HDTenEightyP/NetNews huggingface dataset:
From: km@ky3b.pgh.pa.us (Ken Mitchum)
Newsgroups: sci.med
Subject: Re: Physician's Incomes
Date: 24 Jan 93 20:40:56 GMT
Organization: KY3B - Vax Pittsburgh, PA

In article <lle1ohINN72k@tokio.cs.utexas.edu>, turpin@cs.utexas.edu (Russell Turpin) writes:
|> -*----
|> In article <qpa3f1c@rpi.edu> whangj@vccnw04.its.rpi.edu (Junho Whang) writes:
|> > It's always very puzzling (if I assume a modicum of fairness),
|> > why doctors always gripe about their salary? ...
|> 
|> I have yet to see a physician here start a thread to gripe about
|> their salary.  Rather, I see defensiveness when physicians'
|> salaries are raised as an issue by other people.  Somehow, I
|> suspect if you went into any newsgroup and said of a related
|> profession that its members were paid too much that you would
|> find quite a few posters quick to correct any odd data and to
|> defend what they do make.
|> 
|> Russell

Actually, I think I posted sometime back in response to something that I considered
my own salary appropriate. I am on a salary, which is not the norm for physicians.
I think some physicians are grossly overpaid for some things, and some physicians are
grossly underpaid for what they do. When you consider that physicians' incomes in the
U.S. (not counting residents and interns) vary from about $45K to $1M, it is obvious
you are not talking about a homogenous group. 

-km
Newsgroups: sci.med
From: dyer@spdcc.com (Steve Dyer)
Subject: Re: Voodoo varicocele
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Date: Mon, 25 Jan 1993 19:59:59 GMT

In article <1993Jan24.235452.14511@iecc.cambridge.ma.us> johnl@iecc.cambridge.ma.us (John R. Levine) writes:
>(FLAME FOLLOWS) If so, why is varicocele surgery medicallly respectable
>but homeopathy isn't?  Same situation: lots of anectodal reports, no hard
>facts.

Perhaps because varicocele surgery isn't recommended for conditions
other than varicocele? :-)

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer
Newsgroups: sci.med
From: jallred@spdg.com (John Allred)
Subject: Re: Eye Glass Frames
Organization: Stratos Product Development Group (Seattle)
Date: Tue, 26 Jan 1993 01:37:28 GMT

In article <1993Jan25.161706.661@news.wesleyan.edu> RGINZBERG@eagle.wesleyan.edu (Ruth Ginzberg) writes:
>Hey, you can still get T.E.D.'s (that's Tactical Eye Devices -- SERIOUSLY,
>folks) from the U.S. DoD Military Hospitals for $10.00.  Ever seen 'em???

Ah yes ... we called them "Birth Control Glasses", because, if you
were wearing them, no member of the appropriate sex would be caught
dead with you.

Fortunately, for those of us who looked out of periscopes, contact
lenses were issued.

John (jallred@spdg.com)
--
From: nyeda@cnsvax.uwec.edu (David Nye)
Newsgroups: sci.med
Subject: Re: Physician's incomes
Date: 24 Jan 93 00:35:18 GMT
Organization: University of Wisconsin Eau Claire

[reply to mwd@cray.com]
 
>But a neurosurgeon that I knew was paying $80,000 per year in
>malpractice insurance.  He was a fine surgeon, with a lot of experience.
>He was grossing $200,000 /year.  After malpractice insurance and taxes.
 
Depending on the state, a neurosurgeon can pay over $150,000/yr for
malpractice insurance.  One neurosurgeon here in town just quit because
he couldn't meet his malpractice premiums.  He's now reviewing cases for
an insurance company, working 9 to 5 for the first time in his life.

David Nye
nyeda@cnsvax.uwec.edu
Newsgroups: sci.med,ca.earthquakes
From: jlpicard@austin.ibm.com (Craig Becker)
Subject: Re: earthquakes during surgery
Originator: jlpicard@woofer.austin.ibm.com
Date: Wed, 27 Jan 1993 19:58:22 GMT
Reply-To: jlpicard@austin.ibm.com
Organization: IBM Object Technology Products


frankh@sr.hp.com (Frank Hamlin) writes:
> : I *hope* that for once the "$50 per Tylenol caplet" medical profession does
> : *nothing* about this possibility. What are the odds of this being a real
> : problem? What are the odds of the surgeon not reacting fast enough, even to
> : a real "jolt" 
> 
> While getting a vasectamy, I was talking with the doctor.  While joking
> with him I said to get those sharp things away from me if we have an
> earthquake.  Without missing a beat, he looked at me and said
> "Yea, it's really bad form to loose a patient from a vasectamy"

Fer what it's worth, this was used as a gag on _Too Close For Comfort_
when Ted Knight went in for his vasectomy.

Craig
-- 
-- "You will have the tallest,    Craig Becker, Object Technology Products --
--  darkest leading man in               Internet: jlpicard@austin.ibm.com --
--  Hollywood."                     IBM TR: jlpicard@woofer.austin.ibm.com --
--   - Merian C. Cooper to Fay Wray               VNET: JLPICARD at AUSVM1 --
Newsgroups: sci.med
From: dannyb@panix.com (Daniel Burstein)
Subject: Earthquake warning devices, was: Re: earthquake during surgery
Organization: PANIX Public Access Unix, NYC
Date: Fri, 22 Jan 1993 18:13:06 GMT

the standard way reliable earthquake warning devices work is based on the
fact that radio waves travel somewhat (!) faster thanthe earthquake would
propogate.  So, if you're right where the earhtquake first hits, you won't
have any warning, but if you're, say, 50 miles away, you can have 30
seconds (or thereabouts.  LOTS of fudge factors here).

While this won't make a difference for most people, it is quite helpful
for things like electrical generators, switching equipment, computers, and
other critical devices.  

It reduces damage, but doesn't completely prevent it.  Also, we don't hear
about the successes of such procedures, because, simply, good news isn't
worth reporting.  So the fact that ten passengers were injured when the
train's brakes went into emergency stop mode (actually, I'm not sure if
BART has implemented this, but they were talking about it), will get
covered, but hte fact that not a single train derailed will get missed...

dannyb@panix.com
From: km@ky3b.pgh.pa.us (Ken Mitchum)
Newsgroups: sci.med
Subject: Re: CXR, screening, and anecdotes
Date: 24 Jan 93 23:21:02 GMT
Organization: KY3B - Vax Pittsburgh, PA

In article <1j770jINNgm4@shelley.u.washington.edu>, nodrog@byron.u.washington.edu (Gordon Rubenfeld) writes:
|> 
|>   Just to add to this interesting thread.  It raises a number of very
|> important issues about searching for disease in a healthy person,
|> statistical vs "real" lives, and health economics. 
|>   One would traditionally discuss here the ideal nature of a screening
|> test's sensitivity, specificity, and "cost" (financial and otherwise) of
|> the necessary follow up tests when the screening test is positive.  Does
|> the screening test really help people live longer or just find them sooner
|> (lead-time bias)?  Can newer, generally more expensive, technology be
|> recommended as a screening test when it has not been tested that way?  For
|> example, CT scans have been well studied for defining the location and
|> stage of lung cancer, but recommending them as a screening test without
|> data is foolish and VERY expensive. These are all fascinating and
|> technical questions that lend themselves to quantitative responses.

The best screening tests are cheap tests that identify very treatable diseases
and have few false positives. The CBC (blood count) is one such test. Tests
that are cheap but have a lot of false positives can be very expensive in the
long run: the common test for occult blood in the stool ("guaiac") is one
example, because a positive result leads to expensive tests that are often
negative: I saw one estimate that it cost several hundred thousand dollars
in negative GI tests to discover one GI malignancy this way. The hooker, though,
is that this cost is spread out over a lot of patients, and the guy who discovers
he has cancer at an early stage that can lead to curative surgery benefits.

Some cheap tests identify things we don't know what to do with, such as
serum calcium tests, which lead us to identify people with primary hyperpara-
thryoidism many years before they have symptoms. What to do with these people
is not clear at all.

Somtimes "new" technology leads to identification of things we don't know what
to do with as well. When we started doing CT scans of the abdomen we started 
seeing a lot of what looked like adrenal tumors in people with absolutely no
symptoms or findings to suggest this (CT was done for something totally unrelated
to adrenals). What do we do in these cases? 
 
|>   Anecdotes should not be ignored.  They should be studied, and when
|> disproved, then ignored.  Anecdotes prey on the insecurity engendered by
|> incomplete data and the tails of the gaussian distribution.  

Anecdotes are just that, and most physicians accept them in perspective. However,
personal experience is always going to affect one's perspective, even when one
knows better. That is why no two physicians think exactly the same. 

-km
From: ME.DMG@forsythe.stanford.edu (David Gaba M.D.)
Newsgroups: sci.med
Subject: re: earthquake during surgery
Date: 21 Jan 1993 20:03:02 -0800
Organization: Stanford University
NNTP-Posting-Host: morrow.stanford.edu

In article <1993Jan21.232601.15723@kestrel.edu>,
king@reasoning.com (Dick King) writes:
>
>I could imagine that it would be disconcerting, to say the least, to have the
>ground shake while you're meticulously cutting and repairing a patient.
>However, i understand there to be devices that can give you perhaps a fifteen
>seconds warning of an impending 'quake.  They work because it takes a while for
>
>Does anyone know what is done about the possibility of an earthquake during
>surgery, in the real world?

I am an anesthesiologist at the VA hospital in Palo Alto.
During the 1989 Loma Prieta quake we had two cases going on.
Incidentally, the quake happened in the midst of the annual
meeting of our largest society of anesthesiologists.  Many of
us were in New Orleans at that time!  In any event, the room
shook quite a bit they say, some of our equipment (on wheels) moved
a few feet and then back.  Fortunately, none of the cases were
critical dire emergencies (more on that below), the emergency
power worked fine, the OR suite was in a pretty new building.
The two cases finished up without any problem.

Now, very few operations involve non-stop critical activities.
There is almost always time for the surgeon to stop whatever
he/she is doing so as not to cut anything "by accident."  That
per se is not a great risk.  A bigger risk is that you are having
critical emergency surgery that must be completed, a really BIG
earthquake hits, knocking out both standard AND emergency power.
We are equipped to deal with this, although in an event that sever
it would be pretty challenging.  (For example, the heart-lung
machine that we have has its own battery backup, and failing that
it can be cranked by hand, though it takes a lot of muscle power).

I'm not too familiar with earthquake warning devices, but I would
guess that they would have significant numbers of false alarms.
Furthermore, the warning isn't really going to help very much
so it wouldn't really be worth investign in them even if they
were reliable.

We rewrote our disaster protocol after the earthquake to get people
better prepared.  Actually they all did quite well.  The main
part of our hospital was structurally damaged and had to be
evacuated.  They evacuated over 100 patients (I think) in 28
minutes (pretty good with mostly older inpatients).  One patient
had an abnormal heart rhythm in the parking lot (the temporary
evacuation site) and had to have it shocked electrically in the
parking lot!

David Gaba, M.D.
Assoc. Professor of Anesthesia
Stanford University
From: loftis@hpcc01.corp.hp.com (Kirk Loftis)
Date: Tue, 26 Jan 1993 23:40:24 GMT
Subject: Re: Blood Pressure
Organization: the HP Corporate notes server
Newsgroups: sci.med

/ hpcc01:sci.med / colby@oahu.cs.ucla.edu (Kenneth Colby) / 12:47 pm  Jan 23, 1993 /
|you were right not to go on medication. The fewer medications the
|better. To keep your blood pressure down, walk a mile every other day,
|eat 3\4 portions of whatever you eat, eat meat 2-3x per week (preferably
|turkey or chicken breast ), use Benson's relaxation response, and try
|not to become enraged by the rotteness of the world. I speak from
|personal and professional experience.
|
|		    Ken Colby, M.D.

I can not agree with this statement enough.  Your blood pressure
"appears" to be weight/diet dependent.  I recommend eating healthy (low
fats, low sodium, I am sure you have heard this enough), no smoking and
getting plenty of exercise.  Your heart and kidneys as well as your body
is not something to play around with.  I have had high-blood pressure
all my life, it is heredity in my case.  I naturally gravitated towards
healthy foods and exercise.  My cholerstol count is 167.  

I am sure that my blood pressure has damaged my heart and kidneys.  I am
taking Lisonapril, which I recommend highly.  With this, it is "under
control".  But it is something that I do think about on a daily basis.

Stay away from high blood pressure if you can control it naturally.

Kirk
Newsgroups: sci.med
From: mhosea@seas.smu.edu (Mike Hosea)
Subject: Re: Soft contact lens problem
Organization: SMU - School of Engineering & Applied Science - Dallas
Date: Sat, 23 Jan 1993 05:24:41 GMT

In article <1993Jan22.214903.9874@bmerh85.bnr.ca> wleckie@bnr.ca (Wayne Leckie) writes:
>I first tried an "optician" (basically through the local discount
>glasses & contact lens retailer).  Then I tried an "optometrist".
>Both were dismal flops: major problems with fit and visual clarity. I
>finally tried the contact lens specialist who is partnered with my
>opthalmologist.  Bingo.  From talking with him, I've learned that
>fitting contacts becomes more & more tricky with # of diopters of
>correction.  For the -8 or worse range, see someone who SPECIALIZES in
>fitting contacts to people with poor vision.  My contact lens
>specialist sees 20-50 people like me PER WEEK.
>
>Your friend should ask his opthalmologist for a referral.  If he
>hasn't seen an opthalmologist recently (not "optician", not
>"optometrist"), carry him there.  People with eyesight in our range
>need yearly checkups by an opthalmologist due to high potential for
>development of some major eye problems.

What sort of qualifications would a "contact lens specialist" have?
My guess is that most are optometrists that have chosen to specialize
their practice.  An optician is "minimally" educated--there is a 
certification process.  Optometrists are "O.D.'s"--Doctors of Optometry.
To earn this degree they must complete a rigorous postgraduate program
in optometry, which includes extensive training in the fitting of glasses
and contact lenses as well as early detection and diagnosis of eye
problems.  In some states they can even treat minor problems and prescribe
a limited set of drugs (subsequent to earning the necessary extra 
certification).  No health care profession is better trained to fit
glasses and contact lenses (including (esp.) Opthalmologists).  Unless
you have had or expect to have serious eye problems, there is no reason
to receive yearly checkups by a specialist--as long as you receive yearly
checkups by an (good) optometrist (even one that doesn't specialize in
fitting contact lenses).

-- 
Regards,
Mike Hosea (mhosea@seas.smu.edu)
Newsgroups: sci.med
From: rat2@engr.uark.edu (Tony Taylor)
Subject: Scleroderma
Summary: need info
Keywords: scleroderma
Organization: University of Arkansas
Date: Mon, 25 Jan 1993 01:31:09 GMT

Hey everybody in net land,
            
I need info on the causes and treatments for scleroderma.  Any help
would be appreciated.  


                                        Thanks,
                                        Tony



I want some ICE CREAM!!!! -melinda
From: georgec@eng.umd.edu (George B. Clark)
Newsgroups: sci.med
Subject: Re: Triglycerides
Date: 22 Jan 1993 22:22:40 GMT
Organization: University of Maryland
NNTP-Posting-Host: athens.eng.umd.edu


What about medium-chain triglycerides? That's a buzzword used by
bodybuilders. Do they really need these supplements for optimal
muscle growth, or are they just being fooled by the food-supplement
industry?

Newsgroups: sci.med,talk.politics.med
From: hrubin@pop.stat.purdue.edu (Herman Rubin)
Subject: Re: Canadian healthcare system
Organization: Purdue University Statistics Department
Date: Mon, 25 Jan 1993 19:12:24 GMT

In article <1993Jan25.130426.750@fuug.fi> an4140@anon.penet.fi writes:

>I heard a radio program extolling the virtues of the Canadian national
>health care program.  The guest could find nothing wrong with it, and
>said it ought to be the model for the US. 

>Surely there must be another side to this argument.  Are there no
>shortcomings to the Canadian system?   And even if that were so, is
>it adaptable to the US?  

There are several things wrong with it, and it is not all that much 
cheaper than the cost in the US.  One generally agreed problem is that
many "standard" procedures are not done in Canada, and while the Canadian
plan often picks up the costs, it does not pay the travel, and it does
not help defray the development costs, which US care does.  For another,
one must find a primary care physician, and all else must be referred
through that doctor; I believe that changing such is difficult.  Also,
there are other cost-cutting limitations.

The biggest problem is that it is run by government bureaucrats, who
SO FAR have not been too bad.  "To err is human; to foul things up
takes a computer; to really make a mess of things takes a government."
-- 
Herman Rubin, Dept. of Statistics, Purdue Univ., West Lafayette IN47907-1399
Phone: (317)494-6054
hrubin@snap.stat.purdue.edu (Internet, bitnet)  
{purdue,pur-ee}!snap.stat!hrubin(UUCP)
From: dozonoff@bu.edu (david ozonoff)
Newsgroups: sci.med
Subject: Re: Scleroderma
Date: 27 Jan 93 02:47:25 GMT
X-Newsreader: Tin 1.1 PL5

There is a modest but reasonable literature on solvent exposures and
scleroderma. Solvents are usually chlorinated hydrocarbons, like TCE,
PCE (trichlorethylene and perchlorethylene, resp.) and vinyl chloride.
A good occupational history is needed.

--
Dave Ozonoff
dozonoff@med-itvax1
Boston University School of Public Health
80 East Concord St., T3C
Boston, MA 02118
(617) 638-4620
Newsgroups: sci.med
From: pce9202@bcstec.ca.boeing.com (Patricia Emily)
Subject: Need medical advice-possible tick-borne disease
Organization: Boeing
Date: Thu, 28 Jan 1993 03:55:19 GMT


		
Does anyone have good information on tick borne diseases?  My sister has 
suffered several tick and flea bites last summer.  She has not felt well
for the last several months.  She has flu-like symptoms; generally not 
feeling well.  She has some minor joint inflammation in her right hand and toes.
She says sometimes her finger tips and toes feeled inflammed.  Lately, she
has woken up in the morning with her right hand closed and stiff.  She says
it takes about 30 seconds to work it open.  

She has been to numerous doctors hoping for a diagnosis and relief from the
symptoms.  She has been diagnosed with things like rheumatoid arthritis, lupus,
lyme disease (the tick connection). She has had the test for lyme disease and the
results came back "equivocal" meaning not positive or negative.  The doctor however
is treating her for lyme disease since they will treat if it is suspected.

The antibiotic treatment for lyme disease is Suprax 400 mg, BID for 30 days.
She said that she feels better after only a couple of days of antibiotics.

Does anyone have a clue what is going on here, or have similar experiences??
She has had a hard time finding knowledgable doctors, and still does not have a
definite diagnosis.  I would be interested in hearing from people who have seen
similar cases and can perhaps give some insight.  

What is the prognosis for someone with this type of disease?  

Thanks!


Newsgroups: sci.med
From: banchy@tron.bwi.wec.com (Banchy)
Subject: Re: Soft contact lens problem
Organization: Westinghouse Electric Corporation, Baltimore MD.
Date: Tue, 26 Jan 1993 18:22:49 GMT

In article <1993Jan25.224649.3081@seas.smu.edu> mhosea@seas.smu.edu (Mike Hosea) writes:
>
>Maybe I am behind the times here.  I didn't know there was such a 
>thing as "extended wear" hard lenses (gas permeable or not).  Is the
>material softer than ordinary hard lenses?  Now my lenses do not irritate 
>me (in the absence of an eyelash beneath them), but I am aware of them 
>like I am aware of breathing.  If I bother to think about them I can 
>determine that they are there irrespective of my visual acuity.
>-- 
No, I think the original respondent didn't bother to read the post
carefully enough to determine that I was referring to gas permeable 
lenses.

Tom
-- 
===========================================================================
Tom Banchy             | banchy@tron.bwi.wec.com | "babble, burble, banter,
Software Engineer      | (410) 993-9255 (W)      |  bicker..bicker..bicker"
Westinghouse Electric  | (410) 461-2216 (H)      |        - King Crimson
Newsgroups: sci.med
From: sloubtin@dsg.cs.tcd.ie (Sylvain Louboutin)
Subject: Re: How does the body adjust to high altitude?
Organization: DSG, Dept. of Computer Science, Trinity College Dublin
Date: Mon, 25 Jan 1993 19:52:58 GMT

In <1k1dioINN2lj@im4u.cs.utexas.edu> turpin@cs.utexas.edu (Russell Turpin) writes:

>-*----
>This last ski vacation, for the first time in my life, I
>suffered some altitude sickness.  My first day on the slopes
>ended after an hour with massive fatigue and a sense of
>breathlessness.  The second day I felt fine, even after 
>a whole day of skiing.  Clearly, my body did something in
>those 24 hours to adjust to the high altitude.
>What did it do?
>Russell

another related question:

the current altitude record with a sailplane (non-pressurised aircraft,
although equipped with oxygen breathing system), is slightly more than
50,000 feet.  

what would be the highest possible altitude reachable safely without
pressurisation (i.e., with the crew still able to operate an aircraft)?
and what would happen higher?  (I am not talking of hypozia, here as
a breathing equipment is used.)  In other words what would be the
physiological limit to such records? 



-- 
//Sylvain R.Y. Louboutin,  ph:(+353-1)7021539, e-mail: Louboutin@dsg.cs.tcd.ie
//Distributed System Group, O'Reilly Institute, room F.35, fax:(+353-1)6772204
//Department of Computer Science, Trinity College, Dublin 2, -Ireland-  ASK-18
Newsgroups: sci.med