genomeboy.com

The Lancet has retracted a 1998 paper linking the Mumps-Measles-Rubella vaccine to autism. The journal’s editor spoke to On the Media this week.

I have to start watching more TV.

The physicians and hospital leaders from Cedar Rapids told us how they have adopted electronic systems to improve communication among physicians and quality of care. Last year, they decided to investigate the overuse of CAT scans. They examined the data and found that in just one year 52,000 scans were done in a community of 300,000 people. A large portion of them were almost certainly unnecessary, not to mention possibly harmful, as CAT scans have about 1,000 times as much radiation exposure as a chest X-ray.“I was embarrassed for us,” said Jim Levett, a cardiac surgeon and the head of a large physician group. More important, the area’s doctors and clinics are turning that embarrassment into change by seeking out solutions to reduce the expense and harm of unnecessary scans.

That number of scans in Cedar Rapids may seem shocking, but there is nothing surprising about it. Nationwide, we do 62 million CAT scans a year for 300 million people. So Cedar Rapids’s rate was actually better than average. But all medicine is local. And until a community confronts what goes on in its own population — to the point of actually seeking the data and engaging those who can solve the problem — nothing will change.

Many people feel that it is a more elevated act to donate anonymously: not to pick a recipient, in other words, but simply to show up at a hospital and offer one’s kidney, leaving it to the transplant center to assign it to the next person on the list. Sometimes the recipients in these transactions choose not to meet their donors; sometimes they don’t even send a note to say thank you. For a donor to pick a recipient through a service like MatchingDonors can seem, from this perspective, like egotism—playing God by choosing who will live, and encouraging gratefulness by arranging for a relationship with the recipient. But, in a certain literal sense, a nondirected donation is not altruistic in a way that picking a recipient is, because there is no other there. There is no human story, just a principle; the only thing visible to the donor is his own shining deed.

Larissa MacFarquahar on kidney donation in the New Yorker (registration required). Wow. Best nonfiction I’ve read this year.

For those interested in family history, the NIH is holding a conference in August:

The purpose of this state-of-the-science conference, open to anyone, is to develop a consensus statement that advances the issue of family history by assessing the available scientific evidence on:

• The key elements of a family history in a primary care setting for the purposes of risk assessment for common diseases
• The accuracy of family history, and under what conditions the accuracy varies
• The direct evidence that getting a family history will improve health outcomes for the patient and/or family
• Factors that encourage or discourage obtaining and using a family history
• Future research directions for assessing the value of family history for common diseases in the primary care setting

The details:

• Attend in person August 24-26, 2009 in Bethesda, MD  
• Or register to watch the live Webcast if you can’t travel to attend in person

Does family history really need a conference to generate consensus statements and “advance” the issue? I’m not sure. But I applaud the organizers for (presumably) holding family history to the same evidence-based criteria they so often demand of direct-to-consumer genetic testing.

(Thanks to Erica Holt for the tip)

Nothing like a little primum non nocere when a guy is dying of Lou Gehrig’s disease:

As Joy helped Joshua with his mounting physical needs and cared for their son, Wyatt, who had been born two weeks after Joshua’s diagnosis, the couple pressed Kathy to explore Joshua’s medical options.

They decided he should try what seemed like the next best thing to Iplex — the drug that had triumphed over it in the patent dispute. But the first neurologist they visited refused to give him a prescription.

“This could cause hypoglycemia,” he told Joshua, warning that low blood sugar could result in seizures or brain damage.

“I’ll take my chances of hypoglycemia over laying in the gutter,” Joshua replied fiercely, but the doctor did not relent.

And it gets worse:

The F.D.A. had a month to respond from the date it received Joshua’s application on Dec. 16. When Joshua asked about Iplex now, Kathy told him, “It should be any day.”

On Jan. 16, when Dr. Werwath called to tell her the application had been rejected, she stood up in disbelief.

“How could that be?” she asked, dazed.

Kathy’s friend Mrs. Reimers had received a call with the same news.

“He said they had safety concerns,” Mrs. Reimers said. “This for a drug that was approved for children!”

“Safety,” Kathy repeated. “And what, exactly, is safe about A.L.S.?”

Fantastic article in the Boston Globe about former George Church-student Katherine Aull, who has set up a lab in her apartment and is testing herself for hemochromatosis mutations.

(Hat tip: GenomeWeb)

I’m not sure what to make of this, but someone emailed last night and said, “…I’m guessing that I’m probably the first person to ever tweet your DNA.”

You are correct, sir!

And since you’ve obviously read my profile, maybe you could send me a business card just in case.

Three-fourths of the nation’s doctors practice in small offices, with 10 doctors or fewer. For most of them, an investment in digital health records looks like a cost for which they are not reimbursed.It is scarcely surprising, then, that only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine.

“This is really not a technology problem,” observed Erik Brynjolfsson, an economist at the Sloan School of Management at the Massachusetts Institute of Technology. “It’s a matter of incentives and market failure.”

That market failure is a principal target of the Obama administration’s plan. A main feature of the legislation calls for incentive payments of more than $40,000 spread over a few years for a physician who buys and uses electronic health records.

Better late than never. 

Bob, who’s owned wild animals all his life, admits Higgins has not always been a model pet. When Higgins was 3, he slept with the couple, often awakening Bob in the morning by climbing to the bedroom rafters and dropping onto Bob’s stomach. On one occasion, they got in a wrestling match, and Higgins put one of his “steel-like fingernails” through Bob’s scrotum.

Bob has considered moving him to a sanctuary, but “I’m just too attached to him,” he says.

…

Bob has been bitten several times by Higgins, who now weighs 50 pounds and has large incisors. Once, when Bob was leading him from an outdoor enclosure back to his cage in the house, Higgins exploded and the two got into a battle so ferocious that despite the steel mesh glove Bob was wearing, he screamed for Carlie to get his .22 rifle and put a bullet in Higgins’s head. She got Higgins a slice of raisin bread instead, quickly defusing the fight. But Bob accepts it: a wild animal will never be domesticated, he says.

…

“He shivered and I leaned over and said, ‘Come here, baby, are you cold?’ and he exploded,” Ms. Bowers says. “He started biting and screaming at me, biting any place he could touch. It was a nightmare. We tipped over furniture, I would have killed him if I could. But he was so strong. I tried to choke him to make him stop. We fought for I don’t know how long. I was trying to hold him so he couldn’t bite me. I took one of my big fabric books and held it on his throat.”

…

JUDIE HARRISON, 50 and three times married, is an extreme example of monkey love. She once demanded that her 15-year-old son give up his bedroom for a chimp, and today she is estranged from all three of her children because she put the primates first. Her passion also cost her her home.

Words fail.