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Placebos work, so how do we ethically use them?

The head of Harvard's placebo program is trying to figure out a good answer that question. Maggie 16

The Elephant Man's secrets

"The Elephant Man, Joseph Merrick, was an object of curiosity and ridicule throughout his life - studied, prodded and examined by the Victorian medical establishment. Now, 123 years after his death, scientists believe his bones contain secrets about his condition which could benefit medical science today." [Andrew Bomford / BBC]

A moving account of how hospitals negotiate complicated cases of patient rights

Yesterday, a story about human experimentation spurred an interesting discussion in the comments about patient rights — can somebody who is dying make the informed decision to accept a treatment that could lead to them dying sooner? At Scientific American today, an HIV doctor has written a moving account of dealing with a very similar question, as one of his patients made the choice to refuse food, and her family and doctors were faced with the task of deciding whether or not to feed her through a stomach tube. Maggie 4

China says it will stop harvesting organs from prisoners

More than half of China's donated organs come from executed prisoners. The Chinese government now says it will begin phasing out that practice, starting in November. All new organ donors must volunteer. Of course, there's good reason to be skeptical of this announcement. As Smithsonian points out, the practice has already been illegal since 2006 with not much done to change it. Meanwhile, a harrowing 2011 investigative report by Ethan Gutmann in the Weekly Standard revealed a system that leaves plenty of room for "volunteer" loopholes. Maggie 7

How the stethoscope was invented

The first stethoscope was a sheaf of rolled paper. It later evolved into a foot-long wooden tube. The inspiration: Possibly a couple of French street urchins playing on top of a pile of lumber. Maggie 1

Naming prescription drugs

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How do pharmaceuticals get names like fluoxetine, atorvastatin, modafinil, or sildenafil? Those are the generic names for some common prescription drugs. The drug company with the patent on the pill gets to choose the generic name. The U.S. Adopted Names Council has rules on such matters though, as The Week's James Harbeck writes:

• "Prefixes that imply 'better,' 'newer,' or 'more effective;' prefixes that evoke the name of the sponsor, dosage form, duration of action or rate of drug release should not be used."

• "Prefixes that refer to an anatomical connotation or medical condition are not acceptable."

• Certain letters or sets of letters also aren't allowed at the beginning of new generic names. These include me, str, x, and z.

Every name has two main parts. The back half of the drug name is the same for all drugs in a particular class — for instance, there are a whole raft of cholesterol-lowering drugs that end in -vastatin: atorvastatin (Lipitor), fluvastatin (Lescol), rosuvastatin (Crestor), simvastatin (Zocor), and several others.

"How do prescription drugs get such crazy names?" (via NextDraft)

image: detail of Damien Hirst's "In Search of Nirvana" (2007)

Evidence-based pregnancy should be about decisions, not hard rules

If there's one thing I'm learning from the crop of evidence-based pregnancy books I've been perusing, it's this: Pregnancy ought to involve a lot more complicated decision-making and less blind rule following. That's because the stuff that gets touted as "must-do" or "can't do" is often, in reality, just one way of interpreting a conflicting and correlation-heavy body of data. Usually there is more than one appropriate, evidence-based decision that you can make, depending on your personal beliefs, desires, and goals. At the Wall Street Journal, Emily Oster does a great job of writing about this, using taboo libations alcohol and coffee as the examples. Maggie 41

A big win for consent, privacy, and genome data

The family of Henrietta Lacks — a woman whose cervical cancer cells were harvested and used in scientific research for decades without her knowledge or consent — will now play a role in deciding who has access to the Lacks' cell genome data, and for what purposes. There are loopholes in the new system. For instance, the agreement only applies to scientists who receive National Institutes of Health funding. And the genome of the cells has been sequenced so many times, at this point, that anybody who wasn't NIH funded and didn't want to voluntarily abide by the agreement essentially wouldn't have to.

But it is a big step forward, both for the Lacks family (whose own genetic information is contained in those genome sequences) and for the idea that human genetic information belongs to the people it comes from — not to whoever happens to sequence it.

The happy selfie posted here features NIH director Francis Collins posing with some of Henrietta Lacks' descendants after the agreement was announced.

From the front lines in the fight against antibiotic-resistant bacteria

Bacteria are becoming resistant to one of the last classes of antibiotics available to treat them, writes Maryn McKenna at Nature. Carbapenem-resistant Enterobacteriaceae are a family of lung, blood, and bladder infections that can turn horribly deadly. Meanwhile, at Scientific American, Charles Q. Choi writes about other scientists looking for ways to turn bacteria against one another, unleashing predatory microbes that can destroy drug-resistant bacteria. Maggie 2

Gummi vitamins: Not all they've smooshed up to be

Not all vitamins are created equal. Especially troubling, gummi "prenatal" vitamins that don't contain any calcium, thiamin, riboflavin, or iron. As Joss Fong points out at Double X Science, not only are pregnant women one of the few groups that can be shown to statistically benefit from taking vitamins, the missing iron is also one of the key things those women need. So why can you label a vitamin "prenatal" if it doesn't contain nutrients that are crucial to pregnant women? Consider this another friendly reminder that the dietary supplement industry is largely unregulated and doesn't have to answer to the FDA, except in a few, very specific circumstances. Maggie 9

Beauty of disease

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Medical photographer Norman Barker captures the biological beauty of human disease -- microbes, cysts, diseased cells, as they appear out of context and close up. A professor of pathology and art at the Johns Hopkins University’s School of Medicine, Barker's new book is titled "Hidden Beauty: Exploring the Aesthetics of Medical Science." Above left, the Hepatitis B virus, and right, a fine collection of gallstones.

"Hidden Beauty: Exploring the Aesthetics of Medical Science" (via Smithsonian)

A smart knife for surgeons

Researchers at Imperial College London have invented an electric surgical knife that comes equipped with a built-in mass spectrometer. Electric knives cauterize wounds as they cut, which produces smoke. The iKnife will be able to analyze the chemistry of that smoke to determine, for instance, whether the tissue that was just cut was cancerous or not — allowing doctors to make decisions in the OR that would, today, require them to take samples, send those samples to a lab, and maybe schedule a second surgery. Maggie 4

If you have to take an antibiotic, should you take a probiotic, too?

It probably won't hurt, and it could help, says Scott Gavura at Science Based Medicine. But it's also worth taking a closer look at the nuance behind probiotics, too. These are promising medications and a fascinating field of research, but educating yourself on what we do know and what we don't (especially when it comes to purity of various products) is a really good idea. Maggie 17

Sawbones, an enjoyable medical history podcast

Maximum Fun, the outfit that produces two of my favorite podcasts (Bullseye and Judge John Hodgman) has announced a new show. It's called Sawbones. Jesse Thorn says: "It's about the history of medicine, particularly the crazy bits. It's hosted by Dr. Sydnee McElroy & Justin McElroy. Justin's also one of the hosts of My Brother, My Brother & Me, one of our most popular shows. And they're married. Sydnee's a medical history nut, and Justin good at bothering his wife about things, so they are a good team."

Sawbones

Strange Medicine, by Nathan Belofsky: exclusive excerpt

In Ancient Egypt, doctors applied electric eels to patients with migraines. In the medieval times dentists burned candles into patients’ mouths to kill off those pesky invisible worms gnawing at their teeth.

Read the rest