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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Thursday, July 07, 2005

    Terrorists at Rush Hour: London, you're in our thoughts and prayers. Stand strong.

    UPDATES: Tony Blair:

    "It is important, however, that those engaged in terrorism realise that our determination to defend our values and our way of life is greater than their determination to cause death and destruction to innocent people in a desire to impose extremism on the world. Whatever they do, it is our determination that they will never succeed in destroying what we hold dear in this country, and in other civilised nations throughout the world."

    Charles Arthur:

    Brutal - without warning, on people innocent of anything except being somewhere. Pointless - because it will stiffen the resolve of people not to be cowed by this. Inhuman - to conceive this, to plan it, to hold it in your mind and work towards a day when you carry it out, you've really lost the empathy that makes us human.

    The view from the hospitals.

    London Mayor Ken Livingstone:

    "This was not a terrorist attack against the mighty and the powerful; it is not aimed at presidents or prime ministers; it was aimed at ordinary working class Londoners, black and white, Muslim and Christians, Hindu and Jew, young and old, indiscriminate attempt at slaughter irrespective of any considerations, of age, of class, of religion, whatever, that isn't an ideology, it isn't even a perverted faith, it's just indiscriminate attempt at mass murder, and we know what the objective is, they seek to divide London. They seek to turn Londoners against each other and Londoners will not be divided by this cowardly attack," said Mr Livingston.

    He then had a message for the terrorists who had organised the explosions.

    "I wish to speak through you directly, to those who came to London to claim lives, nothing you do, how many of us you kill will stop that flight to our cities where freedom is strong and where people can live in harmony with one another, whatever you do, how many you kill, you will fail."

    RandomReality, a London EMT:

    I think we had a lot less calls than we normally have, I was sitting on station for longer than normal until I, and another manned an ambulance and took a maternataxi to an Essex maternity department.

    Once the shock had settled, I started to feel immense pride that the LAS, the other emergency services, the hospitals, and all the other support groups and organisations were all doing such an excellent job. To my eyes it seemed that the Major Incident planning was going smoothly, turning chaos into order.

    ...The medical staff at the BMA building did their best to save their 'civilian' staff from looking at the carnage that was left from the bomb on the bus.

    More on the British Medical Association building.

    posted by Sydney on 7/07/2005 08:24:00 AM 0 comments

    Wednesday, July 06, 2005

    Medical Privileges: What's the use of being a doctor if you can't toss off critical assessments of everyone's lifestyle choices?

    posted by Sydney on 7/06/2005 06:04:00 PM 0 comments

    Reaping What They Sowed: After the British medical journal, The Lancet published an article claiming to link the MMR vaccine to autism, the rates of immunization against measles, mumps, and rubella declined steeply in the United Kingdom. And now, mumps is on the increase:

    The measles, mumps and rubella (MMR) vaccine was introduced into the UK in 1988, and a second dose was added to the routine immunization program in October 1996. Although 2 doses are recommended, MMR vaccination is not mandatory in the UK. Vaccine coverage among 2-year-olds declined from 92% in 1995 to 80% in 2003-2004; in some areas of London, coverage as low as 60% has been documented. In 2000, when cases began to increase, 1,089 cases were reported .. The largest increase, however, began during the third quarter of 2004; by 2005, 4,891 cases were seen in January alone (compared with 358 cases seen in the first 5 weeks of 2004) ... During the first 24 weeks of 2005, 40,367 cases of mumps have been reported in the UK, compared with 3,511 for the same period 1 year ago.

    The Lancet published the article in 1998. It retracted it in 2004. But it's oh, so hard, to undo the damage. Makes one wonder why it ever got published in the first place.
    posted by Sydney on 7/06/2005 08:20:00 AM 0 comments

    Thinking Ahead: Advice from the CDC on diagnosing and treating radiation burns. Including a lesson in what not to do with a pocket-sized radiation source. (See Figs. 3-6)
    posted by Sydney on 7/06/2005 08:18:00 AM 0 comments

    Modern Driving Lessons: Driving lessons aren't what they were when I was in high school. These days, they include Evasive maneuvers:

    One of the main lessons of the driving courses is to train the driver's eyes -- through repeated skill drills -- to automatically look in the direction the car needs to go rather than looking at the danger. In the MasterDrive course, lights are used to simulate a drunken driver veering out of a lane into the driver's path. Initially, most drivers slam on their brakes and steer directly into the oncoming car -- some of them even close their eyes and let go of the steering wheel. By repeating the simulation over and over, the driver learns to look and steer toward an open area to escape the oncoming car.

    Driving Dynamics participants spend part of the course behind the wheel of a patented 'slide' car. An instructor sits in the passenger seat with a control box that sends the car into a skid. Initially it's unnerving and even scary, but with instruction and encouragement, the driver quickly learns how to regain control of the car.

    We just watched a lot of scary accident movies.
    posted by Sydney on 7/06/2005 08:15:00 AM 0 comments

    Tuesday, July 05, 2005

    Almost Forgot: Grand Rounds is up with loads of good posts. Did you know that Tigger designed the protoype of the modern artifical heart?

    posted by Sydney on 7/05/2005 07:35:00 PM 0 comments

    Art of Hype: Reuters reports - somewhat breathlessly - that a new website empowers the general public to have greater control over their own health. By posing questions to the user, the website supposedly uses the same sort of thinking process a doctor does when making a diagnosis.

    It's true that doctors form their diagnoses based on answers to a train of related questions and investigations. We ask our questions looking for clues to back up or refute the various hypotheses we're holding in our heads as we examine someone. But aforementioned website is not quite that. It's more akin to the articles the National Enquirer used to run claiming you could diagnose illness by the spots in the iris. Example:

    Q: Do you or your children have blonde hair and blue eyes?

    A: Hyperactive boys are often blonde with blue eyes.

    They may be deficient in Zinc, Magnesium, Vitamin B6 and Essential Fatty Acids.

    I have three boys and one girl all with blonde hair and blue eyes, but I suspect it's because their father is blonde and blue-eyed, not because they have a vitamin deficiency.

    Another - for men only:

    Q: Do you get white spots on your shoes?

    A:If you do, you may be Diabetic, and possibly deficient in Chromium

    When someone is diabetic, they excrete sugar in their urine. When men urinate they usually get splashing as the urine hits the toilet bowl, or urinal. And when the urine splashes dry on their shoes the sugar content causes the spots to turn white.

    I'm not a man, nor am I a diabetic. But I often get white spots on my shoes, especially after I walk in the snow or the rain. It's the salt residue from the road surface.

    The site is interesting, but take its advice with a grain of salt. (Or Zinc, or Biotin, or whatever)
    posted by Sydney on 7/05/2005 04:35:00 PM 0 comments

    Mirror, Mirror: British men like what they see when they look in the mirror:

    A national poll of more than 2000 men asked whether they considered themselves underweight, normal weight, overweight or obese.

    Just one per cent considered themselves obese and 39 per cent said they were overweight - but national statistics show that 65 per cent of men are actually overweight or obese.

    The vast majority - 54 per cent - considered themselves a normal weight and six per cent thought they were underweight.

    I've noticed that about men. Women tend to overestimate their degree of "overweightness" (for lack of a better word) - but a beer-belly toting man will have not a clue that he's overweight. He will, in fact, freely criticize his wife's weight. Why is that?
    posted by Sydney on 7/05/2005 12:30:00 PM 0 comments

    Other Flus: The United Nations tells China to embrace transparency when it comes to bird flu:

    Most human cases have been in Vietnam, but at a three-day conference in Kuala Lumpur experts said China represented a growing risk.

    More than 6,000 wild birds died of the disease in the western Chinese province of Qinghai last month.

    Joseph Domenech, the Food and Agriculture Organisation's chief veterinary officer, said that Chinese farmers' use of a human antiviral medicine, amantadine, on their poultry risked creating resistance in the virus. 'We are asking the Chinese authorities to be more transparent on that.'
    posted by Sydney on 7/05/2005 12:29:00 PM 0 comments

    Anticipation: How will the flu vaccine supply fare this year? Not looking so good. Chiron - the company that couldn't supply any last year - is supplying less than expected this year. Meanwhile, the FDA has plans to improve future supplies.
    posted by Sydney on 7/05/2005 12:28:00 PM 0 comments

    Monday, July 04, 2005


    Patriotic Sweet Peas

    posted by Sydney on 7/04/2005 12:13:00 PM 0 comments

    Sunday, July 03, 2005

    Upsetting the Status Quo: Canadian officials are still reeling at the thought that people might actually be able to buy private health insurance there.

    posted by Sydney on 7/03/2005 08:57:00 AM 0 comments

    Saturday, July 02, 2005

    This Weekend: Enjoy the fireworks, but be safe.

    posted by Sydney on 7/02/2005 08:42:00 AM 3 comments

    Damned if You Do, Damned if You Don't: If a drug causes brain damage in monkeys, would you continue to study it in people? A drug company said, "No," but their research subjects (the humans, not the brain-damaged monkeys) said "Yes":

    Amgen discontinued clinical trials of GDNF last year after some monkeys on high doses of the drug had brain damage. Amgen said it could not justify subjecting patients to additional risk because there was no evidence that GDNF was effective. The Thousand Oaks-based company also said one clinical trial showed that GDNF was no better than a placebo.

    But some clinical trial participants said they experienced dramatic improvements in their ability to perform day-to-day tasks - such as walking and writing - on GDNF. Two groups of patients, one in New York and one in Kentucky, have sued Amgen seeking to force the company to resume providing the drug.

    Researchers say that the drug caused regeneration of brain cells in one human subject, but the drug company says that may be, but their data show no objective evidence of brain function improvement.
    posted by Sydney on 7/02/2005 08:38:00 AM 0 comments

    Terrorist Medical Watch: Another hospital bombed, this time in India:

    One person was killed and 12 people were injured when a bomb went off Saturday inside a crowded part of a hospital in an Andhra Pradesh town.

    The blast took place in the outpatient block of the government-run MGM Hospital in Warangal, 150 km from here, killing a hospital employee and injuring 12 others including six policemen, the police said.
    posted by Sydney on 7/02/2005 08:31:00 AM 0 comments

    Dumbing Down: Robert F. Kennedy, Jr. has been speaking out against childhood vaccines - well, actually against the old ones that contained thimerosal. Michael Fumento points out the many holes in his arguement:

    Thus in his June 21 appearance on MSNBC TV's Scarborough Country, Kennedy told Joe Scarborough, 'We are injecting our children with 400 times the amount of mercury that FDA or EPA considers safe.' He thereby confused the ETHYL mercury from thimerosal and for which there is no evidence of harm and no EPA standard with a different chemical, 'METHYL mercury.'

    Worse, he ignored the correction to his piece appended five days earlier by the publications that co-published it, Rolling Stone and Salon.com. 'The article also misstated the level of' mercury infants received, it stated. It was '40 percent [or 0.4 times], not 187 times, greater than the EPA's limit for daily exposure to methyl mercury.' Thus having been caught overstating exposure by almost 500 times he then doubled even that for Scarborough!

    There are many more corrections added to the original piece, too. Just scroll down.

    P.S. The most exasperating thing about this whole thimerosal debate is the confusion between the two types of mercury. Methyl Ethyl mercury, since it isn't the type found most commonly in the environment, has not been extensively studied. Here's what we know so far about methyl mercury and the human body [Ed. note: I apparently have the same problem as Kennedy in keeping the two types straight.]:

    NIAID-supported studies at the University of Rochester and National Naval Medical Center in Bethesda, MD, looked at levels of mercury in blood and other samples from 61 infants who had received routine immunizations with thimerosal-containing vaccines.

    What types of samples were assessed?

    Mercury levels were measured in blood, urine, and stool samples from infants at different times up to 28 days after vaccination. Researchers also looked at levels of mercury in samples of breast milk, mother's hair, and infant formula.

    What were the primary results obtained from assessment of these samples?

    * Blood levels of mercury were uniformly below safety guidelines for methyl mercury for all infants in this study.
    * Mercury was cleared from the blood in infants exposed to thimerosal faster than would be predicted for methyl mercury.
    * Infants excreted significant amounts of mercury in stool after thimerosal exposure, thus removing mercury from their bodies

    What can be concluded from the results of the Rochester study?

    These results suggest that there are differences in the way that thimerosal and methyl mercury are distributed, metabolized, and excreted. Thimerosal appears to be removed from the blood and body more rapidly than methyl mercury.

    One of the reasons that the CDC decided to recommend avoiding thimerosal in vaccines was that they wanted to err on the side of caution. However, no amount of precaution seems to be enough for activists.

    UPDATE: Orac has more.
    posted by Sydney on 7/02/2005 08:24:00 AM 0 comments

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