Dr. A Live: The Stealth Show

I just finished the latest edition of the Doctor Anonymous Live show. What? You didn't hear about it? Well, that's because I didn't advertise it. To be honest, I was embarrassed by the last show and the technical difficulties that I had.

I think I isolated what the problem, because I did not get kicked off the site this time. I only did a 15 minute show tonight to test things out and everything seemed ok. So, check it out in the sidebar and leave a comment to let me know what you think. Hopefully, next week, I can get back to full steam ahead!

Cell phones cause cancer?

These rumors have been flying around for years. Over the past ten years or so (maybe even longer than that), study after study has been released that proves or disproves the assertion that cell phones cause cancer. The latest study has been done in the UK. This is actually an interesting article from BBC News.

The long-term cancer risk of mobile phone use cannot be ruled out, experts have concluded. A major six-year research programme found a "hint" of a higher cancer risk.

But the UK Mobile Telecommunications and Health Research Programme (MTHRP) did rule out short-term adverse effects to brain and cell function.

Researchers are now expanding the programme to look at phone use over 10 years, and the specific impact on children, which has not been studied.

Research is a funny business in that if you don't like the result, you either extend out the time of the study until you get the result that you want. Or, you amplify the very small results that you have and hypothesize the results that you really wanted in the first place.

In this article, since the six year data didn't get them their result, the article states things like "Cancers do not normally appear until ten to 15 years after exposure." I also love this quote, "With smoking there was no link of any lung cancer until after ten years." Here is the key passage to the entire article:

The team found that there was a slight excess reporting of brain and acoustic neuroma (ear) cancers. Researchers said this was on the borderline of statistical significance.

Translation: "Borderline of statistical significance" means no statistical significance. So, at this point in time, this study failed to make the connection between cell phone use and cancer. The debate will definitely continue. But for now, feel free to continue using that cell phone! But, please, be careful text messaging while driving.

Conservative/Liberal brain activity

Now, I know the most cynical of you out there are saying, "In politics, there is no brain activity." (image credit) And, I bet there are a good percentage of Americans that agree with you. But, I thought that this was an interesting study reported by AFP.

Conservatives tend to crave order and structure in their lives, and are more consistent in the way they make decisions. Liberals, by contrast, show a higher tolerance for ambiguity and complexity, and adapt more easily to unexpected circumstances.

The affinity between political views and "cognitive style" has also been shown to be heritable, handed down from parents to children, said the study, published in the British journal Nature Neuroscience.

In this study, they took 43 right-handed subjects and asked them to perform a series of computer tasks to see how they would do when they had to break from a well-established routine.

The match-up was unmistakable: respondents who had described themselves as liberals showed "significantly greater conflict-related neural activity" when the hypothetical situation called for an unscheduled break in routine.

Conservatives, however, were less flexible, refusing to deviate from old habits "despite signals that this ... should be changed."

Whether that is good or bad, of course, depends on one's perspective: one could interpret the results to mean that liberals are nimble-minded and conservatives rigid and stubborn.

Or one could, with equal justice, conclude that wishy-washy liberals don't stick to their guns, while conservatives and steadfast and loyal.

The late night comedians will have a field day with this. For me, there are just too many jokes around (pointed both at conservatives and liberals) for me to pick from. Maybe I'll come up with something later....

Chip implants: Linked to animal tumor

Back on May 21st, I wrote a post called Chip Implants: Ethical or not? It talked about the use of an implantable chip in the arm of Alzheimer's patients. This chip would have all the medical information necessary for an emergency room physician or other health care professional who needed it. This post generated a great discussion on this topic.

This morning, the AP has an article which states that chips like this have been associated with tumor production in animal studies. What's interesting is that the companies involved knew this information when they went before the FDA for approval. The FDA approved the use of the chips in 1995.

"The transponders were the cause of the tumors," said Keith Johnson, a retired toxicologic pathologist, explaining in a phone interview the findings of a 1996 study he led at the Dow Chemical Co. in Midland, Mich.

Leading cancer specialists reviewed the research for The Associated Press and, while cautioning that animal test results do not necessarily apply to humans, said the findings troubled them. Some said they would not allow family members to receive implants, and all urged further research before the glass-encased transponders are widely implanted in people.

This definitely adds fuel to the fire of the debate of use of this chip in humans. Despite this AP article, I continue to hold the position that these chips should be used. As stated above, animal studies do not necessarily translate into human studies. Keep a close eye on this story. I imagine that there will be more coming from both sides of this debate.

Lazy Saturday

I have to tell you that I'm really going to enjoy today. This is the first Saturday in a long time where there is actually nothing scheduled. I was on call last weekend, and this is actually the first day in about two weeks in which I have absolutely no work responsibilities. It's actually kind of weird. What the heck am I going to do? Well, blog, of course! Here are some things going through my head right now:

The Office Season 3 DVD: I bought this on Tuesday when it was released and I've been looking forward to watching this for a long time. The season 4 premiere is coming up in a few weeks, and I'm looking forward to that. I'm really mad at NBC for not continuing to offer the show on iTunes. However, I think this is contract/negotiation posturing and The Office and other NBC shows will get back on iTunes when NBC figures out that iTunes actually helped their shows (like The Office) become successful.

iPhone whining wins: You may have read my post earlier this week that there was an outcry among iPhone early adopters that it was unfair for Apple to lower the price of the iPhone $200 only after 69 days after its release. Well, Uncle Steve apparently heard those people and posted an open letter on the Apple website saying that there will be a $100 credit coming their way as soon as Apple figures out how to do that. I guess they heard their angry base of supporters and responded. Maybe the political parties and US presidential candidates should learn from this.

Dr. A Live Update: After the debacle of the Thursday show, the Doctor Anonymous engineers and I have been doing a post-mortem of what happened which lead to the early termination of the show. Of course, the first place to start is the ISP itself, and I'm trying to figure out if anything happened there. Other leading candidates are the cable modem or my wireless router. It couldn't be my trusty Mac, HA! Hope you're having a great weekend!

Too hot to fly?

Is this flight attendant dressed appropriately to go to work? Apparently not, according to Southwest Airlines. Kyla Ebbert took her case to the court of public opinion by making an exclusive *cough* appearance on the Today show. (MSNBC)

It was a lot more clothing than the 23-year-old college student wears on her job as a Hooters waitress. Her mother, Michele Ebbert, said she would have told her daughter if the outfit was inappropriate.

“But her outfit is fine, Michele Ebbert told TODAY co-host Matt Lauer. “She looks like every other college girl in San Diego.”

Not according to a Southwest employee identified only as “Keith,” who approached Ebbert after she had taken her seat on the plane and was listening to the flight attendants go through their pre-departure routine.

“He told me, ‘I’m sorry, but you’re going to have to take a later flight. You’re dressed inappropriately. This is a family airline. You’re dressed too provocative to fly on this flight,’ ” she told Lauer.

This is too funny for me. A "family airline?" The term family is used in so many contexts that even I don't know what it means anymore. But, you be the judge. I know employers can interpret their company policies however they want. But, for what this person was allegedly wearing above to be a flight attendant? C'mon, gimme a break....

Listen Live Today @ 4pm

Doctor Anonymous Live! Sept 6th (today!) from 4-4:30pm Eastern Time

I usually try to rehearse for the show with a kind of "test" podcast. But, with my busy schedule this week, I haven't had time to do that. So, this will definitely be a fun show today!

You can also participate in the show! That's one of the fun things about this. I'm going to be logged into google talk before the show. So, if you'd like to say hi before/during the show, you can find me there. You can also send me an e-mail or leave a comment here. Finally, the fun part is that you can call into the show. Just click here for the number.

Can't listen live? Well, that's ok. One of the cool things about BlogTalkRadio is that they record their shows so that you can listen to them later. Starting at about 5pm eastern time, you can click here and listen to the recorded show.

It's just a few hours away now. I hope that you'll be able to join me - either live or listening on the archives. What am I going to talk about? Who knows? You'll have to tune in to find out. I'm just a blogaholic, you know....

Update: Thanks to Cathy for the plug for today's show!

Update 2 (3:15pm): My internet connection just came back after being off for 30 minutes. Hopefully that won't happen again. If it does, then there may be no show for today. Cross your fingers for me!

Update 3 (4:18pm): I give up! My internet has kicked me off about five times in the last 18 minutes. Thanks to all of you who tuned in today to the show. But, for whatever reason, I don't think it was meant to happen today. I'll try again soon for another show.....

Suicides rise as SSRI use falls

Anyone who takes care of children and adolescents remembers the big bruhaha about the use of antidepressant medications and their association with suicides. This was in the context of a huge drug recall at the time (I don't remember which one) and the FDA getting politically killed in the press for (at the time) not being able to protect America's children. (image credit)

Now, we're starting to see the unintended consequences of the black box FDA warning that was placed on these SSRI medications. According to this article from today's Washington Post, as use of the SSRI medications decreased, there was actually and INCREASE in suicides in children.

From 2003 to 2004, the suicide rate among Americans younger than 19 rose 14 percent, the most dramatic one-year change since the government started collecting suicide statistics in 1979, the study found. The rise followed a sharp decrease in the prescribing of antidepressants such as Prozac, Zoloft and Paxil after parents and physicians were confronted by a barrage of warnings from the Food and Drug Administration and international agencies.

The data suggest that for every 20 percent decline in antidepressant use among patients of all ages in the United States, an additional 3,040 suicides per year would occur, said Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who did the study. About 32,000 Americans commit suicide each year.

Now, I admit that I'm not the smartest dude, but even I can connect the dots here. Many docs are afraid to prescribe these SSRI meds, especially to adolescents, because of the huge black box warning - which basically tells docs that they are taking their legal life into their own hands if they prescribe this drug.

Now, some out there are not willing to admit this association. In fact, there are some out there who are aiming the blame at another set of medications as the cause of the increase in suicides.

David Healy, a British psychiatrist who has been critical of the drugs, disagrees. He said that the increase in suicides was more likely caused by the growing use of antipsychotic drugs among children rather than a decline in antidepressant use. "I would be absolutely certain that the increase is not because kids are not being treated," he said. "They may not be getting SSRIs, but they are getting psychotropics."

Of course these kids are not being treated. People like this are making docs think twice about using the best medications (in my opinion) for children and adolesents. I'll be curious to see other reactions to these findings.

Update: Roy from My Three Shrinks just posted on this topic.

Resident work hours

Resident work hours is a buzz phrase used in medical education. About two years following the completion of my residency, there were new rules implemented to try to limit the hours worked my interns/residents. (image credit)

The theory behind this was that interns/residents would not be as tired and would make less mistakes. And, less mistakes would mean less patient deaths (less mortality).

Data just published from the University of Pennsylvania state that since the implementation of resident work hours, mortality rates have not decreased as expected. (WebMD)

The findings "reinforce the impression that there is still not clear evidence for an effect of duty hour reforms on [patient] mortality," suggests an editorial in The Journal of the American Medical Association by David O. Meltzer, MD, PhD, and Vineet M. Arora, MD, of the University of Chicago.

Now, I wouldn't consider myself "old school," but (cue old guy accent) when I was in residency, we didn't have these resident work hour rules. We were on duty until the work was done.

I know that I probably have talked about this before on the blog, but working all those hours during residency really got me ready for my practice now. To be honest, I think I'm working more hours now than I did in residency.

Not only did I learn about clinical issues and diseases in residency, I learned how to try to balance life at work and life at home. I learned how to try to function on less hours of sleep. And, most important, I learned my limitations when I was feeling fatigued.

I could be wrong, but I think these residents being trained today are being sheltered too much and not getting a true taste of what life will be following residency. When they get in the real world, they're going to learn very quickly that there are no work hour rules.

I feel that the American health care system will not feel the real impact of these resident work hour changes for many years. What kind of American medical workforce will have been created with these rules in place? I guess we'll just have to see.

Avoid the popcorn!

I remember when mom and dad got their first microwave oven. I think I was eight years old. When I asked mom what this thing could do, the very first thing she did was put a bag of microwave popcorn in there and turned it on. I was hypnotized by watching and hearing the kernels pop. (image credit)

Now, according to this article from the AP, it is being learned that frequent use of microwave popcorn could put you at risk for a type of lung disease called "popcorn lung."

[A patient] described progressively worsening respiratory symptoms of coughing and shortness of breath. Tests found his ability to exhale was deteriorating, [Dr. Cecile] Rose [pulmonary specialist] said, although his condition seemed to stabilize after he quit using microwave popcorn.

The article goes on to say that more study and research needs to be done to confirm these findings. But, can you imagine the implications if a definite connection is made? This is really making me think twice. Maybe I should opt more for milk duds rather than popcorn while watching my fave DVDs.