Monday, September 28, 2009

The Buzz: Targeting Cancer With Bee Venom

In Animal Studies, Tiny Composite Spheres Deliver Drug Directly to Tumor Sites; 'It's Like an Injection'

A bee sting can be painful, but its venomous payload might hold promise for a beneficial purpose—fighting cancer.
Researchers at Washington University in St. Louis have used an ingredient of bee venom called melittin to shrink or slow the growth of tumors in mice. Melittin's anti-tumor potential has been known for years, but it hasn't been used as a drug because it also attacks healthy cells, including vital red blood cells.
Now the researchers have found a way, using the burgeoning field of nanotechnology, to pinpoint tumors for attack by melittin while largely shielding healthy cells. They do this by attaching the bee-venom ingredient to nanoparticles, which are ultra-tiny, synthetically manufactured spheres. The resultant product, called nanobees, are injected into the blood stream where they circulate until they reach and attack cancerous tumors. The approach also has the potential to avoid some of the toxic side effects seen in older cancer therapies like chemotherapy.


Burst of Technology Helps Blind to See

A nice summary of current ophthalmology research here...

Scientists involved in the project, the artificial retina, say they have plans to develop the technology to allow people to read, write and recognize faces.

Advances in technology, genetics, brain science and biology are making a goal that long seemed out of reach — restoring sight — more feasible.

Tuesday, September 22, 2009

With Genetic Gift, 2 Monkeys Are Viewing a More Colorful Worl

Dalton and Sam are male squirrel monkeys, about a foot tall. Their ancestors lived by eating fruit and insects and dodging falcons in the forest canopy of Central and South America. Dalton and Sam lead a more protected life in the laboratory of Jay and Maureen Neitz at theUniversity of Washington, Seattle. Recently, the Neitzes endowed them with a new genetic gift: the ability to see the world with full color vision.

Sunday, September 20, 2009

Rx for money woes: Doctors quit medicine

Some physicians, fed up with the costs of their practice, are ready to hang up their stethoscopes and shift careers.

Prosthetic Retina - 'Bionic Eye' Artificial Vision Enhancers Being Put To The Test

In a survey conducted about patients’ expectations of electronic retina prostheses (retina implants) a decade ago, visually impaired or blind patients with degenerative retina conditions stated they would be happy if they were able to regain some mobility and recognize faces and read again.
According to the presentations given at the international symposium “Artificial Vision” September 19th, 2009 at the Wissenschaftszentrum Bonn, that's gotten a lot closer.

7 Solid Health Tips That No Longer Apply

Are you taking a daily aspirin or multivitamin to stay healthy? Avoiding eggs and choosing no-cholesterol margarine over butter? Convinced that jogging will ultimately kill your knees? Advice that was once considered gospel truth among the medical community is now being questioned

Drug-electricity combo makes paralysed rats sprint

Rats with severed spinal cords and no feeling in their hind limbs can walk, run, step sideways and jog backwards without re-growing the nerves between the injured site and the brain, raising the prospect of a treatment for people with spinal injuries.

Thursday, September 17, 2009

Touched by Mortality

An excellent essay by Garrison Keiller from the vantage point of being a patient after a stroke...

The doctor who saw me in the E.R. wrote in her report: “nice 67 y.o. male, flat affect, awake, alert and appropriate.” I had appeared with slurred speech and a balloon in my head, had driven myself to United Hospital in St. Paul, Minnesota, parked in No Parking, walked in and was triaged right in to a neurologist who trundled me into the M.R.I. Space-Time Cyclotron for 50 minutes of banging and whanging that produced a picture of the stroke in the front of my brain, so off to the Mayo Clinic I went and the St. Mary’s Hospital Neurology I.C.U. and was wired up to monitors. A large day in a nice 67 y.o. man’s life.

But when the doctor talks about how you must go on a powerful blood thinner lest a stray clot turn your fine intellect into a cheese omelet, you must now accept being 67 y.o. and do as he says. You had intended to be a natural wonder, an old guy who still runs the high hurdles, but mortality has bitten you in the butt.
I like this hospital. St. Mary’s is a research and teaching hospital so you get to observe troops of young residents go by, trailing close behind Doctor Numero P. Uno, and watch them try to assume the air of authority so useful in the medical trade. The nurses, of course, are fabulous. Like many nice 67 y.o. men, I am even more awake and alert around attractive young women. A dark-haired beauty named Sarah brings me a hypodermic to coach me on self-administered shots of heparin, and without hesitation I plunge it into my belly fat.
No man is a coward in the presence of women.

Tuesday, September 15, 2009

Americans Have Been Taken Hostage

Dylan Ratigan from MSNBC calling it as he sees it ... 

The American people have been taken hostage to a broken system.
It is a system that remains in place to this day.
A system where bank lobbyists have been spending in record numbers to make sure it stays that way.
A system that corrupts the most basic principles of competition and fair play, principles upon which this country was built.
It is a system that so far has forced the taxpayer to provide the banks with the use of $14 trillion from the Federal Reserve, much of the $7 trillion outstanding at the US Treasury and $2.3 trillion at the FDIC.
A system partially built by the very people who currently advise our President, run our Treasury Department and are charged with its reform.
And most stunningly -- it is a system that no one in our government has yet made any effort to fundamentally change.
As hostages -- was there any sum of money we wouldn't have given AIG?
Why did we pay Goldman Sachs and all the other banks 100 cents on the dollar for their contracts with AIG, using taxpayer money, while we forced GM and others to take massive payment cuts?
Why hasn't any of the bonus money paid to the CEOs that built this financial nuclear bomb been clawed back?
And more than anything else -- why does the US Congress refuse to outlaw the most anti-competitive structure known to our economy, one summed up as TOO BIG TOO FAIL?
Why is this? Who does our Government work for? How much longer will we as Americans tolerate it? And what, if anything, can we do about it?
As we approach the anniversary of the bailouts for our banks and insurers -- and watch the multi-trillion taxpayer-funded programs at the Federal Reserve continue to support banks and subsidize their multibillion bonus pools, we must ask if our politicians represent the interests of America? Or those who would rob America of its money and its future?

World's only flying eye hospital

In this BBC news piece there is  a nice video of the inside of the Flying Eye Hospital , narrated by my friend, Hunter Cherwek, who is the medical director  of the  Flying Eye Hospital.
On approaching the flying eye hospital, it looks like any of the other passenger jets on the runway waiting to take holidaymakers to exotic destinations.

But this DC-10 jet is exceptional - it houses the only airborne operating theatre for eye treatment in the world.

Its mission is to tackle avoidable sight loss and its charter reaches developing countries where 90% of the world's 45 million blind people live.

Sunday, September 13, 2009

Clean Water Laws Are Neglected, at a Cost in Suffering

This is an eye-opening article in the sense of how pervasive the problem is. The article doesn't even touch upon the problems of water contamination by pharmaceuticals, which has been shown to be an issue for Reno (link)..

The Times obtained hundreds of thousands of water pollution records through Freedom of Information Act requests to every state and the E.P.A., and compiled a national database of water pollution violations that is more comprehensive than those maintained by states or the E.P.A. (For an interactive version, which can show violations in any community, visit
In addition, The Times interviewed more than 250 state and federal regulators, water-system managers, environmental advocates and scientists.
That research shows that an estimated one in 10 Americans have been exposed to drinking water that contains dangerous chemicals or fails to meet a federal health benchmark in other ways.

Those exposures include carcinogens in the tap water of major American cities and unsafe chemicals in drinking-water wells. Wells, which are not typically regulated by the Safe Drinking Water Act, are more likely to contain contaminants than municipal water systems.
Because most of today’s water pollution has no scent or taste, many people who consume dangerous chemicals do not realize it, even after they become sick, researchers say.
But an estimated 19.5 million Americans fall ill each year from drinking water contaminated with parasites, bacteria or viruses, according to a study published last year in the scientific journal Reviews of Environmental Contamination and Toxicology. That figure does not include illnesses caused by other chemicals and toxins.
In the nation’s largest dairy states, like Wisconsin and California, farmers have sprayed liquefied animal feces onto fields, where it has seeped into wells, causing severe infections. Tap water in parts of the Farm Belt, including cities in Illinois, Kansas, Missouri and Indiana, has contained pesticides at concentrations that some scientists have linked to birth defects and fertility problems.

In parts of New York, Rhode Island, Ohio, California and other states where sewer systems cannot accommodate heavy rains, untreated human waste has flowed into rivers and washed onto beaches. Drinking water in parts of New Jersey, New York, Arizona and Massachusetts shows some of the highest concentrations of tetrachloroethylene, a dry cleaning solvent that has been linked to kidney damage and cancer. (Specific types of water pollution across the United States will be examined in future Times articles.)
The Times’s research also shows that last year, 40 percent of the nation’s community water systems violated the Safe Drinking Water Act at least once, according to an analysis of E.P.A. data. Those violations ranged from failing to maintain proper paperwork to allowing carcinogens into tap water. More than 23 million people received drinking water from municipal systems that violated a health-based standard.  

Life Hacks For Doctors

Check out this SlideShare Presentation by Joshua Schwimmer of efficient MD:
The ophthalmologists especially will appreciate the 'scleral icterus" example

Now this is a workout!!!

Saturday, September 12, 2009

Man vs. God

Karen Armstrong says we need God to grasp the wonder of our existence
Richard Dawkins has been right all along, of course—at least in one important respect. Evolution has indeed dealt a blow to the idea of a benign creator, literally conceived. It tells us that there is no Intelligence controlling the cosmos, and that life itself is the result of a blind process of natural selection, in which innumerable species failed to survive. The fossil record reveals a natural history of pain, death and racial extinction, so if there was a divine plan, it was cruel, callously prodigal and wasteful. Human beings were not the pinnacle of a purposeful creation; like everything else, they evolved by trial and error and God had no direct hand in their making. No wonder so many fundamentalist Christians find their faith shaken to the core.

But Darwin may have done religion—and God—a favor by revealing a flaw in modern Western faith. Despite our scientific and technological brilliance, our understanding of God is often remarkably undeveloped—even primitive. In the past, many of the most influential Jewish, Christian and Muslim thinkers understood that what we call "God" is merely a symbol that points beyond itself to an indescribable transcendence, whose existence cannot be proved but is only intuited by means of spiritual exercises and a compassionate lifestyle that enable us to cultivate new capacities of mind and heart.

Obama's Speech

This is an absolutely brilliant, humorous, and insightful post about the U.S. Healthcare system by Doc Gurley....Link here. 

I’ve been watching the healthcare reform debate from a distance, like all doctors. It was a brilliant stroke of genius on the part of both Republicans and Democrats (when they undertook the job of changing all of healthcare) to do so without the input of any practicing physicians. I’m very glad about this – it makes the discussion so much more “out of the box” and “process oriented” and only rarely causes “patient death.”
Besides, I’m waiting for my chance to participate when we overhaul the legal system and exclude all the lawyers. Or maybe I’ll hold out for the Plumbing Reformation Act – I’ve got some deep insights (so to speak) on the whole butt-crack issue.

So you see, this whole healthcare reform thing doesn’t really affect me. Any more than it does you. Sure, I’ve heard tall tales from the rocking-on-a-porch old-timers, those myths about the prehistoric days when dinosaur doctors ruled the earth – when you could throw your primary care massive weight around and decide for yourself how to treat a patient, who you would see and how long to spend. Hell, I even heard there are Jurassic-Park-like pockets where such a thing still exists. Exotic, tribal locales with primitive, rudimentary, non-capitalistic approaches to healthcare. Places like London and Paris and Stockholm. Shudder. Thank God we don’t have to live in fear like those people must.

Rule out Testing

Another great post from the Happy Hospitalist on rule out testing  here.. 
The post really needs to be read in its entirety at the link.

(As an aside one of the frustrating things about the insurance "game" is that the doctor will not be given approval to do a test for a diagnosis according to current CMS rules if the diagnosis is "rule out..."so in the middle ofspending time and effort with regard to the patient's diagnosis one has to creatively pursue a diagnosis for which the insurance company will agree to pay)

A 17 year old female is seen in the emergency room with a chief complaint of shortness of breath. Thus begins the rule out testing.
This is where rule out testing feels so good.
Do you send the patient home with a diagnosis of panic attack and follow up with her doctor? Or do you pursue further testing for pulmonary embolism? That is the million dollar question. And let me answer it for you. Our current system is set up to pursue the diagnosis of exclusion without regards to cost. And here's why. Doctors act out of fear. Patients respond out of the comfort of knowing. And in both situations, neither is personally held responsible for for the cost of their desires. We pay for it through higher premiums. We will pay for it through higher taxes. The patient is immune from the immediate cost of feel good medicine. The doctor is immune from the fear of not knowing. A fear that is driven to spend other peoples money to prevent a bad outcome.
Look at my four box theory on Testing vs Outcomes. The physician will always want to stay on the top line. Because that's where the lawyers work for food. (Bold lettering mine...check out the "Testing vs Outcomes link for further elaboration from the Happy Hospitalist). That's where they feel good. And that's where the patients feel good. That's why rule out testing feels so good.

Is Doctors' Income the cause of health care inflation?

Moving Meat dissects the role of physician income in health care inflation in a counterpoint to an article by Ezra Klein of the Washington Post...Please read the whole post here.

Ezra has an interesting post in which he posits that the problem in health care economics is that the rate of inflation of health care persistently exceeds the general rate of inflation.  Fine; I do not think anybody is in disagreement on that point any more.  He goes a bit further, wrongly, I think, in implying that the solution is just to pay doctors less. 

But that ignores the fact that much of physician's revenue does not go to that physician's income.  Most doctors (ER docs being an exception) have offices to maintain, nurses and assistants to pay, healthcare premiums for this employees, in addition to the malpractice insurance and billing expenses.   Medicine is not a low-overhead game any more!  My gut feeling was that physician income has been stagnant-to-declining over the last decade.

So I went to the Bureau of Labor Statistics and I manually pulled the data on physician income over the 1999-2008 timeframe, and the inflation rate for the same time span and saw that I was more or less right:

Note that for the first six years, physician income was less than inflation, and 2006-7 was only a little bit above the overall inflation rate.  Also note that for two years physician income was actually negative.   2008 was the only year in which physician income increased faster than inflation.

Food Habits More Important In Obesity Than Obesity Gene

You may know that correlation studies have shown that the risk of becoming obese is 2.5 times higher for those who have double copies of the best known risk gene for being overweight or obese, the FTO gene (fat mass and obesity associated).

New discoveries of that sort have led to a resurgence in concern that we may be slaves to our genes, but is that the case?  No, in every study obesity still required high calorie consumption, especially fat.

Monday, September 07, 2009

Lush Land Dries Up, Withering Kenya’s Hopes

LOKORI, Kenya — The sun somehow feels closer here, more intense, more personal. As Philip Lolua waits under a tree for a scoop of food, heat waves dance up from the desert floor, blurring the dead animal carcasses sprawled in front of him.

So much of his green pasture land has turned to dust. His once mighty herd of goats, sheep and camels have died of thirst. He says his 3-year-old son recently died of hunger. And Mr. Lolua does not look to be far off from death himself.

“If nobody comes to help us, I will die here, right here,” he said, emphatically patting the earth with a cracked, ancient-looking hand.

A devastating drought is sweeping across Kenya, killing livestock, crops and children. It is stirring up tensions in the ramshackle slums where the water taps have run dry, and spawning ethnic conflict in the hinterland as communities fight over the last remaining pieces of fertile grazing land.
Related Posts with Thumbnails