Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Reagan and AIDS

I've seen this image posted on my Facebook feed from two very-different friends:



[Update 15/08/23: I had only linked to the original graphic, which has since disappeared. I can't be sure now which image it was, but I think it was something like this one:]



 To which I have twice replied:

1981: # of AIDS deaths in US = 121, HHS funding per death = $1,600

1982: # of AIDS deaths in US = 447, HHS funding per death = $12,427

1983: # of AIDS deaths in US = 1476, HHS funding per death = $19,469

1984: # of AIDS deaths in US = 3454, HHS funding per death = $17,794

1985: # of AIDS deaths in US = 6854, HHS funding per death = $15,847

1986: # of AIDS deaths in US = 11932, HHS funding per death = $19,594

1987: # of AIDS deaths in US = 16908, HHS funding per death = $29,717

So, in 1983, the US federal government was already funding anti-AIDS programs to the tune of nearly $20,000 per death. The disease grew very quickly, from a trickle in the first few years, to almost 17,000 in 1987. It's hard to know in the early days of a new disease if it is going to have a wide effect. Very little was known in early days of how it was transmitted, what the death rate would be, or how many people were at risk. Would you have triggered a massive effort to eradicate a disease because fewer than 500 died in a year? What about fewer than 5,000?

As a point of comparison, probably somewhere around 75,000 people will die in the US this year of hospital-acquired infections.

Sources:

http://www.law.umaryland.edu/.../crsdocuments/96-293_SPR.pdf

http://www.nytimes.com/.../science/aids/timeline88-90.html

http://www.cbsnews.com/.../in-us-hospital-acquired.../

We've been waiting for this

This is what we have been working on at work for the last couple of weeks:



The LA Times has since put up their main article. Of course, they also had to mention the heparin incident as well.

Update (Saturday): The Independent newspaper in Britain has it on their front page: "Brain scans disaster at celebrity hospital". They really play up the celebrity hospital thing, even mentioning Heidi Klum's baby was just born there.

We've been waiting for this story to break. Kinda/sorta hoping it wouldn't, even though we knew it would.

Luckily, I haven't had to do much on this problem. My sis wasn't as lucky, and neither were my co-workers. Rumor has it that the NYTimes will have the story in the next couple of days as well.

Here's Cedars' official press release. Unfortunately, it's a Word document.

Medical Residency

My wife has started her residency in Occupational Medicine here in Tennessee. This is a program within the more general Preventive Medicine program. Since she doesn't have clinical experience in the USA, she has to go through internship training.

She leaves home at 6am, drives 45 minutes to a VA hospital in the area, gets off at 4pm, and drives home. Every few days she is on-call, and has to work overnight, with very little sleep. It seems brutally intense to me, as she barely has time for lunch or a break. We are hoping that it gets a little easier after her Internal Medicine stint is over. And when her stint at the VA is over, she will be at a local hospital which is a 10 minute commute.

I really have to wonder who thought this system was a good idea. How effective can you be after 24+ hours on your feet? How much of what you hear are you going to be able to retain? My experience is that I have far less memory retention ability when I am exhausted. If the point of this internship is education, I think the long hours will be a hindrance.

For now, it's pretty tough. She's only home one day a week, so we don't get a proper weekend. I think both the baby and I miss her!

Althouse v. Chopra et al.

Must read from Ann Althouse
[...] either treatments are supported by scientific testing or they are not. I'm not impressed that "many" alternative therapies have been "scientifically documented to be ... medically effective." The proper distinction is between what has passed scientific testing and what has not. I don't care about the categories "conventional and alternative." If it's proven scientifically it becomes conventional, doesn't it?
Behold the power of a lawyer who knows what she's talking about. Impressive.
Read the original Chopra article too
Heart disease, diabetes, prostate cancer, breast cancer and obesity account for 75% of health-care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle.

Prostate and breast cancer are reversible by diet? These men are dangerous.

SIDS

I find much of the discussion surrounding SIDS (Sudden Infant Death Syndrome) to be BS.

Take this case for example.
Though she [Melissa] felt anguished about leaving her baby for the first time, she also felt certain Jake was in good hands, and she resisted the impulse to check in. Rudy [Melissa's husband], also a physical therapist, didn't. He called the sitter three times, reporting to Melissa each time that the baby was just fine. He planned to pick up Jake at 3:30 p.m. Melissa hadn't heard from Rudy by 4 p.m., so she called his cell.

The instant she heard Rudy's voice, she knew something was wrong. "
So on the first day with this babysitter, an apparently healthy kid dies in an inexplicable way. What a coincidence! I can't imagine any explanation other than SIDS. Can you? But wait, there is more! It seems this medical phenomenon is not uncommon:
about 20 percent of all SIDS deaths occurred while the baby was in the care of someone other than a parent. One third of the infants died during the first week of childcare, and half those deaths occurred on the very first day.
The mystery deepens! Whatever could be the explanation? Science to the rescue:
"It may be that starting a new routine interrupts the baby's sleep cycle, so that when he finally does fall asleep, he sleeps too deeply,"
But of course! That must be it. Changing care disrupts the sleep cycle, and the kids literally sleep themselves to death! It all makes perfect sense, when you see it from a scientific perspective.
Spotting SIDS would seem fairly straightforward, but the truth is quite the opposite. ... The condition can be diagnosed only when a death has been carefully investigated -- including an autopsy, a study of the scene and circumstances of death, and an examination of the baby's medical history -- so that all other possibilities can be ruled out.
To whom, exactly, would spotting SIDS seem straightforward? SIDS is essentially medical jargon for "Beats Me!" SIDS has no positive identifying characteristics. It is merely the absence of observable cause.


An unexplained death of an infant would be a devastating blow to any parent. Most parents would do anything to try to avoid it. But presenting parents with a grab-bag of possible risk factors makes little sense to me. For example, how is "sleeping with a stuffed animal" going to cause SIDS? I can conceive of the remote possibility that a kid could suffocate under a stuffed animal, or could choke on it. But then that would be a suffocation or choking death, not a SIDS death. Is this just a modern version of the old wives' tale that cats steal babies' breath?


I am skeptical of the whole "back to sleep" movement too. The theory is that if you put a kid on his stomach, carbon dioxide can build up around the kid and suffocate it. When I was a kid, mothers were told not to put babies to sleep on their backs, for fear that they would choke if they happened to vomit. Which theory is a parent to believe? I've looked up the scientific studies for some of these claims, and was not very impressed.

New parents are inundated with lists of risks to their baby. Much of what is passed off as science is shaky at best. (Don't get me started on the topic of breastfeeding!). I would suggest that parents take this advice with a grain of salt and a heap of common sense.

As for SIDS, I say any childhood death should be investigated thoroughly. By all means, let's look for common causes. There is no downside to doing so. But it is wrong to assume that every unexplained crib death is in fact due to some such common medical cause.

Update: An interesting article and book.



Ann says: Our medical doctor sister believes most SIDS deaths have always been flat-out murder. Possibly overwhelmed care-givers who do the unthinkable.