October 10, 2007
Category: Cancer • Medicine • Surgery
Here we are, a third of the way into Breast Cancer Awareness Month, and I haven't yet written a piece about breast cancer. Given that it's my primary surgical specialty, perhaps some readers were wondering why not. Truth be told, I've always been a bit ambivalent about Breast Cancer Awareness month. Perhaps it has something to do with the fact that my job makes every month Breast Cancer Awareness month. Or maybe it has something to do with the crassness of some of the promotions designed to attract donations, well-meaning though such campaigns undoubtedly are. From my perspective, any month is a good month to give to breast cancer-related charities, such as the Breast Cancer Research Foundation or the Susan Komen Foundation. Both do fantastic work in funding breast cancer research and advocacy. You shouldn't wait until October every year to do it. However, if the attention each October brings results in more donations and does raise awareness about the importance of early detection, I suppose I shouldn't complain.
One article, however, that did catch my attention was the cover story this week in TIME Magazine entitled The Changing Face of Breast Cancer. To someone like me, who has been spoiled practicing in the U.S., where decades of advocacy have resulted in a situation where most women at risk for breast cancer undergo at elast every other year screening mammography. That's why tumors here tend to be caught at an early stage, unlike 50 years ago, when most tumors weren't detected until they could be felt on physical examination.
The article points out that dealing with breast cancer in the rest of the world is a much different affair than it is in the U.S. and Europe:
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Posted by Orac at 2:35 PM • 6 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Bioethics • Entertainment/culture • Medicine • Movies • Popular culture
One of the most important responsibilities of health care workers and hospitals is to protect the privacy of the patients for whom they care. Unfortunately, in the case of George Clooney's recent hospitalization for injuries sustained in a motorcycle crash, a consequence of electronic medical records was revealed when dozens of employees, some of whom apparently leaked the information to the press, accessed Clooney's medical records. Of course, these employees didn't seem to realize that EMRs allow the tracking and identification of anyone who logs on to the system. Anyone who logs on leaves an electronic trail of exactly what information he or she accessed.
What irritated me as I saw this story on the news and read about it is how many people were defending the hospital employees. A typical statement came from a union representative:
"It was inappropriate but they are paying a steep price. But I don't even think George Clooney would want people to pay. Again, the apology to him for his privacy rights [is necessary], but I think in fact the hospital is overreacting," says Jean Oterson of the HPAA."
Even George Clooney seems to take this line.
From my perspective, the hospital is not overreacting. Leaking confidential patient data is a violation of federal law for which the hospital and employees could be prosecuted. As for what penalties are appropriate, it depends. If an employee only accessed the information out of curiosity and didn't leak it, then I do consider it a rather minor offense that deserves at most a suspension. However, there is a strong suspicion that at least some of these employees did leak information to the press:
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Posted by Orac at 12:01 PM • 10 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Alternative medicine • Antivaccination lunacy • Autism • Blogging • Medicine • Politics • Science • Skepticism/critical thinking
One development that will increasingly pose an interesting and perhaps uncomfortable question for newspapers is the increasing addition of blogs run under the banner of newspapers. I'm not sure if it's cluelessness about the blogosphere leading newspapers to think that they can have bloggers write whatever they want under the newspaper's banner and not have it reflect on their reptuation, but reputable papers have in some cases allowed some seriously credulous people to spread misinformation in a seemingly respectable form.
This thought occurred to me when I was made aware of a blog entry by Julie Deardorff on a blog hosted by The Chicago Tribune called Julie's Health Club. Ms. Deardorff describes her blog thusly:
Julie's Health Club blog is a forum to discuss whatever personal health issues are currently in the news or on your mind. My personal interests include triathlons, running, integrative medicine, children and maternal health, environmental health, sustainable living, nutrition, yoga and Pilates, alternatives to surgery and prescription drugs, and chemicals in the environment.
The other day, Ms. Deardorff posted an unbelievably poorly reasoned article that regurgitated many of the fallacies and canards of the mercury militia, all in the form of a "recovered autistic child" story entitled Autism recovery stories: Mercury poisoning? In it was a "recovered child" story by a woman named Julie Obradovic, who clearly totally buys into the myth that mercury in vaccines causes autism.
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Posted by Orac at 8:26 AM • 8 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Anti-Semitism • History • Holocaust denial
I love it when my efforts are noticed by those at whom they are directed. It's all the reward I need. (Warning: Depending on your place of employment, link may not be work-safe.)
Posted by Orac at 12:39 AM • 8 Insolent response(s) • 0 Insolent link(s) • View blog reactions
October 9, 2007
Category: Blogging
Let me just take a moment to join fellow ScienceBloggers Ed, Revere, RPM, Zuska, Nick, PZ, Razib, Steve, and Bora in encouraging everyone to vote for one of our own, Shelley over at Retrospectacle, for a $10,000 Student Blogging Scholarship.
Don't do it just because I asked you to. Do it because she runs an excellent blog and deserves it. Also, if you don't vote for Shelley, we'll shoot this dog.
Well, not really. I could never shoot a helpless dog. I love dogs. But vote for Shelley anyway. Or maybe we'll give this dog a bath whether he needs it or not.
Posted by Orac at 2:31 PM • 5 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Sports
The game ended too late last night, and I was too tired to do a quick celebratory post, but better late than never.
In case you were wondering, Orac is pleased. Not as pleased as he would have been if it had been the Tigers who beat the Yankees, but pleased enough.
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Posted by Orac at 12:15 PM • 11 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Alternative medicine • Antivaccination lunacy • Medicine • Quackery • Religion
On occasion, I've thought of inaugurating awards for the looniest quackery, alternative medicine, or antivaccination craziness of the year. I was thinking of calling them the Woo Awards, but I've never actually gotten off my lazy posterior to do the work it would take to set up some sort of voting system, and I'm not so sure that a list picked out only by me wouldn't just end up reflecting my personal idiosyncrasies. Be that as it may, with the end of the year fast approaching, if I were going to do it now would be the time to start looking for nominations.
If I were going to give a prize for the looniest antivaccination screed of the year, though, I've found a really strong contender. Not only does it regurgitate pretty much every lie there is about vaccinations, but it combines this misinformation with a religious angle so ludicrous that I'm not sure if I want to laugh or cry. I laugh at it because this guy who wrote it (Greg Ciola) is such an raving twit. I cry because of it because he may persuade credulous parents not to vaccinate their children, thus endangering these children and others with whom they come into contact. In any case, the title of his screed (DANGER LURKING IN FLU SHOTS!) tells you all you need to know about it.
I haven't used the phrase in a while, but if ever there were a rant for which it is appropriate, Ciola's rant is it: The stupid, it really does burn.
If you want to get a flavor of the rampant ignorance and stupidity inherent in Ciola's fevered prose, you don't have to wait long. It's there, right in the beginning:
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Posted by Orac at 9:05 AM • 59 Insolent response(s) • 0 Insolent link(s) • View blog reactions
October 8, 2007
Category: Biology • Medicine • Science
No IgNobels here, the 2007 Nobel Prize for Physiology or Medicine has been awarded to Mario R. Capecchi, Martin J. Evans, and Oliver Smithies for a technique that is so incredibly important to modern biomedical research that it's a wonder they didn't get the prize before:
This year's Nobel Laureates have made a series of ground-breaking discoveries concerning embryonic stem cells and DNA recombination in mammals. Their discoveries led to the creation of an immensely powerful technology referred to as gene targeting in mice. It is now being applied to virtually all areas of biomedicine - from basic research to the development of new therapies.
Gene targeting is often used to inactivate single genes. Such gene "knockout" experiments have elucidated the roles of numerous genes in embryonic development, adult physiology, aging and disease. To date, more than ten thousand mouse genes (approximately half of the genes in the mammalian genome) have been knocked out. Ongoing international efforts will make "knockout mice" for all genes available within the near future.
With gene targeting it is now possible to produce almost any type of DNA modification in the mouse genome, allowing scientists to establish the roles of individual genes in health and disease. Gene targeting has already produced more than five hundred different mouse models of human disorders, including cardiovascular and neuro-degenerative diseases, diabetes and cancer.
It's hard to overstate how important this technique has become. Using this genetic engineering technology, it is possible to produce mice with a gene or genes specifically knocked out. It is possible to introduce a gene into stem cells and produce mice with that gene's expression cranked up to high levels. Scientists can then observe the resulting phenotype. The entire process is illustrated below:
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Posted by Orac at 2:31 PM • 11 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Alternative medicine • Medicine • Quackery • Surgery
Regular readers know that I've long been dismayed at the increasing infiltration of non-evidence-based "alternative" medical therapies into academic medical centers (1, 2, 3, 4, 5, 6, 7). It's gotten such a foothold that it's even showing up in the mandatory medical curriculum in at least one medical school. I've speculated before that academic medical centers probably see alternative medicine as both a marketing ploy to make themselves look more "humanistic" and a new revenue stream, given that most insurance companies won't pay for therapies without solid evidence of efficacy, meaning that it's usually cash on the barrelhead for such woo, without all that nasty hassle of filling out insurance forms and getting preapprovals from tight-fisted claims handlers.
One area of medicine that's always been fairly immune to the lure of non-evidence-based alternative medicine therapies is trauma. After all, unlike the usual panoply of ailments that alternative medicine practitioners like to treat with their therapies, conditions which are usually not life-threatening and which are prone to a large degree of variation, regression to the mean, and psychological overlays, trauma is concrete. You can see the injuries. Broken bones show up on X-rays. Bullets rip holes in bodies. If alternative medicine modalities are good for anything, it's been generally assumed that they wouldn't be much good in trauma, and, for the most part, academic trauma centers have eschewed them.
Not any more. Arguably the most prestigious trauma center in the U.S., the University of Maryland's Shock Trauma Center, is getting into woo in a big way:
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Posted by Orac at 9:08 AM • 37 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Alternative medicine • Cancer • Medicine • Quackery
I've had this story sent to me by a few readers over the weekend, and I think it's worth a brief comment.
I'm basically a child of the 1970s. Although I didn't watch it much, if ever, I remember Charlie's Angels when I was in junior high and high school. Like any adolescent who came of age in the late 1970s, I remember the famous and hot-selling poster of Farrah Fawcett, which graced the bedroom of more than one of my friends, although I never actually owned a copy. A while back, I heard that Fawcett had been successfully treated for anal cancer. Now, I hear from my readers that her anal cancer is back and that she is seeking out alternative medical treatments:
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Posted by Orac at 3:07 AM • 11 Insolent response(s) • 0 Insolent link(s) • View blog reactions
October 7, 2007
Category: Anti-Semitism • History • Politics • Religion
Richard Dawkins really should know better.
That's why it's frustrating to see him put his foot in his mouth in a big way in a recent interview. Indeed, he did it in a way that leaves himself wide open to charges of anti-Semitism:
In an interview with the Guardian, he said: "When you think about how fantastically successful the Jewish lobby has been, though, in fact, they are less numerous I am told - religious Jews anyway - than atheists and [yet they] more or less monopolise American foreign policy as far as many people can see. So if atheists could achieve a small fraction of that influence, the world would be a better place."
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Posted by Orac at 9:56 AM • 131 Insolent response(s) • 0 Insolent link(s) • View blog reactions
October 6, 2007
Category: Humor • Medicine • Science
Ah, yes, it's that time of year again. The winners of the 2007 IgNobel Prize have been announced. There have been several "worthy" winners, for example:
Mayu Yamamoto from Japan won the Ig Nobel prize in chemistry for her development of a novel way to extract vanillin, the main component in vanilla bean extract, from cow dung. In tribute to Yamamoto's achievement, Toscanni's imitated her achievement and distributed samples of the resulting ice cream to Nobel laureates seated on the stage. Loud chants of "Eat it! Eat it!" from the audience finally persuaded the skeptical Nobel laureates to try a taste of their samples.
But I think the competition came down to these two:
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Posted by Orac at 2:30 PM • 3 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Biology • News of the Weird • Science
I know I've said before that I don't really "get" the whole cephalopod thing that P. Z. has, but I wonder if he's heard of this little thing:
Monday, October 8 is Unofficial International Cephalopod Awareness Day.
Certainly, I hadn't.
Posted by Orac at 11:00 AM • 3 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Sports
...for the Indians to advance to the ALCS.
I know, I know, long time readers know that I'm a Detroit Tigers fan. Sadly, after dominating their division during the first half of the season, my hometown team took a late season plunge right out of playoff contention, much to my dismay.
Fortunately, there is one other.
I lived in Cleveland for eight years before I headed to Chicago in the mid-1990s. During that time there, I saw a team that was once considered a joke make it to the World Series in 1995. I became a fan and to this day retain a soft spot in my heart for the Indians--except when they play the Detroit Tigers.
With the Detroit Tigers out of contention, I've turned to rooting for the Indians. Given my extreme dislike of the New York Yankees, you can guess that I've been loving every minute of the last two games, particularly last night's game. It was a nail-biter of a pitching duel, in which the Tribe threatened multiple times but couldn't score to tie the game until the 8th inning, forcing the game into extra innings with a 1-1 tie. Andy Pettite was strong, and Fausto Carmona was amazing, pitching all the way through the ninth inning for the Tribe and giving up only three hits, one of which, unfortunately, was a home run.
Then, in the bottom of the 11th, with the bases loaded and two outs, Travis Hafner worked the count to 3-2.
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Posted by Orac at 9:21 AM • 3 Insolent response(s) • 0 Insolent link(s) • View blog reactions
October 5, 2007
Category: Announcements • Blog carnivals • Skepticism/critical thinking • Skeptics' Circle
Don't forget, once again the time is fast approaching. Soon yet another installment of the Skeptics' Circle will be upon us. In fact, it's less than a week away and due to land at Infophilia on Thursday, October 11. So, if you're a blogger and regularly (or even not-so-regularly) like to apply the scientific method, skepticism, and critical thinking to dubious claims, send the Infophile a submission to the carnival! Contact and deadline information is here, and guidelines for submission are here.
Once again, if you're a blogger want to host an edition of the Skeptics' Circle yourself, drop me a line. I know there are new skeptical blogs out there (I just haven't had a chance to drop a few links yet). Hosting your own Skeptics' Circle is a great way to gain links and visibility. And if you're an established skeptical or scientific blogger who's done the Circle before, wasn't it fun? Isn't it about high time you did it again? Check out the schedule and guidelines for hosting and drop me a line. I'll get you on the schedule, assuming you're not Andrew Weil in disguise.
Posted by Orac at 4:03 PM • 0 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Category: Medicine
Some readers have been sending me links to this article on CNN.com entitled 5 Alternative Medicine Treatments That Work. Unfortunately, Your Friday Dose of Woo took up the time that normally would have gone into given this article the lovingly Respectfully Insolent™ treatment that this utterly credulous article so richly deserves and that you, my faithful readers, demand. Fortunately Mark over at denialism.com has taken the time to fisk this one in detail. Does that mean Orac has nothing more to say on this article?
You know the answer to that one. Mark just made it so that I can restrain my usual logorrheic tendencies and be succinct (or at least as succinct as I can be).
Just a look at the first paragraph should tell you all you need to know about the level of scientific reasoning this article demonstrates:
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Posted by Orac at 1:01 PM • 14 Insolent response(s) • 0 Insolent link(s) • View blog reactions
Orac is the nom de blog of a humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
