A 2009 journal article in the Proceedings of the National Academy of Sciences (PNAS) — promoted in a news release by the journal and picked up by many news organizations — has now been retracted by the authors. But the journal issued no news release about the retraction — an issue of transparency that the RW blog raises. And you can guess how much news coverage the retraction will get.
And this was all over a molecule that could supposedly “make breast tumors respond to a drug to which they’re not normally susceptible” — as the RW blog put it. But it was also a molecule, RW points out, that wasn’t even in clinical trials yet.
He or she who lives by the journal news release risks one’s long-term credibility.
Since the beginning of November, I’ve been dealing with a random few weeks of feeling “real-people sick” (RPS). Like I wrote about last week, diabetes is something I’m used to and can deal with pretty well, but the common cold knocks me right on my end. I deal with colds like a guy. I hate being RPS:
Real People Sick: The differentiation between blood sugar issues and the common cold. Phrase slips out most often when the diabetic admits to not feeling well and must specify that it is not blood sugar related.
This month’s Animas “Life, Uninterrupted” vlog is about being “sick” on top of having diabetes, and about how cracked-out squirrels and I sometimes share the same vocal patterns. Unfortunately, there’s another cameo by Abby (the cat) because she’s usually lounging, all lazy, while I record these things. (That cat needs to get on the ellipmachine or something — chubby little chomper.)
Enjoy, and thanks for not judging me for the squeaky voice and the whining!
*This blog post was originally published at Six Until Me.*
To complain or “be good” is an apparent dilemma for some patients with serious illness.
Yesterday I received an email from a close friend with advanced breast cancer. She’s got a lot of symptoms: Her fatigue is so overwhelming she can’t do more than one activity each day. Yesterday, for example, she stayed home all day and did nothing because she was supposed to watch a hockey game in the evening with her teenage son and other family members. Her voice is weak, so much it’s hard to talk on the phone. She has difficulty writing, in the manual sense — meaning she can’t quite use her right arm and hand properly.
“It’s something I would never mention to the doctor because it is very subtle,” she wrote. “But it has not improved and if anything has worsened over time.”
There are more than a few possible medical explanations for why a person who’s receiving breast cancer therapy might not be able to use her right arm. But that’s not the point of today’s lesson. What’s noteworthy here is that the patient — an educated, thoughtful woman who’s in what should be the middle of her life and is trying as best she can to survive — doesn’t think these symptoms are worth mentioning. Read more »
*This blog post was originally published at Medical Lessons*
I’ve discovered over the years that I really like economics. I never took an econ class in my entire life, since I was pretty focused on the life sciences, but I’ve picked up a fair amount informally over the years. Fortunately I have a strong background in statistics and math, and I’ve done a lot of reading on economics. I wouldn’t say that I have any special level of understanding or credibility on the topic. Perhaps it should be noted that my wife took away the checkbook for good reason. But I enjoy it as a topic, as something to read about and a powerful tool for understanding how the world works.
One consequence of being an ER doc is that you are pretty close to “the street,” and I don’t mean Wall Street. I mean the folks living and scrounging on the streets. As a matter of functioning in the job, you learn the street jargon, you learn what drugs people are using and why, and what the effects of those drugs look like.
The other day I saw a middle-aged guy brought in for acting really weird. Though everything in his social history argued against it, he just looked like he was on meth. I checked a tox, and sure enough, it came back positive. He strenuously denied any drugs, but eventually gave in and admitted the meth use.
I remember in residency walking through downtown Baltimore with a fellow resident and our spouses, and we amazed them by serially identifying the likely drug of choice of the various street people we passed, based on casual observation of their behavior. It’s just what we do. Baltimore was a heroin town. Read more »
*This blog post was originally published at Movin' Meat*
Scientists have discovered a new, highly-transmissible gene that could, quite easily in fact, open a frightening new front in the ongoing global war against superbugs.
The antibiotic-resistant gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections, and blood stream infections.
NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.
The gene has been identified in three U.S. patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists” — that is, people seeking less expensive medical care in India.
“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.” Read more »
*This blog post was originally published at Pizaazz*
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