"It is true, and thus the question of whether it is sad or happy has no meaning whatever."
Bernhard Schlink

Science is best when discussed: leave your thoughts and ideas in the comments!!

Tuesday, August 31, 2004

Increasing Costs 

Another reason health care costs so much is that people (who are not doctors and have no medical training) go about demanding expensive procedures they think (often based on advertising) will do them some good. The current full-body-scan craze is a prime example.

First of all, the chances that it'll find anything in an asymptomatic patient (i.e., the kind getting these scans, because if they had symptoms a doctor could treat them) besides false-positives is very low. Second, in addition to not being helpful in diagnosing or treating cancer (what it's mostly billed as doing), it looks like it actually increases your risk! Is anyone surprised? Not really. I really like Chris Rangel's advice to the people to want these scans (since they're paying out of pocket):
Change over to magnetic resonance whole-body scanning. It may be more harmful to your wallet but it has no proven cancer risk and is just as useless as a screening exam. Have fun!
Now, since I just said people were paying out-of-pocket for this stuff, you're wondering why it makes health care more expensive for the rest of us? Here's how:
Mr. X goes to his doctor, and demands that he be given a full-body scan because *something* might be wrong with him. The doctor says no, but still bills for the visit. Since the doctor is Mr. X's GP, X pays his co-pay and insurance covers the rest. That's, say $100, out of the general pool of money.
Then, Mr. X goes to the body-scan guy on his own, and pays his own $2000 for it. And the scan guy finds ... something. Feeling vindicated, Mr. X goes back to his GP, who sends him on to a series of specialists to look at whatever the scan found. Most of the time, the scans find an artifact (a false positive), so Mr. X has just spent probably thousands of dollars of insurance money on specialist visits and more tests to prove that he does not have an illness no one thought he had in the first place.
The insurance pools have to be replenished from this, so the company raises premiums. Plus, he's increased his chances of actually getting cancer later on, which will cost even more!
Even if the scan finds a real tumor (which is very very rare), it's not likely that detecting it this way will have any effect on his treatment outcome, and thus he's still wasted all that money.


The brains of males and females have a number of specific structural differences. In rats, one is that in males, the BNST area contains more cells than in females, and the AVPV area less. This difference is, like many sex differences, determined by the presence or absence of testosterone early in life (meaning that the "female" is the default state).

A study just published finds that these differences seem to be mediated by a single gene: Bax, which is key to apoptosis. Bax knockout mice have equal numbers of cells in both areas, regardless of gender (or should we say sex? I'm not up on my current identity politics...). I am definitely looking forward to the behavioral examinations mentioned at the end!

Hepatitis C 

Hep C (HCV) is a chronic disease that can lead to liver failure and death. A friend of mine has it, and as a result, she is on medications which have thinned her hair, make her weak, and cause blood vessel rupture in her eye. She has also had a liver transplant, but of course that doesn't get rid of the virus.

HCV infection is on the rise, particularly among gay men in America, who seem to think that AIDS is over, and that AIDS is the only thing they can get from unsafe sex. And unlike Hepatitis A and B, there is no vaccine. Yet. But, the good news is that a new study shows hope of producing one. Yay.

Monday, August 30, 2004

Health Care Reform 

....Is very much needed. Graham, over at Gross Anatomy explains, via cute animation, an idea of which I'm a huge fan. For the curious, his numbers check out with what I have at work; if anything he underplays how unimaginably wasteful the current, third-party-payer system is.

Fatty McCoronary 

Since the FDA finally got around to banning Ephedra earlier this year (I'm not actually in favor of banning things like this, but since we ban some this one needed to go too), there has been an influx of non-ephedra diet supplements (a.k.a. drugs) on the market.

Now, big surprise, these have also been found dangerous, and also ineffective. C. aurantium extracts appear to have similar metabolic effects to grapefruit, and also causes hypertension.

Take-home lesson? Try losing weight the old-fashioned way: eat a healthy diet and exercise! Also, once you're eating right and exercising, grow some self-esteem and stop worrying about it.

Saturday, August 28, 2004


In honor of the recent DC Blogger get-together, and of today's fabulous DCGB event, I've moved my links to DC bloggers to be under their own heading. And because I don't actually have anything useful to say right now, you get a picture, to remind us that there are cooler days ahead.. (Copy right me, 2004, of course)

Friday, August 27, 2004

Medicine in A Dead Language 

In the course of my work, I occasionally run into some bizarre things. In attempting to find a good, policy-oriented (not too philosophical or too econometric) definition of medical technology, I came across this page. Either someone at Advamed has a brilliant sick sense of humor, they've been hacked, or, as is ever more likely, it's a portal to some alternate universe.

Anyone who's taken Latin more recently (not to mention seriously) than I might, just for fun, tell me what it says. But please, only one repetition.


I just found a way to waste way too much time. "The Face of Tomorrow" is a project of putting together composite faces in a bunch of cities in the world...kind of what the city would look like in X years if the population isolated. There's an extensive research literature showing that 'averaged' faces are rated most attractive, so yes, the composites are gorgeous. I spent a lot of time looking at them.

I do note, however, that there seems to be an attractiveness bias in the photos used to make up the composites.

(via LYD)

The Jaw Bone's Connected To The.... 

...Latissimus dorsii?
A German cancer patient who had his jaw removed in 1997 as a radical cancer treatment has now got a new one. Not a fake plastic or ceramic one either: a real, live, bone one! His doctors did a brilliant procedure, where they grew him a new jaw bone in his shoulder muscle, using a mesh model and bone growth factors, and then transplanted it into his face. He can now chew some solid food, and next year they'll get him some teeth!

Fatty McAtkins, Again 

There's plenty of debate about the Atkins Diet, and low-carbing in general. One thing that is becoming clear, however, is that what kind of carbs we eat is important. A study to be released in tomorrow's Lancet details the differences found in rats given a diet containing low versus high glycemic index (GI) carbohydrates. It turns out, much to the surprise of the medical establishment, that the high-GI rats ended up much worse off. They were fatter, had the high-risk "apple" body shape, and their triglyceride levels were triple those of the low-GI group.

So it seems we don't need to worry about no-carb or low-carb, but instead about GI. I can live with that.

Thursday, August 26, 2004

Treatment Options 

No idea where this came from, I think it got sent around my office or something. Sadly, sadly appropriate.


For those who were really annoyed by the running commentary over Bjork's singing at the Olympics opening ceremonies, or like, me, missed them entirely, you can see/hear the full performance. Here. Also check out John Kerry on Jon Stewart (Warning: direct .mov link!!).

Don't you just love the internet?!?!

About A Brain, III 

Some of the oldest conventional wisdom around is that a clean house is a Good Thing. It probably is, but those silly scientists can't ever just leave well enough alone! The problem is compounded by the media, who paint every new bit of research as a black-and-white fact about How You Should Change Your Life. Even the BBC, which is about as good as mass-market journalism gets these days, occasionally does something really stupid.

Today, in the Health section, right next to each other, are two very conflicting articles. One describes research (which, by the details given, is likely crap) showing that messy households are linked to lower intelligence in children. There does not appear to have been a control for income or education. The second highlights hyper-clean houses as a possible cause of asthma in children, and gently blames cleaning products for all sorts of other ills. I've seen some of the older research here, and it's pretty unconvincing.

So, we have two articles from a reputable source, simultaneously telling us that in order to raise smart, healthy, successful children, we must do so in a house that is either messy or clean. Useful, huh?

About A Brain, II 

Other conventional wisdom has been that smoking pot induces psychosis and that excessive Anandamide (an endogenous cannabinoid: something your body makes which is what naturally acts on the system TCH does) was a possible cause of schizophrenia. Studies were done and researchers found that in schizophrenics, Anadamide was hugely increased, and that established a link.

However, as anyone who takes research methods seriously will remind you: correlation does not equal causation!!! More research got done, and it now seems like Anandamide acts as a natural anti-psychotic, and THC causes psychotic symptoms because it reduces Anandamide receptors' (CB1) sensitivity.

Take-home lesson: always do your follow-up experiments!

About A Brain 

A few brainy surprises appeared today, which doesn't really come as a surprise, since we know so bloody little about how all that grey goo does what it does. Anyone who tells you otherwise has never really studied neuroscience, or is delusional. This will be in multiple posts, because I don't want one huge one.

The conventional wisdom, up until this study is replicated, has always been that the adult brain is much, much less plastic (adaptable and changble) than the pre-adult brain. The press release is very short on details, but this is really fascinating. I want to understand the 'rewiring' process, especially...anyone know anything more?

Wednesday, August 25, 2004


As everyone can tell, I'm not a big fan of heath/diet fads. The idea of creatine magically causing you to build extra muscle makes no sense, and there's still no evidence for it (nor do I think there ever will be), but it turns out that it may have other promising attributes. A Temple University study recently linked creatine supplements to increased metabolic energy.

The study was looking for a molecular basis for Chronic Fatigue Syndrome, a condition which may or may not exist (what I've seen seems to indicate that it does, and that it is debilitating), and hopefully sheds more light on that than the release does. And a better understanding of metabolic regulation is a Good Thing too, regardless of immediate commercial applications.

Liver Time 

Jet lag sucks. I don't really get it anymore, having learned to trick my system into adjusting very quickly, but I used to be totally wrecked for a few days after a big trip. Possible treatments for jetlag and shift-worker fatigue are the more commercial (and far less interesting) results of research into circadian rhythms and biological clocks. Since sequencing the genome (and before that too), scientists have found a number of genes which seem to be associated with circadian cycles, but no 'masters' have yet been identified.

A series of experiments lead to identification of a transcription factor, called Rora, which seems to function as such a 'master,' controlling another key gene in the system. The release gives lots of good background on all the processes involved, so its great reading (and not too technical!). Enjoy!

More Sex 

Two quick bits about naughty bits. Researchers have discovered genes in fruitflies that determine the duration of copulation. In other words, they produced Ron Jeremy flies. Just as the Viagra craze was starting to die down, too.....

And the bad news. It seems that the popular hormonal contraceptive, Depo Provera, triples the likelyhood of Chlamydia and Gonoccocal infections. A word for the ladies: D'Oh!

Tuesday, August 24, 2004

Blog Meme 

Or is that "Bleme?" A couple others have posted these, so since I haven't the time or inclination to write a real post, here's mine:

You are a XPIG--Expressive Practical Intellectual Giver. This makes you a Catch.
You are a magazine-cover, matinee idol dreamboat. Parents love you and want to set you up with their kids. However, first dates are tough because it takes time for your qualities to come out.
You are generous and kind. You think first and act later. You are cool in a conflict, but your practical side means if your partner throws out emotional appeals ("why can't we do what I want for a change?") they will grate on your nerves, even when the conflict is resolved.
You're a romantic. You enjoy the thrill of the hunt, and you don't just fall into bed with anyone. You pay close attention to your significant other's needs, and this makes you an excellent lover and partner. The problem is that your friends and lovers may find it so easy to express things to *you* that they lose sight of whether you feel as comfortable with *them*! This doesn't necessarily make you feel under-appreciated -- you're too well-adjusted and self-aware for that -- but you may feel restless. Thus you seek adventure in your life outside the relationship to prove and actualize yourself.
Of all the types, you would make the best parent.
You are coiffed.

Didja see "Big Fish"? 'Cause you're like Ewan MacGregor in "Big Fish."

I didn't see "Big Fish," but any comparison of me to Ewan MacGregor is probably OK in my book! Also, the first three sentences don't match: I'm a dream-boat (fine, ok, sure), parents set me up, but it takes a while for my qualities to come out. Huh? Yes, that third bit is definitely true, both about first dates and my qualities, but it's a non-sequitor there.

I am very attentive, and do tend to lose sight of my own needs while taking care of everyone else. Well-adjusted is another story.

Funny thing about the 'best parent' bit...I'm not at all sure I will ever want kids.

I think I'm pretty well coiffed.

Monday, August 23, 2004

No More 'Owie...' 

A new company will begin, in September, to market an ultrasound device which makes the skin temporarily more permeable, easing drug absorption and reducing the pain of shots. I'm not really clear how/why this works, but it sounds like a good thing to me!

Adonis McStay-Fit 

Mayo Clinic researchers have found that when mice have a mutation in the immune gene TLR-4, they are naturally svelte their whole lives, and don't have age-related bone thinning. Sounds good to me, but I wonder what effect this has on their immune function? They don't seem to have any deficits, but one hopes there's some reason we have a gene that makes us less fit!

Kerry Crushes Bush! 

This happy thought of the day comes via Electrolite. Especially since we know which species will survive the nuclear (no, it's not pronounced "nuc-u-ler") apocalypse.

The Cure! Continued 

I posted earlier about a promising cure for type I diabetes, using transplanted insular cells. That was very promising, but now will hopefully get a boost from some new research in which pancreatic stem cells are coaxed into differentiating into new insulin-producing cells. As I've said before, curing diabetes would not only make millions of peoples' lives infinitely better, it would also lower healthcare costs for all of us.

Safety Dance 

I just got back from visiting my grandparents for the weekend...my grandmother fell and broke her hip. So, falls and patient safety/care quality (they live in the semi-rural Midwest, where health care is...uhm...not as good as I'd like) are on my mind. Lo and behold, two articles!

The University of Washington reports that old people who wear sneakers (which, I note, both of my grandmothers refuse to do) are significantly less likely to fall. Other shoe types were associated with a 30% increased risk, while walking barefoot was even worse. I guess this means I will be going shoe shopping for my grandmothers soon. Oh joy.

British researchers have found that email communication between doctors and patients has serious potential (summary here) to improve the quality of that relationship and care overall, not to mention cutting costs. Even my grandparents use email, and it would be preferable for them to get info from doctors that way, since they often have trouble understanding and remembering what they hear (emails can be kept and/or forwarded to me for interpretation). Very interesting!

Friday, August 20, 2004


After the Quote of the week, we get Great News of the Week!!! An Australian study has found that "using" porn (not really sure what they mean by that, I think of it as more of a visual thing) is good for you. The details are not given, but some things I'm willing to take people's word on!


Quote of the week comes from Eurotrash, and it is:
Eating disorders did well for Mary-Kate Olsen. I'd like to see Paris [Hilton] even thinner. Maybe she'd disappear entirely.
I can think of a few other people I'd like to similarly encourage.

Stinky Without Drinky 

Like getting drunk but hate the taste of alcohol? Well, it's your lucky day! Already available in Europe and Asia, Alcohol Without Liquid (AWOL - perfect for the Preznit!) offers a perfect solution! Instead of sitting around with friends and chatting over a drink, you sit at the bar and put your face in a machine, inhaling alcohol to get buzzed (allegedly without hangover)! Sounds like the perfect social activity, right? And of course people already are trying to ban it, because this is America, and we like making big, exciting black market items out of things that would otherwise just go away.

Quantifying Intelligence 

I'm not a big fan of standardized measures of intelligence. I find they don't get at what's important, namely a person's ability to function, but instead substitute a nice-sounding statistic. And the tests are so totally biased towards 'Western' culture and value systems. /rant. Now on to the science!

Remember all those music lessons you hated as a kid? Well, it turn out they may have made you smarter. A new study of Canadian children showed that the ones who took music (voice or keyboard) lessons for a year had a small but significant, across-the-board IQ boost over control kids, who took no lessons and who took drama lessons. The drama kids, interestingly, got a unique boost in measures of adaptive social behavior (Fascinating, given the social standing of most 'drama kids' in high school!).

There's an old linguistic theory that says what language you speak affects your cognitive abilities. Annoyingly, there is now evidence to support this idea: researchers have found that people of the Pirahã tribe in Brazil, whose language has only the enumerations "one," "two," and "many," can't distinguish between larger groups of objects. It's really kindof creepy, and I almost hope the research turns out to be invalid. Because that's fucking scary.

Thursday, August 19, 2004

More Silliness 

I've always wondered what celebrity I look like...I've gotten John Cusak more than any other. But, according to this website, I look like (1) Iker Casillas; (2) Gary Oldman; and (3) Christian Bale. A bizzare assortment, yes, but I like the first one best (amazing he's the "best fit!"). Now if only I could play soccer worth a damn!

The "Is That a Banana In Your Pocket?" Republic 

A bunch of gay Aussies, pissed off about their government's ban on gay marriage, have banded together around a descendent of England's Edward II (which is horrifyingly appropriate) to create their own Gay Kingdom. They've declared independence from Australia, and have a truly ridiculous web site, and promise to recognize the independence of Taiwan and Nepal, because that will further endear them to major world leaders.


David gets props for this little bit of ridiculous: a black bear raids beer cooler and passes out. Returns the next day for more.

Silly Quiz Time 

(Via Avram)

You are an enzyme. You are powerful, dark,
variable, and can change many things at your
whim...even when they're not supposed to be
changed. Bad you. You can be dangerous or
wonderful; it's your choice.

Which Biological Molecule Are You?

Beam Me Up....Rupert 

Swiss physicists have ‘teleported’ a photon 60 meters. This discovery is a long way from being useful, and is much closer to allowing quantum computers than actual Star-Trek-esque travel, but cool nonetheless. And something said to be impossible not so long ago.


First, medical researchers have developed an electronic 'pupilometer' which gauges pupil reaction time in head injury victims. This is a central test for assessing severity of head injuries on the spot, and making important treatment and transport decisions during the critical fist few minutes after an accident. Helps reduce human error and subjectivity. Cool.

The second is unrelated to vision, but it's about wakefulness (opening your eyes...) so I'm putting it here anyway. UC-Irvine researchers have found critical roles for the relatively recently-discovered Neuropeptide S (NPS): it increases wakefulness/alertness and decreases sleepiness, and reduces anxiety responses. NPS receptors (G-protein) were found in Locus Coeruleus, which has long been associated with these functions. Cool beans, I want my new study drugs!!! NPS receptors (G-protein) were found in Locus Coeruleus, which has long been associated with these functions. Cool beans, I want my new study drugs!!!

Lastly, and most exciting, is a demonstration of a retinal implant system to restore vision. Instead of retinal transplantation, a traditional goal, these guys just put a chip onto the eye that stimulates the nerves that are already there (and usually undamaged). It's a wireless video link from a mini camera the patient has on his/her glasses. The put the implant outside the eye, because "the eye doesn’t like stuff inside; that’s why it doesn’t have a zipper.
So. Fucking. Cool.

Wednesday, August 18, 2004

So Offensive 

MTV used to be cool. Back in the 80's, when they played videos all day and night (and had more than six at a time in rotation, gasp!), only briefly interrupted by Kurt Loder or Tabitha Soren announcing the news in their best I-went-to-journalism-school-for-this-shit??? voice. And even the beginning of the Reality TV era, The Real World (One and Two) was good. It was new, it was interesting, the people were as close to 'real' as you can get on-camera. Then, Everything Changed. MTV all but gave up on music, and as far as I can tell fired all their program writers and execs and replaced them with semi-retarded 12-year-old boys.

But just when you thought Fox had taken the prize for demeaning, offensive programming, MTV strikes back!!! While it seems innocent, a show helping kids come out to their parents (which, thanks in part, I'm sure, to MTV's love for anti-gay stereotypes and artists, lots of kids need), the casting call belies the awful bit: "...we'll explain this hilarious new show..."

Yeah, because risking your relationships with your entire family and turning your life inside out is bloody funny! And no one could possibly get hurt. My parents didn't freak when I came out to them, but if I'd done it on international TV, I would probably not be alive today.

(hat tip to Chrisafer)

McGreevey, Part 2 

I promised a while back to write a real entry about this situation. I'm too busy to write it, and also too tired and generally cranky with life.
Plus, Dan Savage has managed to say most of what I would have said, albeit in a totally different way than I would have said it.

Uncle Sam Gets it Right 

Considering how reliably the Federal Government fucks things up, especially when money is involved and even more when the military is doing the spending, this report on the VA's diabetes management system is both a relief and generally a Good Thing.

One of the major problems in health care today is making sure everyone gets the right treatments and tests, without going overboard and overtreating (which is at best expensive, and at worst dangerous). The VA began a number of years ago implementing its electronic patient tracking systems, with a particular focus on diabetes as a 'target' disease. The results are in, and VA system works better than HMOs. This is being touted as evidence that a nationally funded health program is effective. So maybe we can get some momentum towards a real national health plan!

Another Retrovirus 

HIV gets the lots of attention, both here and elsewhere, but that means that many people forget (or don't know) that there are plenty of other very deadly (and not deadly, but they're less interesting) retroviruses out there.

In an intriguing new study, UK and US scientists have found that certain NK cell immunoglobulin-like receptor alleles seem to be more able to clear the Hepatitis C virus (HCV) than others, granting a sort of immunity to carriers. This effect is likely overwhelmed by high-dose infection, but I wonder if an initial, low-dose infection acts as a vaccine?
This finding likely has implications for other diseases as well, so expect some follow-up in this area.

Nice Tits 

Researchers in the Netherlands have found that female blue tits are better mothers when their mate is 'sexy.' Females paired to more attractive (in blue tit terms, with more UV coloration in his coat) males took better care of their chicks. Very interesting sociological implications, if it applies to humans as well (I'm sure it does, but try getting funded to test it!)

Tuesday, August 17, 2004


I've only watched the swimming (which is amazing and fantastic, plus the guys are all so hot) and some of the beach volleyball (which turns out to be pretty boring), but the Olympics are on, and, as usual a Big Deal. Which is why I cannot resist pointing everyone over here, because it's nice to see it all taken down a notch.


Russian scientists have found a nasal cream to be effective against hay fever. Now, I would love relief from that misery every spring and fall, but I'm not sure how I feel about putting cream up my nose. That sounds both gross and uncomfortable. Plus, don't you also breathe pollen into your mouth?

Baby Steps 

The news today brings two very exciting bits about HIV, but they're still only small steps towards a cure or vaccine. First off, NIH researchers seem to have found a way to coax HIV out of latency, which would allow for better control of infections and, when we have more technology, eradication. So very cool.

The second study is really amazing. It seems that the ever-popular (and controversial) statins have a new benefit: they may block HIV!! Bloody amazing. You gotta wonder what it is about these drugs that makes them so widely beneficial...and what other effects they have that aren't yet apparent.

Monday, August 16, 2004

Sexy Sounds 

You ever notice that people witha certain name all seem to be really hot? No, me neither. But for anyone naming babies these days, you might want to read this article (and others with more details, when published). It turns out that people with certain vowel-sounds in their names are rated hotter than others. "Matt" is a sexier name than "Paul," apparently. Yeah, Matt is pretty damn hot...but so is Paul.

Reading List 

A list of must-read sci-fi. Looks pretty good to me...I've read some of them, heard of most of them. Thoughts?


Indian students are getting a math boost from old Sanskrit texts: "Verdic math" offers a system of tricks and solutions. I should look into this. I have to take the GRE's soon....it might help!

More Marijuana 

The medical marijuana 'debate' (if you can really call it that) still rages, but more and more evidence supports the reasonable conclusion: there's a lot of good medicine in pot. A study released today in Cancer Research, shows that Δ-9-tetrahydrocannabinol, a.k.a. THC, is a potent in vitro and in vivo inhibitor of tumor angiogenesis, and seems to be effective against one of the nastiest types of brain tumor, Glioblastoma multiforme.

Previous research also shows THC's ability to affect apoptosis and other aspects of cell cycle regulation. But don't worry kids: all these things don't seem to happen just from smoking pot (unless you smoke A TON)!

Friday, August 13, 2004

Come On! 

I've been very busy recently, and also there's been a ton of interesting news. So I've been posting things that I'd like to be thinking and learning about, except I'm too busy to do it right now (and have no internet at home, so...), in the hopes that people would engage in lively, informative and interesting discussions like what happens on other blogs' comment boards.

Instead, JK does all the work!

Come on, people!


There are a lot of things that go through my mind on this one. Is he resigning just because he decided to come out? Is it because of the affair (which, had it been a heterosexual affair, would have been much less of a scandal)? Can he now go ahead and become a big-name gay politician, and do some good out of the closet? An essay in today's Post is both interesting and infuriating, often at the same time. I wonder who the author is.

I'd really love to hear what everyone else thinks.

Wednesday, August 11, 2004

Music of the Moment 

Beethoven's Symphony Number 2, movement IV. Because it's only just now popped into my head as being as cool as it is.

Lazy McRhesus 

NIMH scientists have used antisense expression constructs to suppress rhinal cortex dopamine in monkeys, and found that they become workaholics. I could use this: procrastination is one of my favorite things (see also: this blog).

Dance of the X Receptors 

Researchers have discovered another classic example of The Red Queen hypothesis of immunity: patients who contract HIV, but go for long periods of time without developing symptoms, have rare forms of HLA's, which attract killer T cells to infected sites. Since these versions are rare, HIV has not had the chance to adapt to counter them, as it has the more common versions seen in patients who progress quickly to full-blown AIDS. This is really cool.

Broken Systems 

As we all know, the state of healthcare in the US is disastrous. Three articles today effectively demonstrate three reasons why this is so.

Many doctors and Republicans seem very happy blaming the costs of health care on malpractice suits and judgments (which occur only in a tiny miniscule fraction of suits filed), not to mention lawyers. This certainly has an effect, particularly on sole practitioners who get stuck with $150k per year premiums all alone, and doctors in Maryland are starting to join a slightly disturbing trend: going without. It's perfectly understandable...the costs are so high they can't afford to have insurance, and are willing to risk losing everything in a suit just to keep practicing. Yes, malpractice insurance is too high. But I don't like the idea of judgment caps...because while usually it's a just bad luck or poor communication of the risks of a procedure to patients, all too often negligence does occur.

You'd think, along with wanting to reduce their malpractice insurance costs, doctors would want to try to reduce errors (and thus suits), right? Not so much. Doctors are protesting Washington's Electronic Health Record (EHR) program, because it costs them money. Not hundreds of thousands of dollars a year, mind you, just two or three. It's proven to reduce errors, improve quality of care, and improve outcomes, all of which doctors are supposed to want. But as this article shows, and as I've seen doing work in this area docs often hate EHR. Because it cuts, ever-so-slightly (for most) into their bottom line. In fact, it only does that at first: once the systems are installed, they cost very little to run, and more than pay for themselves in improved payment rates, fewer mistakes, fewer lawsuits and (non-monetarily) healthier patients. Funny.

And, on the stupid-government side, Vermont is suing the FDA to make it allow reimportation of Canadian drugs. Go Vermont, I say. It would be better if our government would do something actually useful, like curbing drug prices in the first place, but hey, reimportation is a nice start.

Tuesday, August 10, 2004

Abandon Ship 

Let's hear more of this. National news about GLBT professionals leaving states with discriminatory laws probably won't change public opinion much, but it will make investors nervous. Politicians being notoriously obedient to their corporate masters, well, you can guess what might happen next...

Monday, August 09, 2004

Numbers Game 

Welcome to my 400th Blogger post. I figure a good way to spend this one is with a bit about numbers.

We all know health care in the US is ridiculously expensive. The costs seem to be out of control. There are lots of answers why, but none is complete. A convenient explanation is that, due to our third-party payment system, consumers are isolated from actual costs, and thus consume less wisely than they would in a direct payment scheme. This is almost certainly true: higher copays and coninsurance lead to less demand for care.

An editorial in today's Wall Street Journal discusses this, and the author concludes that expanding tax benefits to cover all health care costs would help. If you make out-of-pocket expenses deductible, she says, high copay/coinsurance plans will become more attractive, and consumers become more exposed to costs, and become wiser consumers, and costs go down. Fine. That's probably right, but I strongly doubt it's the whole story.

First off, the insurance and provider industries would find a way around it. Second, people seeking less care is not necessarily a good thing.


Late Notice 

I meant to post this earlier, but became distracted.

Fuck the Franconia Roller Rink.

Fatty McAtkins, Tumor Edition 

There's been a great deal of debate about whether or not the currently trendy low-carb lifestyle is good or bad for you, or neither. A new study of women in Mexico City may be good news for low-carbers: a diet high in carbohydrates, particularly sucrose and fructose, was positively associated with breast cancer. Polyunsaturated fat consumption was negatively associated, but overall fat intake was unrelated to incidence.

The theory put forth by the authors, of an overactive insuln/IGF-1 pathway, fits nicely into the Atkins Diet, which is designed to lower this pathway's activity.

It appears pretty robust, although much more information is needed before we need to go recommending diet changes. The study is current incident/retrospective, and a prospective study is a critical follow-up.

Not Good 

HIV passed from monkeys to humans some time ago, and while no one is precisely sure how that happened, HIV now epidemic in humans and a global disaster. One very good idea of how HIV made the simian-human jump is through people eating bushmeat, which essentially means monkeys. Despite this, and many other diseases associated with bushmeats, people keep eating them. And now, other, unknown AIDS-like symptoms are showing up unattached to known HIV strains. Under most natural circumstances, the disease would die out quickly, as mostly only those eating the bushmeat would get it, but in the modern world, plagues spread like, ... well ... plagues.

Friday, August 06, 2004


I am a politics junkie, even in boring times. But these days, there are so many things about which to froth at the mouth. Terrorism. The economy. Generalissimo el Fuckwit in the White House. Etc, etc.

However, the one issue that makes me the angriest, even when I dissociate my own personal interest in it, is the gay marriage bullshit. For starters, as my grandmother pointed out some time ago, this is not an issue that should even be legislated at all. Marriage is a religious institution, and that the government calls its civil unions marriage is a side note, and probably at least philosophically inappropriate. The government has no right to tell people how to live their lives, when they are not committing a crime.

The whole idea of our Constitution is that being different type of person than the majority cannot be, per se, a crime. But of course certain people like to ride around on perceived moral high horses and dictate Morality (which is very different and usually opposite from morality). And those people have a disproportionate amount of power in America The reasons are numerous and complex, but they come down to a combination of history - who ended up here - and geography - who ended up where and how they created segregated ideological groups, which, aided by the two-party, federalist electoral system, allows them to wield huge influence.

Yesterday, the state of Missouri passed, by an overwhelming majority, an amendment to the state constitution banning gay marriage and effectively relegating gays to second class citizenship. Other states are in the process of doing the same, all fueled by hate and ignorance, the flames fanned by politics which are (at best) cynical or (at worst) pure demagoguery.

Gay rights groups, who tend to be maddeningly short-sighted, have started focusing on the Kerry/Edwards teams' sort-of approval of this event, instead of working to correct all the societal factors which not only passed it, but make it impossible for K/E to say anything against it.

Anyone who pays even decent attention to things knows that Sen. Kerry, at the very least, would like to see gays granted all the rights they deserve as American citizens, which is no fewer and no more than any other American has or deserves. But, in an election year, when the Republican party has so masterfully crafted a debate around something that shouldn't be a debate at all, the Dems have no choice but to keep pretty quiet. Yeah, condemning this bullshit would be The Right Thing To Do, and would shore up the GLBT vote (except for the fucking evil that is the Log Cabin Republicans), but it would guarantee bigger losses in Missouri, Ohio, Nevada, Iowa, and other critical "swing" states. If the Johns said what they really thought about this issue, they might as well go home now.

But what makes me so mad about this issue/business is: it's so totally, blatantly, undeniably contrived. The opponents of gay marriage really don't have a leg to stand on. There is NO REASONABLE ARGUEMENT against it. The other 'culture war' issues, like abortion, at least are based in real philosophical/religious differences. The so-called "Religious Right" has essentially made up a great deal of theology to create an issue here...there is no consensus among religions that gays are bad or that they shouldn't get married. Not even among Christian denominations. Never has been. All the bits of the Bible that get tossed around as proving that homosexuality is a sin are more or less the same kinds of bits that got tossed around 50 years ago to prove that blacks were inferior, or sub-human. Things taken out of context, mis-translated, etc (the Sodom and Gomorrah story is big here, the subtleties of the original text are generally left out of discussion, for instance the multiple meanings of "to know" in Hebrew and Aramaic, and Midrash regarding both the importance of hospitality and Lot's wife).

I must stop now, and go back to work.

Who Wants To Live Forever? Part 2 

A trio of teams, working in tandem, have found that a compound called resveratrol, found in red wine, slows aging in yeast, fruitflies, and nematodes. Pretty cool. I wonder if it has its effects via Indy? Regardless, any excuse to drink more red wine will do!

Semi-related, Oregon researchers have developed a new antimicrobial, edible food wrapping from chitosan and lysozyme, which could possibly revolutionize shipment and storage. If this means I can reclaim that cabinet currently filled with tupperware, I'm thrilled!

New Target 

As antibiotic resistance becomes more and more of a problem, scientists are somewhat desperately searching for new options. OSU researchers may have found a very powerful new weapon: a protein called DskA, which helps ppGpp bind to RNA polymerase, and induce hibernation. Sleeping bacteria don't resist immune attacks, so goes the theory.

But what happens to all your symbiotic bacteria?

Thursday, August 05, 2004

Job Opening 

Because I know the job market sucks donkey ass, here's a one-of-a-kind opportunity...it could be tons of fun.

More Offspring 

Japanese researchers have done something spectacular. They transplanted germ cells from trout into salmon, and the salmon gave birth to health trout. This technique is being touted as a way to rescue endangered species, though I'd say that's the least of its potential applications. First off, as a proof-of-concept, it could lead to breakthroughs in human fertility treatment, and, as mentioned, produce lots of potentially good, cheap caviar!

More Brains 

NIMH researchers have found that a circuit, involving the orbitofrontal cortex, thalamus, anterior cingulate, and ventral striatum, is active in patients with depression even when they are not depressed. Very interesting, since it shows a substrate of susceptibility, which could not only lead to better (and perhaps even preventative?) diagnosis and therapy, but also further he search for pathenogenesis. Pretty cool, neh?

Other research has found that antibody targeting of amyloid-beta peptides, which make the plaques characteristic of Alzheimer’s, reduces the tangles of the disease, and may slow progression. Clinical trials of a related vaccine were halted due too encephalitis, so who knows where this might lead. But killing this disease would be great.

Wednesday, August 04, 2004

Henri Cartier-Bresson 

Est mort. Une vraie légende, et un de mes photographes préférés, il a fait son notion d'instant décsif, qu'il y a un moment critique où une histoire entière est attrapée dans un instant.

Passing on Your Genes 

Following up on this week's development theme. The conditions under which an individual female lives, in the animal kingdom, affects what sex her babies are likely to be. Those in poorer health and lower social caste tend to have girls, higher-ups tend to have boys. This has never, however, been very well established in humans (although there are some effects seen in poor women in developing countries, mostly confounded by nutrition).

An letter published in the current Biology Letters and reviewed here seems to show a trend in richer Western women. Sortof. The women reported on the sex of their first child, and how long they thought they would live. Women who gave themselves longer tended to have had boys. There may be a real effect here, but by the write-up, I don't see any reason to take it seriously. Why did they think they'd live longer? Maybe because they're healthier, wealthier, and have family history (all linked to boy babies in poor women and monkeys)? and it's a bloody major stretch to go from there to psychological effects, as the piece wants us to do.

...And from the Maybe They'll Die Out Soon Department, a study shows that laws limiting kids' access to guns reduces teen suicide rates. The NRA likes to talk about how they support these laws (but only the ones already in place...and there aren't many), but in reality they fight them tooth and nail. I wonder how many of their kids have to die before they buy a clue. (hint: The answer is "All of them.")

Tuesday, August 03, 2004

Fatty McEnzymes 

Brown University researchers have identified two enzymes, PC1 and PC2, that are critical to hypothalamic regulation of metabolism and food intake. Regulated by Leptin, these two activate a number of nuropeptides, including insulin and TRH, which can make you burn fat and eat less.

In order to make most enzymes, you need vitamins. Besides that, vitamin supplements are all the rage these days, supposedly to prevent and guard against any number of diseases. Antioxidants are especially popular, due to their links to better cardiovascular health. However, new research indicates that you have to actually eat the fruits and veggies that naturally contain the vitamins, as opposed to popping supplements, to get any benefit. Sorry Dr. Atkins!!

Mental Health Day 

Schizophrenia is a debilitating illness, affecting about 1-2% of the population. It can take many forms, and there is not a set of symptoms seen in all patients. Multiple personality disorder is not the same as schizophrenia. Many schizophrenics hear voices in their heads, but those generally seem to them to be other, simultaneous entities (whereas in MPD, the personalities only 'exist' one at a time). It's a bloody awful disease, and its study is, while fascinating, pretty frustrating as nothing seems to work very well for very long.

One of the biggest questions in schizophrenia research is etiology. Why does it happen? What is the cause? There are endless theories and ideas, many supported by some good evidence, but no clear answers. There are genes known to be associated, but none necessary or sufficient for the disease to manifest. Trauma seems to trigger the disease, but not in everyone. A new study has found that exposure to influenza during the first half of pregnancy seems to increase the risk of developing the disease later in life. It looks like a pretty good study, so I look forward to seeing where it leads.

In less exciting news, NIH/NIAAA has released the results of a survey which claims that about 15% of Americans meet the criteria for a Personality Disorder. This may or may not be true, but it reads to me like another case of the pathologization of everything. Psycholog/iatrists are notoriously good at that.

Monday, August 02, 2004


I have so much to say about this, and hope it'll get others to discuss at length as well...that's why I have the commenting thing on here!

There are lots of ways of defining 'adulthood.' The most obvious definition is physical: you are physically mature sometime in your mid to late teens, give or take some years for each person (nevermind that development continues in some significant ways after that...for real biological and most all practical purposes you're an adult). Another way is when you turn 18 (in most of the West), and get to vote/not be legally bound to your parents (except for in a number of financial terms, like financial aid at colleges, f'rinstance). Or when you turn 21 and can legally drink (in the US). In Jewish tradition, you traditionally (although that's its only significance these days) become an adult at 13, with your Bar/Bat Mitzvah. Other definitions include various senses of being 'grown up.' And the meaning of that has changed a good bit recently, as well.

The American Sociological Association has released news of a study on the transition from adolescence to adulthood. It's bloody interesting. For me, the key issue is the artificial extension of childhood-like dependence well past when it seems to be biologically (and I include psychologically here too) useful or appropriate. At 15 or 16, most people could go hunt and gather (not to mention have children) effectively on their own, and certainly have the urges and instincts to do so. This is why "abstinence education" is so ineffective.

The piece mentions educational systems as part of extending early adulthood...I wonder what a similar study in Europe, for instance would see: people there live with their parents much longer than we do here, and there is not (at least in where I was in France) nearly the stigma there is here either. And what about in cultures where many generations live together at all times? Being able to provide for your family still would be a factor there, but in so many different ways.

Hmph. Too bad I didn't have time for a sociology major as well!

Grasping for Relevance 

The Vatican has released its latest polemic against womens rights (and, by implication, against gays). You gotta wonder about the purpose of this kind of thing, not to mention the timing. Kathryn Cramer does a lovely job pointing out so much of the silliness in the document.


UNICEF has just released a report saying that exclusive breastfeeding for the first six months of life could save a million lives a year. This is because breast milk has all the nutrients and hormones and antibodies that a baby needs, among other things. I have no problem believing the estimate, because it's well accepted that breast milk is better than formula, however, I wonder what the numbers really look like: controlling for effects like contaminants in formula/not in breast milk, mother-child bonding, etc....

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