March 26th, 2011 by Berci in Research
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It’s a pleasure to share the great news that we just published our review in Trends in Molecular Medicine under the title, Gene expression profiles in peripheral blood for the diagnosis of autoimmune diseases. We looked at the literature and wrote about whether peripheral blood can be used for the diagnosis of autoimmune diseases or the prediction of the effectiveness of therapies. We also came up with a decision tree and a set of proposed guides in order to facilitate inter-disciplinary collaborations.
The paper is not publicly available, but if you are interested, I’d be happy to send it to you via e-mail.
Gene expression profiling in clinical genomics has yet to deliver robust and reliable approaches for developing diagnostics and contributing to personalized medicine. Owing to technological developments and the recent accumulation of expression profiles, it is a timely and relevant question whether peripheral blood gene expression profiling can be used routinely in clinical decision making. Here, we review the available gene expression profiling data of peripheral blood in autoimmune and chronic inflammatory diseases and suggest that peripheral blood mononuclear cells are suitable for descriptive and comparative gene expression analyses. A gene-disease interaction network in chronic inflammatory diseases, a general protocol for future studies and a decision tree for researchers are presented to facilitate standardization and adoption of this approach.
*This blog post was originally published at ScienceRoll*
March 26th, 2011 by Shadowfax in Opinion, True Stories
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Bongi is an amazing writer, and if you haven’t, I strongly urge you to read his latest post, titled “The Graveyard.”
I imagine that a huge number of doctors know exactly what he means. I remember being told by a surgeon, while I was in medical school, that “you’re not a real doctor until you’ve killed someone.” I thought at the time (and still think) that there was a puerile bravado behind that admonition, but there is also a grain of truth. I have my own graveyard. Curiously, not all of its inhabitants are dead. They are the cases where I screwed up, or, charitably, cases that went bad where I feel that maybe I could’ve/should’ve done things differently.
The missed SAH
The missed DVT/PE
The missed AAA
The missed Aortic dissection
The missed MI
I remember them all, clearly and in detail. Read more »
*This blog post was originally published at Movin' Meat*
March 25th, 2011 by Bongi in Humor, True Stories
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Amazingly enough, no matter how crazy our country gets we are a darn sight better than many of our neighbours. Many people from countries around us flee to South Africa for a better life. Only problem is for the better life you sometimes have to produce a South African identity document. These can be easily bought from corrupt government officials, but why buy one if you can borrow one?
I was working in Qwaqwa. It was an amazingly poverty-stricken place with what seemed to me to be almost total joblessness. I truly don’t know how the people survived. And yet people from neighbouring Lesotho would still move there illegally. I’ve never been to Lesotho personally but if Qwaqwa was a better proposition, then I can’t even imagine how bad life in Lesotho must have been.
Anyway, one day I got to work and was confronted with a sticky problem. The police were there and they apparently needed my help. You see as it turns out, a Lesotho illegal had died a week before in our hospital. In order to qualify for admission to our hospital she needed to be South African. Luckily her sister was the proud owner of a South African identity document and had simply lent it to her, along with her name. I assume they looked similar enough that the clerk working in admissions hadn’t noticed the picture in the book wasn’t that of the patient. More likely she simply didn’t check. The problem was that the patient had been declared dead by the doctor on call that particular night. Or rather the patient’s sister and her ID had been declared dead. At that stage no one yet knew who the patient was. Read more »
*This blog post was originally published at other things amanzi*
March 25th, 2011 by GruntDoc in True Stories
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We have (mostly) non-EM studs rotate through our ED on their sometimes mandatory, sometimes killing a month elective ED tour. There is little reason for EM destined students to rotate in our place, as we don’t have a residency and we’re not part of the club of EM residency directors ( i.e. letter of rec writers). So, usually not EM hard chargers. Nothing wrong with that, but they’re not my cuppa tea.
Today’s lesson: shoulder reduction for the non-EM Stud, and for me in What We Do Isn’t Usual.
As is our norm, after a thorough Hx, PE, Xrays and Time Out, was in on a 2 doc reduction; One does the sedation, one the reduction. I don’t typically have students follow me: I don’t dislike the students, but I don’t have them. Personal preference.
Today, a shoulder reduction. My colleagues’ student. Not destined for a life in the ED (already matched, not in a remotely EM specialty). My colleague is on the sedation, and I’m on the reduction. I, after discussing the technique, in my presence and under my direction, allowed the stud the first attempt at reduction after sedation. No go. Good effort, not enough muscle. Read more »
*This blog post was originally published at GruntDoc*
March 25th, 2011 by David H. Gorski, M.D., Ph.D. in Health Tips, Opinion, Quackery Exposed
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Sometimes when a pundit or politician makes claims that are either contrary to or distort science for ideological or political advantage, I feel the need to discuss those claims, sometimes even sarcastically. Such was the case last week, when Ann Coulter wrote a blisteringly ignorant column, entitled A Glowing Report on Radiation. She wrote this article in the wake of the fears arising in Japan and around the world of nuclear catastrophe due to the damage to the Fukushima nuclear power plant caused by the earthquake and tsunami that hit northern Japan on March 11. Coulter was subsequently interviewed by Fox News pundit Bill O’Reilly on The O’Reilly Factor on Thursday evening:
Yes, according to Coulter, radiation is good for you, just like toxic sludge! Even more amazing, in this video Bill O’Reilly actually comes across as the voice of reason, at least in comparison to Ann Coulter. He’s very skeptical of Coulter’s claims and even challenges her by saying, “So by your account we should all be heading towards the nuclear reactor.”
So, fellow SBM aficionados, is Coulter right? Are all those scientists warning about the dangers of even low-level radiation all wrong? Should we start hanging out in radioactive mine shafts, as Coulter mentions in her column (seriously) in order to boost our health and decrease our risk of cancer?
Not so fast, there, Ann. Here’s a hint: If Bill O’Reilly can lecture you on science and look more reasonable than you, you’re off the rails. Read more »
*This blog post was originally published at Science-Based Medicine*
