tag:blogger.com,1999:blog-4968787219619380438.post6522712679166439244..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Those who can, publish. Those who can’t, blogSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-4968787219619380438.post-34338294431430207972016-02-22T12:36:54.911-05:002016-02-22T12:36:54.911-05:00I understand now. Yes, the intention-to-treat prin...I understand now. Yes, the intention-to-treat principle means that regardless of cause, your case is a failure of antibiotic therapy. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-62433799551457074112016-02-21T22:49:35.487-05:002016-02-21T22:49:35.487-05:00Scalpel, I've seen pinworms in the appendix mo...Scalpel, I've seen pinworms in the appendix more than once. I guess my question (which I didn't really make clear) is, would you consider this case to be a treatment failure for antibiotics? <br /><br />Apologies again for being off topic.artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-25813558035033578282016-02-20T18:19:39.284-05:002016-02-20T18:19:39.284-05:00The problem is that we tend to scare the crap out ...The problem is that we tend to scare the crap out of doctors or they hate us with a passion. For the life of me, I can't see why. Think about it: they will have hundreds to thousands of patients, a possible family, & MOC (for starters). We can spend the time to research and hook up with other "patient experts" that are the 180 degree opposite of Dr. Oz. <br /><br />If someone else is helping to solve the problem, why not consider that a blessing. <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-68051293867867805552016-02-20T16:08:16.090-05:002016-02-20T16:08:16.090-05:00Artiger, pinworms in the appendix have been report...Artiger, pinworms in the appendix have been reported many times. See http://ispub.com/IJS/30/3/2985 for example. If you google or PubMed search, you will find a lot of papers. Don't forget to look for anal pinworms in your patient and maybe treat the family too.<br /><br />Doctor, good story. Academic types can be officious. That could be the problem with Dr. O'Connor. As you noted, they may also have their heads in the sand and not recognize the potential that something they are working on might actually be useful.<br /><br />William, excellent point. The exchange of information is better than it has ever been and some smart people out there can contribute a lot even if they are not professors.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72837112697435252462016-02-20T09:05:49.964-05:002016-02-20T09:05:49.964-05:00The internet has increased the freedom of informat...The internet has increased the freedom of information and ideas. Tremendously.<br />I frequently spend more time reading the comments to articles in the NYT than I do reading the newspaper. Similarly, I am amazed at the quality of reviews of books on Amazon. There are a lot of people in the world who know something that contributes to the discussion who are not associated with any recognized news or university organization. Like skeptical, for example. This is good.<br /><br />William Reicherthttps://www.blogger.com/profile/10062067819184876941noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-30242560937365849392016-02-19T20:48:44.395-05:002016-02-19T20:48:44.395-05:00Had the same issue about 2 months back when attemp...Had the same issue about 2 months back when attempting to "recruit" a team of "research types" to study a never thought of relationship between a compound and cardiac valve elasticity. I was asking around and stumbled on a fellow from a major University in the UK (no names need be used) and basically the shear fact that I was looking to take the final results and use them for the basis of building a for profit entity they popped a gasket and then started the same type of discussion. I being from the clinical world as opposed to they being in the "university" had no concept of the value of research and publication and the like. Even though I have spent 30 years with commercial PharmaCos and Surgical Supply Cos with the FDA I apparently have disgraced the industry by not being "pure." The fact that I approached the EXACT area that they were studying from a commercial standpoint rather then their didactic approach assumed to them that I was inappropriate. Couple it with the fact that they were seeking $250K for a PhD student and other costs to continue their research was somehow acceptable but the net was that no realistic financial gain was acceptable. Interesting that "profit" is bad but "income" is good. <br />When they "publish" at their annual salary or perish that is considered but when you "blog" at no compensation other then shear enjoyment that is unacceptable.<br />Dr DAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-87730592902773231972016-02-18T20:08:27.302-05:002016-02-18T20:08:27.302-05:00Speaking of appendicitis, earlier this week I had ...Speaking of appendicitis, earlier this week I had my second treatment failure of antibiotics for appendicitis this month, this time in a 10 year old. She initially responded well, becoming pain free, afebrile, and eating well less than 48 hours after metronidazole and sulfa were started. (CT scan did indicate uncomplicated appendicitis.) 24 hours after being discharged, which would have been day 3 of treatment, she experienced recurrence of pain and low grade fever, so off to the OR for an outpatient lap appendectomy. The appendix was not perforated but appeared mildly edematous, and the patient looked great postop. Pain gone.<br /><br />Another treatment failure? I'm not sure. Path showed the appendix was full of pinworms. What do you make of that one?<br /><br />Sorry to highjack, but I wanted comment on a fresh thread. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-19792106292950464662016-02-18T13:04:54.615-05:002016-02-18T13:04:54.615-05:00Art and Frank, thanks for contributing. I apprecia...Art and Frank, thanks for contributing. I appreciate your reference to my post about appendicitis.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-92156545973542139412016-02-18T13:02:52.148-05:002016-02-18T13:02:52.148-05:00Chris, well said.
It's possible that Dr. O...Chris, well said.<br /><br />It's possible that Dr. O'Connor is a troll. If so, she has done a remarkably good job of annoying everyone, myself included.<br /><br />In my relatively serious posts, I try to incorporate information from a few different sources in hopes of achieving what you suggest in your first paragraph.<br /><br />Ioannides is famous for critiquing the literature and calling BS when needed.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4459220295479797172016-02-18T10:53:55.490-05:002016-02-18T10:53:55.490-05:00It's worth noting that blogs may actually serv...It's worth noting that blogs may actually serve an important academic role as secondary sources. I doubt Dr O'Connor would suggest that textbooks, review articles, or meta-analyses are not useful sources. Bloggers (serious ones anyway) could fill a similar niche in the publishing heirarchy by comparing and integrating results from multiple different primary studies. <br /><br />Anyone who has read the work of John Ioannides should understand that any individual study is nearly as likely as not to be proven wrong in the future. Some critical analysis of those results (by bloggers and others) might even facilitate good science.Chrishttps://www.blogger.com/profile/13390897461614161786noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-1038466018651295512016-02-17T14:34:51.493-05:002016-02-17T14:34:51.493-05:00Greg
Depends on whose data. As Skeptical pointed...Greg <br /><br />Depends on whose data. As Skeptical pointed out this postings shows one has a lot of data to think about. <br /><br />http://skepticalscalpel.blogspot.com/2010/08/appendicitis-diagnosis-ct-scans-and.html<br /><br /> frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72025895744367109922016-02-17T09:02:31.926-05:002016-02-17T09:02:31.926-05:00I wonder what the Chinese translation of "but...I wonder what the Chinese translation of "butt-hurt" would be. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-88429785954892876492016-02-17T07:46:35.069-05:002016-02-17T07:46:35.069-05:00Greg, thanks for the comments. I don't think y...Greg, thanks for the comments. I don't think you will be seeing original data on many blogs. Some of us have published in real journals before we started blogging. <br /><br />As you well know, I have even published an article in the Canadian Journal of Anesthesia under my pseudonym. I think that makes me credible even in the eyes of Dr. O'Connor.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-67925228504035497842016-02-16T22:06:49.134-05:002016-02-16T22:06:49.134-05:00W Edwards Deming once said "“Without data you...W Edwards Deming once said "“Without data you’re just another person with an opinion.” And that kinda sums up the blogosphere. At their best blogs and other such posts are thoughtful commentary, but remain unsullied by data. Sure, posts may reference other data sources and illuminate those findings, but new, original data is rare. <br />Don't get me wrong, there is plenty to criticize in with both academic publishing and peer review; however one does not have to look very hard for equally shoddy internet comment. Food Babe, anyone?<br />I treat blogs as I do editorials or review articles. Thought-provoking, insightful, opinion. Like we find right here at Skeptical Scalpel.<br />I think blogging and traditional publishing complement each other. There's plenty of room for both.<br />Keep up the good work Skep.<br />Anonymoushttps://www.blogger.com/profile/00636366676099978706noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-69995823397651342582016-02-16T17:23:52.942-05:002016-02-16T17:23:52.942-05:00Les, good points. I think most scientific papers w...Les, good points. I think most scientific papers will be free to readers soon. There's no way to stop them from being posted.<br /><br />I agree it's snobbery -- plus a lack of awareness that things are changing.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-39618060287623662232016-02-16T15:20:41.922-05:002016-02-16T15:20:41.922-05:00@frankbill, that may be because most peer reviewed...@frankbill, that may be because most peer reviewed articles are behind a pay wall. Most articles are $35 a pop for readers who aren't affiliated with a university. Blogs are ideal because they are accessible for most readers. <br /><br />O'Connor's description of blogger reeks of snobbery. What would she say about Jill Viles, a muscular dystrophy patient, who doesn't hold a Ph.D., who helped identify a gene mutation related to both muscular dystrophy and athleticism. I suppose monks who study pea plants would be excluded by O'Connor's criterion as well. Lesnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-14809860439899797022016-02-16T14:22:50.733-05:002016-02-16T14:22:50.733-05:00Your guess is correct and certainly true in my cas...Your guess is correct and certainly true in my case. See this post: http://skepticalscalpel.blogspot.com/2014/08/a-paper-of-mine-was-published-did.html<br /><br />A post of mine on appendicitis has had >57,500 page views. Here's the link if you are interested http://skepticalscalpel.blogspot.com/2010/08/appendicitis-diagnosis-ct-scans-and.htmlSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-70415299120092719312016-02-16T14:06:12.105-05:002016-02-16T14:06:12.105-05:00My guess is more people read blogs then read peer ...My guess is more people read blogs then read peer reviewed publications. frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-29096320167009682232016-02-16T11:06:28.012-05:002016-02-16T11:06:28.012-05:00Chris, good point. She got my attention with her o...Chris, good point. She got my attention with her outrageous statement. I think she's capable of more. Maybe she should blog.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-77115454844976700342016-02-16T10:52:06.789-05:002016-02-16T10:52:06.789-05:00Clearly there are some things rotten in the peer r...Clearly there are some things rotten in the peer review system, so I don't think peer reviewed publications are what they used to be. The quote you cited from Dr O'Connor sounds mostly like sour grapes from an elite whose domain is being encroached upon by the commoners.<br /><br />That said, being able to throw shade like that would actually make her a pretty good blogger!Chrishttps://www.blogger.com/profile/13390897461614161786noreply@blogger.com