Firefox and Santander Banespa

If you use internet banking and the most secure browser available you will probably notice you can´t login to the Banespa. Vote for this error at bugzilla so maybe it will become solved.
Update: Sometime last year, the bank itself solved the problem.

This is the end, for D&D

In all these years who hasn´t yet heard the ending of the animated series Dungeons and Dragons in that they discover through Tiamat (who would be an angel) that they actually died in an accident on the rollercoaster and were sent to Hell and that the Dungeon Master is the Devil?
Well I found out recently that Michael Reavers one of the scripters for the series has posted a comment about this ending in his site. He says it absolute poppycock and he presents the ending he had written which is called Requiem.
Without further ado, click here to find out about it.

Visits

People do come a lot to this blog to know about self-inflicted diseases. I wonder what some people expect to find. Leave me a comment if you want to know something specific.
Sorry for the lack of updates recently but I'm very caught up in exams for my third year residency, trying to go for a cardiology posting.

Feedback

Please leave comments! They won't go unanswered. And perhaps they generate ideas for new posts...

Re-election day

This weekend the second round of brazilian elections is going to take place to decide who will be president for the next four years. In Brazil that decides candidates for executive branch in two rounds, unless a candidate achieves more than 50% of votes in the first round.
Lula failed by less than 1% to reach that tally.
Now electoral campaigns put him at over 20% margin over his opponent Alckmin.
I fail to see how can people sympathize with him. It's true, I did vote for him the last time. But that was before the sheer number of scandals that have taken place during his four year term. Practically all the members of his high echelon have resigned or stepped down (José Dirceu, Palocci, Genoíno, Gushiken, Berzoini, and the list goes on and on...)
And Lula's support only grows!
Imagine if he openly assaulted a bank, people would still applaud him!

That doesn't mean I'd be very happy voting for Alckmin either. Fernando Henrique 2 terms before Lula had me very unhappy.

Which is why I've decide the vote null.

Not because it will nullify the elections. I know that null votes are counted as if you made a mistake. But it's still the only way to show some discontent at the prospect of brazilian politics.

Different perspecitve

This little blue dot through seen through saturn´s rings, this insignificant blue dot, it´s earth.
Credit:Ciclops

Random Country

I´m gonna choose some random country to compare that probably has a lousy health system... uhm... how about Brazil

I don´t know what kind of information Matthew Holt has on Brazil´s health system, but it is definitely untrue. Despite disparities between the states with the state of São Paulo where I live offering perhaps the best public health system in the country, there are some positive points overall. For example we offer all AIDS patients antiretroviral drugs for free, (of course they are seen, admitted , and have CD4 checks performed as needed)!
I work at the public hospital in my city and we have practically the state of the art. When a patient becomes too costly for the private hospitals they will usually send them to us. I think Matthew Holt should use another random example other than Brazil if he doesn´t really know the facts. Or even better, not use any random example at all.
http://www.hcrp.fmrp.usp.br/gxpsites/hgxpp001

Money and winners

Nothing else to be said.

Defining death take 2

As a physician, one of the actions we have to take is to pronounce someone's death. Now this is not as straight-forward as it seems to be. You could maybe attempt to check the patient's vital signs mainly respiratory movements, pulse. But when these stop, as in a respiratory arrest or cardiac arrest, not only this doesn't mean death in most cases, but on the contrary it means that emergency measures may be indicated to revert the condition and trying to keep the person alive, and with a quality of life. So what I'm saying is that at the moment of the arrest his neurons, myocites are still alive and have potential to stay alive.
These emergency measures are an attempt to get new oxygen into your blood and to get your blood flowing in your body taking that oxygen to your organs.
So that doesn't count as death. Patients can also be kept alive through mechanical ventilation, through drugs that keep their blood pressure at a minimum to oxygenate their organs, in hopes that the condition that led them to need these measures will be reversible and the patient will be able to maintain his blood pressure without drugs and be able to breath well without help from a respirator.
Sometimes this condition is not reversible, such as a damage so severe to the brain that there is no hope. In this kind of patient, for example young people who suffer from car accidents, their hearts have no disease and could be kept alive indefinitely with mechanical aid. But sometimes, this patient may brain dead. So maybe this is the best definition of death. How to define this is not easy as well. Because of organ donation, rigid protocols have been estabilished. They usually involve the observation of the absence of primitive reflexes and more elaborate exams such as an electroencephalogram or as my previous post a functional MRI attested by more than one physician.

Visitors!

Hey this is so cool! I just installed statcounter to see what goes on, since nobody has ever left a comment for me. And with just a few days I've had a few visitors.
Thank you very much for your visits! I have even been inspired to write a longer essay about one of the searched topics!

Trust them.

Diebold's election system computers are easily hackable in less than a minute. Makes you wonder if the brazillian version of it (the "urna eletrônica") is any better. In Brazil we have one sole device that is used in the entire nation. Results come up in a couple of hours as 3.5" disk are launched onto the grid. What if somehow these computers can be tampered in the same way? I'm also very surprised at the almost ravenous reaction of diebold, it's almost as if they're saying they're guilty.

How to define death.

As technologies advance further and further something that seems so simple as to say if somebody is dead or not becomes more and more complicated. Enter functional-MRI into the picture.
For people who came into my blog though I wrote a little bit more here.

Grand Rounds 101!!

Got my first link ever, and even better from the 101st Grand Rounds!!! A big thanks to Protect the Airway and tune in to the next grand rounds...

Negligence

Today at work, I was forced to report negligence towards an elderly patient. I feel very sorry for this situation. This is the third time I have seen the same patient in a very short period of time. He always comes in a very poor state of hygiene. It is sad. His family doesn't seem to give him any of the medications necessary, they do not follow our orientations, and most of all they refuse to put him into a home.
They say they have to work and cannot watch him during the day, which is why now he is filled with pressure sores from his occipitus down to his ankles, they do not give him his medications that was prescribed because besides the fact that it is expensive, that will make him evacuate more often (which in fact is part of his treatment), and diapers are expensive as well. Today he came in with two diapers, which the nurse explained to me, make them last longer for the contents of one diaper will spill onto the other.
The most outrageous fact of all is that the family always is hard demanding on the whole staff to watch out for this patient: he is so sick, this is absurd, how could the let him go out of the hospital in this state. He always goes home a little bit better, but a few days later comes back a total wreck.
Which is why I made the choice of reporting him. Doesn't this run away from the medical-patient relationship? Should I have confronted the family more before doing this?

Transparency

Great initiative: http://perfil.transparencia.org.br/

Null Votes

In Brazil, with the growing unhappiness derived from the various political scandals that always result in no punishment to the people involved, people more and more want to find a way to vent their frustration.
This has resulted in a campaign for the null vote. While I agree in part, it is not for the reason that is posted in an email circulation brazil defending the null vote. There they state that 50% plus one vote will lead to the voiding of the whole election process. The brazilian electoral code clearly states in article 219-224 that this is not the case, and it is very clear that null votes simply are not considered for the elections. The president is determined by the majority of the valid votes, and null and blank votes are not valid. So if you get an extreme case where 99% of the votes are null or blank, then the president will be elected on the majority of the 1% of votes left.
OBS:In Brazil we vote using an electronic device that is the same throughout the country. To vote null in it, one must type a number that does not belong to a candidate such as 99, and the confirm it.
To the law, a null vote is a misvote, meaning somebody made a mistake while voting, it is not considered a protest.
But the reason I do support the null vote is that even though it will not be considered, an election won with a high number of null votes, will somehow show the general insatisfaction

Positive de-action

Educafro is an organization in Brazil that is promoting the racial quotas to be established in public universities thinking that will solve racial minorities disparities. I cannot begin to believe how somebody can buy this argument! I mean, establishing the necessity that a racial minority such as indians or blacks need their own special quota to get into an university is saying that their are not as mentally able as the other students who don't need quotas! We could begin by asking what is a race, what is it to be black? Is there going to be someone who's going to look at my skin and say I'm black?! No, it seems you can define yourself however you want to. What if somebody wants to take advantage of this, somebody who is just a little tanned and marks himself as black, what then? Genetic studies of races reveal that there is no such think as a black or white race and that the polymorphisms are much greater than that. This quota politic is pure demagogy! It's just to divert attention to the real problem: the lack of a decent public elemantary and high schools that would naturally raise students who would be capable of going through university admission tests just like any other person. Goverments in the past decades have been seriously dismantling the whole public education: giving lousy wages for teachers, students are so badly prepared that sometimes they can get to eighth grade not knowing how to read!!!!!

Self-inflicted diseases

I talked about this a while ago, one in four doctors in the UK are starting to think the same thing: Should we pay for self-inflicted diseases such as lung cancer and cirrhosis... As I mentioned in my post, I think there might be something good out of it if, and only if, you ensure free treatment to whomever is engaged in trying to stop their addiction.
Source: Kevin M.D. weblog

Attack on the congress

I seriously condemn the attack made on the Brazilian congress by dissident MST (movement of the landless) dissident called MLST (movement for the freedom of the landless). Nevertheless, I think people should pay attention to this fact.
There is a global discontentment in this country in relation to the Congress. After all, how many politicians involved in serious corruption scandals have been forgiven by their own peers! >500 people participated in that revolt, and this global sentiment is present throughout. For example, how many people have jokingly said that: we should bomb everybody in Brasilia... even though of course, no one actually wants to do harm, the feeling is there. And the revolt is a symptom of it.
In the same manner that the attack on the world trade center in 2001 is that there is discontentment in the whole world, and maybe specially in islam in regards to america's foreign policy. The least we should do is open our eyes and try to see what is really going on.

Intelligence wins out!

U.S. District Court Judge John E. Jones III has decided the controversial case concerning the teaching of the so called intelligent design (ID) in public schools. He defined ID as being creationism relabeled:

By comparing the pre and post Edwards drafts of Pandas, three astonishing points emerge: (1) the definition for creation science in the early drafts is identical to the definition of ID [intelligent design]; (2) cognates of the word creation (creationism and creationist) which appeared approximately 150 times were deliberately and systematically replaced with the phrase ID; and (3) the changes occurred shortly after the Supreme Court held that creation science is religious and cannot be taught in public school science classes in Edwards.

and that intelligent design isn't science at all.

After a six week trial that spanned twenty-one days and included countless hours of detailed expert witness presentation, the court is confident that no other tribunal in the United States is in a better position than are we to traipse into this controversial area [and] . . . in the hope that it may prevent the obvious waste of judicial and other resources which would be occasioned by a subsequent trial involving the precise question which is before us.

Intelligent design, as well as creationism, and other claims of supernatural intervention in the origin of life or of species are not science because they can not be tested. Their axioms are based on authority, revelation, or religious belief.

source: NEJM 2006 Volume 354:2277-2281.