For medical reviews of the television show House, this is the best place to start. Reviews of the new season will start on September 21st, with the first review posted a few hours after the season opener airs.

For medical review of comic books, stroll through the archives, or start here. A look back at the classic medical comics of the ’50s and ’60s can be found during my annual Flashback Weeks.

Finally, for some true stories of medical training, look here.

“That’s sad,” I said as I walked by.

“Yes,” the receptionist agreed. “Poor girl, she must be addicted to something nasty.”

“No, not that. She’s got a bad case of Tinea Versicolor — I can’t believe her publicist let her go out like that. See all those white spots on her shoulder and chest? That’s a fungal infection. She should have had that treated — or at least covered up — before she went got herself photographed.”

Commotio cordis is a rare and frequently fatal condition. It occurs when an individual receives a direct blow (blunt trauma) to the chest at precisely the right time in the cardiac cycle to stop the heart and cause a cardiac arrest. Children are more susceptible to the condition than adults.

Sports injuries are a common cause of commotio cordis, particularly thrown baseballs and softballs. Other causes include physical blows to the chest during a fight, steering wheel impact in motor vehicle accidents, and even the blunt force of bullets stopped by body armor.

The best, and really only, treatment for commotio cordis is immediate cardiopulmonay resuscitation, usually requiring defibrillation and cardiac medications.

Wikipedia has a good write up on commotio cordis

Commotio cordis has been in the news recently because of a lawsuit filed by a New Jersey family against several groups: a maker of aluminum baseball bats, the Sports Authority*, and Little League Baseball**. It’s an unfortunate story on many levels: Twelve year-old Steven was pitching in a baseball game when a line drive hit by the batter caught him square in the chest, causing his heart to stop beating. He was eventually revived, but remained in a coma for several weeks, and now has severe brain damage.

It’s a sad story and an unfortunate case, but personally I think it’s a stretch to treat it as cause for a lawsuit. I know that we Americans always like to blame someone when something goes wrong, but there are times that it’s not appropriate. This is one of those times.
There is no hard evidence that aluminum bats are any more dangerous than wooden ones, particularly in cases of commutio cordis (remember, it’s an issue of timing, not an issue of force).
There is an inherent risk of injury in playing any sport. Proper safety precautions will minimize this, but never eliminate it entirely. I am well aware of this whenever I go for a bike ride on the back country roads near me. Who knows what drunk-driving redneck may be out there weaving across the center line?***
And suing Little League because they endorsed the bat? Give me a break.

Just so everyone doesn’t think I just pick on comic books and television (and the occasional movie), today’s Picture Quiz comes straight from the pages of this week’s Newsweek.

What are the error(s) in the image reproduced above? It comes from the article “A New Reason to Frown” and is about potential problems recently discovered with Botox injections. For those of you who want to play along at home, it’s on page 45 of the April 21st edition of the magazine.

Previous picture quizzes

This coming week, I’ll be hosting Grand Rounds here at Polite Dissent. Please send all submissions for Grand Rounds to grand@politedissent.com by Sunday, 16 March, no later than 6PM (Central Time).

With the U.S. Navy scheduled to shoot down an errant satellite later this week, I thought this would be a good time for a space-related PSA. This Captain America/Young Astronaut Council ad is from the back pages of Captain American #307, an otherwise forgettable issue featuring Nomad and Madcap.

The Young Astronaut Council was formed in 1984 to get children interested in space and science. According to their article on Wikipedia, they are “the largest youth aerospace organization in the world” (though I’m not sure that’s a title with a lot of competition). As far as I can know, the Young Astronaut Council is still in operation today, though you couldn’t tell it from their website, which I seem to be unable to access.

For another relevant PSA, check out this one from Airboy #22 (May 1987) which takes an unkind look at the SDI program (”Strategic Defense Initiative” — i.e. the “Star Wars” program — a plan to shoot incoming enemy ballistic missiles out of the sky).

More PSAs

Make that 27, because there have been 3 cases reported this summer related to freshwater lakes in Florida — and possibly more unreported cases.

Links:
My reviews of House, Season 2, episode 20 and episode 21
CDC fact sheet on Naegleria infection.
CNN article: “Deadly amoeba lurks in Florida lakes”

Youngsters in the St. Louis area have been hit hard in the last six months by an outbreak of shigellosis, an infectious disease that isn’t typically life-threatening but can cause severe flu-like symptoms.

Since Nov. 1, 648 people statewide _ primarily kids ages 4 and younger and their caregivers _ have come down with shigellosis, and most of the children attend day care centers. All but about 100 were in the region that includes St. Louis and surrounding counties, said Larry Phelan, an epidemiologist for the Missouri Department of Health and Senior Services.

The disease is typically characterized by diarrhea, headaches, nausea, vomiting, stomach aches and cramps.

Link to the full article at seattlepi.com
Other quizzes

Fox TV: Sexual Song Lyrics Prompt Teens to Have Sex Sooner
MSNBC: Raunchy Songs Can Prompt Earlier Teen Sex
CNN: Study: Sexy Music Sexy Music Triggers Teen Sex

It was hard to miss those headlines. A recently published study, partially funded by the “think tank” Rand Corporation, addresses the subject of teens, musical choice, and sexual behavior, but the actual results are not nearly as dramatic as the media outlets — or even the study authors — would have you believe.

The article, “Exposure to Degrading Versus Nondegrading Music Lyrics and Sexual Behavior Among Youth“, is published in the most recent issue of Pediatrics, a well-respected medical journal – though it is toward the back of the issue.

In the study, researchers questioned teenagers by phone at three instances over a period of several years about their musical preferences and their sexual behaviors. The results suggest that there is a correlation between listening to music with degrading sexual lyrics and earlier initiation of sexual intercourse. That’s pretty much all the study shows: adolescents that listen to sexually charged music tend to experience sex earlier.

Note that the study does not demonstrate causation, it only shows correlation. It does not show that listening to sexual music causes or is responsible for this sexual behavior. The authors would like us to think that they’ve controlled for every other possible variable that could explain sexual behavior, but given that we don’t know all these variables, it’s hard to see how they could control for them. In fact, at the end of the article, the authors hedge their bets and admit this very fact.

The bottom line is that the authors and reporters are reading entirely too much into the study. It’s yet another example of the post hoc ergo proctor hoc fallacy equating correlation with causation. I’ve seen this behavior frequently from the media, but I become concerned when I see authors who should know better using the same poor logic. This is a study published to justify a point of view, not advance science.

A few final thoughts:

• Teenagers lie, particularly about sex, even to researchers on the phone. I see no mention of whether this was addressed at all.
• The study only addresses a strictly heterosexual definition of sex. Going simply by the numbers, several hundred of their respondants were likely to be homosexual.
• The musical grading of “sexual vs non-sexual” and “degrading vs non-degrading” is entirely subjective.
• The researchers only asked about an extremely limited number of performers (16).
• Many of the p values (the measure of the likelihood that the results were obtained purely by chance and not by correlation) are too high to be making such strong pronouncements. Strangley, no r values (the measure of correlation) are listed.
• Personally, I’m always suspicious of reports that come out of “think tanks” (though at least this one was published in a peer-reviewed journal).