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  • November 7, 2013
  • 01:00 PM

If We Are Not Competent With Direct Laryngoscopy, We Should Just Say So - Part I

by Rogue Medic in Rogue Medic

This study starts out looking good, but there is a huge problem with the design.

If the person intubating felt that he needed to use the video laryngoscope to get the tube, then the patient was not randomized into the study.

How was this paper accepted for publication with such an obviously violation of research methodology?
... Read more »

Yeatts DJ, Dutton RP, Hu PF, Chang YW, Brown CH, Chen H, Grissom TE, Kufera JA, & Scalea TM. (2013) Effect of video laryngoscopy on trauma patient survival: a randomized controlled trial. The journal of trauma and acute care surgery, 75(2), 212-9. PMID: 23823612  

  • October 29, 2013
  • 08:02 PM

Bridging Study in Clinical Trials: Definition, History, and Importance

by Imtiaz Ibne Alam in Medical-Reference - A Pioneer in Medical Blogging

In today’s economic environment, globalization of pharmaceutical products has turned into the key to success for drug manufacturers. Investors in new drug development are therefore required to do more at less cost and faster rate now. However, sponsors are facing a new challenge due to ethnic factors, as the pharmacodynamic or clinical data in the original population could vary with the population in the new region. ... Read more »

Liu JP, & Chow SC. (2002) Bridging studies in clinical development. Journal of biopharmaceutical statistics, 12(3), 359-67. PMID: 12448577  

  • October 3, 2013
  • 05:34 PM

Exhibitionism in Medical Education: The Brindley Lecture – Heralding A Sexual Revolution

by Pranab Chatterjee in Scepticemia

The first boom in treatment for male erectile dysfunction came in the 1920s and 1930 when the Russian-origin French surgeon Serge Abramovitch Voronoff started to prescribe surgical implantation of monkey testicles in the human scrotum to augment sexual prowess. This gained quite a bit of fan following for a couple of decades and brough Voronoff […]... Read more »

  • September 4, 2013
  • 11:00 PM

Unreasonable Fear of Hypotension and High-Dose NTG - Part II

by Rogue Medic in Rogue Medic

Continuing from Part I to look at the results of the study of high-dose SL (SubLingual) NTG (NiTroGlycerin – GTN GlycerylTriNitrate in Commonwealth countries) by EMS for CHF (Congestive Heart Failure) that Peter Canning wrote about.[1]

For CHF, more NTG does not produce more of a drop in blood pressure.

If you disagree, provide evidence.... Read more »

Clemency BM, Thompson JJ, Tundo GN, & Lindstrom HA. (2013) Prehospital High-dose Sublingual Nitroglycerin Rarely Causes Hypotension. Prehospital and disaster medicine, 1-4. PMID: 23962769  

  • August 29, 2013
  • 06:20 PM

Unreasonable Fear of Hypotension and High-Dose NTG - Part I

by Rogue Medic in Rogue Medic

Peter Canning writes about a study of high-dose sublingual nitroglycerin by EMS for congestive heart failure.[1]

I have some problems with the study.

The doses are not high doses.... Read more »

Clemency BM, Thompson JJ, Tundo GN, & Lindstrom HA. (2013) Prehospital High-dose Sublingual Nitroglycerin Rarely Causes Hypotension. Prehospital and disaster medicine, 1-4. PMID: 23962769  

Bertini G, Giglioli C, Biggeri A, Margheri M, Simonetti I, Sica ML, Russo L, & Gensini G. (1997) Intravenous nitrates in the prehospital management of acute pulmonary edema. Annals of emergency medicine, 30(4), 493-9. PMID: 9326864  

  • August 25, 2013
  • 06:27 PM

The Art of Resurrection

by The Neurocritic in The Neurocritic

Resurrection, Raffaellino del Garbo (1510)In the world outside of Christianity, horror, and science fiction, the dead cannot be brought back to life. Or can they? A feature in the The Observer from earlier this year profiled Dr. Sam Parnia, critical care physician and author of Erasing Death: The Science That Is Rewriting the Boundaries Between Life and Death (called The Lazarus Effect in the UK). The article begins in a dramatic fashion:Sam Parnia – the man who could bring you back from the ........ Read more »

Mateen FJ, Muralidharan R, Shinohara RT, Parisi JE, Schears GJ, & Wijdicks EF. (2011) Neurological injury in adults treated with extracorporeal membrane oxygenation. Archives of neurology, 68(12), 1543-9. PMID: 21825216  

  • August 16, 2013
  • 12:16 AM

End of Life Gamma Waves: Altered State of Consciousness or Artifactual Brain Activity?

by The Neurocritic in The Neurocritic

"I had been in labor for my daughter for 16 hours. The labor was difficult and the Dr. approached me and told me it may come down to a choice between the child or myself.  ...  The labor dragged on and on and finally they came in and broke my water. I was rushed into delivery and within minutes my heart had stopped. I remember seeing a beautiful being of light enter the room. She told me I had to return as it was not my time yet. I was sucked back into my body as they restarted my br........ Read more »

Borjigin J, Lee U, Liu T, Pal D, Huff S, Klarr D, Sloboda J, Hernandez J, Wang MM, & Mashour GA. (2013) Surge of neurophysiological coherence and connectivity in the dying brain. Proceedings of the National Academy of Sciences of the United States of America. PMID: 23940340  

  • July 31, 2013
  • 10:45 PM

Dilaudid – Start With 2 mg or Start With 1 mg?

by Rogue Medic in Rogue Medic

What is the proper interval before we should give another dose of opioid to patients who still have significant pain?

This study suggests that 3 to 5 minutes would be ideal, but that the ED (Emergency Department) is not a setting where that is practical. ... Read more »

  • July 24, 2013
  • 12:14 PM

Mammoth Cloning: the Ethics

by ulian Savulescu in United Academics

he display of a frozen mammoth in Japan has again raised questions as to the possibility of creating a live born clone of extinct animals.

Theoretically, mammoths could be cloned by recovering, reconstructing or synthesizing viable mammoth DNA and injecting it into the egg cell of a modern elephant whose nuclear DNA has been removed; alternatively, mammoth genetic material could be introduced into an elephant genome in order to create a mammoth-elephant hybrid or chimera.

This raises an et........ Read more »

Douglas T, Powell R, & Savulescu J. (2013) Is the creation of artificial life morally significant?. Studies in history and philosophy of biological and biomedical sciences. PMID: 23810562  

  • July 8, 2013
  • 02:45 AM

Do Paralytics Improve Outcomes Following Resuscitation?

by Rogue Medic in Rogue Medic

This study will get some people excited because of an impressive p value for an odds ratio of improved cardiac arrest outcomes - 7.23 (1.56–33.38) p = 0.01.

NMBs (NeuroMuscular Blockers/Blockade) are paralytic drugs that are used to prevent movement by the patient. Does this study truly show that immediate use of NMBs improves neurologically intact survival from cardiac arrest?... Read more »

Salciccioli JD, Cocchi MN, Rittenberger JC, Peberdy MA, Ornato JP, Abella BS, Gaieski DF, Clore J, Gautam S, Giberson T.... (2013) Continuous neuromuscular blockade is associated with decreased mortality in post-cardiac arrest patients. Resuscitation. PMID: 23796602  

  • June 29, 2013
  • 09:00 AM

Lack of Association of Guillain-Barré Syndrome With Vaccinations

by Rogue Medic in Rogue Medic

Don’t expect the self-proclaimed vaccine safety organizations to write about this, unless they are claiming that it is a part of some sort of international conspiracy of governments, universities, private companies, and other research organizations.

They are not interested in safety.

They are interested in creating fear and making money off of the fear they create.... Read more »

Baxter R, Bakshi N, Fireman B, Lewis E, Ray P, Vellozzi C, & Klein NP. (2013) Lack of association of guillain-barre syndrome with vaccinations. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 57(2), 197-204. PMID: 23580737  

  • June 27, 2013
  • 03:45 PM

Looks Like Anaphylaxis, But Isn't

by Rogue Medic in Rogue Medic

Half an hour after lunch, a 67 year old man passes out.

He regains consciousness, as often happens with syncope.

He is not quite back to normal, blood pressure is 80/60 mm Hg, heart rate is 110, respiratory rate is 25, oxygen saturation is 99% on room air, with a temperature of 96.8° Fahrenheit.

If we tilt him, we will probably get a worsening of his vital signs, but there is no need to actually obtain the numbers if the assessment is causing deterioration.... Read more »

Bourcier S, Mongardon N, Daviaud F, Moachon L, Arnould MA, Perruche F, Pène F, & Cariou A. (2013) Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock. The American journal of emergency medicine, 31(1), 2700-3. PMID: 22809767  

Senthilkumaran S, Menezes RG, Ravindra G, Jena NN, & Thirumalaikolundusubramanian P. (2013) Antabuse reaction due to occupational exposure-an another road on the map?. The American journal of emergency medicine. PMID: 23791458  

Ehrlich RI, Woolf DC, Kibel DA. (2012) Disulfiram reaction in an artist exposed to solvents. Occup Med (Lond)., 62(1), 64-66. DOI: 10.1093/occmed/kqr172  

  • June 22, 2013
  • 02:43 PM

[Warning: NSFW] Sex and the CT (MRI, Actually)

by Pranab Chatterjee in Scepticemia

Disclaimer: This post contains a lot of explicit images and one explicit video as well. The language is also not suited for the run of the mill blog, but in the spirit of writing unhindered, I have edited myself as little as possible. If there is a possibility that graphic references to (human) sexual activities offend […]... Read more »

  • June 12, 2013
  • 12:30 AM

Publication Bias - The Lit Whisperers

by Rogue Medic in Rogue Medic

The Lit Whisperers raise an important point about publication bias and the validity of published studies that show benefit from a drug company study of a treatment that still has patent exclusivity.[1]

There are many problems with science. Science will never be perfect, but only people who do not understand science claim that it should be perfect.

One of the problems with science is publication bias. A paper that has a positive results about a brand name drug is twice as likely to be publi........ Read more »

Kudenchuk, P., Cobb, L., Copass, M., Cummins, R., Doherty, A., Fahrenbruch, C., Hallstrom, A., Murray, W., Olsufka, M., & Walsh, T. (1999) Amiodarone for Resuscitation after Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation. New England Journal of Medicine, 341(12), 871-878. DOI: 10.1056/NEJM199909163411203  

  • June 8, 2013
  • 01:45 PM

Get Science Right: Covering Fraud

by Andrew Porterfield in United Academics

In the search for truth and answers, scientists often get it wrong. That’s the way science works; you test a hypothesis, compare your results, tweak your ideas, and maybe create a new hypothesis. Error is a big part of this process—but what if those errors are, instead, deliberate fraud? ... Read more »

  • May 18, 2013
  • 03:10 PM

‘Is ‘cloning’ mad, bad and dangerous?’ – an argument revisited

by Lee Turnpenny in The Mawk Moth Profligacies

Is 'cloning' appropriate terminology for somatic cell nuclear transfer derivation of human embryonic stem cells?... Read more »

Tachibana, M., Amato, P., Sparman, M., Gutierrez, N., Tippner-Hedges, R., Ma, H., Kang, E., Fulati, A., Lee, H., Sritanaudomchai, H.... (2013) Human Embryonic Stem Cells Derived by Somatic Cell Nuclear Transfer. Cell. DOI: 10.1016/j.cell.2013.05.006  

  • May 8, 2013
  • 05:30 PM

Does experience matter – Part II

by Rogue Medic in Rogue Medic

In spite of the evidence to the contrary and a lack of rationality in the claim, we continue to be told that increasing the number of people with a title, such as paramedic, will result in better care.

Here is more evidence that dividing the skills among more people leads to less skilled care.

The authors begin by referring to other studies that demonstrate the high failure rate of doctors performing procedures on children.

How is that relevant to EMS? We have a low frequency of use of ........ Read more »

  • May 2, 2013
  • 05:30 PM

Will IV Oxygen Save Lives?

by Rogue Medic in Rogue Medic

Intravenous oxygen delivery that works?

Maybe temporary oxygenation, but not yet.

Will this change the approach to CICV (Can’t Intubate, Can’t Ventilate) patients?

No, but it may change the approach to CICO (Can’t Intubate, Can’t Oxygenate) patients.

The distinction is important. ... Read more »

Kheir, J., Scharp, L., Borden, M., Swanson, E., Loxley, A., Reese, J., Black, K., Velazquez, L., Thomson, L., Walsh, B.... (2012) Oxygen Gas-Filled Microparticles Provide Intravenous Oxygen Delivery. Science Translational Medicine, 4(140), 140-140. DOI: 10.1126/scitranslmed.3003679  

  • April 22, 2013
  • 08:30 PM

Why Hang Them Seperately When We Can Hang Them Together?

by Jesse Marczyk in Pop Psychology

For those of you lucky enough to not have encountered it, there is a concept known as privilege that floats around in predominately feminist-leaning groups. The basic idea of the concept of privilege is that some groups of people have … Continue reading →... Read more »

DeScioli, P., & Kurzban, R. (2013) A solution to the mysteries of morality. Psychological Bulletin, 139(2), 477-496. DOI: 10.1037/a0029065  

  • April 17, 2013
  • 06:34 PM

Van Gogh was afraid of the moon and other lies

by TheCellularScale in The Cellular Scale

I remember the first time I realized just how easily false information gets spread about.A terrifying starry nightI was in French class in high school. Our homework had been to find out 1 interesting fact about Van Gogh and tell it to the class. When it was my turn, I said some boring small fact that I no longer remember. My friend sitting behind me, however, had a fascinating fact: When Van Gogh was a young child, he was actually afraid of the moon.The teacher and the class were all quite impre........ Read more »

Lewandowsky, S., Ecker, U., Seifert, C., Schwarz, N., & Cook, J. (2012) Misinformation and Its Correction: Continued Influence and Successful Debiasing. Psychological Science in the Public Interest, 13(3), 106-131. DOI: 10.1177/1529100612451018  

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