April 8th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Opinion, Research
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One of the things about science-based medicine that makes it so fascinating is that it encompasses such a wide variety of modalities that it takes a similarly wide variety of science and scientific techniques to investigate various diseases. Some medical disciplines consist of mainly of problems that are relatively straightforward to study. Don’t get me wrong, though. By “straightforward” I don’t mean that they’re easy, simply that the experimental design of a clinical trial to test a treatment is fairly easily encompassed by the paradigm of randomized clinical trials.
Medical oncology is just one example, where new drugs can be tested in randomized, double-blinded trials against or in addition to the standard of care without having to account for many difficulties that arise from difficulties blinding. We’ve discussed such difficulties before, for instance, in the context of constructing adequate placebos for acupuncture trials.
Indeed, this topic is critical to the application of science-based medicine to various “complementary and alternative medicine” modalities, which do not as easily lend themselves to randomized double-blind placebo-controlled trials, although I would hasten to point out that, just because it can be very difficult to do such trials is not an excuse for not doing them. The development of various “sham acupuncture” controls, one of which consisted even of just twirling a toothpick gently poked onto the skin, shows that.
One area of medicine where it is difficult to construct randomized controlled trials is surgery. The reasons are multiple. Read more »
*This blog post was originally published at Science-Based Medicine*
April 4th, 2010 by GruntDoc in Better Health Network, News, Opinion, True Stories
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There’s a nice WSJ article on how forward treatment of combat casualties has become possible. Kudos to these deployed doctors, and to the military that invests the time, money and effort to make things like this happen:
Dr. York, an interventional radiologist who usually performs surgery at the U.S. Naval Medical Center in Portsmouth, Va., is especially skilled at treating internal injuries. His type of surgery—using X-rays and imaging equipment to guide catheters through veins to perform micro-operations—is comparatively rare in emergency rooms. But in the cramped Kandahar hospital, it is critical to saving lives.
via Wounded Soldiers Have Increased Odds of Survival – WSJ.com.
Probably the world’s only front-line (literally) interventional radiologist.
HT: He who shall not be named.
*This blog post was originally published at GruntDoc*
March 25th, 2010 by Harriet Hall, M.D. in Better Health Network, True Stories
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One night in 1882, a critically ill 70-year-old woman was at the verge of death at her daughter’s home, suffering from fever, crippling pain, nausea, and an inflamed abdominal mass. At 2:00AM, a courageous surgeon put her on the kitchen table and performed the first known operation to remove gallstones. The patient recovered uneventfully. The patient was the surgeon’s own mother.
This compelling story is the beginning of an excellent new biography of William Halsted, the father of modern surgery, Genius on the Edge: The Bizarre Double Life of Dr. William Stewart Halsted, by Gerald Imber, M.D. Read more »
*This blog post was originally published at Science-Based Medicine*
March 8th, 2010 by Bongi in Better Health Network, True Stories
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South African society is a completely lawless society. Pretty much everyone does just what they like and more often than not they get away with it. Red lights are just a suggestion, yet it is not uncommon to see a taxi stop in the middle of the road without warning. This attitude goes through almost all levels.
Yet there are some laws that people do obey. The law of gravity comes to mind. Mostly if you trip or fall off a wall or out a window you do approach the earth with increasing velocity and finally come to rest in some form of disrepair when you finally meet said earth, even if you are South African. Another law that is obeyed was well illustrated by a patient we once saw in the old days. Read more »
*This blog post was originally published at other things amanzi*
February 19th, 2010 by Bongi in Better Health Network, Humor, True Stories
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We can sometimes look good in our jobs. I suppose it comes with the territory. But sometimes this is not a good thing.
Danville is an interesting place. Actually the place itself is drab but it is full of interesting people. To say it is populated by the lower echelons of the gene pool is an understatement of note. For some reason every reprobate and inbreed seems to have found their way there. Throw a few generations of fetal alcohol syndrome into the mix and you have the average Danville resident. Then add a strong predilection to grandpa (a local aspirin caffeine headache powder) to round off with. Usually when they presented to the hospital it is with a bleeding peptic ulcer or a perforated peptic ulcer. In fact they seldom present to us with anything else. Read more »
*This blog post was originally published at other things amanzi*
