Medical Singularity

Koman, Catholics, and the Pill

Sun, 19 Feb 2012 15:59:39 -0500

Great passage that is very important to understand:

Prior to modernization of childbirth, 1 in every 150 births ended in the death of the mother. As the average woman likely had 4 to 6 pregnancies in the 1920s, probably 1 out of every 20 women died in childbed. Today, that number is 8 in 100,000 births in a large part due to antibiotics and C-sections, but also due to pregnancy spacing afforded by contraceptive technology and many fewer pregnancies in older women. The average woman (thanks to pregnancy planning) has under 2 pregnancies so the absolute decline in deaths due to childbirth is about 10000%. The reduction in breast cancer deaths despite A LOT of attention has only beenabout 20% at best. Maybe God is trying to tell us something.

(via usafamilymedicine)

Amazing new Stroke Therapy using Stents

Sun, 05 Feb 2012 13:05:01 -0500

Amazing new Stroke Therapy using Stents :

\ Wow, great study out of Oregon Health Sciences! New interventional stroke therapy with great results so far…

The stent expands the interior walls of the artery and allows blood to get to the patient’s brain immediately to prevent as much brain damage as possible. The clot seeps into the mesh of the stent. Then, after five minutes, the stent and clot are removed together.

(via OHSU.edu)

Instead of Exercise, try Irisin: The Muscle Hormone

Sun, 29 Jan 2012 16:10:00 -0500

Instead of Exercise, try Irisin: The Muscle Hormone:

// Dana-Farber Institute research found a hormone released during exercise, which is responsible for converting stagnant white fat cells into brown fat cells. Brown fat cells burn calories, rather than store calories.

// Researchers injected obese mice with this protein and found better glucose tolerance and decreased body weight.

// I don’t like the idea of treating lifestyle problems with pills, but in certain cases this could be of real value

(via TheWeek.com)

// PS - IMHO The Week magazine is the only paper subscription worth the money, really, it is awesome.

Gates donates $750 million to fight AIDS, TB and malaria

Thu, 26 Jan 2012 17:29:00 -0500

Gates donates $750 million to fight AIDS, TB and malaria :

// Bill Gates and his Foundation deserve a Nobel Prize

// What he has done with his great fortune is far beyond simple donation, he has saved millions of lives from starvation, infection and lack of basic healthcare.

// He is no longer the richest person in the world, simply because he contributes so much damn money. awesome

// A truly inspirational person. Need more Bills like this.

(GatesFoundation.org)

Video consults with dermatologists aid treatment

Thu, 26 Jan 2012 14:07:00 -0500

Video consults with dermatologists aid treatment:

// Dr. April Armstrong from UC Davis looked at Live-Video derm consults of 1,500 patients 2003 - 2005

// Great work… what I see to be done further is have a control group to compare patient outcomes between PCP vs Telederm and stratify by disease type. Ultimately, PCP’s will learn to take care of many derm conditions with occasional oversight via TD

They found that the video consult led to a change in diagnosis from the referring primary care doctor’s decision in 70 percent of cases. Those changes included a diagnosis of psoriasis or eczema when primary care doctors had originally suspected a skin infection, or a change in the determination of whether or not lesions were considered cancerous.

Even more frequently, the consults led to a recommendation to start or stop taking a particular medication, or to change medication doses or the way a medication was given.

In total, there was a change in how a patient’s condition was managed after almost 98 percent of video consults, the researchers reported in the Archives of Dermatology this week.

(via Reuters originally in Archives of Dermatology)

// Let’s not forget how the U.S. compares to the other...

Tue, 24 Jan 2012 08:06:38 -0500

// Let’s not forget how the U.S. compares to the other developed nations… Innovation is necessary for drastic changes.

(via Forbes.com)

Bill Gates Has Given Away $28 Billion Since 2007, Saving 6 Million Lives

Sat, 14 Jan 2012 13:09:03 -0500

Bill Gates Has Given Away $28 Billion Since 2007, Saving 6 Million Lives:

// The amazing impact of the Bill & Melinda Gates foundation. This is a great read. Great respect.

// The amount that foundation has invested into philanthropy is $2B more than the US Budget for Foreign Aid

// Their biggest impact on lives has been through Vaccination and Immunization!

(via BusinessInsider.com)

Surgeons Implant Synthetic Trachea in Baltimore Man

Fri, 13 Jan 2012 18:15:04 -0500

Surgeons Implant Synthetic Trachea in Baltimore Man:

// Sweden does it again!

// 2nd such operation in the world. How amazing.

“What we did is surgically remove his malignant tumor,” Dr. Macchiarini said. “Then we replaced the trachea with this tissue-engineered scaffold.” The Y-shaped scaffold, fashioned from nano-size fibers of a type of plastic called PET that is commonly used in soda bottles, was seeded with stem cells from Mr. Lyles’s bone marrow. It was then placed in a bioreactor — a shoebox-size container holding the stem cells in solution — and rotated like a rotisserie chicken to allow the cells to soak in.

After two days, it was installed in Mr. Lyles during an elaborate operation in which it was sutured to his throat and lungs. All told, the treatment cost about $450,000, Mr. Lyles said.

(via NY Times)

India on Track to Be Declared Polio-Free Next Month: Scientific American

Tue, 10 Jan 2012 12:31:00 -0500

India on Track to Be Declared Polio-Free Next Month: Scientific American:

// Truly amazing!

// Vaccines have saved more lives in the history of mankind than any other invention. Salk invented the 1st Polio vaccine (injected) in 1952 followed by Sabin oral drops vaccine (now used in the developing world).

For the first time, the polio virus has disappeared from the country for 12 months, but it could still be re-imported from neighboring nations that continue to fight the devastating disease

Weighing the Evidence on Exercise - NYTimes.com

Thu, 05 Jan 2012 15:58:22 -0500

Weighing the Evidence on Exercise - NYTimes.com:

// Timely piece for many New Years Resolutions…

“In general, exercise by itself is pretty useless for weight loss,” says Eric Ravussin, a professor at the Pennington Biomedical Research Center in Baton Rouge, La., and an expert on weight loss. It’s especially useless because people often end up consuming more calories when they exercise. The mathematics of weight loss is, in fact, quite simple, involving only subtraction. “Take in fewer calories than you burn, put yourself in negative energy balance, lose weight,” says Braun, who has been studying exercise and weight loss for years. The deficit in calories can result from cutting back your food intake or from increasing your energy output — the amount of exercise you complete — or both. When researchers affiliated with the Pennington center had volunteers reduce their energy balance for a study last year by either cutting their calorie intakes by 25 percent or increasing their daily exercise by 12.5 percent and cutting their calories by 12.5 percent, everyone involved lost weight. They all lost about the same amount of weight too — about a pound a week. But in the exercising group, the dose of exercise required was nearly an hour a day of moderate-intensity activity, what the federal government currently recommends for weight loss but “a lot more than what many people would be able or willing to do,” Ravussin says.

(via NYTimes and JayParkinson)

Dermatology Top Stories of 2011

Sun, 01 Jan 2012 15:08:26 -0500

Dermatology Top Stories of 2011:

// So much new medical information is published daily, it is sometimes overwhelming to stay on top of everything….

// JournalWatch is a great website that I subscribe to. They filter the top stories per my interests and send me email updates.

// Here is the list of the top Dermatology Publications in 2011 - Great list indeed!

(via JournalWatch)

My Plan to Learn Spanish - Duolingo

Tue, 27 Dec 2011 08:04:30 -0500

My Plan to Learn Spanish - Duolingo:

// As fluent Russian speaker I know the power of connecting with patients in their native tongue. For the last four years, as I saw a significant number of Spanish-only speaking patients, I realized my Spanish speaking ability is lacking….

// Thanks to the guys who made Re-CAPTCHA (awesome TED Talks Link), DuoLingo promises to teach a language for free and translate the web at the same time. I will add this to my Evening routine.

// Brilliant

Archives of Dermatology: Maggots Quickly Clear Chronic Leg Ulcers

Mon, 26 Dec 2011 19:57:03 -0500

Archives of Dermatology: Maggots Quickly Clear Chronic Leg Ulcers :

// Apparently, Magot therapy has been FDA approved since 2004

// 105 Hospitalized patients with non-healing lower-leg ulcers

All patients wore blindfolds during the treatment and were unaware of the difference in treatment schedules

At day eight of treatment, the percentage of the wound area covered by slough was 54.5% in patients given maggot therapy compared with 66.5% (P=0.04) of the wound area in a control group, according to Anne Dompmartin, MD, PhD, of Centre Hospitalier Universitaire de Caen, and colleagues

(via Archives)

// Neti pot causes a 2nd death in Louisiana… please take...

Mon, 19 Dec 2011 19:49:37 -0500

// Neti pot causes a 2nd death in Louisiana… please take note everyone

“If you are irrigating, flushing, or rinsing your sinuses, for example, by using a neti pot, use distilled, sterile or previously boiled water to make up the irrigation solution,” said Louisiana State Epidemiologist, Dr. Raoult Ratard. “Tap water is safe for drinking, but not for irrigating your nose.” It’s also important to rinse the irrigation device after each use and leave open to air dry.

(via Dept of Health)

As Doctors Use More Devices, Potential for Distraction Grows

Sat, 17 Dec 2011 12:26:00 -0500

As Doctors Use More Devices, Potential for Distraction Grows:

// Great read about the negative impacts of personal technology in the medical setting at the point of care!

// Just like texting while driving, the same thing is happening in hospitals. We need better monitoring and accountability when individuals break the rules.

// We can borrow a lot of the methods employed in other industries to tackle the issues of employee Internet abuse… for starters, define the rules and consequences of non-compliance. Apply it to CEO, MD, RN, Technician etc.

Research on the subject is beginning to emerge. A peer-reviewed survey of 439 medical technicians published this year in Perfusion, a journal about cardio-pulmonary bypass surgery, found that 55 percent of technicians who monitor bypass machines acknowledged to researchers that they had talked on cellphones during heart surgery. Half said they had texted while in surgery.

(via New York Times)

Online Stanford Anatomy Class - Starts Jan 2012

Mon, 05 Dec 2011 16:01:13 -0500

Online Stanford Anatomy Class - Starts Jan 2012:

// I just signed up to take this online teaching class so I can brush up on my Anatomy! Especially since I won’t have much time to attend a real anatomy lab

// Some of the technology in use looks awesome!! I am very excited.

(via Anatomy-Class.org)

2011 Top Game Changers in Primary Care: 1. And the Top Game Changer Is...

Sun, 04 Dec 2011 18:20:00 -0500

2011 Top Game Changers in Primary Care: 1. And the Top Game Changer Is...:

// Study of 38,000 women and Vitamin supplement use shows negative effects and detrimental health risks.

New findings from Iowa Women’s Health Study,^[15] published in October 2011, showed very few benefits if any of vitamin or mineral supplements. In fact, there was a suggestion of some risk associated with several of them. The study followed more than 38,000 women, with an average age of 62, for up to 22 years. There were more than 15,000 deaths during the follow-up period. Vitamin B6, folic acid, iron, magnesium, and zinc were associated with about a 3%-6% increased risk for death, whereas copper was associated with an 18.0% increased risk for total mortality when compared with corresponding nonuse. In contrast, use of calcium was inversely related to risk for death

(via Medscape)

The Bomb Buried In Obamacare Explodes Today

Fri, 02 Dec 2011 23:11:31 -0500

The Bomb Buried In Obamacare Explodes Today:

(The “bomb”) is the provision of the Affordable Care Act, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

// Important to be aware of this regulation and its enforcement should take effect in 2014…

// Perhaps new insurers that are more lean will evolve and those with higher overhead expenses dissolve. Regardless, this is definitely noteworthy!

(via Forbes)

"So we have 100,000 people a year who pick up infections at hospitals, all because somebody..."

Fri, 02 Dec 2011 22:09:20 -0500

“So we have 100,000 people a year who pick up infections at hospitals, all because somebody didn’t wash their hands. And it is a — it has become a kind of emblematic sign of how much difficulty we’re having in medicine in grappling with our complexity. This is not about how great your doctor is or how great your nurse is; this is about how great the system is in making sure everybody does the right thing. And you would think that this we could do: just make sure everybody washes their hands. And — sorry, I got the number wrong: 2,000,000 people pick up infections in hospitals, but 100,000 die from those infections. So when you’re talking about that kind of public health impact, the fact that we hadn’t solved it is a serious indictment of where we are.”

- One of my inspirations, Atul Gawande talking about the power of teams and utilizing checklists (via BigThink)

Dietary Fibre and Colorectal Cancer

Fri, 02 Dec 2011 21:50:00 -0500

// Yes that is Fibre spelled with a bre, the British way!

// The Sep 2011 British Medical Journal published the largest Meta-Analysis on this topic

// Critical Finding:

A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer.

// Keep on eating that Flaxseed and purchase cereals that are WHOLE grain! (links to my favorite brands)

(via BMJ.com)