Jun 8, 2011 at 23:40:25
“Except there is no R&D to be done on these drugs. They are well understood. Companies aren't making them because the financial incentive is low. However, these drugs can be sold as a profit, so I would hope that a company would at least devote some resources to making them.”
NancyY on Jun 10, 2011 at 17:51:30
“"Well understood"? Do you 'understand' Gemcitabine? Cisplatin? Tarceva? Xeloda? These are all chemo drugs which a family member took for pancreatic cancer. He went to MD Anderson Cancer Hospital, which is one of the most renowned cancer hospitals and research centers in the country. But, as I understand it, no cure has been found for metastasized pancreatic cancer. They can stave it off for awhile, as this family member had two complete remissions; but it came back with a vengeance. Pancreatic cancer is the #4 killer cancer of men and the #5 killer cancer of women in this country. It gets to a philosophical question of "the most research for the betterment of the most number of people".”
Jun 8, 2011 at 23:30:01
“The causes are more profound than hormonal surges or prefrontal cortex atrophy. There are pathological cases as described here, but they are in the minority. Simply put, from an evolutionary standpoint, cheating makes sense for both sexes. Men that cheat increase their chances of reproducing; male parental investment in humans and across most mammals is fairly small. If you can sire children from 10 different women, and do so, then natural selection dictates that you will be more successful than a monogamist.
And before women get a holy attitude, human women are more likely to cheat right when they are at the most fertile part of their cycle. The logic is that if you can get genes from an attractive/powerful male and have their more plain spouse assist in raising the child, they can have the best of both worlds: high parental involvement and sexy genes. Now of course thoughts like these are not why individuals cheat, nor is this predisposition an excuse, but cheating is part of human biology for both sexes. It doesn't make it right, though.”
nikanj on Jul 11, 2011 at 11:10:30
“'Siring' children is a far different thing than making sure that they
have a healthy childhood so that they can mature to continue said sire's
genetic line. Which is better -- ten malnourished offspring who, if they
do reproduce, will probably degrade your genetic line, or two or three
well-cared-for offspring who have a much greater chance of enhancing
your genetic line when they reproduce ?
The 'have as many babies with as many women as you can' argument
for male infidelity is not really a good reproductive strategy if you think
about it from the perspective of the offspring. (What a concept !)”
FeralForever on Jun 9, 2011 at 06:25:53
“And just how was it determined that women cheat at the most fertile part of their cycle? Absurd.
It's been determined that women cheat for emotional reasons, not sexual, more often than not...and ovulation does NOT increase libido....Female animals who go into "heat" are NOT of the human type...”
Grinling Gibbons on Jun 9, 2011 at 05:53:38
“Evopsych isn't even science, yet everyone who quotes it manages to sound as if they're delivering a sermon from the mount. Let's please distinguish between self serving theories and actual objective fact.”
“I disagree. From an Israeli perspective the status quo looks better than ever, and that is part of the problem. Astute Israeli right wingers have recognized that with an enormous tactical military advantage, diminishing power of neighbor states, and 100% reliable carte blanche support from the United States they have nothing to gain by making concessions. They don't need a lasting peace because their borders are secure and the ability of Hamas or Hezbollah to do actual damage to Israel is very small. For the purposes of the United States and a lasting peace solution in the Middle East the status quo is a total disaster, but as long as the US pledges allegiance to Israel it is far easier for the Israeli government to appease the right wing settler parties and just deal with the occasional rocket launch from Gaza than it would be to make the painful concessions good faith negotiations would require. Because of the fractured nature of Israeli politics, the government is literally dependent on the far right for survival, which makes the inability of the country to compromise all the more tragic for the moderates that want something to be done.”
Adewale Ajadi on May 23, 2011 at 10:33:43
“Your position is logical and actually persuasive but problem is that it underestimates the adaptive capacity of the people of Palestine, the profound demographic changes and the unknown and unpredictable quality of the democratisation of knowledge , military and otherwise.”
“Unfortunately, there is no evidence to back up your gut feeling so I think the righteous indignation can be put aside.
Obama's plan in no way would make Israel a second rate power in the region. Israel would become more crowded because they would have to stop building illegal settlements in the West Bank, but in no realistic contingency would Israel be politically, economically, or militarily dominated by their neighbors. If Israel wishes to execute a land grab of all of the occupied territories and wall of the Palestinians into ever-shrinking slums they can do it without our support just fine.”
“If you have MRSA or VRE or an obvious skin abscess that is exactly the time you should be taking antibiotics. If you mess around with plant extracts and it doesn't work the infection can spread and then you get nice and septic and have a hospital vacation to look forward to. MRSA and VRE are pretty dangerous and need to be treated with powerful antibiotics. There are drugs that work on these particular bacteria still.
However, the advice to avoid antibiotics for conditions they are not clearly indicated for is good. It has been shown that if you get a powerful antibiotic that kills off the competition you are more likely to be colonized with resistant bugs that can cause subsequent infections. The key is striking the middle ground; take antibiotics when you need them as directed and don't go asking for them when you don't.”
Cyrus Trance on May 13, 2011 at 17:27:55
“If you have MSRA or VRE and you are not treated with the most current antimicrobial therapy you can become septic and die.”
“I work in emergency departments and the number one waste of time and resources of the ER is dealing with patients who have poor primary care. So many cases could have been sent to the PCP the next day but the patient has no guidance from their primary. So many patients don't have primary care. And huge numbers of patients have chronic conditions that are poorly managed or not managed at all by a primary doctor and end up seeking expensive ER treatment for conditions that ER docs can't help. Good, numerous, and qualified primary care doctors are badly needed.”
rothomaha on May 12, 2011 at 21:10:53
“And, in my own experience, a lot of the people who end up in the ER are there because they were SENT THERE by their primary care providers, especially between 5 p.m. and 8 a.m. - I've been there, too and have seen it over and over again.”
Bibbo on May 12, 2011 at 19:30:56
“I am a primary care physician. I am board certified in Internal Medicine and enjoy the challange of the mix of intellectual(science-fact based medicine) and art( eccentricities of each patient) that goes into primary care. The trust of the patient is indispensible. The importance of this trust is something I don't think anyone really understands unless you experience it yourself. One has to actually practice medicine to understand what I'm saying. That's a problem. All our experts are perhaps "book" smart but they are about to really mess things up. The old time "family doctor" that many of us in our 50's and 60's grew up with is being abolished. You will not know your doctors in the new medicine(Obamacare) and the doctor will not see you as an individual but as a disease that is given a score that determines how much on average the doctor can spend of the govts. money to treat you. Say you need to be hospitalized for a appendectomy....well the govt. statistics will predict the average case should take 4 hospital days and X amt. of $$ for tests like blood work and otherthings....if you heal slow or costs more...instead of the medical team feeling extra sympathy they get a bit ticked off since you will make them look bad...not cost efficient.All patient-doctor interactions will be distorted. The expensive patients will be the new "lepers"...no one wants them.”
alongst on May 12, 2011 at 18:12:29
“As a Family Practice physician who now works in the ER, I can say you are mostly right- except many of these patients admit to being too lazy to make an appointment !
"It's easier just to come here !" is the comment I hear all the time. It's also why at 5 PM, we get a large rush of patients, almost always on Medicaid, for minor things they should see their doctor for, but don't want to take time off from work to do so .
If the Hospital Administrators would grow a backbone and let us refuse to treat nonemegencies, a lot of this problem would correct itself.”
“Unfortunately we can't supply and distribute enough anti-retrovirals to the people who have declining CD4 counts in the developing world right now. Increasing the scope of disease for which they are indicated will only exacerbate the shortage.”
“Relations with some of the humans in Florida may not conform to certain husbandry or good veterinary practices, so you need to be careful down there. I think the evidence is in that fact that somehow a majority of the elected representatives of the state were stupid enough to think this "issue" merited their attentions.”
“You know, Mitt, grasping subtlety is not a strength of the American voting electorate. Especially the right wing base you need to win the nomination, which really appreciates an us vs godless evil liberals who hate America, babies, and God narrative. Just throw in the towel, it's not going to happen.”
“It's also a sign of overly pliable physicians. Show some backbone and don't do a contraindicated procedure because somebody wants it. Of course, this goes to some of the negative aspects of consumerization of healthcare, which is a complex issue (that may also have positive aspects).”
“Doctors in some specialties will never live luxuriously. Most MDs these days are upper middle class jobs; they make really good money but won't get rich, especially considering a high debt burden. As for PhDs, they don't get paid nearly as much but then again they are funded in grad school and the hours may not be less but are much more in their control.”
foresure on May 8, 2011 at 17:04:36
“Reply to rabidbadger (2:33 a.m.)
"Doctors in some specialities will never live luxuriously".
Meaning that some will.
"Most MD's ... make really good money but won't get rich". It depends, doesn't it on what "really good money" means.
And what "get rich" means.
Residents are paid a moderate, middle class salary during Residency. Therefore, they are funded.
If a specialist is self employed, or a partner in a group, how does that specialist not have control of is work hours?
According the University of Florida Medical School web site, 89% of their students receive financial aid of some sort.
The real issue is what is the Specialist's debt to income ration ten years after completion of residency?
But, finally, PhD's don't continually whine and cry about how overworked and underpaid they are.”
“"Taking all this data together, we can estimate that the normal, healthy age at menarche under
conditions of excellent nutrition without caloric excess would probably fall somewhere between 15 and 18."
I would love to see the evidence for that. Although the article raises interesting questions that sentence is absurd. The more reasonable interpretation of this phenomenon is that improving nutritional value of the diet (not necessarily great nutrient content, but abundant caloric resources) is inducing females to menstruate earlier because of they can. Reaching reproductive state earlier in resource rich environments is seen all the time in animals. When you think about this in humans you want to look at what other animals do with increasing access to resources.
There is simply no basis for this claim. On the contrary, there is every reason to believe that an animal will attempt to become reproductive as early as possible. Whether or not this is ideal for long term health is irrelevant; getting breast cancer right after menopause is not a selected trait. Maximizing reproductive lifespan has major fitness consequences.”
“It is very good that you can read primary scientific literature. Despite the amazing distribution of many articles for free to the general public, reading these critically is a very advanced skill. Unfortunately, most people are dependent on books written for the general public, which ultimately only amount to one person's opinion and are prone to exaggeration to increase marketability. I would like to see some real experts on fields like this (not some guy with an MD and basic scientific literacy) to be responsible for conveying information to the public. Unfortunately, honest assessments of uncertainty, divided opinion, and contradictions in the data don't attract much attention.”
“Scientific knowledge is not disseminated in books. Books are not medical science sources, although some provide excellent reviews. Still, somebody who writes 200 pages on a particular subject and sells that work for profit obviously has some agenda to push and has already drawn conclusions. This person will find data and interpret it in a way to convince you or make a good selling book. If they are conscientious and impartial this is a good way to communicate science to lay people, but they don't offer you data to interpret yourself and their interpretation is not the gospel truth. That is not to say that primary literature is always impartial, but just realize that these books are each one individual's interpretation of vast and possibly contradictory volumes of literature among thousands of scientists that study these issues.”
“The problem with the use of radiation fears to oppose nuclear power is that fossil fuels, especially coal, contain trace amounts of radioactivity themselves. With the amount of coal burned annually hundreds of times more radiation is release by coal use than would be newly designed nuclear plants functioning well (ie, your backup power system is not in the basement when you are right on the shore). A good nuclear plant releases almost no radioactivity as long as the core is controlled and the waste contained. Compare this to a coal plant where waste is spewed into the upper atmosphere, often consisting of longer lived more hazardous isotopes than 131-I, creating a situation of tonic low level fallout globally.
We are at a situation where no amount of wind or solar investment will replace coal. With the use of newer reactor designs, many vastly improved from those in operation now we could drastically reduce coal usage. A nuclear scare after Three mile Island killed support for new nuclear plant designs in the US. How far would we be with 30 years of US funding and engineering expertise plowed into these designs instead of into ethanol subsidies? Despite the obstacles drastic improvements are out there waiting to be built. Ultimately, the risk of short term focal damage to areas like Chernobyl or Fukishima in my opinion is preferable when compared to the slow killing of the entire planet by fossil fuels.”
aligatorhardt on May 9, 2011 at 00:15:15
“Short term damage? Even the cesium takes 200 years to decay to background levels, strontium takes longer, plutonium lasts thousands of years. There are 13 isotopes as fission products produced by overheated nuclear fuel. The nuclear waste lasts hundreds of thousands of years. Renewable energy resources in this country are many times more than enough to replace all nuclear and coal and natural gas plants. This will not be accomplished overnight, but wasting money on dirty power is not a wise investment.”
Sarah Lovinger on May 7, 2011 at 15:59:35
“rabidbadger--While I agree that coal-fired power plants threaten human health and our environment in hugely significant ways, nuclear power plants do not really provide a better way to meet our electricity hunger. RAther than spend billions on more nuke plants, I'd love to see the US gov't. invest in green energy research. Harnassing the power of the sun could keep us going in killowats for a very long time.”
“It's not. It's the cradle of the human species (although this is debatable) The cradle of civilization is in Iraq. Does that make you feel better or worse, because personally right after I typed that I realized that I couldn't tell.”
“It was criminal as far as I am concerned, but really my greatest condemnation goes to the governments of these countries. While the Americans need to do as much as possible to fight AIDS, the ultimate responsibility goes to the leaders of these countries who are too busy fighting civil wars and pillaging the resources of their own countries (not really talking about Tanzania here, but many of the countries in the region) to fight this disease and the social misconceptions around it.”
“I think it bears mentioning that the doctrine of Christ's altruistic self-sacrifice is ethically distinct from capturing, raping, and mutilating an unwilling victim. These killings of albinos aren't sacrifice, they are slaughter. Sacrifice implies that you are forfeiting something of value to yourself.”
JimStricker13 on May 5, 2011 at 13:34:42
“It does not bear mentioning. It is ALL magical thinking.
Killing people (willing or unwilling) achieves nothing but a brutal and unnecessary death.
The story of Jesus is a relic from a time when it was widely believed that the spilling of human blood was a way to curry favor with a deity.”
“"They happen to be the center of most of the modern manufacturing and tech innovation in the world today."
That's not accurate. They are a huge manufacturing power, but China is nowhere near overtaking the US and Europe in the department of technological innovation. Furthermore, the J-20 is about three meters longer than the F-22 suggesting that they do not even have the same mission. Based on what we've seen there is no reason to think the J-20 is anything beyond Raptor class in capability. In fact it probably performs somewhere between the F-22 and F-35 at best, and there is no guarantee that China has devised a way to make the J-20's radar undetectable to to US fighters. American radars and radar detectors are very good and not the kinds of things China could get their hands on from photos or F-117 scraps.”
any mouse on Jan 24, 2011 at 03:11:48
“Boy are you living in the 1960s.
Chinese engineering is as advanced as US engineering adn in some areas is better.
Sure China "borrowed" a lot over the last 60 years to bootstrap themselves into the 21st century, but they are now long past being just copy-cats and are doing some very advanced innovative engineering.
One simple example, the world's fastest computer is now Chinese!”