The Journal of Painfully Obvious, Common Sense and Useless Findings

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whopper said:
I've noticed that there's a lot of people who just want to get published or can't come up with good ideas for publication.

I got a great case-a patient with neurosarcoidosis & everytime it acts up he gets agitated. However since none of the previous doctors who had him rated his agitation on a scale & because I can't do daily MRIs to confirm that its all due to his neurosarcoidosis (which I'm convinced it is), I won't even attempt to publish it.

Reason why I'm convinced its all his neurosarcoidosis is because no psyche med benefitted him, then when he gets a big dose of corticosteroids he's a perfect gentleman again.

When I was chief at my program, some residents came up to me and asked me for ideas for a study for publication. I shot down almost every single one...
"how about a case study where I give this guy who's depressed an antidepressant?"

I was going to pursue a study (& this might be of interest to you Faebinder) where we tracked patients on Risperdal Consta for 2 years. Reason why is because the PACT team put almost all their clients & Risperdal Consta & they were noticing that a subset of their patients, after a specific amount of time on this med seemed to decompensate as if the med stopped working. They even gave me a number of months where it seemed to stop working. That PACT team had dozens of clients so it could be enough for a study. Unfortuantely by the time I got the idea, I only had a few months left in the program.
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Wow, interesting study. I am not sure about compliance though... patients are notoriously not compliant with the night dose you need to give with risperdal consta.
 
wolfvgang22 said:
Maybe the outcome of research like this does not have any immediate or obvious usefulness, but it's sometimes hard to tell what will come of asking questions that have "obvious" answers. After all, prior to Newton and Galileo, it was "obvious" to Aristotle that everything tried to move towards its proper place in the crystalline spheres of the heavens, and that physical bodies fell toward the center of the Earth in proportion to their weight. I'm sure you can probably think of better examples than this.

The feeling that findings are obvious can be related to the following: the false consensus effect, selfserving cognition, hindsight bias, baserate neglect, illusory correlations, and the fundamental computational bias.
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Somewhat tangential point, but all the studies coming out supporting talk therapy as more effective with lower relapse rates than antidepressants, were a big fat "duh" to me. But, as a future psychotherapist (lord willing), all I can say is thank god for those studies.
 
patients are notoriously not compliant with the night dose you need to give with risperdal consta.
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Not an issue. The PACT team at Atlanticare drives to the patient's house & gives them the Consta shot. If a patient is noncompliant, they'll know about it within hours.

Problem with this study you'll encounter is not compliance with patients. It'll probably be attendings at ARMC not wanting to work with you on this project. ARMC is a community hospital, and you won't find too many psychiatrists there with academic interests. Dr. Cagande however is pushing to advance more research there, and I wouldn't be surprised if Dr. Hasson supported the same move. (Wish Hasson came in several months before I left instead of right when I left). Drs. Zwil & Melendez are also on top of the current data & Melendez mentioned to me a few times he wanted to work on some research projects.
 
Researchers say diabetes, high blood pressure may reduce survival in people with Alzheimer's.

UPI (11/5) reports, "People with Alzheimer's disease who also have diabetes or high blood pressure may die sooner than those who don't," according to a study published in the journal Neurology. Columbia University researchers recruited "323 people who...later developed dementia. Memory tests and physical exams were then given every 18 months." The authors "found that after an Alzheimer's diagnosis was made, people with diabetes were twice as likely to die sooner than those without diabetes who had Alzheimer's disease. People with Alzheimer's disease who had high blood pressure were 2.5 times more like to die sooner than those with normal blood pressure."
 
Someone needed to finish their PhD thesis maybe? :meanie:
 
Still Kickin said:
Researchers say diabetes, high blood pressure may reduce survival in people with Alzheimer's.

UPI (11/5) reports, "People with Alzheimer's disease who also have diabetes or high blood pressure may die sooner than those who don't," according to a study published in the journal Neurology. Columbia University researchers recruited "323 people who...later developed dementia. Memory tests and physical exams were then given every 18 months." The authors "found that after an Alzheimer's diagnosis was made, people with diabetes were twice as likely to die sooner than those without diabetes who had Alzheimer's disease. People with Alzheimer's disease who had high blood pressure were 2.5 times more like to die sooner than those with normal blood pressure."
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omg....:laugh:

why?!
 
I've seen some docs in research institutions not be able to create anything worthy of publication, and after several months or even years of this, they start looking bad.

So some of them start trying to do research on anything---anything that will get published.
 
From Medwire:

Depression, mania in bipolar disorder may result from separate psychological processes, research suggests.
MedWire (2/6, Davenport) reports that, according to a study published in the British Journal of Psychiatry, "depression and mania in bipolar disorder result from separate psychological processes, but even euthymic patients have cognitive vulnerability to depression." For the study, researchers from the UK's University of Bangor in Gwynedd examined "34 bipolar disorder patients in a manic/hypomanic or mixed affective state, 30 bipolar disorder patients in a depressed state, 43 bipolar disorder patients in a euthymic state, and 41 healthy controls," assessing them "using the Structured Clinical Interview for DSM-IV and a battery of self-report and clinician-administered scales." The team found that "patients in the mania group had significantly more positive affect than euthymic and depressed patients, while depression patients reported significantly less positive affect than the euthymic and control groups." In addition, "there were strong associations between depression and negative cognitive style and weaker correlations between manic symptoms and reward-related measures."

I think I get it now...
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I love this thread.

I can't believe I've been spending all my time in the gas forum... as psych is clearly where all the crazy #!&% is.
 
Doc Samson said:
Generalized tonic-clonic seizure after a taser shot to the head

http://www.cmaj.ca/cgi/content/full/180/6/625
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Love it.

"In electroconvulsive therapy, an initial charge of 38–60 millicoulombs is used, according to therapeutic protocol in the United States.8 It is plausible that a copper dart penetrating the scalp and discharging 95 pulses of 100 microcoulombs each could trigger a generalized convulsion. " (emphasis mine)
 
Wow, I was reading something somewhat related to this topic last night:

http://www.latimes.com/news/local/la-me-kingtimeline,0,4905048.story

"Martin Luther King Jr.-Harbor Hospital, formerly known as King/Drew, has been unable to meet state and federal patient care standards for more than 3 1/2 years. Some key dates:

...June 2004: The Medicare agency finds patients are in immediate jeopardy because the hospital relied too heavily on county police to use Taser stun guns to subdue aggressive mental patients...

...December 2004: The Medicare agency again finds patients in immediate jeopardy because of continued use of Tasers on mental patients..."
 
Still Kickin said:
Wow, I was reading something somewhat related to this topic last night:

http://www.latimes.com/news/local/la-me-kingtimeline,0,4905048.story

"Martin Luther King Jr.-Harbor Hospital, formerly known as King/Drew, has been unable to meet state and federal patient care standards for more than 3 1/2 years. Some key dates:

...June 2004: The Medicare agency finds patients are in immediate jeopardy because the hospital relied too heavily on county police to use Taser stun guns to subdue aggressive mental patients...

...December 2004: The Medicare agency again finds patients in immediate jeopardy because of continued use of Tasers on mental patients..."
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Yet the same agencies would probably consider it "inhumane" if they were injected with haloperidol against their will... 🙄
 
OldPsychDoc said:
Yet the same agencies would probably consider it "inhumane" if they were injected with haloperidol against their will... 🙄
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Or the old school clubbing/choking-out.

I think folks who are outraged by things like Tasering probably don't have a good understanding of the limited toolbelt of hospital security.
 
notdeadyet said:
Or the old school clubbing/choking-out.

I think folks who are outraged by things like Tasering probably don't have a good understanding of the limited toolbelt of hospital security.
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Is "limited toolbelt" listed in DSM?
 
More research from the department of :smack:...
SUMMARY AND COMMENT
Does Circumcision of HIV-Infected Men Prevent HIV Acquisition in Their Female Partners? Free!
July 30, 2009 | Anna Wald, MD, MPH | Women's Health
Risk for HIV transmission was highest among couples who resumed sexual activity before wound healing was complete.

Reviewing: Wawer MJ et al. Lancet 2009 Jul 18; 374:229
Baeten JM et al. Lancet 2009 Jul 18; 374:182
 
Not psych, but still appropriate for this thread. Just ran across this gem of a title during a PubMed search:

Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children.

Glanz JM, McClure DL, Magid DJ, Daley MF, France EK, Salmon DA, Hambidge SJ.

Pediatrics. 2009 Jun;123(6):1446-51.

PMID: 19482753 [PubMed - indexed for MEDLINE]
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:wow: NO kidding?!?!
 
The only thing that would have been more :smack: is..

Refusal of pertussis vaccination is associated with less pertussis vaccination
 
Psychiatry is not that bad. You should look at psychology literature. Oh yeah, and the names that are given to the theories are mind-numbing. Physics and chemistry have some cool theories...namewise that is. 🙂
 
Hmm, just WTF were they trying to get out of that study?

Makes me think the guy running the study just enjoyed that TV show Scare Tactics just way too much and decided to make a job out of it.
 
Yep got onioned! I thought it was fake at first, then looked at it for signs it was fake, didn't see any, then thought it was real, while missing the "painfully obvious" onion heading!
 
OldPsychDoc said:
When I read this today, I knew I had to dredge this thread back up! 😀

New Study Shows People With Panic Disorders Respond Poorly To Being Locked In Underwater Elevators
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"Throughout the 200 clinical trials we ran, all participants suffered immensely and reported that they did not enjoy the experience," said Lepore, explaining the results were the same whether the sound of a thrashing great white shark or that of an exploding torpedo was suddenly blasted over loudspeakers as the elevator doors shook violently. "Most interestingly, every single subject appeared to be further agitated when informed that oxygen levels in the elevator were dropping rapidly. Typically, some variance is expected in trial studies, but in this case we found none."
To determine whether their results could be replicated, researchers conducted numerous additional studies. In one experiment, anxiety-prone participants told they were taking part in a sleep study were sedated and transferred to a cockroach-filled casket with their hands and feet bound.
In another, researchers discovered that if they stranded subjects on a stalled ski lift 100 feet in the air just after sunset on a remote, deserted mountain next to a total stranger screaming "OH MY GOD, OH MY GOD, WE'RE GOING TO DIE, WE'RE BOTH GOING TO ****ING DIE UP HERE," people who have panic disorder—especially when coupled with larger abandonment issues—do not respond positively.
"Although thought-provoking, this research only scratches the surface of what we hope to learn," Lepore said. "I think we're going to need many, many more hours of research in the field with hundreds of participants before we reach any conclusion that can be deemed definitive."



hahahaha this is brilliant!
 
"What patients want from emergency care"

“People think the hospital has unlimited resources,” said Kenneth Certa, M.D., an associate professor of psychiatry and human behavior and director of the residency training program at Thomas Jefferson University Hospital in Philadelphia.

They see a pathway to hospitalization, of course, but sometimes also to food, shelter, clothing, social services, and social contact, said Certa.

However, emergency rooms are overcrowded, and sometimes beds are scarce, he said.

Certa has developed a rule of thumb about these patients' demands: “The more the patient wants to stay in the hospital, the less likely he needs to, and the more he wants to leave, the more likely he needs to stay.”​
 
A professor in residency taught me the above.

Patients that are in need of help generally do what the doctor recommends. Those with an agenda make demands of wanting to stay or go. Those that want to stay to the point where they broadcast their intentions were often malingerers. Those that wanted to leave were often psychotic.

I wouldn't say this is true of all settings, but in an ER and short term psychiatric facility servicing an area with high homelessness and low-SES, unfortunately it's been my experience this is true often. Just don't get so cynical that you apply it to everyone. The professor I mentioned helped me get over my niavete as a PGY I, but to this day I still think he took it a bit overboard.

Ah, the good old days of seeing someone go to the hospital because they wanted free air conditioning during a heat-wave, and when you tried to discharge them, explaining to them that this is not what a hospital was for, they threatened suicide.
 
atsai3 said:
"What patients want from emergency care"

Certa has developed a rule of thumb about these patients' demands: “The more the patient wants to stay in the hospital, the less likely he needs to, and the more he wants to leave, the more likely he needs to stay.”
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I do tell students at the Psych Emerg Service that, "Quite often, those who want to stay need discharge and those that want discharge need to stay. Your job is to find the EVIDENCE that this is true in this case, or the EVIDENCE that it's not. Although this rule of thumb is true often enough to be a consistent perversity of psychiatry, you can't assume that it's true in THIS patient until you've gotten enough evidence and presented it well enough to make your case in either direction. And get the collateral information before you present your conclusion."
 
Here's one for you guys...

Eating Disorders appear to raise the risk of death

http://www.nlm.nih.gov/medlineplus/news/fullstory_113959.html

People with eating disorders, especially those with anorexia nervosa, have an increased risk of death, a new study indicates. More research is needed to identify the factors that raise risk of death in people with eating disorders, the authors said.

The study is published in the July issue of the journal Archives of General Psychiatry.
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Eating Disorders appear to raise the risk of death. Yeah, no **** Sherlock 🙄
 
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