More pontification than a 15 minute office visit
University of Georgia and Department of Defense have developed a gel the call “Fracture Putty” which contains stem cells. So far in lab rats, it has shown dramatic improvement in healing of fractures.
Read about it here
As a physician, I’m pretty excited about all of the recent stuff I’ve been seeing about stem cells.
I’m really hoping some of this stuff makes it into mainstream medicine soon.
A report published today in the New England Journal of Medicine details a potential new treatment not only for Leukemia but for other cancers as well.
Go read the full report for further details, but in a nutshell, researchers at Univ. of Pennsylvania harvested T-cells from patients with Chronic Lymphoid Leukemia. They then genetically modified them to target the cancer cells, as well as modifying them so that, unlike in previous similar trials, the modified cells would proliferate and persisit in-vivo. They then transfused the cells back into the patients.
While this is a VERY small trial, the results were beyond delightful.
Lets hope the better funding they are almost certain to receive leads to something remarkable.
Kudos to science!!
This is an interesting study that was recently in the Annals of Family Medicine.
Basically, the researchers wanted to find out if there was any association between drinking Hot Tea and/or Hot Coffee and levels of nasal colonization with MRSA.
Their findings do suggest that drinking Hot Coffee and/or Hot Tea may decrease the likelihood of nasal MRSA colonization.
I think it would be premature based on this study to draw anything conclusive, particularly with regards to the “Why” of any such protective effect, but it’s an interesting study nonetheless, and I think one that warrants further investigation.
Researchers in japan have developed a remotely controlled miniature camera that can be used for endoscopy.
It looks a bit like a tadpole. It appears very similar to the “capsule endoscopy” cameras that came on the scene several years ago. With those, you basically swallowed a camera that was encased in a clear pill shaped container. This thing passively moved along your gastrointestinal tract snapping pictures until you pooped it out.
With this new gizmo from Japan, it’s not a passive journey. It has a little mechanical tail sticking out of it with which a doctor using a joystick can control it and basically pilot it through your GI tract.
It can apparently be inserted from either end….i.e. via your mouth or your “other end”.
According to this article, it was originally tested on dogs and is now ready for us.
Some potential advantages I see are the ability to get pictures within places not really reachable with current endoscopes…i.e. the small intestine, and also, I would imagine this procedure would likely need less anesthesia/sedation perhaps.
The potential negatives I see are 1. This thing getting stuck somewhere and requiring surgery to remove and 2. This thing causing a perforation, illeus or intususception.
Still, overall it looks like a pretty cool device to me.
And right on the heels of my last post about the FDA warnings on Actos and Avandia and the inevitable lawsuits to come….here’s a new FDA warning about Chantix and increased cardiovascular risk.
Chantix lawsuit anyone?
Here’s my page on Chantix from a couple years ago. Enjoy.
Cheers!
The FDA has come out with some new warnings about Actos and it’s association with bladder cancer.
It wasn’t too long ago that they came out with warnings about another drug in the same family, Avandia. That one has serious cardiovascular concerns.
I’m sure it won’t be too long before we start seeing a bunch of advertisements from lawyers wanting you to join lawsuits related to Avandia and Actos.
I know lots of doctors will fear being named in these lawsuits related to Avandia and Actos and will stop prescribing them. It’ll make life a little more difficult for the drug reps who are tasked with convincing doctors to use these drugs.
Cheers!
So I came across this link on an online forum I frequent.
It’s basically a story about the impending closing of a dialysis clinic at Grady Memorial Hospital in Atlanta.
The gist of the story is one of human tragedy. There is a substantial number of folks who depend on this dialysis clinic to stay alive who will now be forced to find an alternative.
That won’t be easy for many of them to do however because so far, this dialysis clinic has been treating them for free.
According to the story, about two thirds of the patients who have been receiving their dialysis there are illegal immigrants, presumably most of whom have their origins south of the U.S. border with Mexico. (they did mention one illegal immigrant from Ethiopia)
Because they are here illegally, they have no insurance and also have no public health care benefits (i.e. medicaid and/or medicaid). So Grady has been forced to eat the cost associated with treating them.
Those who are not here illegally ALL have Medicare paying for their dialysis.
Between the two groups this dialysis clinic has been costing Grady about 2 million bucks a year in losses. Overall, Grady is losing about 33.5 million bucks a year and therefore has to find places to cut costs. This dialysis clinic is squarely in their cross-hairs.
This sucks for everyone involved.
Illegal immigrants or not, these are people and this is a real and potentially life-ending situation for them.
That said, I don’t really know what the solution is (but I do propose one idea at the end of this posting). Grady is mostly a tax-payer supported institution. Is it fair to expect the taxpayers in this country to continually pay for the care of people who are here illegally? Fair or not, can we afford to do this indefinitely?
On the online forum where I found this link, the overall tone from the left was that this story represented our need for universal health care in the U.S. so that these folks would be covered illegal immigrant or not. They use this article to argue for supporting Mr. Obama’s plans to reform the health care system in the U.S.
Perhaps Joe Wilson was right.
The thing I was wondering about however is this:
Why are these folks even here in the first place? I don’t mean that as in Why do we allow them to be here, but rather, I mean Why do they even want to be here?
According to the folks on the left, everyone knows that U.S. health care sucks. After all, we spend more per capita than anyone else and have dismal health outcomes such as lower life expectancy and higher infant mortality. Right?
If you are sitting in Mexico or Honduras or El Salvador, etc. and need dialysis, why the heck would you illegally sneak across the border to receive your health care here?
Michael Moore says our health care here sucks. He says that you can get great health care in the socialist utopia of Castro’s Cuba. I’m sure that if you come from Mexico, it’s probably easier to get into Cuba. I’m sure the proletariat there would welcome fellow proletarian brothers with open arms. No need to sneak across the dessert under darkness of night. No need to pay smugglers to get you past the U.S. border patrol. No need to learn a new language.
Why didn’t these folks in need of dialysis simply immigrate to Cuba instead?
So here’s what I propose. The article claims that there are about 90 patients dependent upon this outpatient dialysis clinic. The article claims that about two thirds of them are illegal immigrants without any sort of insurance. The other 30 or so patients have medicare and medicaid and therefore should be able to afford for care in other facilities.
That leaves about 60 or so folks. Just about enough to fill a small airliner.
How bout putting them on a small airliner and giving them a one-way ticket to Cuba?
Hell, I’d even be willing to chip in for a one-way ticket or two provided one of them has Michale Moore’s name on it. 
Problem solved. Next!
Cheers,
Sam
It has long been known that genetics and environment play a part in risk of developing MS.
It has also long been known that risk of MS goes up as people live further and further from the equator.
Now a study has come out showing that proteins activated by Vitamin D interact with genes on Chromosome 6 that have been shown to have the strongest effect on development of MS.
Specifically, people carrying a copy of the gene variant DRB1*1501 are more likely to develop MS. Those carrying two copies of this variant are even more likely to develop this devastating disease.
This study suggests that the aforementioned proteins that are activated by Vitamin D bind to the DNA sequences adjacent to the DRB1*1501 gene and alter it’s function.
On the surface at least, this seems to make sense.
Adequate skin exposure to particular wavelengths of ultraviolet radiation in sunlight is a major source of Vitamin D in humans. Folks living further from the equator tend to get less of this exposure, and tend to have lower levels of Vitamin D.
So, it certainly would not surprise me if Vitamin D is playing a role in the increased MS risk seen in these folks.
You can read more about this study here.
There is a lot of debate regarding Vitamin D, effects of low levels, appropriate testing guidelines, appropriate guidelines for “normal blood levels, appropriate treatment of high levels, etc.
Perhaps, if there is any interest, I’ll devote a future post to some of these issues.
How ’bout it readers? Would you like to see a more detailed post about Vitamin D?
Cheers,
Sam
My last post commented briefly on Tanzania’s Nationalized Healthcare System.
Now I’d like to give a link to a really super duper facet within the oft touted UK National Health Service.
That’s right folks. Nothing to see here. Just move along.
I can’t wait until the Obamessiah brings a great system like this to the Colonies!
Tanzania began nationalizing their healthcare system in 1975.
Private medial practice was outlawed in 1980.
You can read a bit about it here.
Recently, the Tanzanian Prime Minister, Mizengo Pinda, ordered the suspension of issuance of licenses to traditional healers.
You can read about this here and here.
So, not to make too much light of the plight of these truly unfortunate people, but I’m left wondering about something.
Godspeed to you, Mr. Pinda. I don’t think you need to appologize at all for your remarks. If anything, they do not go far enough!
Read more about this disorder here.
Interesting article here.
In a nutshell, it’s an article about a recent development in the enchanted land of The Great White North.
Apparently our friends in The People’s Republic of Cannuckistan passed a law that basically says that airlines can’t charge an extra fare on domestic flights for passengers who require an extra seat because they need to be accompanied by a personal attendant due to a medical condition, or for folks whose butts are too big to fit in a regular airline seat. This new law is affectionately known as the “One-Person, One-Fare” rule.
This left the airlines in a bit of a quandry. How to determine who qualifies for a free second seat due to their obesity?
They basically had three choices. Continue reading ‘Eh, Canada, Hate to Butt In, Butt….’
Saw an interesting blurb on the internet this morning about a French physician who claims that Baclofen, which is a drug normally used to treat folks with spastic muscle disorders, was able to cure him of his addiction to alcohol.
Here’s a link to a brief story on it.
It would be nice if subsequent research shows this to be of benefit.
Drug addiction is a terrible thing that tears people’s lives apart.
Hmmmmmm……..I wonder if Baclofen could help eliminate my craving for junk food?????
John Goodman had a nice blog post today. I typically enjoy reading his stuff and recommend it to my readers.
After reading his post linked to above, particularly the very last paragraph just above his signature, take a look at this MSNBC story.
Cheers,
…Sam
I saw a sort of neat story on the BBC News website about researchers in Louisiana who are taking proteins from alligator blood and trying to use them to develop new antibiotics.
Other than handbags and good eating, alligators are mostly just a bit of a nuisance in these parts.
I think it would be great if these researchers are successful in their quest.
Of course, natural selection being what it is, I’m sure that MRSA (Methicillin Resistant Staphylococcus Aureus) would likely eventually evolve into GRSA (Gator Resistant Staph Aureus).
By the way, the picture above of the little alligator is one I took back in 2003 at the Dauphin Island Sea Lab Estuarium.
He always sort of reminded me of Schnappi, the darling of German MTV, when my wife and I were living over there in 2004-2005.
(Oh, and before some smarty-pants feels the need to correct me, I do know the difference between alligators and crocodiles, but “See ya later, alligator” didn’t seem nearly as original for the title of this post.)
There was an interesting story on MSNBC.COM about hands-only CPR.
As a physician, every two years I get re-certified in Basic Life Support (BLS), which is essentially what most folks know as CPR, as well as Advanced Cardiac Life Support (ACLS), which is essentially what they try to portray in shows like “E.R.” when everyone is dramatically yelling stuff like “Give him an amp of epi, stat!”.
Since finishing residency, I no longer practice any obstetrics (for reasons discussed in my medical liability and malpractice reform blog post), so I no longer get re-certified in Advanced Life Support in Obstetrics (ALSO).
I have never gotten certified in Advanced Trauma Life Support (ATLS), which is something that the surgeons and ER docs all get certified in. I don’t do ER medicine, so I haven’t really been able to justify the extra expense and time involved with getting this certification. I keep thinking perhaps I will get it someday though, as moonlighting in the local ER may be something I’d like to pursue in the future. For now though, I’ll leave the chest tubes and tracheotomies and such to others. Continue reading ‘Hands Only Cardiopulmonary Resucitation (CPR)’
“Huh, this post title sounds different than what you emphasized in your last two weight-loss posts Dr. Sam?
I thought you said it was all about the calories.”
If that’s what you thought, go read those posts (The Hacker’s Diet and How to Lose Weight) again, a little more closely.
What I was emphasizing with those posts was that when it comes to losing weight (fat), it’s primarily all about the calories you consume.
I don’t want this message however to be misinterpreted as saying something along the lines of “As long as the calories are where they need to be, eat whatever the heck you want.”
That is most definately NOT my message.
Sometimes I like to surf around news sites in other parts of the globe to get a better feel for what’s going on in other countries, as well as how the foreign press is presenting what’s going on here in the U.S.
In my opinion, access to folks in all the far flung places of the world is the greatest thing about the Internet.
Anyway, I was buzzing around the website for England’s The Daily Telegraph the other day, reading all the news that’s “Fit for Brits,” when I came across an interesting story about some breakthrough medical research being done at UCLA on Alzheimer’s Dementia.
Here’s the story titled UCLA drug aids Alzheimer’s patient ‘in minutes’. Please give it a read, and then come back here. It’ll only take a minute or two.
Okay, the following is a totally political rant. If you aren’t interested in a bunch of political ranting about socialized medicine, or the problems with Medicare funding, etc, (which, by the way is probably indicative of sanity and common sense on your part) then you should probably skip this post as it will most likely just irritate you. There is nothing in it that is informative about any particular medical topic or anything. It is not categorized under the “How to stay healthy” or “Silly Fun Stuff” categories for a reason. Disclaimer over with now. If you read further, don’t say you weren’t warned.
This will be a quick post, which I think is only fair considering the Epic War and Peace style dissertation I put the readers through with my last post on How to Lose Weight.
This is just a sort-of follow up to my post about Penumbra. If you remember, at the end of that post, I posed a couple of questions about potential other uses for this technology.
One of those other uses I wondered about was whether or not this treatment could be used for occlusive arterial conditions other than strokes, such as heart attacks for instance.
Well, it seems I’m not the only one who considered this sort of idea. A study published in today’s New England Journal of Medicine titled Thrombus Aspiration during Primary Percutaneous Coronary Intervention shows very promising results from a study in the Netherlands looking into just just this sort of thing.
As promised, I will keep this post short by avoiding going into a lot of details about this study. Hit the link above if you wish to get into the nuts and bolts of it.
In a nutshell however, the Dutch researchers compared doing a conventional stent placement in a heart attack victim vs first using a device (that sounds very much like the Penumbra device) to vacuum the clot out of the blocked coronary artery prior to placement of a stent.
They found that using the vacuum technique resulted in better perfusion and outcomes compared to conventional stent placement alone.
I just read an interesting story about a new treatment for occlusive strokes.
The device is known as Penumbra and is being put out by the company of the same name Penumbra, Inc.
From the story I read, and from my brief visit to the company website, it looks like it might have promise to treat some stroke victims who otherwise would be sort of out of luck.
Basically, from the description, this is a catheter type device that is threaded into the femoral artery (The great big artery in your groin that feeds blood to your leg), and is worked in retrograde fashion up the aorta and then into the appropriate arteries (carotid, etc.) until reaching the site of the blocked artery inside the skull. It then acts basically like a vacuum cleaner and sucks out the blood clot that is blocking the artery and causing the stroke.
