Dirk Hanson‘s post on cannabis hyperemesis garnered another pertinent user comment:

Anonymous said…

My son suffers from this cannabinoid hyperemesis. At this moment he is here at my home on the couch suffering. I have been up with him for 3 days with the vomiting and hot baths. He says this time its over for good. This is our third bout. The first two time we went to ER, they put him on a drip to hydrate him, and gave him some pain medicine and nausea medicine. After a few hours he went home and recovered. This time we went to Urgent Care, put him on a drip, pain med, Benadryl, and Zofran. He felt better. That was yesterday, today we are right back with the nausea, but the Zofran limits the vomiting. I’m hoping tomorrow will be much better. He hasn’t eaten for 3 days. He let me take a video of him at Urgent Care before treatment, and in the video he was heaving and begging himself with tears never to smoke again. My son has smoked for 14 years.

I reviewed several case reports back in 2010. The comment thread was robust (this was originally posted at the Sb version of the blog) and there was considerable skepticism that the case report data was convincing. So I thought I’d do a PubMed search for cannabis hyperemesis and see if any additional case reports have been published. There seem to be at least 17 new items in Pubmed since the Soriano-Co et al 2010 that I referenced in the update.

One in particular struck my eye. Simonetto and colleagues (2012) performed a records review at the Mayo Clinic. They found 98 cases of unexplained, cyclic vomiting which appeared to match the cannabis hyperemesis profile out of 1571 patients with unexplained vomiting and at least some record of prior cannabis use. The profile/diagnosis was created from the prior Case Report literature that I reviewed but unfortunately I can’t get access to this paper to tell you more.

The other thing to think about is the relative increase in case reports in the past year or two. As I think I commented at the time, this is typical of relatively rare and inexplicable health phenomena. The Case Reports originally trickle out…this makes the medical establishment more aware and so they may reconsider their prior stance vis a vis so-called “psychogenic” causes. A few more doctors may obtain a much better cannabis use history then they otherwise would have done. More cases turn up. More Case Reports are published. etc. It’s a recursive process.

I think we’re seeing this at work.

And as more cases emerge, separated in time and space, the denialist position of blaming a contaminated cannabis product (or bad bongs) gets harder and harder to sustain.

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As I previously noted (somewhat critically) that the NIAID had posted sample R01 grants and the corresponding summary statements. Well, they’ve added some R21 applications to the page.

Again, I wonder how useful this really is for most applicants. First thing you notice is that it takes a perfect score to get funded. Three of the four received 10s and the fourth limped home with an 11. Remember, the study section score range starts at 1, which is then multiplied by 10 after the voting of the entire panel is averaged.

Then there’s this (emphasis added):
From the Dow summary statement’s resume of discussion: “Strengths of the application include the accomplished investigator and research team, strong preliminary data, the direct doable and logical set of experiments, and the likelihood of paradigm shifting insights into meliodosis

From the resume on the Starnbach app: “Strengths of the application include the innovative use of the novel GPS strategy, compelling preliminary data, an investigator with a strong bacterial pathogenesis research track record, an excellent and appropriate set of collaborators, and a high degree of confidence that import results will emerge from these studies.

Weis, individual critique #2: “Strong and compelling preliminary data is presented that indicate a high likelihood of success

Well, at least NIAID is telling it like it is with these examples…..

Also, if you get the GWG against the defending Stanley Cup champions in OT of Game 7 in the playoffs…well, you sure as hell can play.

Keep it classy, Bruins fans, keep it classy.

Kaaaaaaaahhhnnnnn!!!!

April 26, 2012

The eternal conundrum of institutional IT decision making: that designed to make it “easy” for utter morons in the system invariably fucks up workflow beyond all recognition for those who have even the slightest familiarity with the system.

Corollary: the morons never use the system anyway.

Idiot runners

April 26, 2012

Christ.

The notion that I have to be all #getoffylawn about the concept of fartlek pains me.

It is not intervals, you do not pluralize the word and you most certainly should not be throwing up at the end of the workout.

is wrong.

Seriously? People are complaining that mentoring in academic science sucks now compared with some (unspecified) halcyon past?

Please.

A question arose on the Twitts, to whit, how many years of postdoc training are required before getting a faculty level job. I’ll be flexible here, this is not just tenure track but let’s keep it to academic science and a professorial type equivalent appointment. Something that lets you apply for research grant funding and is not explicitly “training” or temporary or whatnot.

I am most curious about the trends over time. So I want to break this down by the year you were first appointed. Answer the appropriate poll for your case please.

First up, the youngsters:

Okay battle hardened, no-longer-noobians…your turn.

Okay oldsters, we know you all had it totally made in the shade when you were exiting graduate school….