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New Theories About A Link Between Uterine Environment And Autism Raise Questions Without Answers

Two news events got people talking recently.  One was that Casey was deemed not guilty of killing little daughter Caylee ( “O.J. all over again”, I heard repeatedly).  I must admit I was rather surprised….

The second was the results of two new studies that were published in the Archives of General Psychiatry.  One of them stated that environmental factors during pregnancy might contribute as much as genetics in the development of autism spectrum disorders.  The 2nd study conducted by Kaiser Permanente Northern California found a 3 times higher risk of autism if the mother took antidepressants in the first trimester of pregnancy.

With the incidence of autism disorders increasing over time to the current range of 3-6 per 1,000 births, these studies are of interest to millions of parents and professionals.  Autism affects boys at a rate of three times more than girls,  and is usually detected by the age of 3.   The cause has been maddeningly unknown.

While genes certainly play a part (as they do in most every disorder) other theories and assertions have been disproven.  It certainly does not have anything to do with “poor mothering” or “lack of maternal bonding”.  Those theories did more harm than bloodletting in the 19th century!  The link between autism and vaccines has been thoroughly debunked.  If you believe in science and research, you must believe that vaccines are not the cause and finally leave that one in the dust. Read more »

*This blog post was originally published at EverythingHealth*

Did You Know Natalie Portman Co-Authored A Paper About Neuroimaging?

Did you know that Natalie Portman (under the name, Natalie Hershlag) published a paper in a scientific journal in 2002 while at Harvard?

Frontal lobe activation during object permanence: data from near-infrared spectroscopy.

The ability to create and hold a mental schema of an object is one of the milestones in cognitive development. Developmental scientists have named the behavioral manifestation of this competence object permanence. Convergent evidence indicates that frontal lobe maturation plays a critical role in the display of object permanence, but methodological and ethical constrains have made it difficult to collect neurophysiological evidence from awake, behaving infants. Near-infrared spectroscopy provides a noninvasive assessment of changes in oxy- and deoxyhemoglobin and total hemoglobin concentration within a prescribed region. The evidence described in this report reveals that the emergence of object permanence is related to an increase in hemoglobin concentration in frontal cortex.

*This blog post was originally published at ScienceRoll*

5 Important Reasons To Protect Your Eyes From The Sun’s UV Radiation

A Pterygium

Dermatologists have done a great job promoting sun safety. We all know that we should use sunscreen or sunblock to avoid burns, and to reapply it religiously when we plan to be outdoors for long periods of time. But how often do we think about protecting our eyes from the same UV rays?

A dear friend of mine has been on a long-term medicine that makes her skin especially sun-sensitive. She did not take sufficient precautions to protect her eyes from UV radiation (though she always wore sunscreen on her skin), and she developed a pterygium that looks just like the photograph above. Her condition reminded me of the importance of eye protection, and I thought I’d offer you 5 excellent reasons to start shielding your eyes from the sun. UV protection is critical for avoiding:

1. Photokeratitis. Photokeratitis is essentially a sunburn of the front layer (cornea) of your eyeball. If you’ve ever had a burning sensation in your eyes after a long day at the beach, or in the snow, you may have burned your eyes. Just as skin sunburns are painful and take a few days to calm down, eye pain can be very uncomfortable. But worse than the temporary discomfort is the increased long-term risks of pterygia, cataracts, and other eye conditions (see below).

2. Pterygia. Pterygia are overgrowths of corneal tissue that can grow across the iris and pupil. They can be cosmetically unsightly, and can block vision if they grow large. They are caused almost exclusively by UV damage, and are most common in people who live near the equator (because their exposure to UV radiation is highest). Surgery is the only known treatment for pterygia, though as many as 50% grow back, and surgical divets in the cornea can cause visual problems.

3. Cataracts. Cataracts are opacities of the eye lenses that lead to partial or total blindness. The exact mechanism by which they occur is unclear, though we know that sun exposure contributes to their development. Cataracts are the number one cause of blindness in the world.

4. Skin Cancers. Basal cell carcinoma (BCC) is a type of skin cancer that primarily develops on skin that has been sunburned, especially in childhood. Melanoma is a deadly form of skin cancer that is much rarer than BCC, but also most commonly develops on skin that has been burned. Squamous cell carcinoma (SCC) is the least invasive type of skin cancer, and usually develops on skin that has had the largest total amount of sun exposure over a lifetime. People who don’t protect the thin eye skin and lids from UV radiation (beginning in childhood) are more likely to develop cancer around the eyes

5. Macular Degeneration. Exposure to the sun’s UV rays can cause damage to the deep structures of the eye, including the retina. Light focused on the macula (the most important part of the retina for vision) can cause damage in the area over time. Macular degeneration results in visual damage and even blindness.

Ok, so I hope I’ve convinced you that UV protection is critically important for your eyes… How can you protect yourself? There are 4 primary strategies:

1. Wear UV protective sunglasses. When buying sunglasses, check out their product labels and avoid glasses that are purely cosmetic – opt for those that block 99-100% of UV A and B rays. Larger glasses and wrap-arounds offer the most coverage. Remember that kids need sunglasses too!

2. Wear a wide-brimmed hat. Although a hat doesn’t always protect you from glare and light reflection from other surfaces, it can reduce the total amount of radiation that reaches your eyes and skin.

3. Wear UV-protective contact lenses. Most people don’t realize that some contact lenses are manufactured with a UV protective layer already built in. Although they are not large enough to protect the entire eye surface (or the skin around the eye) they offer an added layer of protection against harmful UV rays. However, not all contact lenses offer UV protection, and of those that do, not all provide similar absorption levels. An eye care professional can prescribe Class 1 UV-blocking contact lenses, which provide the greatest level of UV protection and which have a Seal of Acceptance for UV Absorbing Contact Lenses from both the American Optometric Association and the World Council of Optometry’s Commissions on Ophthalmic Standards. These lenses block more than 90 percent of UVA rays and 99 percent of UVB rays.

4. Protect your eyes all day. UV radiation for the eyes is actually worse when the sun is lower in the sky. Researchers at the Kanazawa Medical University in Japan found that during early morning and late afternoon, UV exposure to the eyes was about double that of the hours around noon during Spring, Summer and Fall.

For more information about protecting your eyes from the sun, you may enjoy listening to my recent interview with Dr. Stephen Cohen.* He is an optometrist who lives in Arizona – and is therefore well acquainted with UV radiation! Scroll down to the bottom of the page after clicking on the link and you’ll see the podcast.

***

Note that I was paid by Johnson & Johnson Vision Care, Inc. to host the radio show with Dr. Cohen.

Fourth Of July: Top Tips For Fireworks Safety

As the 4th of July approaches, I’ve begun to hear fireworks exploding in my neighborhood.  It’s been dry here, so in addition to the risk of injuring a person, there is a risk of setting the fields on fire.  I sure hope my neighbors are being responsible.

I hope you will all have a safe and happy July 4th.  Be safe and stay out of the ER.

Please use the following tips:

  • Never allow children to play with or ignite fireworks.  A responsible adult should be in charge.
  • Read and follow all warnings and instructions.
  • Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised.
  • Do not smoke when handling any type of “live” firecracker, rocket, or aerial display.
  • Keep all fireworks away from any flammable liquids, dry grassy areas, or open bonfires.
  • Keep a bucket of water or working garden hose nearby in case of a malfunction or fire.
  • Take note of any sudden wind change that could cause sparks or debris to fall on a car, house, or person. Read more »

*This blog post was originally published at Suture for a Living*

Pediatric Emergency Drug Calculator: Great Idea, Not Ready For Prime Time

Photo Jun 12, 10 15 47 PM Pediatric Emergency Drugs is designed to be a quick med list calculator for pediatric emergencies. For folks who deal with pediatric emergencies have the challenge of not only determining the proper drugs to use, but also to get the dosage right by age.

At the first page you are met with a screen to enter the age of the child and either allow the program to pick the estimated weight or put your own weight in. This is a nice feature as often in pediatric emergencies patients arrive through the door needing immediate care and a weight is unavailable. The estimated weight it appears to pick is the 50% for a boy of the selected age. Allowing you to pick the gender of the child would be helpful in narrowing down the weight a little further since girls of a given age would weigh a little less.  Another option would be to allow the use of Broselow colors. These days the standard for most ERs is the Broselow tape which is a plastic foldable tape that doses based on length.

Once you select your patient you have a section of drugs broken down into: cardiac arrest meds, infusions, and bolus drugs. The cardiac arrest meds are short a few drugs. There are no drugs for treating ventricular fibrillation (amiodarone)  and they do not make mention of the dose of electricity for synchronized cardioversion (only for defibrillation). The infusion list assumes you are mixing all drugs in 50mL bags which is not usually the case. (we usually use 100 or 250mL bags for drips). Also, in America thanks to JCAHO regs medicated infusions need to be have standardized concentrations and not use the “rule of 6” employed by this program. The list of bolus drugs is missing a few key drugs as well such as midazolam and hydrocortisone for sepsis. Read more »

*This blog post was originally published at iMedicalApps*

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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