DIY Make your own SAD

light box here.

Brad Evans

Campyobacter jejuni

transmitted in unpasteurized milk at a fair in Kansas.

Brad Evans

Evidence Based Medicine

What is evidence based medicine? The words themselves seem to mean that science should be used to make medical decisions. Well, this is all fine and good. Without a doubt, scientific evidence should be used to help make medical decisions. But, all decisions involve varying proportions of fact and value judgments. For instance, the decision as whether to continue medical care in dire circumstances involves some fact, but mainly value judgments. So, right off the bat, there is one problem with the words "evidence based medicine." It implies that all judgments in medicine should be based on scientific evidence.

Another problem is that many use the term "evidence based medicine" to mean that having total access to evidence will improve medical decisions. "Evidence based" can be turned on its head: What evidence is there that total access to genetic information and medical charts will improve medical decisions? What is meant by access? Who gathers information and what will it be used for?

Let's return again to "evidence based medicine." What is it and who decides what it is? There often are three individuals or organizations involved: the patient, the doctor, and the entity paying for the medical care. Suppose the paying entity, which is usually the government or an insurance company, carries out a study showing cost savings that would be recognized if a certain course of medical care were pursued. How much should that information be used in making a medical decision?

This is just a taste of the problems that the phrase "evidence based medicine" brings with it.

Respiratory Histoplasmosis

in people who traveled to El Salvador to renovate a church. From MMWR.

Brad Evans

1-bromopropane neurologic illness

reported in MMWR.

Brad Evans

Bicyclists get campylobacter...

from sheep droppings in the mud on the course. They ate and didn't wash their hands first.

Brad Evans

Chemicals in schools...

Not drugs. Well, maybe drugs AND chemicals used in shop and chemistry classes. Probably not as big a problem as suicide and drug abuse, but still a worry.

Brad Evans

Recall of dry pet food because of...

No, not melamine (which causes kidney stones), but Salmonella infections in humans.

Brad Evans

Listeria Infections - MMWR

Here.

Brad Evans

Rabies in a dog from Iraq

Cautionary tale here from the CDC.

Brad Evans

Up to 5% of Shanghai infants may have kidney stones

Due to milk contaminated with melamine, up to 5% of children under age 3 may have kidney stones.

Brad Evans

Everything I know about thallium poisoning I learned from Agatha Christie

Thallium poisoning, from the CDC.

Brad Evans

Salvia, Sally D, Magic Mint

Salvia, apparently derived from the Salvia plant, produces hallucinations and is becoming a drug of abuse.

Brad Evans

Medical treatment for obesity soon?

Reports say that a medical treatment for obesity, based on the hormone ghrelin, will be available within five years. If true, this could eliminate gastric surgeries for obesity. One wonders at price comparisons between gastric surgery and a new medicine.

Brad Evans

Epilepsy and Drowning

People with epilepsy have a 15-20X increased risk of drowning. They should shower, not bathe, and they should be under direct observation while swimming.

Brad Evans

Medicare rates hospital quality

Medicare is providing information on quality of care for individual hospitals. I have high deductible insurance, so, what I want is price information on common hospital charges, like the emergency room.

Brad Evans