A patient with yellow palms of hands ✋️
Yellow palms in a 55-year-old female. Some of the more common causes include:* Carotenemia: This is a condition that occurs when you have too much carotene in your blood. Carotene is a pigment found in many fruits and vegetables, such as carrots, sweet potatoes, and spinach. When you eat too much carotene, it can build up in your skin and give it a yellow tint.* Liver disease: Liver disease can cause a yellowing of the skin, including the palms of the hands. This is because the liver is responsible for breaking down carotene and other pigments. If the liver is not functioning properly, these pigments can build up in the sk...
Source: cochinblogs - July 23, 2023 Category: Radiology Source Type: blogs
Clinical Trials 101: Lecture 5
Okay, you ' ve made it through the preliminary rounds and now you ' ve gotten funding for your Phase III trial. In the old days, you could just go ahead and do it and if your sponsoring drug company didn ' t like the results, they would just bury them and not publish. Or, you could do what are called post hoc analyses, trolling through your data to find some endpoint that seemed to come out positive for some sub-group within your sample, and then pretend that ' s what you were looking for all along. Without getting too deep into the philosophical weeds, if you do that, your p values are bogus and the effect probably isn ' ...
Source: Stayin' Alive - October 22, 2022 Category: American Health Source Type: blogs
Clinical Trials 101: A digression
I ' m going to take a break from explaining the right way to do clinical trials to say a bit about a really, terribly, awful bad way to do it.That would be homeopathy. The link is to a piece about a consumer organization that is suing CVS for putting homeopathic " remedies " on the shelf next to actual over the counter medications that might do something useful. (A lot of them don ' t really either but that ' s another story.)First there ' s the question of biological plausibility. Homeopathy is radically and irremediably inconsistent with everything we know about physics, chemistry and biology. If we believe everyth...
Source: Stayin' Alive - October 21, 2022 Category: American Health Source Type: blogs
Clinical Research 101: Lecture 3
Now that we ' ve cleared away a bit of the underbrush, let ' s say you think that Eye of Newt Toe of Frog (Eontof) is potentially therapeutically useful against Creeping Crud (CC), and you want to test it. You face a whole lot of considerations. One is that you ' re going to need funding, which means you need to persuade somebody -- either the National Institutes of Health or a pharmaceutical company, most likely -- to invest in your idea. They ' re going to want to know that there ' s a reasonable chance of success with Eontof, and in the case of the pharmaceutical company that they can make money off of it, which brings ...
Source: Stayin' Alive - October 17, 2022 Category: American Health Source Type: blogs
Clinical Research 101: Lecture 2
Editor ' s note: Only about 15 million people so far have gotten the new bivalent Covid booster that ' s specifically formulated against the Omega variants that are currently circulating. I got it a few days ago, Walgreen ' s was offering appointments the same day! I got the flu shot at the same time, both absolutely free. Do it!So, picking up where we left off, to determine whether an intervention is beneficial, harmful or basically useless you ordinarily need a comparison group. There are actually exceptions. You don ' t need a randomized controlled trial for parachutes when jumping out of airplanes because you alr...
Source: Stayin' Alive - October 15, 2022 Category: American Health Source Type: blogs
Freeze Peach and Lies
We ' ve discussed here more than once the problematic aspects of the concept of free speech in general, and what the First Amendment means specifically.An excellent case in point is California Assembly Bill AB 2098. The link is to a post by physician David Gorski, who is irredeemably long winded, bu the gist of it is:It shall constitute unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness o...
Source: Stayin' Alive - September 26, 2022 Category: American Health Source Type: blogs
Iatrogenic disinformation
The Covid pandemic brought nuts with M.D. degrees out of the woodwork. Of course they were always around -- Viz. Mehmet Oz, who had a popular TV show he used to spread medical disinformation for years. Many physicians signed a petition to have has medical license pulled, or for Columbia to fire him, but neither happened. Now Richard Baron and Yul Ejnes in NEJM discuss the problem of how licensing boards should respond to physicians who spread disinformation, notably by social media since most of them don ' t have a TV show. (Of course, some of them worked for the Trump Administration and currently work for Ron DeSantis, a ...
Source: Stayin' Alive - July 7, 2022 Category: American Health Source Type: blogs
Nucking Futz
Andrew Prokop points out what is obvious, but seems generally to be ignored. The text messages between Virginia Thomas and Mark Meadows reveal not only that the wife of a Supreme Court justice conspired with the White House chief of staff to try to overturn the results of the 2020 presidential election, they also reveal that Ms. Thomas apparentlyactually believedDump ' s lies about it, but a whole lot of Q-Anon level insanity as well. Furthermore, we should have noticed by now that a whole lot of prominent conservative activists, politicians and other elected officials do as well.It isn ' t just a lot of uneducated yokels ...
Source: Stayin' Alive - March 26, 2022 Category: American Health Source Type: blogs
The torrent of bullshit
It ' s paywalled, but if you still have a NYT free read left you might want to check outGetting Rid of Joe Rogan Won ' t Solve the Health Misinformation Problem, by Julia Belluz and John Lavis. As they rightly point out, Joe Rogan and his guests spew dangerous falsehoods, but we ' re swimming in an ocean of crap. Health disinformation is as old as commerce. In the 19th Century, all of medicine was basically bunk, but people made fortunes selling worthless " patent medicines, " through traveling shows or by mail order, and in stores. It wasn ' t until 1912 that congress passed legislation outlawing labels with fa...
Source: Stayin' Alive - February 8, 2022 Category: American Health Source Type: blogs
The devolution of conservatism
Rejection of some elements of science by some conservative factions is readily explainable. Creationists cling to a pre-scientific belief system. Climate change deniers (apart from those who have a personal financial stake in fossil fuels and put greed ahead of their granchildren ' s lives) are committed to the Free Market ™ religion, which is inconsistent with anthropogenic climate change, therefore climate change must be a hoax.However, rejection of medical science does not have such a ready explanation. The Director of the National Institutes of Health, Francis Collins, is retiring.He has given an exit interview to CB...
Source: Stayin' Alive - December 17, 2021 Category: American Health Source Type: blogs
Merriam ‐Webster Needs To Update Its Definition of “Anti‐Vaxxer”
Jeffrey A. SingerPolitical polarization hinders progress against the COVID-19 pandemic.Political polarization may explain why, after former President Trump called the off ‐label use of the anti‐malarial drug hydroxychloroquine a “game‐changer” in the battle against COVID-19 (randomized controlled trials found that isnot the case), public health officials and the mainstream press appear uninterested in the off ‐label use of any other drugs as therapeutics against a COVID infection.For example, impressive data from randomized controlled trials show the off ‐label use of the off‐patent (...
Source: Cato-at-liberty - December 6, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Transcript for Growing Trust in Patient-Physician Relationships
Below is a transcript of the following Academic Medicine Podcast episode:
Growing Trust in Patient-Physician RelationshipsNovember 1, 2021
Read more about this episode and listen here.
Toni Gallo:
Hi everyone, I’m Toni Gallo. I’m a staff editor with the journal. And my cohost for today’s episode is Dr. Colin West, one of Academic Medicine’s deputy editors. And we’ll be talking to Dr. Richard Baron about his article entitled, “A Trust Initiative in Health Care: Why and Why Now.” That article was published in the April 2019 issue of the journal, and it’s available to read for fre...
Source: Academic Medicine Blog - November 1, 2021 Category: Universities & Medical Training Authors: amrounds Tags: AM Podcast Transcript Audio COVID-19 doctor-patient relationship health care health disparities health equity patient centered care trust Source Type: blogs
Get Ready for Deepfakes
By KIM BELLARD
The Tom Cruise TikTok deepfakes last spring didn’t spur me into writing about deepfakes, not even when Justin Bieber fell so hard for them that he challenged the deepfake to a fight. When 60 Minutes covered the topic last night though, I figured I’d best get to it before I missed this particular wave.
We’re already living in an era of unprecedented misinformation/disinformation, as we’ve seen repeatedly with COVID-19 (e.g., hydroxychloroquine, ivermectin, anti-vaxxers), but deepfakes should alert us that we haven’t seen anything yet.
ICYMI, here’s the 60 Minutes story:
...
Source: The Health Care Blog - October 13, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Artificial Intelligence Health Tech COVID-19 deep learning deepfakes dr fauci Kim Bellard Misinformation Source Type: blogs
Talk About The Triumph Of Hope Over Experience. This Rather Takes The Cake!
This appeared last week. Will specialists consent to Greg Hunt revealing their fees? The Medical Costs Finder site is being revamped 10th September 2021 By Antony Scholefield On the scale of government-funded white elephants, the Medical Costs Finder website is certainly not the biggest beast in the health policy safari park. It has not generated the taxpayer bills of My Health Record or disappeared into the National Medical Stockpile like Clive Palmer ’s 30 million doses of hydroxychloroquine — never to be seen again. But it has failed to fulfil its basic promise: to let patients compare fees between ...
Source: Australian Health Information Technology - September 17, 2021 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
More Laughing, More Thinking
By KIM BELLARD
There was a lot going on this week, as there always is, including the 20th anniversary of 9/11 and the beginning of the NFL season, so you may have missed a big event: the announcement of the 31st First Annual Ig Nobel Awards (no, those are not typos).
What’s that you say — you don’t know the Ig Nobel Awards? These annual awards, organized by the magazine Annals of Improbable Research, seek to:
…honor achievements that make people LAUGH, then THINK. The prizes are intended to celebrate the unusual, honor the imaginative — and spur people’s interest in scie...
Source: The Health Care Blog - September 15, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Research health research Ignobel Kim Bellard Source Type: blogs
