Each year, millions of Americans are afllicted with conditions attributed to cardiovascular disease. Of these cases, many adults are experiencing a new conservative approach to treatment involving exercise, diet and the use of simple prescription medications. Of the medication choices, healthcare professionals are turning to the use of Plavix, as a platlet cluster blocking agent. Understanding the use of Plavix, in the risk of cardiovascular disease, the side effects and contraindications of Plavix use, will assist patients with making a more educated healthcare choice in terms of treating cardiovascular disease.
Plavix, manufactured by Sanafi – Synthelaba, is a drug commonly used in patients who have experienced a recent cardiovascular event. As a prescription used to prevent the cluster or clotting of platelets, Plavix is believed to significantly reduce the risk of heart attack, stroke and other coronary artery events. With dosing as simple as one, 75 milligram tablet per day, Plavix is an easy and safe alternative to the other therapeutic cardiovascular drugs on the market.
As with most FDA approved medications, the use of Plavix, in the treatment of acute cardiovascular conditions, does not come without side effects and contraindications. For patients with a sensitivity to aspirin, Plavix may produce similar results in response to treatment of the cardiovascular condition. Additonal side effects may also include increased bleeding, loss of vision and gastrointenstinal pain. When symptoms are persistent and do not dissipate, consultation with a physician is recommended however most common side effects will generally disspate through the course of treatment. In addition to these dissipating side effects, patients using Plavix may also experience respiratory distress, depression, rash and urinary tract infections. When these symptoms present, consultation with a physician may be necessary.
For women who are pregant or may become pregnant, the use of Plavix is not recommended. As a Category B drug, it is not clearly known what role Plavix may play in terms of fertility and the implications on a fetus. Additionally, the use of Plavix in the cardiovascular patient, including those patients who presently suffer from a blood clotting disorder, is not recommended as Plavix provides similar effects to that of aspirin; a thinning blood.
As with any cardiovascular treatment, the primary goal is to reduce the risk of a cardiac event, which may lead to death. When considering a cardiovascular program, diet and exercise are vitally important. In addition to controlled diet and exercise, the use of prescription medications will provide the most optimal treatment outcomes. For information regarding Plavix use, visit www.plavix.com and consult a cardiovascular specialist.
What a week! And it’s only Thursday. Besides the usual and expected problems of running out of paint, losing things, losing volunteers, people being late, lack of hot water, lack of space, and just general chaos that exists when 25 people share the same living space, we have had a plague descend on our house. Literally.
We started off with 25 volunteers. One of them got either mono or strep throat the day before they were supposed to leave and had to drop out last minute, which left us with 24. Yesterday (Wednesday), two of the volunteers started feeling bad after lunch time at the placement, so I sent them home to sleep, which left us with 22. Later that evening, one of the two said that he was really not feeling good, so I had to take him to the hospital, where it turned out that he had a gastrointestinal infection. They gave him an IV and prescribed a bunch of medicine.
Today (Thursday) morning, 7 more volunteers said that they weren’t feeling well and had been vomiting all night, so Ana Maria took all seven of them to the clinic, with the group leader who opted to stay with them, while I took the rest of the volunteers to the placement, which left me with 14. After at the placement a few hours, a few of the other volunteers were not feeling well. One of them took a pill which she turned out to be allergic to, and started having a reaction. I had to rush her to the ER with another volunteer who wanted to come with her, which left 12 at the placement. While I was at the ER, I got a call from the placement saying that two more of the volunteers were feeling sick and wanted to go home. From the ER, I arranged our bus to take them home, and Ana Maria took them to the clinic.
I headed back to the placement when the girl with the allergy was safely at home and treated, and only had about a half-hour left of time to work. When I got back there, I discovered two more people sitting out, and one working despite having thrown up a few times. So I had the bus take everyone home. On the bus, one of the people who had been sitting out started shaking a lot, so when I got home I took her to the clinic too, leaving only 9 healthy people.
Some thoughts:
I got to witness 3 different IVs in less than 24 hours. I hate needles, and I hate hospitals.
When I was in the ER with the girl with allergies, the friend that came with left his shirt back at the placement, because it was hot. Nearly every person there asked me if we had just come from the beach. One person took me aside and told me that it wasn’t proper for my friend to be walking around without a shirt.
I was sitting in the waiting room, sitting cross legged, when a lady told me to put my feet down. I did, assuming she wanted me to not get the seat dirty, but it turned out she was concerned that I wasn’t being ladylike.
What were they sick with? There are a few exceptions, but I think it was a reaction to something they ate combined with the fact that they had been partying hard all week, not sleeping well, dehydration, and spending every day in the hot sun. Moral of the story? Get lots of sleep, drink lots of water, and wear clean underwear when you leave the house, just like mommy said.
Earlier this year I wrote a post (along with fellow Sciblogger Grant) concerning the sale of homeopathic remedies in pharmacies. Monday night saw the release of England’s Science and Technology Committee’s “Evidence Check 2″ report on Homeopathy (also ably covered by Grant). One of the issues covered by the report is that of pharmacy responsibilities regarding sale of these remedies. Essentially the report recommended that sales continue but with adequate disclaimers stating that there is no scientific evidence that homeopathic products work beyond the placebo effect.
I see this as a compromise between commercial freedom to sell safe, though not necessarily effective, products and patient informed consent. It’s reasonable even if I disagree that it is ideal. Regardless, I thought it was a good excuse to look once again at our own pharmacies and see how the selling of scientifically unsupported remedies aligns with their professional responsibilities.
Enquiring into this area I was directed to the Pharmacy Council Code of Ethics for pharmacists. The Pharmacy Council seems to fill the function of professional association and regulatory body for pharmacists their functions including:
prescribe the qualifications required for scopes of practice within the profession, and, for that purpose, to accredit and monitor educational institutions and degrees, courses of studies, or programmes
and
consider the cases of health practitioners who may be unable to perform the functions required for the practice of the profession
Perusing the Code of Ethics (which may be found Here) I found a number of sections that I feel should preclude pharmacists from selling homeopathic remedies in good conscience. In order to try and represent the spirit of the code as accurately as possible I have included here both the relevant over-arching Principles that pharmacists should strive for as well as the Specific Obligations that I feel make my point (any emphases are mine).
The first principle is one of patient autonomy:
Principle 1: Autonomy The pharmacist shall promote patient
self-determination, respecting the
patient’s right to understandable
information, privacy, and confidentiality
1.4 Professional services Where the patient is seeking or receiving, from the
pharmacist or from other personnel for whom he or
she has responsibility, any professional service or
intervention, the pharmacist must ensure that the
patient is provided with credible, understandable
information about reasonably expected results,
outcomes or effects of the service or intervention, any
risks of receiving the service or intervention, and any
insufficiency of evidence about the efficacy of the
service or intervention, to allow the patient to make
an informed choice.
This to my reading implies that should pharmacists sell homeopathic remedies they are obligated to inform the patient of the lack of scientific underpinnings for the use of the remedy. One of the objections I have run into regarding the sale of these remedies in pharmacies is that they are commercial enterprises and are within their rights to sell products regardless of their medicinal value. This is partially true but these remedies are specifically sold to treat symptoms, not as entertainment, confection or cosmetic. The Code has several entries covering this aspect the first of which is:
1.5 Independent information The pharmacist must ensure that their advice is
independent of personal commercial considerations.
Does this not imply that the sale of unscientific medicines should not be undertaken simply because it make financial sense? We will return to this point later.
The next Principle covers patient needs:
Principle 2: Beneficence The pharmacist shall optimise medicines
related health outcomes for the patient
according to their concerns, needs,
cultural values and beliefs
2.2 Quality use of medicines
The pharmacist must provide scientifically-based,
unbiased medicines information to healthcare
providers, patients and the community in order to
optimise medicines related health outcomes.
My reading of this point leads me to understand that any information provided regarding pharmacy products must have scientific backing and moreover must not be biased by the pharmacist’s own views. Any such information regarding homeopathy must therefore be negative.
But, what if the pharmacist is not asked for this information? After all, I do not usually go in asking for a lecture if I already think I know what I need. I think the next obligation covers this instance:
2.8 Involvement in sale of medicines and other
therapies
The pharmacist must be involved and intervene in the
sale of any medicine, complementary therapy, herbal
remedy or other healthcare product whenever this is
necessary to ensure a reasonable standard of
pharmaceutical care.
Scientifically speaking homeopathy should not be considered to encompass a “reasonable standard of pharmaceutical care”.
The next Principle of relevance concerns fairness:
Principle 4: Justice The pharmacist shall practise fairly and
justly and promote family, whanau and
community health
4.4 Commercial interests not to override good
practice The pharmacist must ensure that commercial interests
are not permitted either to override the independent
exercise of their own professional judgement on
behalf of a patient or to compromise the standard of
care provided by them or to affect their cooperation
with other healthcare providers.
Once again the issue of financial gain over patient care is addressed with commercial interests coming off second best when the standard of care is concerned.
The next Principle is one I feel is of especial importance when the reputation of pharmacists in the wider community is considered and their self representation in the media is a factor (remember, they’re the health professional you see most often). This is trustworthiness, pharmacists are seen as, and promote themselves as, first and foremost medical professionals not business interests. The sale of homeopathic medicines is antithetical to this position and undermines their credibility in this regard, in direct contraction to the Code of Ethics as follows:
Principle 7: Trustworthiness The pharmacist shall act in a manner
that promotes public trust in the knowledge and ability of pharmacists
and enhances the reputation of the
profession
7.7 Non-medical goods and services The pharmacist must not purchase or sell from a
pharmacy any product or service which may be detrimental to the good standing of the profession or bring the profession into disrepute.
If the sale of scientifically worthless remedies such as homeopthy does not do this I don’t know what would, perhaps offering Therapeutic Touch?
Finally the Principle of dignity undermines the pharmacist’s sale of unsupported medicines:
Principle 8: Dignity The pharmacist shall provide
information about professional services,
medicines and healthcare products in a
dignified manner without making
exaggerated or unsubstantiated claims
8.4 Medicines not ordinary articles of
commerce A pharmacist must only participate in promotional
methods that do not encourage the public to equate
medicines with ordinary articles of commerce.
If the previous examples of why remedies should not be sold with the sole purpose of earning money for the pharmacist this should put that argument to rest. The sale of medicines (which many people consider homeopathy to be) should not be equated with ordinary articles of commerce. This puts the lie to arguing that these remedies are simply another commodity to be bought and sold like chewing gum regardless of therapeutic value.
8.8 Evidence of efficacy
The pharmacist must only promote to a potential
purchaser that any medicine, complementary therapy,
herbal remedy or other healthcare product associated
with the maintenance of health is efficacious when
there is credible evidence of efficacy.
This last obligation explicitly refers to promotion of a therapy to a patient by the pharmacist which I don’t think any reputable pharmacist would do for homeopathy but arguably the presence of the product in the store constitutes an implicit promotion of it to potential customers. This point goes back to the principle of trustworthiness, the public trusts the pharmacist to stock efficacious products. To include unscientific therapies among their wares undermines and betrays this trust. Perhaps I am naive to think so but I think the Pharmacy Council’s own Code of Ethics backs me up when I say that we should hold pharmacists to a higher standard than your average shop owner.
Related articles by Zemanta
Homeopathy and Pharmacy (blacktriangle.org)
No to homeopathy placebo | Edzard Ernst (guardian.co.uk)
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Jack Benny Part 1
Jack Benny Part 2
How Jack Benny found Mary Livingston
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Jack Benny vs. Groucho 1955
Rochester’s on strike too
Rochester’s on strike too
Jack Benny Kills Mel Blanc
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Rochester’s on strike too
Related Posts On Pronk Palisades
The ocean is the home of the shark, and the forest is the home to the wood pigeon.
Kia ora from Aetearoa again! Two week of lecture block is now over!! For the past fortnight, everyday was filled with lectures and lectures and lectures! Without fail it would be from 830 to 4 or 5 at times. Basically we recapped a number of CVS,Respi and MSK pathologies but with more clinical orientation. Hence medicine was making more sense. And amongst the interesting lectures were Maori and Pacific Health. Thus the title of this post: came across this when we we being briefed about the protocols of visiting Orakei Marae. That’s the sort of HQ for one of the Maori clan over here in Auckland. We had two and half days of lectures and language classes solely on this area. It was interesting to acknowledge that the Pakeha ( Europeans) actually admit that they had and are being racist yet they did nothing much about it! Ironic to the title, the Pakeha’s oblivious to such, being originally an immigrant themselves, they have taken over Aetearoa by cunning mischiefs and sheer force, reducing the Maori and the Pacific to just the minority and yet claiming the land as their own. Doesn’s that just sound too familiar??
Other than that, life’s good. Having mini excursions around town. And for next week, the real medicine begins! Will be starting a 6 week run (Postings are known as runs here) on Psychiatry! hohoho!
Training to become a doctor is a long, frequently arduous process: pre-med, pre-clinical years, clerkships, and finally residency and possibly fellowship before one can finally set up practice independently. Most people who make it into med school eventually finish, at least in the U.S., but despite the best efforts of the admissions offices, many students struggle to get through, and others do not find life as a physician as satisfying as they had supposed.
Enter the personality test. This study reports on how the Big 5 personality traits affect performance in medical school. Unsurprisingly, students who scored high in measures of conscientiousness did well in both their basic science and clinical training, while extraverts improved substantially once the focus shifted to patient care. In further confirmation of the obvious, openness and agreeableness were found to be beneficial, and neuroticism harmful to academic performance.
This NY Times summary of the paper suggests a personality test in lieu of MCATs for applicants. As much as an awesome improvement that would be to the application process, it seems redundant: college transcripts offer a pretty easy way to screen for conscientiousness, and the interview gives adcoms the chance to weed out folks that lack social skills. Plus, the neurotic fraction of pre-meds would obsess over the “right” answers anyway, ultimately defeating the utility of the test.
A better use of personality tests in medicine could be in choosing a potential specialty. People tend to cluster in fields where they like their colleagues or the lifestyle, with the result that specialties develop personalities of their own. Orthopedic surgeons have a reputation as jocks, since it’s a field to which young athletes are frequently exposed. Pediatricians are frequently women who want a family-friendly specialty, or, according to one pediatrician I know, short men. This guide to choosing a specialty breaks down the major fields by Meyers-Briggs type, and the results seem pretty spot-on: as an INTJ, I like puzzles but am not detail-oriented; the book suggests people of my temperament do well in problem-solving specialties like neurology, pathology, and internal medicine.
Ultimately, I don’t think personality type is that important. In my (limited) experience, success in medical school seems to depend on: i) liking people, and ii) being willing to do the work. Oh wait, that’s…extraversion and conscientiousness. I guess personality is destiny after all.
It’s reading week. I figured I’d try to catch up on 2 weeks worth of neglected neuro, but it’s hard to focus when there’s a cliff around the corner and an epiphany in my rearview.
I’ll explain what that means.
3rd year is creeping up faster than I expected; electives, tracks, getting ”P-I-M-P-ed” and the whole shabang. It’s time to decide what I really want to do for the rest of my life. And that’s not even the hard part …fighting to get there will be. Like those couple of months before May 15, I think I’m approaching another junction in life that involves putting as much unmitigated, naive ambition as possible into a small, unforgiving metal cage, and watching it swirl viciously around on itself, biting and clawing tooth and nail, until some parties, unfortunately enough, perish under the pressure…unmatched so to speak. Ugh.
Truthfully, it’s probably not going to be that bad. Not like undergrad. Or the Olympics (haha, they’re on TV right now, broadcasting from Vancouver!, if you’re wondering about the awkward allusion …another source of distraction from neurology). Still, the whole idea of having to strategize that hard again, just to assure oneself of a non-ambiguous future, makes it feel like Darwin doesn’t let up. Ever. (There’s an R4 match in medicine too..fantastic).
How to do what elective when, how to look good in front of program directors, how to behave at learning-time vs. audition-time, how to book at more than one site so you can guarantee yourself multiple interviews when CaRMS rolls around, how diversify your experience enough to seem well trained in all medicine but also dedicate the impossible 6weeks to ’holy grail’-ing …yadda yadda yadda
Too many strategies, too little brain space, almost no time. – That’s the cliff around my corner.
I guess it would help if I had a starting point and actually knew what ‘grail’ of a specialty I was chasing. Stupidly though, I have no idea. They always say you can at least pick between surgical and medical in your first two years…something about this inherent ‘dichotomy’ in any group of med students. Seriously? Maybe this means I’m actually Palestinian-Israeli (sorry, should watch the PC here, I just couldn’t find any other flagrant, contradictory analogies for my surg and med inclinations).
In all seriousness, I really don’t know what I’m going to do. I told EZ the other day, when I was walking with him to the bus stop, that every field has its ‘bread and butter’ and I’m not sure I want to eat carbs for the rest of my life.
His response (apart from ‘you should do anaesthesia – hands of a surgeon, mind of an internist… paid per hour to do sudoku…pretty sweet’) was that I should figure out who I am and go from there…ie the whole ”what fits best with your personality”-argument. It’s a good point, and I have given it thought, especially over the summer. I just never come up with useful, definitive conclusions.
To hazard at lame cliches, I feel like I don’t know who I am.
That was the epiphany I mentioned earlier. Lame, I know. So lame. But it’s true.. we went on a ski trip to Sunshine/LL and I spent a lot of time with the usual group. The only thing different was that a couple of non-PC jokes (Asian vs. Canadian athletes in the Olympics) came up over hot chocolate by the TV. Normally, I’m the one cracking the jokes, and I don’t mind, but since that pre-Christmas blunder at Avenue over discussions of MJ, I’m more than hesitant in my interpretation of ‘joking’. Maybe that’s why I’ve never melded completely with the group? Inherently, I’m different… not just the skintone or eyes (haha, I’m not turning this ‘who am I and what kind of doctor should I become?’ into a totally unrelated discourse on racial identity a la Asian North American Literature no, I just mean that I don’t have the same commonality of experience as most people who surround me …and as a consequence, I don’t really know how to put a finger on my ‘personality’?…hard to explain).
Think of it this way, in terms of the games you used to play as a child. To a certain degree (ugh, getting all philosophical, sorry), the games define your culture of ‘growing up’, who you are, your paradigm and personality. They probably unwittingly define what types of people you gravitate toward and what activities/positions/responsibilities you’re most content with later in life (ugh, desperately trying to draw some med-career-relevance from this disjointed ramble). So childhood games…what kind of person am I, and will I like prescribing more than cutting?
Well, I’m not the small-town kid who raced to the hockey rink every Saturday morning, went camping with my family in the summertime, sped around on a skidoo in the winter, hiked or fished a lot, drank tons of beer when I first got into university, rode in the back of my dad’s pickup, or ran around the park with my huge golden retriever…etc
I’m also not the kid who lived in the white mansion with regal black roof at the top of the hill (sorry, looking at too many facebook pictures of SP’s Harvard friends.. makes me a little queasy to be honest). I never wore pastel polos and overpriced childrens’ khakis, rode family horses, ate meals prepared by a live-in chef, spent summers in the hamptons, or subconciously looked down at poor, ethnic kids and addressed them as “they“. I never played with golf clubs, antique porcelaind dolls, or stocks.
I’m definitely not the chirpy, happy, eternally-overly-optimistic, glasses-wearing, church-fellowship-going, studies-4-months-before-any-major-exam Asian crew (yes, ironic *see above about racial identity). My parents also failed to beat me into a piano prodigy, chess champ, badminton star, or 21-year-old physics PhD.
So what am I? Where’s my personality? And what career should I pick accordingly? Perhaps there’s some specialty out there perfect for the indecisive, confused, and lonely. Those kids used to play with popsicle sticks, chopsticks, bake-able Fimo, and elastic bands, trying to construct a makeshift lollipop spinner like the electric ones at Walmart, which their mom wouldn’t buy because it seemed like a waste of hard-earned post-doc salary. When the spinner failed, those kids resorted to building tiny bird-nest models with toothpicks and cotton balls. There must be a field/residency that corresponds to this category of childhood game. A specialty both thoughtful and practical; cerebral and sort-of hands-on. Something few can understand or master, because all the doctors practicing it refuse to fit properly into a predefined group.
Ever notice your friends smoke cigarettes when they drink, but not when they’re sober? Ever wonder why? Like everything else, there is a motivating factor. Nicotine and alcohol share addictive properties but in combination the effect elevates pleasure centers x2!
Heres how: Smoking in combination with drinking increases levels of the “do-all” neurotransmitter dopamine. Elevation of dopamine effects a collection of neurons within the striatum, a subcortical part of the forebrain, called the nucleus accumbens. In turn the nucleus accumbens mediates the pleasure center of our brain. Alcohol and nicotine, as well as other drugs of abuse, increase dopamine in the nucleus accumbens, which is a key reinforcing aspect of addiction.
While one part of our brain is pleasuring itself, another is experiencing a game of push and pull.
Monoamine oxidase (MAO) is a naturally occurring enzyme that breaks down monoamine neutrotransmitters such as dopamine. MAO inhibition is a property of nicotine and alcohol and when consumed together the buildup of dopamine ensures a more pleasurable outcome.
Now, this is definitely not a reason to start smoking cigarettes while you’re drinking. The side effects of the drug combination include hypertensive crisis i.e. high blood pressure, tachycardia, hypomania, seizures, hepatoxicity just to name a few.
Richard Sole and Brian Goodwin compiled a book detailing the applications and seemingly inescapable presence of complex systems in the biological sciences in their pioneering book Signs of Life: How Complexity Pervades Biology. Now let me begin by saying that this is not light reading and probably not for everyone. That is not to say you need a science background to understand this book. The authors did a wonderful job of separating the technical science and math from the main themes of the book and use a multitude of pictures, diagrams, graphs, charts, and figures to detail their thesis.
Signs of Life
Scientists have long reconstructed systems and analyzed their individual parts to understand how they fit together with regards to the whole. It has worked wonderfully for some time. However, now scientists are realizing that in nearly every field of biology from cellular and molecular biology to ecology and physiology that analyzing the parts of the whole simply does not yield predictable behavior. Why do certain stem cells become skin cells and others become neurons if they have the same genome? Why do some creatures seem to hold up an entire ecosystem if only a small percentage of animals actually eat these species? Sole and Goodwin begin by explaining how nonlinear interactions between individuals form complex systems. This understanding of complex systems and the emergent behavior, that is, behavior that cannot be performed by individual units but can be performed by the system as a whole, can offer us novel ways of approaching these deep problems of biology. Sole and Goodwin show us how issues once considered inexplicable, are now being unraveled and explained with complex systems biology.
Episode 4 takes a look at the state of our nations health, and discovers that the best place to get a view is by looking in our own mirror! Learn why the health care system will continue to fail, and how your personal choices can not only improve your own quality of life, but reduce MY tax burden!
Well, that was the headline we should have gone with. It is of course a hat tip to the Daily Mail, a tabloid publication that is desperate to tell the UK population that just about everything causes cancer. (I found that website by googling ‘cancer causes daily mail’, which is in itself quite a neat headline. Unfortunately I think we’re closer to curing cancer than curing the Daily Mail. Oh well.)
So, we know that tumours have this nasty habit of sending out malignant cells into the rest of the body. They break off from the primary site and get into the blood and lymphatic systems, occasionally washing up in convenient organs where they can settle down and create new tumours, or metastases. This is partly why cancer is so difficult to cure: you can cut out the original malignant growth, zap it with X-rays and take all sorts of evil drugs (‘evil’ because they are designed to kill cells, and you’re made up of cells; and discrimination between the cancer cells and normal cells is a huge problem); but if one metastatic cell survives, you have to start all over again. And if it’s managed to find a home deep in a bone, or the brain, or somewhere equally inaccessible, it’s game over.
It turns out things are even worse than that. Circulating tumour cells, if they find their way back to their original ‘home’, can actually stimulate growth of the original cancer. Nasty. As the authors say,
Tumor self-seeding could explain the relationships between anaplasia, tumor size, vascularity and prognosis, and local recurrence seeded by disseminated cells following ostensibly complete tumor excision.
‘Ostensibly complete tumor excision’—that’s right, because no matter how good your surgeon is, you can never be sure you’ve cut every last bit out; or that some cells haven’t already gone walkabout.
The good news is that certain cytokines derived from the tumour, IL-6 and IL-8, act to attract the circulating cells, and that they get back in via the matrix metalloproteinase collagenase I (MMP-1) and fascin-1 (it’s the actin cytoskeleton again! These guys get everywhere). If we can find a way to selectively block these pathways we should be able to start thinking about appropriate therapeutic approaches. Gentlemen (and ladies), start your (grant-writing) engines.
Kim, M., Oskarsson, T., Acharyya, S., Nguyen, D., Zhang, X., Norton, L., & Massagué, J. (2009). Tumor Self-Seeding by Circulating Cancer Cells Cell, 139 (7), 1315-1326 DOI: 10.1016/j.cell.2009.11.025
Twitter storm
It’s been pretty hectic on the twittertubes this week. Following a random conversation at the Scholarly Kitchen I suggested writing papers in 140 characters would be a wheeze. I turned it into a competition, and we had an amazing response. Check back on Monday to find out who’s the lucky winner of a bag of f1000 swag.
Badger Wars
I don’t have a lot to say about badger culling to prevent/reduce bovine TB (except maybe to say that killing vermin with a high-powered rifle and decent ’scope is one of the most humane ways of doing this).
I just like the sound of a ‘randomized badger culling trial’. Oh, and when someone ‘explains’
This trial was undertaken in very specific circumstances and it could be misleading to extrapolate the findings to any future control program.
you can be pretty sure there’s a vested interest or extreme prejudice somewhere. Even when the trial shows that there’s no economic benefit. Jenkins, H., Woodroffe, R., & Donnelly, C. (2010). The Duration of the Effects of Repeated Widespread Badger Culling on Cattle Tuberculosis Following the Cessation of Culling PLoS ONE, 5 (2) DOI: 10.1371/journal.pone.0009090
Valentine’s Day
Just a reminder to all you chaps out there—it can’t hurt to buy some flowers, even if you don’t want to buy into the whole commercialization thing. A nice dinner doesn’t cost you much either, and could pay dividends in the romance stakes. But at the very least, show you really care by getting checked out:
Take a test for #Valentine’s Day. Sexual health appointments across Lincolnshire within 48 hours. Call 01522 539 145
It gets pretty lonely up there in Lincolnshire. Have a good weekend, and I hope it’s full of lovehearts and kisses. Failing that, a beer or three can have much the same effect.
A Chinese herbal medicine practitioner has not cut his hair for 60 years and keeps it in a bag on his back.
Peng Fu, 79, of Suining, started to grow his hair when he started to learn traditional Chinese medicine at the age of 20.
“From then on to now, 60 years, I have never once cut my hair,” he told West China City Daily.
“My hair started to turn white 10 years ago, but I have not lost much.”
Peng says he loves his long hair so much that he won’t let anyone else touch it, although he admitted he rarely washes it.
He started tossing it into a bag and carrying it on his bag to make his life easier. At the last measurement, his hair was 8ft 10ins (2.7m) long and weighs nearly 9lbs (4kg).
Peng makes a living by digging up herbal medicines from the mountains and selling them in markets.
When I’m at work, I’m all there. It’s all consuming. It swallows me up, whole. When I’m on 12 day blocks, I’ll wake bolt up right thinking of Mrs S’s chest pain or Mr T’s blood pressure. Did I hand them over to the night team, did I finish their work up properly, did I do my best for them? I still haven’t gotten to grips with the fact that each decision is perhaps just one of hundreds in the day for me but may be THE one for the patient. Just because I order tests, stick in drip lines, listen to hearts day in day out; for most of the patient’s in the hospital it’s a time of firsts, from being seen on ward rounds to being taken to theatre. Hospitals are alien. I need to remember just how scary each step can be when you’ve got no idea what’s happenning to you or what the diagnosis might be. And when patients’ get angry, throw a rude comment in my direction and when families demand to know facts and figures, they’re often scared. It is scary and it’s unknown.
“It’s hard. There’s all these wires, all these tubes, all these medicines, all these new words, all these explanations but I just want to know what’s happening.”
I wonder if you ever loose the worry, the waking-bolt-up-right-in-the-night moments, the image face of a patient on a knife edge or the pain etched on the faces of their loved ones. I’m not sure you do. But somehow I think you must become more at peace with your decisions in light of years of experience. At least I hope you do. Otherwise, I’m pretty sure it would be a pretty unbearable exsistence.
In 1922, Canadian scientists isolated insulin for the first time. Now, over 80 years later, our neighbors to the north are helping diabetics again by devising the cheapest way yet to produce insulin. This advance could significantly reduce the expense of treating the disease, which currently costs the US $132 billion dollars a year.
To create the cheap “prairie insulin,” scientists at the University of Calgary genetically engineered the human gene for insulin into the common plant safflower. Once the gene activates, the flower begins producing insulin faster than traditional methods that utilize pigs, cows, yeast, or bacteria.
This is the first instance of a plant producing the insulin, and it does so prolifically, to the tune of 2.2 pounds of insulin per acre of flowers. At that rate, 25 square miles of safflower could produce enough insulin for the world’s entire diabetic population.
(Hat tip to Phil over at Skeptic Money for passing this little gem along )
Below is some footage from a BBC show called Dragon’s Den, where would-be entrepreneurs make a sales pitch to the assembled judges about why their idea is worth funding. In this case, a homeopathic doofus pitches his “miracle water” to them using the standard alt-med, “natural is good” woo-woo, with disastrous results. What follows is, to me, an excellent example of in-your-face skepticism in action – with the perfect combination of hard questioning, demands for evidence & research, and moral outrage. Take a look…
Although the risk of MRSA as posed to athletes is high, wrestlers are at an even higher risk. High school wrestlers are at a high risk for MRSA due to direct contact with the mats. For those who attend tournments, their risk of contracting MRSA increases 16 fold. Health officials are urging all schools to practice precautions in order to prevent further spread of MRSA and other skin infections, such as pimples and boils. Those who carry MRSA are estimated to be in the millions so caution is strongly encouraged. For further information, see:
Urgent Care Providers Tout Benefits of A-Claim Medical Payment Solution
Carrollton, Texas – The American Academy of Urgent Care Medicine (AAUCM) has begun a sponsorship of the A-Claim™ medical payment solution that includes discounts on A-Claim for all AAUCM members.
A-Claim (www.A-Claim.com) is a proprietary medical payment solution developed by Preferred Health Technology Inc. (PHT) of Carrollton, Texas, that is changing the way physicians, hospitals and other health care providers are paid. The system simply and securely verifies patients’ insurance eligibility, provides real-time copayment and deductible responsibilities for each patient, adjudicates insurance claims, and accepts credit, debit or prepaid cards for payment at the time of service, before the patient leaves the office.
By knowing what a patient owes and securing payment at the time of service, physicians can streamline billing procedures, lower collection costs and accelerate cash flow. Patients can authorize payment immediately and avoid sending checks through the mail. Studies show that health care providers collect only about 50 percent of their charges from patients who leave the office without paying.
Franz Ritucci, M.D., AAUCM president, said, “The AAUCM continually seeks out companies that provide valuable products and services tailored to the specific needs of urgent care. We are pleased to have developed this relationship with A-Claim. AAUCM members now have discounted access to A-Claim’s medical payment solutions, giving them the opportunity to utilize A-Claim’s valuable services in their practices.”
A-Claim’s patent-pending technology works with all major insurance plans and any medical office’s practice management or EMR system. It is available for a low monthly subscription fee and minimal transaction charges.
“A-Claim allows the office staff to simply swipe a patient’s insurance card to verify immediately whether the patient is eligible for insurance benefits and to determine the amount of any copayment, coinsurance or unmet deductible the patient will owe,” said Mary Dees Griffith, president of PHT. “This is more important than ever as more patients switch to high-deductible insurance plans and pay more out of pocket for medical services.
“We are pleased that the AAUCM has recognized the benefits A-Claim offers its members and their patients. We look forward to helping members receive accurate and timely payments for the services they provide.”
About PHT
Preferred Health Technology Inc., headquartered in Carrollton, Texas, provides electronic payment and transaction-processing services to the health care industry. Its parent company operates one of the largest health care insurance data center sites in the world in support of Medicare, Medicaid, TRICARE, the Federal Employee Program and Medicare Advantage health plans, as well as other private health plans.
About the AAUCM
The AAUCM represents physicians, physician assistants and nurse practitioners who practice urgent care medicine in various clinical settings throughout the United States. The AAUCM’s purpose is to contribute to the field of urgent care medicine in the areas of professional growth, scientific and medical research, and medical education, all to improve the overall quality of medical care.
All you can do is laugh when your first day back starts, not with “Welcome!”, but with “So, the innervation of the gastrointestinal tract can be divided into intrinsic and extrinsic…”
We are neck deep into week two with a whole case already behind us and no signs of slowing down. Maybe it’s the love and holiday vibes persisting, but I’m actually finding it kind of nice. The expectations of us are so high; to read so much, to learn so much, to condense so much, that even if you only achieve half of what you’re supposed to do you’ve still done a ton of work. I’m happy to just get through it.
I’ve got a different perspective this year and it’s much rosier.
Anthony Brinton Wolbarst, “Looking Within: How X-Ray, CT, MRI, Ultrasound, and Other Medical Images Are Created, and How They Help Physicians Save Lives”
University of California Press | 1999-11-16 | ISBN: 0520211820 | 219 pages | PDF | 85,3 MB
BOOK DESCRIPTION
A hundred years ago, a doctor had no way to look within the body of a patient other than to slice it open. That changed radically at the turn of the century, with the discovery of X-rays. X-ray and other forms of diagnostic imaging technology developed slowly but steadily from then until the 1970s, at which point a revolution occurred. Made possible largely by the availability of powerful but inexpensive computers, the rapid and widespread adoption of computed tomography (CT) and, a decade later, of magnetic resonance imaging (MRI) greatly expanded the power of clinical imaging, and even changed the ways in which physicians view and think about the human body.This unique guide explains how the principal imaging devices work and how they help physicians save lives. It gives readers a grasp of the major medical technologies that might come to play important roles in their lives, and it provides succinct, easy-to-understand, and reliable explanations for those who wish to explore the issues of the associated benefits, costs, and risks in an informed manner. In nonspecialized language, Looking Within discusses how X-ray, fluoroscopic, CT, MRI, positron emission tomography (PET), ultrasound, and other medical pictures are created, and explores the essential roles they play in the diagnosis and treatment of patients. It should be of interest to patients and their friends and loved ones, and to those who are simply curious about this vitally important, exciting, and cutting-edge branch of medicine. Its brief but clear descriptions of how these essential tools work should also be of value to health care providers in supporting and educating their patients.
Whilst researching Dame Hilda Lloyd for our list of great Brummie women, I came across this article in the Times Higher. What a peculiar story. Highly appropriate for here as it links two of the women on our list (Hilda Lloyd and Jane Bunford) and creates an intriguing connection with the fabulous Gracie. We may not be able to claim her as a great Birmingham Woman, but if the story is true, she certainly left her mark on the city in a more direct way than we might have predicted!
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_b.png?x-id=b36090d5-0ba7-4ec2-98dc-b635000b882e)
Episode 4 takes a look at the state of our nations health, and discovers that the best place to get a view is by looking in our own mirror! Learn why the health care system will continue to fail, and how your personal choices can not only improve your own quality of life, but reduce MY tax burden!
I don’t have a lot to say about badger culling to prevent/reduce bovine TB (except maybe to say that killing vermin with a high-powered rifle and decent ’scope is one of the most humane ways of doing this).
Safflower Wiki Commons
)
All you can do is laugh when your first day back starts, not with “Welcome!”, but with “So, the innervation of the gastrointestinal tract can be divided into intrinsic and extrinsic…”