Sunday, January 31, 2010

Planning A Wardrobe

My closet is a mess. I am trying to weed out some stuff, but I just haven’t had the time to get it organized this fall (it’s winter now…).

Perhaps it’s time to rethink my wardrobe goals. Last week I saw a post by Diane Danielson on making a business plan for your wardrobe.

Here are the rules:

1.  Write a mission statement. 

2.  Find your signature look and stick with it. 

3.  Promote from within. 

4.  Downsize strategically. 

5.  Employ best practices.

6.  Scale down expansion plans. 

7.  Negotiate lower prices with vendors. 

These can be boiled down to (1)Figure out how you want to dress;   (2)Keep what works with your image and chuck the other stuff; and (3)Only buy stuff that will work with your life, and try to get the best price.

Of course, I am still stuck at the strategic downsizing phase, with no end in sight. Wish me luck.

Friday, January 29, 2010

Blogolutions = SUCCESS!

On December 30 I blogged a summary of my output for 2009 and made blogolutions for 2010. We are now 4 weeks into the year, so I thought it was time to assess my progress:

1. Three to five posts each week, with an average of 15 per month.

Today is post 18 for January, or 4.5 posts/week. I deserve a cookie!

2.  At least once each month I will address something of substance from the world of biomedical science.Photoxpress_4364600

So looking at my 17 posts before today, 4 deal firmly with biomedical topics and 6 with scientific communication. Another cookie for me!

3.  I will continue to FWDAOTI as I see fit.

I classify 3 of my posts in this category. You know, I don’t really want this many cookies. Maybe glasses of wine instead?

4.  If I want to write about something , I will, because this blog is for me.

Thus the posts dealing with shoes. And the video of Laser Cats 5, the funniest SNL Short in a long, long time…

So far I am 4 for 4, making these my most successful resolutions ever. I wonder why I can’t do this with the weight loss and exercise resolutions?

The past week has been sparse because of patient care duties. I have some new ideas to explore next week when my schedule eases up a bit.

Photo courtesy of PhotoXpress.

Tuesday, January 26, 2010

Health Care Reform NOW

My daughter came over the other night, excited because she could graduate next December, after 4.5 years of college. Since she spent her first year as a dance major, getting a degree in Communication/Public Relations this quickly required some work.

She fears the current job market a bit,SpoonJen and has picked up some GRE study guides… “Just in case.”

My biggest fear? Her health insurance.

Dancers are elite athletes. The degree of fitness she achieved amazed me. While 2.5 years without daily dancing have reduced that level, she is still in good shape. She clearly has special skills.

When she was 14 or 15, she complained about her heart beating fast during dance class. She often had gone hours without eating or drinking, and may have been a bit dry. We told her to take better care of herself.

One day this happened while I was waiting to take her home; she could only speak about 2 words without gasping. When I touched her pulse, it was too fast to count (can you say “Major Maternal Guilt?). After some challenges with the event monitor (it took superglue to get the electrodes to stick through a sweaty dance class), we finally diagnosed supraventricular tachycardia (SVT). Her condition was not life-threatening; the major risk was injury if she fainted when it happened. Since it often happened on stage, and she generally kept performing, this presented a bit of a problem.

We tried drugs to control it, but they made her SOOOO GROGGY. She finally learned to valsalva and break the rhythm, even in short off-stage moments during performances. The cardiologist no longer sees her. Now that she dances only in more casual situations, her SVT does not happen. Jazzercize class? No problem. Running 2 miles? No problem.

Insurability? Problem.

Her SVT is a pre-existing medical condition that, without reform, will make her uninsurable. She could not start her own business, or join a small company. As it stands at the moment, she will have to seek out a fairly large employer with good group coverage. Luckily, while a student, our policy will still cover her.

As a physician, I see this situation frequently. A parent loses a job or changes employers, and someone in the family is uninsurable. How many Americans are “insurance hostages” to their current employers?

As a physician and a parent, I support health reform. So congress, DO SOMETHING. The status quo is not acceptable… for me, my patients, or my family.

Thursday, January 21, 2010

Civility: Mud-Wrestling & Roller Derby

First, a disclaimer: I did not attend Science Online 2010 last weekend. I did follow the official conference twitterfeed, and my blogosphere buddies’ tweets.

One session sounds like it rocked, like a mud-wreCivilitystling meets roller derby event: Online Civility.

The analogy oft repeated in blogworld since that time: My blog is my home, and I set the rules.  Don’t come in and piss on my carpet.

A whole bunch of posts have been spawned by attendees, both those “against” civility and those who would never want piss on their carpet.

The “don’t piss on my carpet” crowd takes exception to the linkage with the American civil rights movement. And they are wrong to ignore this link.

I can remember people complaining about blacks (note: original terminology from my youth has been softened) wanting to eat in the same dining room or use the same water fountain as “us.” Changing these inequities required breaking the rules, getting arrested, and generally upsetting those who made the rules.

“But it’s our state (school, restaurant, bus) and these are our rules. People who want to be in here with us need to follow them or go somewhere else.” Not too hard to do in blogworld; but is this the message you really want to send? “If you don’t want to play our game, go elsewhere.” If those who disagree with you go away, you may never discover you are wrong. At least not until it is too late to make a graceful change.

I have also found that the “standard” for “niceness” is different for men or women. Men expressing different opinions disagree; if a woman expresses a different opinion she is bitchy, shrewish, or on-the-rag. [Note: twat was another term that could have been included, but it seems that this is a “cute” term among the “don’t piss on my carpet” crowd, and, therefore, inoffensive.]She couldn’t possibly have a thought-out opinion (unless another man present agrees with her, of course).

RosaOne important thing to remember: When you chastise someone for “pissing on your carpet,” you may go down in history  as “arresting Rosa Parks for sitting on the bus.”

What seems like a small act of rule enforcement today may not be judged that way by history.

After 2 children and 2 cats (and being a nephrologist) I have developed a talent for getting piss out of the carpet. Try to get to the toilet, please, but a little rug tinkle will not be the end of the world…

Everything I Need To Know About Trolls I Learned In Kindergarten

According to Wikipedia:

TrollIn Internet slang, a troll is someone who posts inflammatory, extraneous, or off-topic messages in an online community, such as an online discussion forum, chat room or blog, with the primary intent of provoking other users into an emotional response[1] or of otherwise disrupting normal on-topic discussion.[2]

A discussion of “bait and switch” titles got trolled into something else today… Trolling the trolling discussion is just wrong!

Now, I personally use the bait and switch thing all the time. One of the joys of studying puberty is that sexual development and hormones are involved. I can usually work the term “sex” into the title of my talks. Lots of people show up. They are often disappointed and leave early, but they show up hoping to learn more about the erotic lives of diabetic mice… I had never considered this a type of trolling, but the behaviors are clearly related.

Lots of anti-trolling tactics are promoted, especially DFTT (don’t feed the trolls). We all know the most definitive way to defeat a troll, though. Go back to Kindergarten GoatSockPuppet(you really did learn everything you need to know there)…

All it takes to whack-a-troll is a Big Billy Goat Gruff.

While online sock-puppetry is ordinarily discouraged, a sock-puppet-billy-goat might be OK.

Just have to keep the billy goats away from Terrified Tabetic! (Click through, if you don’t know why).

Wednesday, January 20, 2010

Watch Out, Pixar!

I was introduced to a website called Xtranormal today.

It lets you make movies. Just by typing. Or even cut-and-paste. Like this one:

Yup, the spam email I got last week is now an animated movie! How cool is that? And the robo-voice and mispronunciations fit the letter to a tee!

This may be the start of a beautiful relationship. Or the beginning of something really awful. Only time will tell…

“Shoe” Confessions

Yesterday’s errands required a stop at one of our local malls, an arcade of shops including a DSW. Could a quick peek at the clearance rack really hurt anyone?

That depends on whether you ask me or my spouse.

LovelyShoesThe luscious satin beauties shown here called my name from the top shelf, the level I can barely see. Although not professionally photographed (yes, this is my desk),  they may still lift your spirits as they did mine. Satin peep-toes are not the shoes of winter, especially given the mix of sleet and snow falling from the heavens today. According to the box the cloth and patent heel are “light tan,” but the fabric glows with a pink or mauve tone as the light shifts across them. I slipped them over my black tights and realized that their 4-inch heels far out-comforted the 2-inch ones on yesterday’s booties.

After a brief bout of algebra, I realized these could be had for a mere $29.95. Did I really need them? Would my feet go unshod without them? No… but their beauty and reminder of weather-to-come provided a much needed mental health lift far less expensive than therapy and antidepressants.

Now I am planning what to wear with them to a fundraiser in April. Some of my readers may see them at the APS Publications Banquet in Anaheim during Experimental Biology. Their delightful neutral color makes them quite adaptable, although peau de soie may prevent their wear as everyday workhorse shoes.

Of course, the other fundraiser I must attend in April has a LoveBoat theme, so other sleek nautical pumps might still be in order.

Sorry, honey; I promise I will reorganize the closet soon.

Monday, January 18, 2010

For My Tweeps at SciO10

Many of your were at Science Online 2010. While you were thinking about duck sex and other wackaloonacy, you missed one of the best episodes of Saturday Night Live in years IMHO.

This may be the funniest video I have ever seen…

Peeing Red

The other night my pager buzzed as I pulled back the covers to settle into bed. A child in the emergency department was whizzing blood.ColoredFluids

Gross hematuria, urine that appears bloody to the naked eye, has coloration ranging from cherry KoolAid to Coca Cola. A number of substances can color urine; the presence of actual blood must be confirmed by finding red blood cells on microscopic examination. The dipstick test may show “blood” but it detects hemoglobin (from red blood cells) and myoglobin (from muscle breakdown), both of which may darken the urine color.

Approximately 1 out of every 1000 outpatient visits to a pediatric primary care physician is due to bloody urine. About 80% of cases occur in males, and 30-40% of the time no diagnosis can be made. Since the condition almost always resolves without long-term consequences, this presents less of a problem than you might think.

Thorough history and physical examination should be directed toward trauma, familial problems, and evidence of disorders that cause inflammation in the kidney (nephritis). Other evidence of nephritis includes high blood pressure, an abnormal glomerular filtration rate (estimated by a blood test, the serum creatinine), or significant proteinuria (>100 mg/dL by dipstick). An ultrasound or other study is sufficient to diagnose stones, tumors, or other anatomic problems that can cause bloody urine. Urine studies for calcium and other stone-forming disorders may also be indicated.

If your child pees blood, please don’t ignore it- s/he does need a thorough medical evaluation; however, don’t panic! While hematuria may be scary for patient and parent, it is rarely a serious long-term medical condition. 

Photo courtesy of PhotoXpress.

Saturday, January 16, 2010

An Open Letter

Dear Lucky Magazine,

I have enjoyed your periodical for several years now and I subscribe. My job in academia occupies a lot of time, and skimming your magazine for new stuff while I dry my hair every morning is a joy.

Now you have made me angry.

In your Lucky Girl section (page 56 of the February issue), you feature the essentials of Audrey Dettmar, a 24-year-old pastry chef. Her shoe pick probably fits my life better than hers ShoePick(and her suggestion to pair these with knee-high socks is just wacky). I would also call them spectator pumps rather than brogue pumps; however, either way they would work with suits or jeans. Great multitasking shoes, especially for spring travel. Good price as well.

I went online  to get a better look and, perhaps probably, order them.

They were NOWHERE to be found on the Bass Shoes site. Nor any other shoe site out there.

I know part of your job is to drum up advance demand for new products. This is how a waiting list forms. I can accept that. What makes me angry is Audrey saying these are one of her essential items when THEY CANNOT BE POSSESSED YET.

I hope you are happy. I now find myself wandering over to every day or two looking for these shoes. I am, officially, obsessed.

I realize scanning the bit of page above probably breaks a gazillion copyright laws (although I have given clear attribution), but this item wasn’t pictured on your website, so I could not link to it. Nor could I link to it on the Bass website (see above). Thus, I was left to violate the law with my trusty scanner.

It’s all your own fault, you know…



Friday, January 15, 2010

Winter Can Be Beautiful

This morning I awoke to an ominous announcement on the radio:

Warning: Freeze Fog

I was pleasantly surprised to back out of my garage into a true winter wonderland (ignoring the filthy piles of plowed snow that still line all of the streets and parking lots, of course). My father sent me this picture of his backyard and the protected stream behind it.

I got a closer shot of our crabapple tree with the camera built into my Blackberry.


Each branch is coated with ice. More delicate ice forms spikes along the branches, each resembling a stack of the snowflake nonpareils  sold to decorate baked goods. The effect inspires and requires no plowing. I suspect it will be gone by the afternoon.

I vote that we replace snow with freeze fog in upcoming winters.

Thursday, January 14, 2010

“Your Suggestion is Required Urgent”

Today I got the most exciting email. I just had to share it with the world!

Hello ,
How are you and your family doing? Hope this mail meet you in a good condition of health. Listen carefully to what i am about to disclose to you and make sure it stays with you alone and no one McChrystalelse, i mean no third party. I am General Stanley McChrystal of the United State Army currently in Afghanistan.

Wow! I was shocked because the sender’s name was Dawn!

You might wonder how i came across your contact, yes every one will wonder but what you must know is that when you are a good man news about you easily spread. A junior officer gave me your contact information and we want you to do a job for us which you will also benefit from, you are earning this benefit due to your generousity to the world out there as you well know that we live in different world.
Before i enlighteen you more on what we want you to do for us, we will not entertain telephone call as you are well aware that we are fighting against terrorism here and discussing issues that i about to disclose to you on official military line can be very dangerous for us so for that reason we will communicate via electronic mail and skype.

Well, I am not a man, but I do give generously of myself to the world, at least to some degree. How flattering that they are taking this risk to contact me!

Secondly, no exchange of any documents as our FTP SERVER is constantly blocked and every of our movement appears on raiders while we also have restricted areas that we are not authorised to visit, every documents will be sent to you via the United Nation Diplomatic Personal regarding the delivery of the 2 boxes.

Yup, you have to watch out when your every move is on “raiders.” That is almost as bad as having it on “radar.”

Now listen because this is were you fit in and your percentage is sure. During one of our raid we exchanged fire with some terrorist planning to acquire ammunition from some arms dealers from Cuba and recovered some consignment containing raw United State Dollars which i and my junior officer secretly took and kept it with the United Nation Diplomatic Storage House here as personal effect, what we want you to do is receive the two box containing the money $34.3 million on our behalf and we will split it in 35% 25% 25% 15% among the four of us. The 35% comes to me while you and my junior officer get 25% each and the 15% goes to charity organization.

Ah, that famous Cuba-Afghanistan connection. I mean, these countries are so intertwined culturally, religiously, and geographically, it was bound to come up sometime…

The United Nation Diplomatic Service have delivery locations in the following countries around the world were the boxes can routed from to your country, we want you to let us know among the following countries the one that suite you best to route the 2 boxes to your country. 1. United Kingdom 2. Ghana 3. Germany 4. Spain 5.China
I believe you don't have problem with the sharing, let me know the country that best suites you so that we can make delivery arrangement immediately. Your name and delivery address and your telephone number will be needed by the diplomat so that he can give you a call when he arrive the country of your choice. Immediately i fly out of here i will contact you and meet with you in person.
Please take down my skype identity Stanley.McChrysta@skype and add me to your skype so that we can meet online, am always at the military base.
If you are interested please get back to me via my personal email address:
Please get back to me as soon as possible.
General Stanley McChrystal

Wow! 8.575 million raw US dollars (wouldn’t want them cooked, now, would we?) are mine if I drop everything and fly to the UK, Ghana, Germany, Spain, or China. Who am I kidding; I couldn’t go to ScienceOnline this week!BS Button That’s why I’m sharing this opportunity with my online buds, because I know a number of you would jump for this sort of opportunity!

I am surprised the general doesn’t have better spell and grammar checkers on his computer, but he is busy with the war effort.

Why do people fall for this crap anyway?

Tuesday, January 12, 2010

Like Questions at a Beauty Pagent

When applying for residency, the one portion of the application form with any potential for individual expression was the infamous personal statement. Having reviewed about a million of these now, I appreciate how mundane they can be. It is sort of like asking Miss USA contestants their opinions on world peace.

Now, for the first time in 26 years, I find myself constructing a personal statement.

As part of the recent changes at NIH, this component has been added to the humble biosketch. We now have to “briefly” explain why we are the best-est, most-qualified, ideal person to play our role on the project proposed.

The simple truth, that I am the person interested enough to propose this work, just won’t cut it.

How about “the voices in my head keep telling me to do this.” No?

Photoxpress_4896891 “I am a gift from the gods about to impart new critical knowledge to your world.” Perhaps a bit over-the-top (although members of my family might find this one completely in character).

I finally played it straight. I listed my experience with the relevant techniques that have not yet been applied to a novel exciting model, and my clinical background that fits the question at hand. So predictable!

It should be bloody obvious from the proposal that I am the ideal person to pursue this question in this manner at this time. If it is not, then I have not written it right.

By the way, I am fully in favor of world peace. May I have a tiara now?

Photo courtesy of PhotoXpress.

Monday, January 11, 2010

“Don’t Be Such a Scientist:” Part Two

Last week I wrote about Randy Olson’s book Don’t Be Such a The girl the boxerScientist. Now that I have finished the read, I want to revisit Chapters 3 (Don’t be such a poor storyteller) and 4 (Don’t be so unlikeable). These chapters touch on current issues in the blogosphere.

In chapter 4, Olson expresses dismay about the foul language and intolerance displayed in evolution posts on ScienceBlogs:

The voice that came through in all of these blog posts, and even more intensely in the comments of fellow evolutionists, was not just offensive; it was also incredibly condescending and arrogant.

In this chapter, Olson concerns himself with likeability of scientists; in other words, maintaining civility within the discussion (a topic at SciOn later this week). He does have a point; people are unlikely to listen after you have called them fuckwits.

Unfortunately, a reasonable civil discussion violates chapter 3; let’s face it, conflict is essential for a good story.  People don’t pay to watch two guys glare and name-call in the ring; they want to see punches! Conflict sells and drives blog traffic (and income); the only way to make this bigger is to make it a nude-mud-wrestling grudge match (although I doubt most of the contributors on ScienceBlogs should be seen nude).

Let’s face it: some of those conflicts in commentary are damn entertaining! Virtual evisceration is sort of like “Shark Week” for readers, especially when you agree with the sharks! The danger, though, is that less aggressive species get scared off, leaving only those voices in complete agreement (see this post by Isis for more on this danger). You end up preaching to the choir (egads, a scientist uses a religious analogy), and you have to work even harder to generate conflict, leading to fights among the choir (this is why there are no longer any moderate republicans).

Unfortunately, I don’t have the solution to this problem (if I did, do you thing I would be plugging away on this post?). I try to stay civil on my little soapbox on the web, and I have to remain civil in ASN Kidney News, the magazine I edit. I do allow my inner snark to appear when I’m commenting on others’ sites.

Perhaps being a medical doctor is good training for this sort of conflict; if a teenager asks me about getting tattoos, I can say no, absolutely not, tattoos are stupid. Or I can talk to them about the safety issues surrounding the procedure, not to do it on the day they get hemodialysis and receive anticoagulation, and then discourage it (in med school I saw the effects of time and gravity on most tattoos, and it isn’t pretty). Most of the time, the latter approach has prevented or delayed the onset of tattooing without alienating my patient. Of course, the first scenario would make a much better story… especially if s/he gets the tattoo and returns to shoot up my clinic.

Photo courtesy of PhotoXpress.

Friday, January 8, 2010

HIPAA Meets Politics Via Twitter

The following story hit my mailbox yesterday, courtesy of HIT News. twitter-logo Seems a worker in Mississippi has lost her job by getting a little snarky with protected health information via twitter:

A simple tweet has sparked a HIPAA compliance and public relations mess at Mississippi’s University Medical Center, and an administrative assistant is out of a job as a result, reports a local TV station.

The controversy began when Mississippi governor Haley Barbour posted this tweet on his Twitter page: ”Glad the Legislature recognizes our dire fiscal situation.  Look forward to hearing their ideas on how to trim expenses.”

“Schedule regular medical exams like everyone else instead of paying UMC employees over time to do it when clinics are usually closed,” tweeted UMC administrative assistant Jennifer Carter. She had heard that the governor had come into UMC for a physical one Saturday three years ago, and that the clinic had to be staffed up with 15-20 workers just for his visit.

Next: Carter paid dearly …

Two days later, Carter was in UMC’s compliance office for violating HIPAA’s privacy provisions. The Compliance Department told her the Governor’s Office had tracked her down and told them to deal with her,” according to WLBT.

Carter says she was suspended without pay for three days and “strongly encouraged to resign,” which she did. She says she ”wasn’t really jabbing” at the governor.  ”That’s just what people do on Twitter.”

I explored a number of the links provided on the site, yet I have one big unanswered questions about the event:

Did the governor publicly acknowledge his physical or its results at the time of this appointment? Those in the public eye, especially in an election year(Barbour is up for re-election in 2011, so this event took place during his last quest for office), often have their physicals and then assure the public that they are in great health. If it was public knowledge that he had the physical, then I am confused about where the break in protected information occurred. Carter said nothing about his health, merely commented on the “unnecessary” costs the state may have incurred. Given security issues with a prominent government official, the situation described may have been the least disruptive for the medical center’s other patients. It could even have been a cost-effective measure when all other factors were considered.

If the appointment was not publicly acknowledged, then Carter’s tweet was clearly a violation of HIPAA, since knowing the date and circumstances of a medical procedure can compromise one’s privacy. Twitter_Birds_rasterizedHer defense- she ”wasn’t really jabbing” at the governor- seems silly. Clearly, she was questioning the governor’s judgment and priorities. Such “jabbing” would be protected speech… if a healthcare appointment weren’t involved.

Social media, like twitter, allow us to find our audience as never before. We all must remember our legal and moral responsibilities, and use these freedoms wisely.

Thursday, January 7, 2010

What I’m Reading (& EVERYONE Should Read)

A few years back EB featured a movie, Flock of Dodos.Dodos This film exploring the “debate” between evolution and intelligent design was captivating, educational, and entertaining. Its creator, Randy Olson, inspires me. A tenured professor, he left academia, attended film school at USC, and now makes movies about science.

Think Michael Moore with a PhD. In short, this is the career path of my dreams. That or writing the Great American Novel, developing the screenplay, and winning the Oscar for it. But I digress.

When I saw Olson’s book on communicating science, I had to read it immediately. Yesterday I read a review, downloaded it to my Kindle, and devoured about 40% of its virtual pages already.

Don’t Be Such a Scientist provides the answer to the real question facing science today!DontBe

A number of scientists with good communication skills kvetch about the public’s lack of literacy. Most seem focused on educational policy and getting “the facts” out there in an accessible way. If we provide the data, the public will “get it.”

Dr. Olson debunks this attitude almost immediately. Through amusing stories of his experiences in acting and film classes, as well as life under the Hollywood sign, he illustrates a major problem: most of the public engages in issues through feelings, not through thought, something similar to my prior post on the book Unscientific America:

Ultimately, two antithetical forces are at work here. Science demands testable facts to support its theories. Religion is based on faith which requires belief without proof. Having grown up in the bible belt, I can tell you that new earth creationists are not swayed by the fossil record or any other evidence you present regarding the reality of evolution. They believe.

Olson’s book discusses ways to relate to the public on this visceral level so they care about the science. Important issues need to be more visual and emotional; the opposite tactic that most scientific groups pursue!

It brought to mind several other books I have read dealing with science and exploration around the turn of the last century. Thunderstruck was the most recent of these, a story of the invention of wireless communication by Marconi intertwined with a murder mystery and transatlantic flight. What these books all had in common?

Scientists had to put on a show.

Federal funding for science? Just not there except for weapons in time of war. No, those who “discovered” stuff had to be independently wealthy or appeal to wealthy donors. Explorers and inventers would give demonstrations of their discoveries in hopes of acquiring funds for their next venture.

I am trying to imagine the last manuscript I read as a show. It would never make it to Broadway… As a movie, it would not even hit the direct to DVD market. On YouTube? Fuggedaboutit!

I have always acknowledged my creative streak, my desire to “put on a show.” Editing a magazine has been a much better fit than a journal, simply because we have to make it visually exciting (getting doctors and scientists to write for a magazine has been a bit of a challenge, but that’s another story). Olson’s book fits with my own, admittedly biased, viewpoint on the problem with science dissemination. If I didn’t have a grant to write (speaking of boring scientese), I would finish perusing the book right now.

By the way, Dr. Olson, I would love to work on a movie. Call me- we’ll do lunch (isn’t that the Hollywood way?).

Tuesday, January 5, 2010

Radiation Safety

A question arose this morning about the risks of radiation from backscatter imagers.

Background radiation exposure in the US is ~3mSv (milli-Sieverts, equivalent to ~300 mrem). The lifetime risk of a lethal malignancy from all causes in the US is ~20%. A single 10mSv exposure at age 25 years increases the lifetime risk to 20.05%; however, the cumulative risks of repeated exposures are unclear.

A CT scan of the abdomen and pelvis exposes a person to 4.5 – 18 mSv of radiation; a plain film of the same area involve 0.7 mSv (See Adv Chronic Kidney Dis 16:48, 2009 for more on these types of studies).

So what is the danger from these new scanners? According to a posting at How Stuff Works:

According to the Health Physics Society (HPS), a person undergoing a backscatter scan receives approximately 0.005 millirems (mrem, a unit of absorbed radiation). American Science and Engineering, Inc., actually puts that number slightly higher, in the area of .009 mrem. According to U.S. regulatory agencies, 1 mrem per year is a negligible dose of radiation, and 25 mrem per year from a single source is the upper limit of safe radiation exposure. Using the HPS numbers, it would take 200 backscatter scans in a year to reach a negligible dose -- 1 mrem -- of radiation. You receive 1 mrem from three hours on an airplane, from two days in Denver or from three days in Atlanta. And it would take 5,000 scans in a year to reach the upper limit of safety. A traveler would have to get 100 backscatter scans per week, every week, for a year, in order to be in real danger from the radiation. Few frequent flyers fly that frequently.

backscatter-1These scanners appear to offer little danger from radioactivity. The posting referenced above is from 2007 when these devices underwent initial testing in the Phoenix airport. The scanner program generated the cartoon image to the left, although its capabilities are more dramatic as shown on the right-hand portion of the image.

Regarding the diminished image used, the following comment was raised in the article:

Some wonder how, then, the system can actually boost security. And the manufacturer, American Science and Engineering, Inc., admits that distorting the image does decrease the machine's usefulness. What if someone tapes a vial of liquid explosives to his scrotum?

Like deja vu, huh?

Saturday, January 2, 2010

Only on the Roof, Please

Last week my parents asked me a medical question (I’m a doctor- it happens). A friend of theirs just had shingles and suffered. A lot. Photoxpress_5068751

My parents now wanted to know “if the shingles vaccine is worth it.”

Shingles, or varicella-zoster, occurs in individuals sometime after chickenpox. After the immune system “conquers” the varicella (chickenpox) virus, this wily pathogen lies in our nerve cells, waiting. Waiting. Waiting…

As we age or develop problems with immunity, the virus can be reactivated, producing blistering lesions along a nerve root. Like chicken pox on steroids…

If the zoster (shingles) weren’t bad enough, severe pain may persist in the affected area for months after the rash heals. My parents’ friend has such pain that she cannot drive 3 months after the flare.

I have not suffered shingles personally, but I have seen it in my immunosuppressed patient population. The vaccine reduces the risk of shingles by ~50%, and post-herpetic pain (the fancy doctor-talk name for the nerve pain) by ~2/3.

I told my parents to get that vaccine. Even though the level of protection is not as good as with childhood vaccines (which are 95+% effective in preventing most infections), shingles is a bitch.

The CDC has a great site with FAQs and podcasts about this topic for patients and healthcare workers.

Photo courtesy of PhotoXpress.

Friday, January 1, 2010

Sad Times

This morning The Scientist sent out its top 5 articles of 2009, according to the number of page views. The list appears below:

1. Merck published fake journal

Our investigative report of how the company paid Elsevier to produce a publication that looked like a peer-reviewed medical journal but contained no disclosure of sponsorship

2. OA publisher accepts fake paper

The experiment tested whether a nonsensical article written by a computer program could pass peer review and be accepted. The experiment worked

3. iPhone apps every biologist needs

A PhD student's top 10 smart phone applications that boost his efficiency and help his research

4. Elsevier published 6 fake journals

In a follow-up to our #1 story of the year, the publisher admits to putting out a total of six publications that looked like peer reviewed medical journals, but did not disclose sponsorship by pharmaceutical companies

5. Viral cause for prostate cancer?

Prostate cancer is increasingly looking like an infectious disease, and may be sexually transmitted

Bad publishing ruled. Two sordid tales feature Elsevier’s sins (#1 and Star#4), while story #2 demonstrates the lax standards of some Open Access publishers.

I am also saddened that only one of these stories is really science. Apps for the iPhone are hot, and I certainly clicked on that one as well. But it seems what really gets our attention is scandal.

Scientists click on dirt and gossip the same way we all read the headlines on the tabloids while waiting in the check-out line.

I wonder if Elsevier can spin this into a fake journal reality show?