A special federal court ruled yesterday that vaccines do not cause autism and that thousands of families with autistic children are not entitled to compensation, delivering a major blow to an international movement that has tried for years to link childhood immunizations with the devastating disorder.
The ruling closes one chapter in a long feud that has pitted families with autistic children against the bulk of the scientific establishment. Those who believe passionately that routine childhood shots are to blame for the rising toll of autism feel they are locked in a David-and-Goliath struggle against vaccine manufacturers, corrupt scientists, federal agencies and the mainstream media. It remains to be seen whether yesterday's ruling will end the controversy -- or be seen as just more evidence of what some call a conspiracy.
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The vast majority of credible scientific studies have shown -- and all federal health agencies have strenuously argued -- that there is no connection between vaccines and autism. And public health officials have repeatedly warned that fewer immunizations will endanger children's lives.
Nevertheless, concerns about vaccines such as the "MMR" shot, which protects children against measles, mumps and rubella, have grown so widespread that some parents are choosing to forgo vaccinations. About one in 12 children does not receive the MMR vaccine in the United States, according to the National Center for Health Statistics.
Yesterday's ruling involved three separate cases, each of which explored a different mechanism by which vaccines might cause autism. Working independently, three special masters acting as judges in the federal "vaccine court" issued separate but similar rulings that found no evidence that the vaccines had caused the children's disorders.
The decisions are especially telling because the rules of the vaccine court did not require the plaintiffs to prove their cases with scientific certainty -- all the families needed to show was a preponderance of the evidence, or "50 percent and a hair." To the extent that these cases are representative of the claims made by some 4,800 other families seeking compensation, those cases would appear to be on shaky ground.
Ruling on a case brought by Theresa and Michael Cedillo of Yuma, Ariz., special master George L. Hastings used italicized words for emphasis and wrote that his extensive analysis of the evidence showed that the Cedillos' vaccine-autism theory was "very wrong."
"Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment," Hastings wrote.
The Cedillos contend that their daughter Michelle abruptly fell sick a week after she received an MMR shot when she was about 16 months old. Today, at age 14, she requires round-the-clock care, suffers from seizures, has lost nearly all her vision and has constant abdominal pain.
"We are terribly disappointed by the decision," Theresa Cedillo said in an interview. Referring to Michelle, she said, "I feel she was vaccine-injured and should be entitled to compensation."
The rulings are subject to appeal, and Kevin Conway, a lawyer representing the Cedillos, said there was no question of throwing in the towel.
In another test case, special master Denise K. Vowell heard charges brought by Kathryn and Joseph Snyder of Port Orange, Fla., who argued that the MMR vaccine, or a mercury-based preservative in it called thimerosal, had triggered in their son Colten pervasive developmental disorder -- part of the "autism spectrum."
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) I hope that maybe this will take a little bit of the guess work and trial and error out of finding the right applications to use. There's an icon at the beginning of each section that if clicked will take you to the iTunes store where you can download it or just find more information. If you have trouble with the link, you can also go into the iTunes store or use the "App Store" icon on your iPhone or iPod and search for the application by name. 
Don't worry, if you should decide to use Epocrates, your medical soul is still safe. Epocrates is a free drug reference library that includes dosing information, contraindications, adverse reactions, drug interactions, pharmacology, pricing info and even pictures of the drugs. You can set a formulary which allows you to check to see if a particular drug is available for a patient under certain drug plans and if a cheaper alternative might be available. Another tool is the "Pill ID" which allows you to identify a drug simply by the way it looks. This can come in handy when a patient comes in with a collection of pills they're taking but aren't quite sure of what they are. Epocrates also comes with a basic set of medical calculator equations, but you'll probably find that other applications will do those better. 
Skyscape is actually a collection of three different applications rolled into one. It's probably as close to an all-in-one medical application as you're going to find. Much like Epocrates, the Skyscape people hope that you'll go beyond what you're given for free and purchase their other products. Unlike Epocrates, these products are usually medical books and reference materials that have been formatted to use on an iPhone or iPod. These tend to be pretty expensive and unless you have cash to burn or a strong interest in a particular topic, you're probably not going to be too tempted by them. One possible exception is the "5-Minute Clinical Consult" which is program that allows you to put in your findings and then spits out a diagnosis. It comes highly rated from those who use it, but a one year subscription is $68 dollars, so it's not cheap.
With this one you're going to have to be a big spender, but it's worth it. Diagnosaurus (quite a mouthful) is a differential diagnosis dream. The program groups diagnoses by organ system, symptom or disease. You can also lump the different diagnoses into one group and search them all at once. It's extremely helpful at making sure you know all of the possible causes for a particular symptom as well as making sure you have a complete differential diagnosis. So, how would this be helpful? Here's a couple of examples...
You can probably guess what this one is. It's a whole bunch of medical calculations in one place. Many of the other programs will also have medical equations, and this is another place to find them. You could probably get away with just using the "Archimedes" application that comes with Skyscape, but this app is so popular and used, it's hard not to put it on the "must have" list. If anything, it'll save you a step or two from trying to find the equation you're looking for in another program. Really not much more to say about it, so I'll include what the makers have to say:
CHICAGO—The Occupational Safety And Health Administration released figures Monday indicating that record numbers of elementary-school art teachers are falling victim to pneumosparklyosis, commonly known as glitter lung.