Recently in Media Category
According to Medscape's newly published (2012) report on physician income, almost half (46%) of the surveyed physicians (N > 25,000) would not choose medicine as a career, and nearly 80% would not choose the same practice setting, if they had to do it over again. Nearly 60% regret their specialty choice. Perhaps income, especially for radiologists and orthopedic surgeons, lightens the emotional load. But money can soothe only so much unhappiness.
The distressing thought for the day: The general dissatisfaction among currently practicing physicians bodes ill for encouraging bright young adults to pursue medical careers.
The distressing thought for the day: The general dissatisfaction among currently practicing physicians bodes ill for encouraging bright young adults to pursue medical careers.
And reasonably, I might add. Here's the video link. Notably the piece was done with the cooperation from higher-ups at Duke Med (ie, Robert Califf).
Potti is now an oncologist at South Carolina's The Coastal Cancer Center, the website for which advertises Potti's time at Duke University and (not surprisingly) makes no mention his colossal scientific fraud while there.
Potti is now an oncologist at South Carolina's The Coastal Cancer Center, the website for which advertises Potti's time at Duke University and (not surprisingly) makes no mention his colossal scientific fraud while there.
Continue reading 60 Minutes "Does" the Duke-Anil Potti Tragedy.
In a Pharmalot interview, money manager, blogger, and diabetic David Kliff absolutely excoriates "Buttah Queen" Paula Deen and insulin-maker Novo Nordisk for their newly announced, and arguably duplicitous, promotional relationship. Kliff easily tosses out words like "hypocrite," "shyster," and "bastardizing" like so many fat calories in a bacon-and-fried-egg hamburger with doughnut buns.
First Jeffrey Kindler, then Lipitor, and now this: Pfizer announced today that * Bloody hell.
In its search (some might say crusade) to link repetitive head injury with chronic traumatic encephalopathy, or CTE, in professional sports, Boston University's Center for the Study of Traumatic Encephalopathy revealed that another NHL player, NY Rangers' enforcer Derek Boogaard, had the condition at a remarkably advanced stage. Boogaard died in May of this year, at the age of 28, as a result of an overdose of alcohol and prescription narcotics, and the Center solicited Boogaard's family to examine the athlete's brain. The results of the examination, which are convincingly described and displayed in a multipart NYT video piece, were reported by the paper on December 3rd. Boogaard is now the fourth NHL player with the condition in the Center's case series of this particular sport.*
Among the disturbing facets of the NYT coverage, NHL commissioner Gary Bettman downplays the risk of brain injury as a result of brawling in his league* and minimizes the Center's research as "preliminary" and "great for headlines." One is reminded of neurologist Ira Casson's essential denial of the association between repetitive head injury and CTE in January of 2010. Casson was co-chairman of the NFL's panel on brain injury until he resigned November of 2009, largely owing to his perceived insensitivity toward a possible link.
* The Center's case series of NFL players with CTE, 13 of 14, is substantially larger.
** Which he, inexplicably, denies is allowed.
Among the disturbing facets of the NYT coverage, NHL commissioner Gary Bettman downplays the risk of brain injury as a result of brawling in his league* and minimizes the Center's research as "preliminary" and "great for headlines." One is reminded of neurologist Ira Casson's essential denial of the association between repetitive head injury and CTE in January of 2010. Casson was co-chairman of the NFL's panel on brain injury until he resigned November of 2009, largely owing to his perceived insensitivity toward a possible link.
* The Center's case series of NFL players with CTE, 13 of 14, is substantially larger.
** Which he, inexplicably, denies is allowed.
And probably rightly so, given a number of issues.- The Harvard press release is terribly (and irresponsibly) overdramatic, emphasizing the "endocrine-disrupting" effect of bisphenol A (which is only documented in laboratory animals, to my knowledge) and the >1200% increase in urinary BPA after consuming canned soup (Progresso) for 5 days. There is no mention of absolute numbers in the attention-grabbing press release, just the astonishing percentage jump.
- The JAMA report, available here (courtesy of JunkScience.com), is actually published as a letter and not a more stringently peer-reviewed article.
- JunkScience.com takes the letter authors to task for not distinguishing between the urinary measurement of BPA (which is evidently not possible or very difficult) and that of a quickly produced metabolite. BPA is evidently rapidly processed in the body, and its "biologically inactive" metabolite (not BPA per se) was actually measured in urine, says JunkScience.com (the blog further claims that at least some of the authors should have known or do know this fact).
- While the percentage increase of mean urinary BPA values among canned-soup eaters is very impressive, we're talking about differences in MICROGRAMS PER LITER: 1.1 mcg/L after 5 days of fresh-soup consumption vs 20.8 mcg/L after 5 days of canned-soup consumption, for a difference of 19.7 mcg/L.*
- The urinary spike in BPA (or its metabolite) was probably transient, and the authors themselves acknowledge, "The effect of such intermittent elevations in urinary BPA concentration is unknown."
* In the updated National Health and Nutrition Examination Survey, levels of BPA were detected in all subjects older than 6 years of age. Geometric means were approximately 2 mcg/L, but levels rose to 20 mcg/L (or thereabouts) in the 95th-percentile groups.
Image of can of Progresso vegetable minestrone soup from progresso.com.
Forbes's Matthew Herper on Bill Gates on vaccines and pharma: There's sufficient ink for undeniably venerable ideas and acts, but an "unimpressed" Gates disparages Novartis's Gleevac, a molecule that has completely revolutionized the treatment of CML.
“There’s always this divergence between what’s financially attractive and what has dramatic profit and the number of life years that you really save...Do the math on [Gleevac] versus, says, preventing Parkinson’s or preventing Alzheimer’s. It’s in a different universe."
I have to say that the most astonishing finding from President Obama's most recent routine physical examination is not that he's smoke-free or that his LDL fell with presumptive dietary changes or that he even got a PSA test but that he has 20/20 vision, near and far, without correction. Who the hell doesn't have to wear glasses for something after the age of 50? Photo of a glassless #44, from http://www.whitehouse.gov/about/presidents/barackobama.
From this week's issue of Neurology.Using MR venography and ultrasound* in 40 patients with MS, German investigators failed to replicate the 100% prevalence of chronic cerebrospinal venous insufficiency (CCSVI) defined famously (and notoriously) by Zamboni et al in 2009 (for background, start here or search Pathophilia for "Zamboni"). This newly published study, by the authors' account, is at least the 13th study** that has failed to validate Zamboni's theory of venous insufficiency in MS and his follow-up idea that the stenting of cerebral veins (ostensibly to improve the egress of iron) could be somehow objectively clinically beneficial.
Here's the parade of negative studies cited by the German authors (Doepp et al); 11 of these studies have been published in English-language peer-reviewed journals (all of which are reasonably well regarded).
Ultrasound studies
- Doepp F, Paul F, Valdueza JM, Schmierer K, Schreiber SJ. No cerebrocervical venous congestion in patients with multiple sclerosis. Ann Neurol. 2010;68:173-183.
- Baracchini C, Perini P, Calabrese M, Causin F, Rinaldi F, Gallo P. No evidence of chronic cerebrospinal venous insufficiency at multiple sclerosis onset. Ann Neurol. 2011;69:90-99.
- Krogias C, Schroeder A, Wiendl H, Hohlfeld R, Gold R. "Chronic cerebrospinal venous insufficiency" and multiple sclerosis: critical analysis and first observation in an unselected cohort of MS patients. Nervenarzt.
- 2010;81:740-746. (article in German)
- Mayer CA, Pfeilschifter W, Lorenz MW, et al. The perfect crime? CCSVI not leaving a trace in MS. J Neurol Neurosurg Psychiatry. 2011;82:436-440.
- Centonze D, Floris R, Stefanini M, et al. Proposed CCSVI criteria do not predict MS risk nor MS severity. Ann Neurol. 2011;70:52-59.
- Sundstroem P, Wåhlin A, Ambarki K, Birgander R, Eklund A, Malm J. Venous and cerebrospinal fluid flow in multiple sclerosis: a case control study. Ann Neurol. 2010;68:255-259.
- Wattjes M, van Oosten BW, de Graaf WL, et al. No association of abnormal cranial venous drainage with multiple sclerosis: a magnetic resonance venography and flow-quantification study. J Neurol Neurosurg Psychiatry. 2011;82:429-435.
- Zivadinov R, Lopez-Soriano A, Weinstock-Guttman B, et al. Use of MR venography for characterization of the extracranial venous system in patients with multiple sclerosis and healthy control subjects. Radiology. 2011;258-562-570.
Measurement of intraocular venous pressure
Measurement of CSF ferritin levels
* Specifically dynamic extracranial color-coded duplex sonography (ECCS).
** The cited studies do not include the essentially negative ultrasound study from the University of Buffalo, which was recently published in April in Neurology. Consequently the peer-reviewed tally comes to 14 negative studies.
Image of neck veins from Gray's Anatomy (1918).
