Medblogs Grand Rounds 10

is up: DoctorMental: Medical Grand Rounds 10

Target has what You’re Looking For

A screen capture of an unusual holiday offering:
happy holidays, hophead

I suspect the original link will be “broken” (meaning fixed) by the time you read this, but here it is: http://www.target.com/gp/detail.html/601-0824952-0161764?asin=0823916839
Update: now the link is broken.

FYI, heroin did’t match anything on their site.

via Instapundit

More in the extended Entry
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Safe Cycling

the helmet makes the outfit

Safety First!

New Sidebar Entry

I have a new sidebar entry, linking to the Medblogs Grand Rounds hosts, starting this week, with another link to the Medblogs GR Archives.

Hope this helps.

It’s not that I’m a Procrastinator

…it’s that I’m Deadline Oriented.

Flu and You

Well, actually, from the current stats, NOT you. For those who need something to worry about, however, read to the bottom.

CDC – Influenza (Flu) | Weekly Report: Influenza Summary Update 46, 2004-2005 Season

Week ending November 20, 2004-Week 46

The following information may be quoted:
Synopsis:
During week 46 (November 14-20, 2004)*, influenza activity overall was low in the United States.
… However, in the Mid-Atlantic region there were increases in both the proportion of patient visits to sentinel providers for ILI and the percentage of laboratory specimens testing positive for influenza. Two states reported widespread activity, and 1 state and New York City reported regional activity. Thirty-one states and the District of Columbia reported sporadic influenza activity and 14 states reported no influenza activity.

It’s about 3/4 type-A, but enough type B that this year, should I actually see any flu, amantadine won’t be my drug of choice.
However, there’s even better news if you got this years’ influenza vaccine:

Antigenic Characterization:
CDC has antigenically characterized 11 influenza viruses collected by U.S. laboratories since October 1, 2004: nine influenza A (H3N2) viruses and 2 influenza B viruses. All of the influenza A (H3N2) isolates were characterized as A/Fujian/411/2002-like (H3N2), which is the influenza A (H3N2) component recommended for the 2004-05 influenza vaccine. Both influenza B viruses characterized were B/Shanghai/361/2002-like, which is the influenza B component recommended for the 2004-05 influenza vaccine.

So, luckily, the flu isn’t bad this year (so far; things can change), but to date we’ve been spared a horrible epidemic.

Speaking of horrible epidemics, WHO warns of dire flu pandemic

BANGKOK, Thailand — The World Health Organization has issued a dramatic warning that bird flu will trigger an international pandemic that could kill up to seven million people.

The influenza pandemic could occur anywhere from next week to the coming years, WHO said.

“There is no doubt there will be another pandemic,” Klaus Stohr of the WHO Global Influenza Program said on the sidelines of a regional bird flu meeting in Bangkok, Thailand.

“Even with the best case scenario, the most optimistic scenario, the pandemic will cause a public health emergency with estimates which will put the number of deaths in the range of two and seven million,” he said.

“The number of people affected will go beyond billions because between 25 percent and 30 percent will fall ill.”

No vaccine even possible before 2007 at the earliest.

I’m not hugely concerned, yet, about a bird-flu pandemic. I think I’d have an entirely different concern if I lived in a high-population-density country with lots of close contacts to birds (like Asia).

Home for the Holidays

My wife has contributed to the blog! Here’s what she has to say:

Home for the holidays?? Sorry Mom?….

I usually DO the holidays, but this year I can?t. I am recovering from surgery, so we are going to Mom?s. I just called her house, it does not sound good, my eldest daughter is unhappy and surly, and my sister sounds stressed and disgusted. Mom is exhausted.

Get out the hose.

One of my favorite movies is Home for the Holidays with Holly Hunter. Charles Durning turning the water hose on his son and son in law, fist fighting in the front yard is the best. We all have dysfunctional families. That?s what family is all about. If I knew anyone with a picture perfect family, I would bow down and say BS! Where are you hiding the stress of real life? My only job this year is to cook the Turkey. So, Mom called me yesterday asking “will the turkey will have crisp skin?” ( I hope so)… “will it will be moist?” ( that?s the plan) and “do you plan to cook it until done?” (well, no, I plan to give everyone in the house the dread underdone turkey disease?the trots).

What kind of weird family do I have? One just like yours?

Medblogs Grand Rounds 9

shrinkette: Grand rounds #9 is up. Go forth, and see what the Shrinkette has linked.

Nurse: Worst Job in Science

Don’t believe me? Believe Popular Science:

Nurse – Popular Science

In our Internet-based summons for readers to top (bottom?) last year’s “Worst Jobs” list, nurses nominated themselves in droves: “Still a no-respect profession. Doctors treat you like slaves.”? “The pay is substandard for all the training.”? “Just look at the current shortage.”? Indeed, the government estimates that we’re short 110,000 nurses, and that by 2008 we’ll need half a million more.

Numerous studies echo the dissatisfaction of our nurse readers. Nurses are fleeing the profession because of stress, long hours, low pay and lack of advancement opportunities. The cost? A recent University of Pennsylvania study found that surgical patients at hospitals with the worst nurse-staffing levels (ergo the most overworked nurses) have a 31 percent greater chance of dying. If this trend doesn’t improve, we might soon find “patient” topping our list.

(emphasis added)
And if you don’t believe me, believe the nurses who nominated themselves.

Google Scholar

Google Scholar
Excellent tool for doctors or others seeking technical papers. I’d been looking for a paper about a particular tox topic, and was unable to find it with a regular medline search. Google Scholar found it on the first page of returns.

Not so Secret Service

I guess there isn’t much going on in Chile, or this was a Really Big Deal:

CNN.com – Secret Service agent clashes with Chilean police – Nov 20, 2004

Several Chilean and American agents got into a pushing and shoving match outside the cultural center where the dinner was held. Bush noticed the fracas after posing for pictures on a red carpet with the summit host, Chilean President Ricardo Lagos and his wife and first lady Laura Bush.

Abandoning the other three, Bush walked over to the agents, reached through the dispute and pulled his agent from the scrum.

The president, looking irritated, walked away with the agent. The incident was shown on APEC television.

“Chilean security tried to stop the president’s Secret Service from accompanying him,” said White House deputy press secretary Claire Buchan. “He told them they were with him and the issue was resolved.”

There has to be a lot of interesting politics in the security of international protection,and I’m sure the Secret Service has been through worse, though nothing really pops to mind from the press. Although initially I wondered at the restraint of the Agent in Question for not deliberately wounding the Chilean in front of him (and there can be no mistake, this was a very deliberate attempt by the Chileans, foiled by our “Cowboy President”). Then, I wondered if this was some sort of payback for a real-or-imagined-slight of the Chileans in the past, then the realization that I didn’t understand the politics swept over me. Hmmm.

Politics happens in all fields. In this instance, the President managed to diffuse an international incident before it got started (I have to think the Secret Service would have shot their way in, or died trying, before being locked out), and bully for Bush for stopping it before it really got started.

Update: Chileans have their revenge. No soup for you!

Personal Responsibility and Cashing In

Tonight while eating dinner at work I was watching the news, which I thought would be the least objectionable thing on. I was wrong.

There was a follow-up feature on a local tragedy, the death of a toddler just 2 1/2 years old, run over by her dad in a driveway backup accident. This is a horrible thing, and I cannot imagine the loss, grief and guilt this would engender in the parents of this poor child. I can imagine a lot of responses, but was unprepared for this couples’ response: ‘It’s the car makers fault for not putting in a backup camera':

WFAA.com | News for Dallas-Fort Worth, Texas | Latest News
The family of a Garland girl who was accidentally killed last month when her father ran over her is suing a major car manufacturer for negligence.

On October 9, (dad) backed up his Infiniti SUV and tragically ran over and killed two-and-a-half-year-old (child).

“You just can’t imagine the absence that is in our hearts right now with the loss of our daughter,” mother…said. “She rocked our world … she was everything to us.”

The family is suing Nissan, the parent company of Infiniti. They claim new back-up video cameras or sensors which detect objects behind a vehicle were available, and should have been installed in their SUV.

“This manufacturer was already putting it on some of its other vehicles, and it should have put it on this one,” attorney Windle Turley said.

In a phone interview with News 8, Nissan/Infiniti spokesman Kyle Bazemore said the child’s death was “very sad, very tragic,” but added that even when an SUV comes equipped with a back-up video camera, it’s not fool-proof.

“It’s a convenience; it’s not a substitute for proper reversing procedures,” Bazemore said. “Drivers should always turn around and look.”

“Yes, it’s our responsibility, but so many tragic things have happened with children because of that,” (mom) said.

Yes, it’s our responsibility, but

and that’s where you lose me. I cannot be sadder this child died, and these may well be the most responsible and attentive parents on the planet, but what happens to your child is your responsibility, period.

And when horrible misfortune befalls you, don’t blame the car manufacturer because ‘backup cameras’ were available but “weren’t installed”. According the Kelly Blue Book, 2003 Infinity FX35 and 45’s (I don’t know which model this was, there is no mention in the article and the televised report showed only a glimpse) both come with a “video system” as an option, and as it’s broken out separately from the DVD, that tells me it’s (probably) backup cameras.That tells me it was an option, just one that wasn’t ‘opted in’. Even if a backup camera wasn’t available, you knew it wasn’t there the day you bought the thing, and knew that backing up is inherently dangerous. Don’t blame a conveniently deep-pocketed manufacturer for your own negligence.

I have come to a very depressing conclusion: the only tort reform that will ever be really effective is people taking responsibility for their own decisions, their own lives, and the realization that nobody is perfect. I don’t see our culture embracing that anytime soon.

More’s the pity.

Message to Movable Type Users

I have been getting hammered with comment spam, but have been using Jay Allen’s MTBlacklist with pretty good, if not perfect, results.

The other day I got sick of it and started looking for another solution, and renamed my comments file, following the instructions here.

Since renaming, I haven’t gotten one piece of comment spam. Comment spammers are in it for the volume, and so just hit everyone with the default-named comment files.

So, go forth and tinker, and leave the spammers behind. For now.

Smokeout

ACS :: Great American Smokeout

The American Cancer Society (ACS) holds the Great American Smokeout? each November to help smokers quit cigarettes for at least one day, in hopes they will quit forever. This year’s event will be held on November 18, 2004.

So, dump your butts, and live longer.

2004 Medical Weblog Awards

EchoJournal.org

The 2004 Medical Weblog Awards
2004 Medblogs Awards

Today we would like to announce The 2004 Medical Weblog Awards which will honor the best of the medical blogosphere.

Voting for the awards will be open to all, but you will only be able to vote once (we control the polling software: so no hacking or cookie manipulation will be tolerated). Nominations are now accepted in the comment section of this post. You can nominate yourself or your favorite medical blog.

Nominations are open through most of December.

Update: nominations need to be in the comments of EchoJournal’s contest post (now conveniently linked), NOT this one.