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A New Superbug?

newNYCfashion 300x199 New Superbug AlertScientists have discovered a new, highly-transmissible gene that could, quite easily in fact, open a frightening new front in the ongoing global war against superbugs.

The antibiotic-resistant gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections, and blood stream infections.

NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.

The gene has been identified in three U.S. patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists” — that is, people seeking less expensive medical care in India.

“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.” Read more »

*This blog post was originally published at Pizaazz*

Inner Ear Infections: Still No Need For Antibiotics

Kids get inner ear infections and then they get antibiotics, despite a long-standing knowledge that it’s not always best. Any physician knows this, but who hasn’t faced an irate or anxious parent in the exam room insisting on a prescription, whether the evidence warrants it or not?

Reuters reports that the tally for all those antibiotics is $2.8 billion dollars, or $350 per child annually. And there’s only a slight benefit to them.

While hardly comforting to the parents, physicians can add more heft to their argument that antibiotics are only modestly more effective than nothing, and they can avoid the rashes and diarrhea that antibiotics incur. Read more »

*This blog post was originally published at ACP Internist*

What Does “Anti-Vaccine” Really Mean?

We write a lot about vaccines here at Science-Based Medicine. Indeed, as I write this, I note that there are 155 posts under the Vaccines category, with this post to make it 156. This is third only to Science and Medicine (which is such a vague, generic category that I’ve been seriously tempted to get rid of it, anyway) and Science and the Media.

There is no doubt that vaccines represent one of the most common topics that we cover here on SBM, and with good reason. That good reason is that, compared to virtually any other modality used in the world of SBM, vaccines are under the most persistent attack from a vocal group of people, who, either because they mistakenly believe that vaccines caused their children’s autism, because they don’t like being told what to do by The Man, because they think that “natural” is always better to the point of thinking that it’s better to get a vaccine-preventable disease in order to achieve immunity than to vaccinate against it, or because a combination of some or all of the above plus other reasons, are anti-vaccine.

“Anti-vaccine.” We regularly throw that word around here at SBM — and, most of the time, with good reason. Many skeptics and defenders of SBM also throw that word around, again with good reason most of the time. There really is a shocking amount of anti-vaccine sentiment out there. But what does “anti-vaccine” really mean? What is “anti-vaccine?” Who is “anti-vaccine?”

Given that this is my first post for SBM’s self-declared Vaccine Awareness Week, proposed to counter Barbara Loe Fisher’s National Vaccine Information Center’s and Joe Mercola’s proposal that November 1-6 be designated “Vaccine Awareness Week” for the purpose of posting all sorts of pseudoscience and misinformation about “vaccine injury” and how dangerous vaccines supposedly are, we decided to try to co-opt the concept for the purpose of countering the pseudoscience promoted by the anti-vaccine movement. Read more »

*This blog post was originally published at Science-Based Medicine*

Can Social Networks Predict Epidemics?

Nicholas Christakis talks about how social networks predict epidemics in a TEDMED presentation:

After mapping humans’ intricate social networks, Nicholas Christakis and colleague James Fowler began investigating how this information could better our lives. Now, he reveals his hot-off-the-press findings: These networks can be used to detect epidemics earlier than ever, from the spread of innovative ideas to risky behaviors to viruses (like H1N1).

*This blog post was originally published at ScienceRoll*

Rectal Cancer Becoming More Common In Younger People

Rates of rectal cancer in those younger than 40 have been increasing, the LA Times reported recently.

Researchers studied data from the Surveillance, Epidemiology and End Results (SEER) Registry and looked at the change in rectal and colon cancer incidence in those under 40 from 1973 to 2005. Overall rates were low, but while colon cancer incidence remained constant, rectal cancer incidence increased by an average of 3.8 percent annually, the authors reported in the journal Cancer.

The authors didn’t advocate routine screening in those under 40, but did recommend that physicians be more alert to the possibility of rectal cancer in those presenting with symptoms such as rectal bleeding, according to the Times. (LA Times)

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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