthreatening documentaries. The sweat samples were then stored in a freezer until needed for the study...
Technorati Tags: , , , , ,

Thursday, March 30, 2006

Hilarious Journal Articles #46: Prayer for Patients Causes Postoperative Complications

This study suggests you should not tell someone going for surgery, "We'll be praying for you..."

Study of the Therapeutic Effects of Intercessory Prayer in Cardiac Bypass Patients, from the American Heart Journal:
Intercessory prayer is widely believed to influence recovery from illness, but claims of benefits are not supported by well-controlled clinical trials. Prior studies have not addressed whether prayer itself or knowledge/certainty that prayer is being provided may influence outcome. We evaluated whether (1) receiving intercessory prayer or (2) being certain of receiving intercessory prayer was associated with uncomplicated recovery after coronary artery bypass graft (CABG) surgery.

Methods Patients at 6 US hospitals were randomly assigned to 1 of 3 groups: 604 received intercessory prayer after being informed that they may or may not receive prayer; 597 did not receive intercessory prayer also after being informed that they may or may not receive prayer; and 601 received intercessory prayer after being informed they would receive prayer. Intercessory prayer was provided for 14 days, starting the night before CABG. The primary outcome was presence of any complication within 30 days of CABG. Secondary outcomes were any major event and mortality.

Results In the 2 groups uncertain about receiving intercessory prayer, complications occurred in 52% (315/604) of patients who received intercessory prayer versus 51% (304/597) of those who did not (relative risk 1.02, 95% CI 0.92-1.15). Complications occurred in 59% (352/601) of patients certain of receiving intercessory prayer compared with the 52% (315/604) of those uncertain of receiving intercessory prayer (relative risk 1.14, 95% CI 1.02-1.28). Major events and 30-day mortality were similar across the 3 groups.

Conclusions Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications.
Technorati Tags: , , , ,

Flickr: Solar Eclipse

From Flickr. Uploaded by Rogério Mariano on 29 Mar '06, 8.25pm PST.

Wednesday, March 29, 2006

NIH Panel Finds No Extra Risk in Caesarean Sections

From The Washington Post:
Caesarean sections are not necessarily riskier than vaginal deliveries and may be safer in some ways for the mother and baby in many cases, an expert panel concluded yesterday.

The panel convened by the National Institutes of Health did not endorse delivering babies by the surgical procedure, but the experts found no clear reason to routinely discourage women from choosing that option, which continues to grow in popularity. The findings contrast with decades of medical advice aimed at trying to reduce the number of Caesareans, which for years were seen as unnecessary, costly and potentially risky.
The press release is here and the consensus statement is here.

Technorati Tags: , , ,

Pinot Noir Sequenced

From Discovery Channel News:
Italian researchers have cracked the genetic code of the grapevine, the first fruit genome to be mapped and a development that likely will change the future of wine-making, they announced at a news conference in Trento. The grape variety sequenced was Pinot Noir, which becomes the second food crop to be sequenced, after rice. Among the first vines to be domesticated about 2,000 years ago, the grape is grown around the world, but thrives in the Burgundy region of France.
Via the Biotech Weblog.

Technorati Tags: , , ,

Grand Rounds 2.27

From NHS Blog Doctor:
Welcome to this week’s Grand Rounds, the weekly fest of the best of medical and medically related blogging from round the world. This week, the theme is cricket, the finest sport in the world. Test match cricket is played over five days. For those unfamiliar with the game, here is a thumbnail sketch.

You have two sides, one out in the field and one in. Each man that's in the side that's in goes out, and when he's out he comes in and the next man goes in until he's out. When they are all out, the side that's out comes in and the side that's been in goes out and tries to get those coming in, out. Sometimes you get men still in and not out.When a man goes out to go in, the men who are out try to get him out, and when he is out he goes in and the next man in goes out and goes in. There are two men called umpires who stay out all the time and they decide when the men who are in are out. When both sides have been in and all the men have been out, and both sides have been out twice after all the men have been in, including those who are not out, that is the end of the game.

Got that? Pretty straightforward, really.
Technorati Tags: , ,

World's 10 Best-Selling Drugs

Via Wired News:
Pfizer's cholesterol pill Lipitor remains the best-selling drug in the world for the fifth year in a row. Its annual sales were $12.9 billion, more than twice as much as its closest competitors: Plavix, the blood thinner from Bristol-Myers Squibb and Sanofi-Aventis; Nexium, the heartburn pill from AstraZeneca; and Advair, the asthma inhaler from GlaxoSmithKline... (slideshow of top 10 drugs here)
Technorati Tags: , ,

Tuesday, March 28, 2006

Savant Profile: Gilles Trehin and the city of Urville

From the Wisconsin Medical Society:
Gilles Trehin has been drawing since age 5, but at age 12 he began designing an imaginery city he named URVILLE which is described in great detail on this posting, and on his own linked web site as well. The background of the evolution of Gilles's talent in his childhood years is described on this posting as well by Gilles's father, Paul. Gilles has presented his remarkable work at a number of autism conferences and conventions which are always well received, and which he very much enjoys sharing with those audiences. — Darold Treffert, MD
Via BoingBoing.

Technorati Tags: , , , , ,

Monday, March 27, 2006

Yet More on Stanislaw Lem (from Warren Ellis)

Via Warren Ellis:
In 1974, Philip K Dick began to inform on his sf colleagues, accusing them of being part of a Communist conspiracy — led by Stanislaw Lem, his great admirer — to kidnap him. Typically, although he mailed some of these letters to the FBI (they were ignored), he put others in a trashcan behind his house, assuming that whomever was watching him would deliver them… (one letter is preserved here)

(Also: “The honorary voting of Stanislaw Lem to membership is the sheep voting the wolf a place at the communal hearth,” Dick warned Science Fiction Writers of America members in ‘75. “They certainly must be licking their chops back in Krakow right now.”)
Technorati Tags: , ,

Inducing Labor for Convenience

From the New York Times:
Earlier this year, a pregnant Pittsburgh Steelers fan told local reporters that she had asked her doctor to induce labor early so she could watch the Super Bowl. Once her obstetrician determined that the procedure would be safe, and that the Steelers were in fact headed to the big game, he consented...
Technorati Tags: , ,

The Spearhead of Cognition, an Essay on Stanislaw Lem

From an essay on Stanislaw Lem, who recently died, called "The Spearhead of Cognition," by Bruce Sterling:
You're a kid from some podunk burg in Alabama.
From childhood you've been gnawed by vague
numinous sensations and a moody sense of your own
potential, but you've never pinned it down.
Then one joyful day you discover the work of a
couple of writers. They're pretty well-known (for
foreigners), so their books are available even in your
little town. Their names are "Tolstoy" and
"Dostoevsky." Reading them, you realize: This is it!
It's the sign you've been waiting for! This is your
destiny-- to become a *Russian Novelist*!
Fired with inspiration, you study the pair of
'em up and down, till you figure you've got a solid
grasp of what they're up to. You hear they're pretty
well-known back in Russia, but to your confident eye
they don't seem like so much. (Luckily, thanks to some
stunt of genetics, you happen to be a genius.) For
you, following their outline seems simple enough--in a
more sophisticated vein, of course, and for a modern
audience. So you write a few such books, you publish
'em, and people adore them. The folks in 'Bama are fit
to bust with pride, and say you've got Tolstoy beat
all hollow.
Then, after years of steadily growing success,
strange mail arrives. It's from Russia! They've been
reading your stuff in translation, and you've been
chosen to join the Soviet Writers' Union! Swell! you
think. Of course, living in backwoods Alabama, it's
been a little tough finding editions of contemporary
Russian novelists. But heck, Tolstoy did his writing
years ago! By now those Russians must be writing like
nobody's business!
Then a shipment of modern Russian novels
arrives, a scattering of various stuff that has
managed to elude the redtape. You open 'em up and--
ohmiGod! It's . . . it's COMMUNISM! All this stupid
stereotyped garbage! About Red heroes ten feet tall,
and sturdy peasants cheering about their tractors, and
mothers giving sons to the Fatherland, and fathers
giving sons to the Motherland . . . Swallowing bile,
you pore through a few more at random--oh God, it's
Then the _Literary Gazette_ calls from Moscow,
and asks if you'd like to make a few comments about
the work of your new comrades. "Why sure!" you drawl
helpfully. "It's clear as beer-piss that y'all have
gotten onto the wrong track entirely! This isn't
literature--this is just a lot of repetitive agitprop
crap, dictated by your stupid oppressive publishers!
If Tolstoy was alive today, he'd kick your numb
Marxist butts! All this lame bullshit about commie
heroes storming Berlin and workers breaking production
records--those are stupid power-fantasies that
wouldn't fool a ten-year-old! You wanna know the true
modern potential of Russian novels? Read some of my
stuff, if you can do it without your lips moving! Then
call me back."
And sure enough, they do call you back. But
gosh--some of the hardliners in the Writers' Union
have gone and drummed you out of the regiment. Called
you all kinds of names . . . said you're stuck-up, a
tool of capitalism, a no-talent running-dog egghead.
After that, you go right on writing, even criticism,
sometimes. Of course, after that you start to get
This really happened.
Except that it wasn't Tolstoy and Dostoevsky. It
was H.G. Wells and Olaf Stapledon. It wasn't Russian
novels, it was science fiction, and the Writers' Union
was really the SFWA. And Alabama was Poland.
And you were Stanislaw Lem.
Technorati Tags: , , ,

Stanislaw Lem Dies in Krakow at Age 84

Via Yahoo! News:
Polish author Stanislaw Lem, one of the world's leading science-fiction writers, died on Monday in his home city of Krakow at the age of 84 after a battle with heart disease...

Lem, born on September 12, 1921 in what is now the Ukrainian city of Lviv, studied medicine before World War Two. After the war, communist censorship blocked the publication of his earliest writing.

After the fall of communism in 1989 Lem ceased writing science-fiction, instead devoting himself to reports on near-future predictions for governments and organizations.

He wrote essays on computer crime, as well as technological and ethical problems posed by the expansion of the Internet.
Technorati Tags: , ,

Breastfeeding Benefits Are Different Than Assumed

Via Slate:
Like almost all new parents, when my wife and I were in the first flush of parenthood four decades ago, we were possessed to do the best we could for our babies. We were also skeptical of conventional wisdom. In those days, that combination meant we would opt for breast-feeding. It's a little shocking to say this now, but at that time almost no one chose to breast-feed. Our pediatrician gently tolerated our eccentricity but told us, apologetically, that he couldn't help—he knew nothing about it. Fortunately, both grandmas were knowledgeable and supportive and things worked out...

When you ask a bunch of doctors about how breast-feeding prevents infection, they get it wrong—I know they do, because I've asked the question. Doctors tell you that colostrum (produced in the first three days or so after a baby is born) and breast milk are full of maternal antibodies. Next, doctors say that these maternal antibodies are absorbed into the infant's blood circulation and thus serve to protect infants from disease.
Technorati Tags: ,

Sunday, March 26, 2006

Flickr: Monastery St Barbara - Close up

From Flickr. Uploaded by AlfGX on 23 Mar '06, 12.07pm PST.

Flickr: Over The Rainbow

From Flickr. Uploaded by davebrosha on 24 Mar '06, 3.01pm PST.

Informed Consent at Issue in Cases Involving Rabies-Infected Kidneys

Families of two people who died after receiving rabies-infected organs have filed separate suits against the hospital and others involved in the transplants, alleging that the defendants failed to provide enough information about the donor to obtain informed consent from the recipients.

Cheri Jean Wells, 50, and Joshua Hightower, 18, received kidneys from Arkansas resident William Beed Jr. in May 2004, and they died the month after their transplant surgeries. Two other recipients of Beed's organs also died, one during the transplant surgery, according to a July 3, 2004, news release from the Centers for Disease Control and Prevention.
Technorati Tags: , , , ,

Researchers create pigs that produce heart-healthy omega-3 fatty acids

Via EurekAlert:
Researchers report they have created pigs that produce omega-3 fatty acids, which are known to improve heart function and help reduce the risks for heart disease, representing the first cloned transgenic livestock in the world that can make the beneficial compound. The research could be a boost to both farmers and health-conscious consumers seeking an alternative and safer source of omega-3 fatty acids. Currently, the only way for humans to realize the benefits of omega-3 fatty acids is by taking dietary supplements or by eating certain types of fish that may also contain high levels of mercury.
Technorati Tags: , , , ,

Grapefruit Juice Drug Interactions

From the Center for Food-Drug Interactions:
The Center for Food-Drug Interaction Research and Education, led by the University of Florida, was established in the spring of 2003 to help identify and analyze possible food-drug interactions and any resulting effects.

We welcome you to browse the site, which currently houses scientific research and information about drug interactions with grapefruit juice.
Technorati Tags: , ,

Riya (Photo Search and Face Recognition)

From the Riya Website:
We started this company after realizing that we had 1000's of digital photos on our computer all labeled DSC0009.jpg, that our friends just never remembered to send us the photos we wanted from them, and that searching for images on the web just doesn't work very well.

We are a group of determined face recognition and text recognition researchers and engineers who believe it is time for a new type of photo search that uses technology to look inside and automatically tag photos. We hope this will revolutionize how people "see" the world.
Technorati Tags: ,

Friday, March 24, 2006

Flickr: random latte art

From Flickr. Uploaded by tonx on 19 Mar '06, 1.27am PST.

Flickr: Jelly Scrum

From Flickr. Uploaded by jurvetson on 21 Mar '06, 5.46pm PST.

Patient Quote of the Day: Cocaine

Clinical Cases and Images:

"You know doctor, my chest was hurting so bad that I took some cocaine to help it."
Technorati Tags: , , , ,

New Links from MedlinePlus

Via MedlinePlus:
Alcohol and Youth

Parents - Spring Break Is Another Important Time to Discuss College Drinking
National Institute on Alcohol Abuse and Alcoholism

Coronary Disease

Male Fat Distribution Pattern and Coronary Risk Profile Linked to X Chromosome; Women Lacking Ovarian Function Shy, Anxious
National Institute of Child Health and Human Development


New Strategies Help Depressed Patients Become Symptom-Free
National Institute of Mental Health

High Blood Pressure

Older Hispanics Can Prevent High Blood Pressure
National Heart, Lung, and Blood Institute

Hispanic-American Health

Older Hispanics Can Prevent High Blood Pressure
National Heart, Lung, and Blood Institute

Mental Health

Aggression-Related Gene Weakens Brain's Impulse Control Circuits
National Institute of Mental Health

Premature Ovarian Failure

Male Fat Distribution Pattern and Coronary Risk Profile Linked to X Chromosome; Women Lacking Ovarian Function Shy, Anxious
National Institute of Child Health and Human Development

Sleep Disorders

Your Guide to Healthy Sleep
National Heart, Lung, and Blood Institute


Defective Immune System Response to Smallpox Vaccine Detailed in New Study
National Institute of Allergy and Infectious Diseases

Taste and Smell Disorders

Importance of Being Tasty
National Institute on Deafness and Other Communication Disorders
Technorati Tags: , , , , , , , , , , ,

Thursday, March 23, 2006

Flickr: Abode of the God-Kings

From Flickr. Uploaded by Kenny Maths on 20 Mar '06, 3.09am PST.

Vesivirus Linked to Hepatitis of Unknown Cause

From EurekAlert:
A virus of ocean origin [Vesivirus] that can cause a range of diseases in several animal species has been found in human blood samples. The virus, or antibodies to it, was found most often in the blood of individuals with liver damage, or hepatitis of unknown cause related to blood exposure.
Technorati Tags: , , ,

Emergence of Mycobacterium tuberculosis with Extensive Resistance to Second-Line Drugs (XDR TB)

From The CDC:
This report documents the existence of XDR TB [extensively drug-resistant tuberculosis] as a serious and emerging public health threat. Population-based surveillance data are needed to describe the magnitude and trends of XDR TB worldwide. Activities to detect drug-resistant TB accurately and rapidly and treat it effectively should be expanded, including development of international standards for SLD-susceptibility testing, new anti-TB drug regimens, and better diagnostic tests. Such measures are crucial if future generations are to be protected from XDR TB.
Technorati Tags: , , ,

Anthrax Victim Dances As He Awaits Release

From The Washington Post:
A dancer and drum maker who became infected with anthrax danced for reporters Wednesday in a hospital auditorium, showing off his remarkable recovery from a rare and usually fatal form of the disease.

Vado Diomande, a 44-year-old New York City resident, collapsed more than a month ago during a dance performance in Pennsylvania. Health officials believe he may have inhaled anthrax spores from the African animal hides he uses to make drums.
Technorati Tags: , ,

Wednesday, March 22, 2006

Flickr: Dramatic Sunset Behind The Loggerhead Key Lighthouse From The Top Of Ft. Jefferson, Dry Tortugas National Park, Florida. _MG_0706 1to1

From Flickr. Uploaded by red_moon_rise on 16 Mar '06, 11.16pm PST.

Hilarious Journal Articles #45: 'Executive' monkeys influenced by other executives, not subordinates

From the Duke Press Release:
When high-ranking monkeys are shown images of other monkeys glancing one way or the other, they more readily follow the gaze of other high-ranking monkeys, Duke University Medical Center neurobiologists have discovered. By contrast, they tend to ignore glance cues from low-status monkeys; while low-status monkeys assiduously follow the gaze of all other monkeys. The discovery represents more than a confirmation of what most people believe about their bosses, said the researchers. The findings reveal that gaze-following is more than a reflex action; that it also involves lightning-fast social perception.
Technorati Tags: , , , ,

Pets Can Catch MRSA From People

A friend of mine's rabbit caught MRSA from her. (She's a nurse.)

Now there are signs dogs and cats can catch a dangerous superbug from people. At a large Philadelphia veterinary hospital, scientists report that over a three-year period, 38 dogs, cats and other pets caught a drug-resistant staph infection.
Technorati Tags: , , ,

There's a Coyote in Central Park

From The New York Times:
Last night, the coyote managed to evade a formidable search party, including dozens of police officers and parks workers with a police helicopter searching overhead. Police sharpshooters shot tranquilizer darts, but it was not known if any had found their mark.
Technorati Tags: , , ,

Tuesday, March 21, 2006

Flickr: untitled

From Flickr. Uploaded by lynl on 20 Mar '06, 11.17pm PST.

BiDil Sales Are Disappointing

From The New York Times:
A new drug hailed last year as a breakthrough for black heart patients has become a major disappointment for its maker, NitroMed, and the company announced yesterday that two top executives involved in bringing the product to market had resigned...

The American Heart Association officially designated BiDil as a major treatment advance after research indicated it could extend the lives of black heart-failure patients by 43 percent over 18 months. And some financial analysts had predicted annual sales could eventually reach $825 million, based on BiDil's use by about 750,000 black heart failure patients...

The company also was criticized for pricing the drug at $1.80 a pill, about twice what some financial analysts had predicted. Some patients take up to six pills a day.
Technorati Tags: , , , , ,

Not All Antiseptic Hand Gels Kill Germs

From Zap*Germs, which reviews recent studies on alcohol hand gels:
A surprising discovery has been published in Emerging Infectious Diseases: alcohol-based hand gels with less than 60% alcohol can't be counted on to kill most harmful bacteria and viruses...
Technorati Tags: , ,

"Hero M.D." is Actually "Hero D.O."

Newsweek Quoted in Gawker: ‘Hero M.D.’ Is Totally Hero, Not So Much M.D.
On our March 20 cover, we referred to Dr. Richard Jadick, the brave military physician who saved dozens of lives during the battle for Fallujah, as “Hero M.D.” Dr. Jadick is in fact a D.O., or Doctor of Osteopathic Medicine. Osteopathic medicine takes a holistic approach to medical care, emphasizing prevention and focusing on the body’s musculoskeletal system…
Technorati Tags: , , , , ,

Two on Meningococcal Infection

Unbounded Medicine: Purpura fulminans as severe complication of meningococcal infection
The clinical picture is as follows: acute onset of cutaneous hemorrhage and necrosis secondary to vascular thrombosis and disseminated intravascular coagulation. Often there is pain followed by petechiae. Ecchymoses develop and evolve into painful indurated, well-demarcated purple papules with erythematous borders (as you can see in the image this lesions are coalescent). Then this lesions progress to necrosis with formation of bullae and vesicles. Gangrenous necrosis can follow with extension into the subcutaneous tissue and occasionally involves muscle and bone.
'You're Very Ill' Takes a Sudden Turn to 'You're Very Lucky' - From The New York Times
Only two people in all of New York were officially known to have contracted chronic meningococcemia that winter, she told me when I was done chuckling. "Lucky me!" I responded.

Then a question occurred to me. "How's the other person?"

"The other person," she said after a brief silence, "did not do as well."
Technorati Tags: , , , ,

Grand Rounds 2.26

Grand Rounds 2.26, this week's best posts of the medical blogosphere, is up at HealthyConcerns.

Technorati Tags: ,

Monday, March 20, 2006

An Update on the Tragic TGN 1412 Trial

From Health Care Renewal:
Our most recent post on the lack of transparency in the trial run by Parexel of TGN 1412, a drug developed by TeGenero, which left all six participants in intensive care with multi-organ system failure, was here.

This trial has generated tremendous media attention. Thus, we now know a bit more about it, but still not much.

According to TeGenero's website, the drug TGN 1412 is a monoclonal antibody that targeted the CD28 receptor on T-lymphocytes. The drug is not meant to destroy T-lymphocytes, but rather to activate the CD28 receptor. According to TeGenero, the TGN 1412 leads to "pronounced T-cell activation and expansion." Thus, unlike some other monoclonal antibodies used to treat cancer, this drug was meant to change the settings, as it were, of the patient's immune system. This was thus a novel therapy, and hence one whose results might have been unpredictable.
Technorati Tags: , , , ,

Flickr: ovn-roasted alligatr

From Flickr. Uploaded by Esthr on 19 Mar '06, 2.11am PST.

Flickr: Wolf.

From Flickr. Uploaded by stonefaction on 18 Mar '06, 6.11pm PST.

"Red-Hot Research Papers of 2005"

Ordered by number of citations. From Science Watch:
1 P.M. Ridker, et al., "C-reactive protein levels and outcomes after statin therapy," New Engl. J. Med., 352(1): 20-8, 6 January 2005. 124
2 G.H. Bardy, et al., "Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure," New Engl. J. Med., 352(3): 225-37, 20 January 2005. 107
3 S.D. Solomon, et al., "Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention," New Engl. J. Med., 352(11): 1071-80, 17 March 2005. 97
4 R.S. Bresalier, et al., "Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial," New Engl. J. Med., 352(11): 1092-1102, 17 March 2005. 93
5 J.C. Barrett, et al., "Haploview: analysis and visualization of LD and haplotype maps," Bioinformatics, 21(2): 263-5, 15 January 2005. 90
6 S.E. Nissen, et al., "Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease," New Engl. J. Med., 352(1): 29-38, 6 January 2005. 82
7 D.A. Hinds, et al., "Whole-genome patterns of common DNA variation in three human populations," Science, 307(5712): 1072-9, 18 February 2005. 74
8 L.P. Lim, et al., "Microarray analysis shows that some microRNAs downregulate large numbers of target mRNAs," Nature, 433(7027): 769-73, 17 February 2005. 73
9 E.R. Miller, et al., "Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality," Ann. Intern. Med., 142(1): 37-46, 4 January 2005. 73
10 A. Howell, et al., "Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years adjuvant treatment for breast cancer," Lancet, 365(9453): 60-2, 1 January 2005...
Technorati Tags: , , ,

Medical Conversation of the Day: Endocarditis and the Dentist

"I'm worried I'm going to get endocarditis [an infection of the heart valves] from going to the dentist."
"You won't. You don't have any risk factors, like heart valve disease."
"But I know someone that got endocarditis from going to the dentist and he didn't have heart valve disease."
"Was he shooting up drugs at the time?"
"Well, yeah, but he was sure he got endocarditis from going to the dentist..."

Lasix and Furosemide vs. Bumex and Bumetanide

Note to self: Stop writing lasix on prescriptions. Write furosemide. No one gets lasix anymore, and writing lasix only invites confusion.

Also: Lasix is to bumex as VHS is to betamax. Lasix grabbed all the market share, but bumex is better.


I've finally gotten off my ass and changed the template to display comments at the end of every page. They are no longer hidden. Comment away.

Sunday, March 19, 2006

Nonprofit Hospitals Face Scrutiny Over Practices

From The New York Times:
Congressional leaders, concerned that many nonprofit hospitals are not providing enough charity care to justify their tax-exempt status, say they will set standards for the industry if it does not do so itself...

When members of Congress raise questions about executive pay, they sometimes point to the compensation paid by teaching hospitals in New York. Tax-exempt organizations generally have to file annual returns with the Internal Revenue Service.

These forms, which are open to public inspection, show that the president of NewYork-Presbyterian Hospital, Dr. Herbert Pardes, received more than $4.3 million in compensation in 2004, plus $1.2 million in contributions to his employee benefit plan. About half of his pay was a reward for performance in prior years, the hospital said.

Dr. Spencer Foreman, president of Montefiore Medical Center in the Bronx, received $1.1 million in compensation and $712,000 in benefits.

In an interview, Dr. Foreman said, "Congressional interest in this area is quite appropriate, and we as an industry have to come forward with a comprehensive response." But in defining the proper level of charity care, he said, it is "totally unrealistic" to apply the same mathematical formula to nonprofit hospitals in destitute urban neighborhoods and affluent suburbs.

Technorati Tags: , , , ,

Patients in New York State Linger in Hospitals Longer

Via Newsday:
Health experts say difficulties in finding a place for poor and elderly patients often means they become trapped in hospitals, languishing in sick environments with little to do long after they should have been discharged.

Caroline Steinberg of the American Hospital Association said the problem surfaces more frequently in New York state, which has large elderly, poor and immigrant populations.

It's one reason why the average length of a hospital stay in New York State is 6.6 days, above the national average of 5.1 days, according to AHA.

Patients could get trapped in hospitals for a myriad of reasons...
Technorati Tags: , ,

Killer Nurse Becomes Kidney Donor

From CBS News:
A New Jersey judge is allowing the state's worst serial killer to donate a kidney, as long as he and his doctors meet certain conditions.

The order leaves unresolved when Charles Cullen might undergo an operation to remove one of his kidneys. The kidney would go to the relative of a friend...

A judge in Pennsylvania added a 12th life prison sentence against the former nurse who killed at least 29 patients in two states.
Technorati Tags: , ,

Flickr: Best viewed large

From Flickr. Uploaded by - Proserpina - on 18 Mar '06, 10.29am PST.

NYT Article on Sperm Donation

Wanted: A Few Good Sperm - From The New York Times:
One day last October, Karyn, a 39-year-old executive, pulled her online dating profile off JDate and, two sites she had been using, along with an endless series of leads, tips and blind dates arranged by friends and colleagues, to search for a man she wanted to marry and raise a family with. At long last, after something like 100 dates in the past 10 years and several serious relationships, she had found the man she refers to, tongue only slightly in cheek, as "the one." It all began last summer, when she broke off a relationship with a younger man who wasn't ready for children and got serious about the idea of conceiving on her own. She gathered information about fertility doctors and sperm banks. "Then a childhood friend of mine was over," she told me. "I pulled up the Web site of the only sperm bank that I know of that has adult photos. There happened to be one Jewish person. I pulled up the photo, and I looked at my friend, and I looked at his picture, and I said, 'Oh, my God.' I can't say love at first sight, because, you know. But he was the one."
Technorati Tags: , , ,

Medical Mashups

From UBC Google Scholar Blog:
Think of mashups as making connections where none existed before. Content created anew, using disparate data from RSS feeds, public databases, or open data sources. In searching, ‘mash-ups’ (see wikipedia) are websites that pull content from disparate sources on a single page. Here's a simple example: Helicobacter pylori.
Technorati Tags: , , ,

Where Does the Future Come From?

More on Robert Altman's Heart Transplant

For those who were surprised to learn that the director Robert Altman had a heart transplant: apparently it took place in 1995 and was originally reported in Variety, but Altman later denied the story because of the "stigma" associated with transplantation.

From Army Archerd:
Robert Altman had heart transplant surgery Dec. 3, 1995, at Cedars-Sinai Medical Center in Los Angeles. I reported in my Daily Variety column on Dec.7, 1995, "Good wishes are out to director Robert Altman who underwent heart transplant surgery Sunday. Altman had known the surgery was necessary since last March, friends say." I called to convey my good wishes to Altman...
Technorati Tags: , , , , ,

Saturday, March 18, 2006

Plavix's Great Slogan

"You're no match for a dangerous clot."

Technorati Tags:

Flickr: temple guard #4

From Flickr. Uploaded by Kris Kros on 16 Mar '06, 7.06am PST.

Flickr: Washington Capitol

From Flickr. Uploaded by epmd on 15 Mar '06, 3.12pm PST.

With Pneumonia Care, Higher Volume Hospitals Do Worse

This study suggests that high volumes, at least in the case of pneumonia, can adversely effect quality of care.

From Volume, Quality of Care, and Outcome in Pneumonia -- Lindenauer et al. 144 (4): 262 -- Annals of Internal Medicine:
Results: Physician volume was unrelated to the timeliness of administration of antibiotics and the obtainment of blood cultures; however, physicians in the highest-volume quartile had lower rates of screening for and administration of influenza (21%, 19%, 20%, and 12% for quartiles 1 through 4, respectively; P 0.01) and pneumococcal (16%, 13%, 13%, and 9% for quartiles 1 through 4, respectively; P 0.01) vaccines. Among hospitals, the percentage of patients who received antibiotics within 4 hours of hospital arrival was inversely related to pneumonia volume (72%, 64%, 60%, and 56% for quartiles 1 through 4, respectively; P 0.01), while selection of antibiotic, obtainment of blood cultures, and rates of immunization were similar. Physician volume was not associated with in-hospital or 30-day mortality rates. Odds ratios for in-hospital mortality rates rose with increasing hospital volume (1.14 [95% CI, 0.87 to 1.49], 1.34 [CI, 1.03 to 1.75], and 1.32 [CI, 0.97 to 1.80] for quartiles 2 to 4, respectively); however, odds ratios for 30-day mortality rates were similar...

Conclusion: Among both physicians and hospitals, higher pneumonia volume is associated with reduced adherence to selected guideline recommendations and no measurable improvement in patient outcomes.
Technorati Tags: , , ,

Creative Suicide Attempts: Intravenous Injection of Rattlesnake Venom

From The Southern Medical Journal - Volume 99(3) March 2006 p 282-284 Suicide Attempt by the Intravenous Injection of Rattlesnake Venom:
A 14-year-old male milked the venom from a rattlesnake and injected it with a syringe into his right antecubital vein in a suicide attempt. He immediately developed severe pain and vomiting, then hypotension, swollen lips and tongue, and coma. The injection site did not have the considerable tissue damage seen with severe rattlesnake envenomation. Critical hematological abnormalities, gastrointestinal bleeding, and hematuria developed over 24 hours. He received crotalidae polyvalent immune fab (ovine) antivenom and was discharged after 5 days without sequela. This patient's clinical findings were similar to those seen in patients bitten by rattlesnakes with rare intravenous envenomation.
Technorati Tags: , , ,

Doctor Stories #12: "It's a liver."

Via Push Fluids:
Chief Resident: (Wearing gloves, holding a tied up grocery bag.) Glasses, will you throw this in a red biohazard bag?
Dr. Glasses: (No gloves for me.) Er, what's in the bag?
CR: It's a liver.
Technorati Tags: , ,

Getting "Chipped" - Interviews with RFID Pioneers

Via Make Magazine:
I met up with a bunch of RFID innovators at the Seattle Dorkbot Gathering at the COCA art gallery. These folks are implanting RFID chips into their bodies and making cool projects that they can interface with. These RFID tags are tic-tac sized and are the same kind of thing that many pets have so that they can be identified if found. Flat versions can be found in library books too. In this video I interview Amal and Jennifer who have both been "chipped." You'll also see Phillip get injected with his own RFID tag. It's a big needle and so this video is not for those who throw up or pass out at the sight of big needles.
Technorati Tags: ,

FDA Says 2 More Women Have Died After Taking Abortion Pill

From The Washington Post:
The Food and Drug Administration reported yesterday that two more women have died after taking the RU-486 abortion pill, bringing to seven the number of fatalities associated with the drug since it was approved for use in 2000.

The agency said that it was investigating the new reports, provided by the manufacturer of the drug, but so far was not able to confirm any cause of death. In four earlier fatalities of California women who had undergone medical abortions, the victims died of a form of blood poisoning caused by Clostridium sordellii, a common but rarely fatal bacterium.
Technorati Tags: , , , , ,

"Congratulations! You created dopamine neurons." (Virtual Stem Cell Laboratory)

From Children's Hospital Boston:
This interactive feature gives you the chance to manipulate embryonic stem cell growth and differentiation in your own virtual stem cell laboratory. It presents you with a dynamic, self-replicating "culture" of embryonic stem cells. At your disposal is a choice of factors. Do nothing and the cells will continue to replicate, but all of the new cells will also be embryonic stem cells. By selecting a certain sequence of these factors, however, you should be able to create muscle cells, neurons and other cell types, as well as the intermediary cells that lead to the specialized ones.
Technorati Tags: , ,

Friday, March 17, 2006

Robot Snake

From TechEBlog, ACM-R5 Amphibious Snake-Like Robot:
Powered by a lithium-ion battery, the ACM-R5 is a radio-controlled amphibious robot designed to move like its real world counterpart. It can slither or swim underwater for 30 minutes on a full charge. Inside, you’ll find an intricate sensor system (attitude/torque), small-sized camera, and a 32bit micro controller.
Impressive. Go see. Via William Gibson.

Technorati Tags: ,

Hilarious Journal Articles #44: Soap Operas and Talk Shows on Television are Associated with Poorer Cognition in Older Women

From the Southern Medical Journal:
Background: No information exists regarding whether a favorite television category choice affects attention, memory, or cognition among older women.

Methods: Cross-sectional data from a population-based community sample of 289 older cognitively and physically intact women who were surveyed about television use. The cognitive battery included measures of psychomotor speed, executive attention, immediate and delayed verbal memory, and global cognition.

Results: Talk shows (P 0.05) or soap operas (P 0.05) as a favorite television category were consistently associated with poorer scores on all cognitive outcomes in both unadjusted and adjusted analyses. Clinically significant cognitive impairment across domains were associated with watching talk shows (OR = 7.3; 95% CI = 1.9, 28.4) and soap operas (OR = 13.5; 95% CI = 3.7, 49.5).

Conclusions: Clinical interviews can incorporate questions about television viewing habits. Endorsements of talk shows or soap operas as frequent and favored television programming may identify those at risk for cognitive impairment and targets for further cognitive screening.
Technorati Tags: , , , ,

Doctor Stories #11: Questions

From Intueri:
What if he has schizophrenia? What if this is just the beginning? What if his brain is slowly cracking and is about to shatter into a million pieces? What if this is the last time he will ever have a somewhat firm grasp on reality? Does he realize that he has changed? Does it scare him? How does he explain it to himself? To everyone else?
Technorati Tags: , , , , ,

The Respiratory Rate As Secret Code

From Blogborygmi:
I've noticed that our ED's nurses, when they want to bring to my attention a patient's tachypnea, actually record "19" or "21" as the respiratory rate ... It's like they're sending me a secret code through the vitals that not all is well. Sometimes, when things are busy, this can be our only interaction -- so it's particularly sly and efficient.
Technorati Tags: , , , ,

Physician, Divest Thyself (Article on Cleveland Clinic in American Journal of Bioethics)

From the American Journal of Bioethics:
Peter Levin and I penned the editorial in the current issue of AJOB on an issue that attracts more readers to this blog than most others: continuing controversy concerning Cleveland Clinic cardiovascular docs Eric Topol and Toby Cosgrove. Here's our take: Cleveland Clinic is among the world’s elite healthcare institutions, and is a major initiator of improvements in cardiac care. It also is one of the last healthcare institutions in the country still under the complete control of physicians. The Clinic’s CEO, cardiac surgeon Dr. Delos “Toby” Cosgrove, answers to no academic officer or faculty senate. The Cleveland Clinic stands for physician independence, and that is what is in jeopardy. Patients expect physicians to make judgments on treatment solely based on their needs and wishes, not on the economic interests of the physician...
Technorati Tags: , , , , ,

National Resident Matching Program Results (Match Day 2006)

A review of the National Resident Matching Program Results by A Chance to Cut is a Chance to Cure:
The annual exercise of medical student flagellation took place yesterday. The review of the statistics provide a glimpse of how medical students are voting with their feet.
Technorati Tags: , ,

Flickr: 富士山 (Mt. Fuji)

From Flickr. Uploaded by /\ltus on 13 Mar '06, 1.39pm PST.

Thursday, March 16, 2006


I'm interested in this. Does anyone have an invitation?

From the Website:

MyMedwork is a unique professional network that helps
physicians connect, search, and find information on the
basis of trusted relationships.

Member Benefits:
  • A Visible, Extended Network of Physician Colleagues
  • Time-Saving Personalized Search
  • Secure, Spam-Free, Peer-to-Peer Message System
  • Free, Auto-Generated, Customizable, Public or Private Web Site
Technorati Tags: ,

Review of "Body Brokers" In Wired

In Wired:
Want to buy a head? On the American body-part market, the going price is between $500 and $900, plus another $50 if you'd like the brain, too. A torso will set you back as much as $3,000, while a single foot could cost $650.

At these prices, there's plenty of temptation for people to take advantage of the dead. But as a disturbing new book reveals, the burgeoning trade in human remains is largely unmonitored. Universities, mortuaries and medical companies routinely buy and sell arms, legs and elbows with virtually no oversight.

The inevitable result? Crooked deals, stolen corpses and lots of looking the other way.
Technorati Tags: , ,

More On Milosevic-Range Hypertension

Some Milosevic Doctors Call Care by Tribunal Inadequate - From The New York Times:
By January his blood pressure readings became increasingly erratic, with levels as high as 260/180, Dr. Andric has said in the Serbian press. Irate at charges that he had not been taking his medicine, Mr. Milosevic agreed to new blood tests. It was in part that examination that led prison doctors to suspect foul play, perhaps by Mr. Milosevic, Dr. Uges said. Was there some substance that would nullify the blood pressure medicines? "We realized that the only thing that could do this was rifampicin," he said. A blood sample was found to contain the compound.
Technorati Tags: , ,

Recent Patient Quotes

(Submitted by a reader.)

"I have a mine grain headache."

"I don't need to use birth control. I've been sediment for two years."

On a form asking if the patient has used any medications or taken any drugs, and if so, for what reason: "Weed. No special reason."

Surrogate Decision Makers May Be Wrong One Third Of the Time

From The Archives of Internal Medicine -- The Accuracy of Surrogate Decision Makers: A Systematic Review, March 13, 2006, Shalowitz et al. 166 (5): 493:
Background Clinicians currently rely on patient-designated and next-of-kin surrogates to make end-of-life treatment decisions for incapacitated patients. Surrogates are instructed to use the substituted judgment standard, which directs them to make the treatment decision that the patient would have made if he or she were capacitated. However, commentators have questioned the accuracy with which surrogates predict patients' treatment preferences. Methods A systematic literature search was conducted using PubMed, the Cochrane Library, and manuscript references, to identify published studies that provide empirical data on how accurately surrogates predict patients' treatment preferences and on the efficacy of commonly proposed methods to improve surrogate accuracy. Two of us (D.I.S. and D.W.) reviewed all articles and extracted data on the hypothetical scenarios used to assess surrogate accuracy and the percentage of agreement between patients and surrogates. Results The search identified 16 eligible studies, involving 151 hypothetical scenarios and 2595 surrogate-patient pairs, which collectively analyzed 19 526 patient-surrogate paired responses. Overall, surrogates predicted patients' treatment preferences with 68% accuracy. Neither patient designation of surrogates nor prior discussion of patients' treatment preferences improved surrogates' predictive accuracy. Conclusions Patient-designated and next-of-kin surrogates incorrectly predict patients' end-of-life treatment preferences in one third of cases. These data undermine the claim that reliance on surrogates is justified by their ability to predict incapacitated patients' treatment preferences. Future studies should assess whether other mechanisms might predict patients' end-of-life treatment preferences more accurately. Also, they should assess whether reliance on patient-designated and next-of-kin surrogates offers patients and/or their families benefits that are independent of the accuracy of surrogates' decisions.
Technorati Tags: , , ,

Government Health Researchers Pressed to Share Data at No Charge

From The Washington Post:
Political momentum is growing for a change in federal policy that would require government-funded health researchers to make the results of their work freely available on the Internet.

Advocates say taxpayers should not have to pay hundreds of dollars for subscriptions to scientific journals to see the results of research they already have paid for. Many journals charge $35 or more just to see one article -- a cost that can snowball as patients seek the latest information about their illnesses.
Technorati Tags: , ,

Wednesday, March 15, 2006

Hilarious Journal Articles #43: The Case of the Second Tongue

From General Dentistry:
A 20-year-old woman had a hypertrophic lesion of the tongue (25 mm in diameter) associated with a recent piercing. She was concerned because the tissue looked like “another tongue.” Diagnosis and practical therapy for this case is discussed and the post-treatment status is described.
Technorati Tags: , , ,

Is Your Pet Infected With A Computer Virus? -- Study Demonstrates Possibility of RFID Viruses

From the RFID Viruses and Worms Press Release:
Has your dog or cat contracted a computer virus? It’s not impossible. These days, large numbers of pets and livestock have a small chip implanted under the skin so that they can be identified if they stray or turn out to be infected with a disease. As these chips only have a limited memory capacity, it was widely assumed that they could not become infected with a computer virus. However, researchers at VU Amsterdam have now discovered that this is a real possibility. Fortunately they have also come up with a number of adequate countermeasures.

The chips in question are called Radio Frequency Identification Tags, or RFID tags. These are small, relatively cheap microchips, which can be used to tag supermarket products, for example. They can also be implanted into pets or livestock. The same chips are used in public transport chip cards, ski passes or on baggage labels at airports.
The paper -- "Is Your Cat Infected with a Computer Virus?" -- is here.

Cardiology Quote of the Day

Regarding the inability to resuscitate many people with cardiac arrests: "Death is a common complication of death."

Use of Implanted Patient-Data Chips Stirs Debate on Medicine vs. Privacy

From The Washington Post:
Using the system, emergency-room doctors could scan unconscious or incoherent patients to quickly check their blood type and find out if they are taking any medications or have allergies or other medical conditions. Nurses could identify family members and determine whether patients are organ donors or have living wills. Surgeons could scan patients on the operating table to make sure they are working on the right person.

VeriChip Corp. of Delray Beach, Fla., is selling kits containing scanners and the large-bore needles used to insert the chips, and recommending that doctors charge patients about $200 each. The company has sold about 2,500 chips worldwide for use in people, and several hundred have been implanted, including about 100 in the United States, spokesman John Procter said. So far in the United States, however, most of the chips have been implanted into the company's own employees. Suspecting that many people are hesitant to get the chips until more emergency rooms are able to scan them, the company has begun giving scanners to hospitals for free, Procter said.
Technorati Tags: , , , ,

Tuesday, March 14, 2006

Wireless, Implantable Drug Delivery Devices

Chronic, programmed polypeptide delivery from an implanted, multireservoir microchip device, in Nature Biotechnology:
Implanted drug delivery systems are being increasingly used to realize the therapeutic potential of peptides and proteins. Here we describe the controlled pulsatile release of the polypeptide leuprolide from microchip implants over 6 months in dogs. Each microchip contains an array of discrete reservoirs from which dose delivery can be controlled by telemetry...

Stem Cells Harvested from Menstrual Blood

Via ABC:
At the meeting of the American College of Cardiology, Dr Shunichiro Miyoshi reported that he and his colleagues at Keio University in Tokyo collected menstrual blood from six women and harvested stem cells that originated in the lining of the uterus.

They were able to obtain about 30 times more stem cells from menstrual blood than from bone marrow, Miyoshi says.

The stem cells were then cultured in a way to induce them to become heart cells.
Technorati Tags: , ,

Ransomware: Trojan Cryzip Extorts Decryption

From ZDNet:
A Trojan making the rounds encrypts victims' files and demands a $300 payment to have them decrypted and unlocked...
Technorati Tags: , ,

Treating "Prehypertension" with Atacand (Candesartan) -- The TROPHY Study

Two third of patients with "prehypertension" develop hypertension within four years (!). Candesartan , an angiotensin-receptor blocker, apparently delays (or prevents) the development of hypertension.

I'm betting that treating patients with BPs of 130s/80s will become the new standard.

From the New England Journal of Medicine -- Feasibility of Treating Prehypertension with an Angiotensin-Receptor Blocker:
Background Prehypertension is considered a precursor of stage 1 hypertension and a predictor of excessive cardiovascular risk. We investigated whether pharmacologic treatment of prehypertension prevents or postpones stage 1 hypertension.

Methods Participants with repeated measurements of systolic pressure of 130 to 139 mm Hg and diastolic pressure of 89 mm Hg or lower, or systolic pressure of 139 mm Hg or lower and diastolic pressure of 85 to 89 mm Hg, were randomly assigned to receive two years of candesartan (Atacand, AstraZeneca) or placebo, followed by two years of placebo for all. When a participant reached the study end point of stage 1 hypertension, treatment with antihypertensive agents was initiated. Both the candesartan group and the placebo group were instructed to make changes in lifestyle to reduce blood pressure throughout the trial.

Results A total of 809 participants were randomized (409 were assigned to candesartan, and 400 to placebo). Data on 772 participants (391 in the candesartan group and 381 in the placebo group; mean age, 48.5 years; 59.6 percent men) were available for analysis. During the first two years, hypertension developed in 154 participants in the placebo group and 53 of those in the candesartan group (relative risk reduction, 66.3 percent; P After four years, hypertension had developed in 240 participants in the placebo group and 208 of those in the candesartan group (relative risk reduction, 15.6 percent; P Serious adverse events occurred in 3.5 percent of the participants assigned to candesartan and 5.9 percent of those receiving placebo.

Conclusions Over a period of four years, stage 1 hypertension developed in nearly two thirds of patients with untreated prehypertension (the placebo group). Treatment of prehypertension with candesartan appeared to be well tolerated and reduced the risk of incident hypertension during the study period. Thus, treatment of prehypertension appears to be feasible.
Link: Patient Information on High Blood Pressure

Technorati Tags: , , , , , ,

How Not to Get Bitten by Your Dog

Twice in the last three months I've seen patients with minor dog bites and I've counseled them on how not to get bitten by their dogs. This is not trivial. Dogs play hard, and if a dog does not learn to inhibit their bite around humans, he/she could playfully bite a child. Teaching bite inhibition to dogs is critical.

(As an aside, one of the first dialysis catheters I placed as a resident was in a patient with overwhelming sepsis from Capnocytophaga canimorsus related to a playful dog bite. The patient developed kidney failure, required multiple extremity amputations, and died. This helps explain why I'm sensitive to the topic.)

An effective method of teaching bite inhibition is this: If the dog nips you, even slightly, yell OWWW! as if they just bit through your hand. Then get up and ignore them completely for five minutes, at which time normal play can resume. This quickly teaches dogs that biting humans is wrong and it demonstrates the fragility of human flesh.

More information courtesy of Clinical Cases and Images: "Prevention and Treatment of Dog Bites" and a patient handout.

A New Syndrome of Superior Memory: Hyperthymestic Syndrome

From Neurocase:
This report describes AJ, a woman whose remembering dominates her life. Her memory is “nonstop, uncontrollable, and automatic.” AJ spends an excessive amount of time recalling her personal past with considerable accuracy and reliability. If given a date, she can tell you what she was doing and what day of the week it fell on. She differs from other cases of superior memory who use practiced mnemonics to remember vast amounts of personally irrelevant information. We propose the name hyperthymestic syndrome, from the Greek word thymesis meaning remembering, and that AJ is the first reported case.
Technorati Tags: , , ,

Spending on Drug Advertising Slows

Via CBS News:
Client confidentiality prevents Andrew Schirmer from revealing specifics, but it's easy to believe his claim that his job has been especially challenging lately. Schirmer is trying to devise a new ad campaign for Viagra, Pfizer Inc.'s erectile dysfunction drug, at a time when racy spots for impotency pills helped fuel the public's ire over drug commercials. There hasn't been a Viagra TV ad since November 2004, when regulators requested Pfizer halt the commercials because they violated several regulations, including making unsubstantiated claims.

"With all the sex in ads this is the one place where we can't use sex," laments Schirmer...
Technorati Tags: , , ,

Flickr: Exhibitionist

From Flickr. Uploaded by Luís Vieira on 9 Mar '06, 2.16pm PST.

Flickr: I see you

From Flickr. Uploaded by Disgruntled Bookworm on 10 Mar '06, 2.30am PST.

Monday, March 13, 2006

Lipitor Demonstrates Improvement in Kidney Function in Patients With Coronary Heart Disease

Via PRNewswire, commenting on a new analysis of the TNT Trial:
Patients with coronary heart disease (CHD) and elevated cholesterol who took Pfizer Inc's cholesterol- lowering medicine Lipitor (atorvastatin calcium) experienced improved kidney function, and those improvements were significantly greater among patients taking the highest dose (80 mg). The data, from an analysis of nearly 8,000 patients from the Treating to New Targets (TNT) trial, were presented today at the 55th Annual Scientific Session of the American College of Cardiology and published online in the Journal of the American College of Cardiology. "We anticipated that atorvastatin might provide a protective effect and slow the typical decline in kidney function in this patient population, but we didn't expect to see this level of improvement," said Dr. James Shepherd, TNT steering committee member and clinical academic consultant, Department of Pathological Biochemistry, University of Glasgow Medical School. The analysis assessed eGFR, or estimated glomerular filtration rate at the beginning and end of the five-year TNT clinical trial. eGFR is used to measure kidney function -- patients with eGFR of less than 60 mL/min are considered to have chronic kidney disease (CKD). eGFR naturally declines with age. Patients in the TNT study did not experience a decline in eGFR -- patients taking Lipitor 10 mg experienced an improvement in kidney function (5.6 percent) and patients taking Lipitor 80 mg experienced a highly significant increase in kidney function (8.5 percent). Fifty percent of patients taking Lipitor 80 mg were no longer classified as having chronic kidney disease.
Technorati Tags: , , , ,

High Blood Pressure Due to Automatic Blood Pressure Monitors

I'm a fan of automatic arm blood pressure monitors like the Omron HEM series. Most of the time, people appreciate the sense of control and assurance these machines provide. And occasionally, the rare severe case of white coat hypertension will be unmasked. For example, some people have systolic pressures of 180s in the office and 120s at home. So if their medications are increased to treat the high blood pressure in the office, then at home, they pass out from low blood pressure. Blood pressure monitors are enormously helpful in these and other cases.

But rarely, the opposite happens. The occasional person is so unnerved by the blood pressure monitor that it actually causes their blood pressure to increase. Seeing the high reading, in turn, causes them to panic, and they press the button again and again to take more readings, becoming more and more panicked, which in turn causes the pressure to rise even more. This usually results in a frantic phone call.

To try to prevent this from happening, I tell people to take their blood pressure only once after sitting quietly for five minutes. This usually solves the problem.

(As a related aside, Hilarious Journal Article #8 is a letter in the New England Journal of Medicine titled "An Acute Hypertensive Episode Triggered by an Ambulatory Blood-Pressure-Monitoring Device.")

Link: Patient Information on High Blood Pressure

Technorati Tags: ,