March 10th, 2011 by RyanDuBosar in Better Health Network, Health Tips
Tags: ACP Internist, Air Travel Health Risks, American College Of Physicians, Bedbugs, Deep Vein Thrombosis, Dehydration, DVT, E. Coli, Hand Sanitizer, Handwashing, In-Flight Health Tips, Infectious Diseases, Internal Medicine 2011, MRSA, Preventive Health, Preventive Medicine, Ryan DuBosar, Time Magazine, Travel Health
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For those of you planning air travel to your next medical conference (and ACP Internist isn’t too shameless to plug Internal Medicine 2011 — we hope to see you there), TIME reports that there are five health risks that are rare yet have recently happened. Tips on avoiding these maladies include:
— E. Coli and MRSA on the tray table. Microbiologists found these two everywhere when they swabbed down flights. Bring your own disinfecting wipes.
— Bedbugs in the seat. British Airways fumigated two planes after a passenger posted pictures online about her experience. Wrap clothes in plastic and wash them.
— Sick seatmates. Everyone has experienced (or been) this person. Wash your hands.
— Deep vein thrombosis (DVT). Tennis star Serena Williams experienced a pulmonary embolism, possibly related to recent foot surgery. But DVT can happen to anyone restrained to a cramped position for long periods of time. Move around in-flight (but not during the beverage service, of course.)
— Dehydration. Dry cabin air may make it more difficult to fight off infections. Drink more water.
*This blog post was originally published at ACP Internist*
March 9th, 2011 by AndrewSchorr in Better Health Network, Research, True Stories
Tags: Andrew Schorr, Autoimmune Disease, Clinical Trials, Drug Companies, EGID, Eosinophilic Gastroenteritis, Gastroenterology, House MD, Magic Bullet, New Medications, New Treatments, Niche Science, Oncology, Pancreatic Cancer, Patient Power, Pharma Scientists, Pharmaceutical Industry, Pharmaceutical Research, Science and Medicine, Targeted Medicine
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Maybe you read the other day in The New York Times that the pharmaceutical industry has a problem. Big blockbuster drugs like Lipitor are going off patent and the industry leaders don’t have new blockbusters showing promise to replace them. So the big companies search for little companies with new discoveries and they consider buying them. Industry observers think the days of $5 billion-a-year drugs to lower cholesterol or control diabetes may be past for awhile, and the companies will have smaller hits with new compounds for autoimmune conditions and cancer.
When I saw my oncologist for a checkup yesterday — the news was good — we chatted about the article and the trend toward “niche science.” We welcomed it. We didn’t think — from our perspective — the world needed yet another drug to lower cholesterol. We need unique products to fight illnesses that remain daunting, some where there are no effective drugs at all. For example, my daughter has suffered for years from what seems to be an autoimmune condition called eosinophilic gastroenteritis (EGID). Her stomach gets inflamed with her own eosinophil cells. They would normally be marshaled to fight a parasite in her GI tract but in this case, there’s nothing to attack. So the cells make trouble on the lining of the stomach and cause pain and scarring. Right now, there’s no “magic bullet” to turn off these cells. My hope is some pharma scientists will come up with something to fill this unmet need.
In the waiting room before I saw my doctor at the cancer center in Seattle I overheard a woman on the phone speaking about her husband’s new diagnosis of pancreatic cancer. I was sitting at a patient education computer station nearby. When she was finished I introduced myself and showed her some webpages to give her education and hope: pancan.org and our Patient Power programs about the disease. She was grateful. I did tell her — and she already knew — that there was no miracle drug for pancreatic cancer and that it was a usually-fatal condition. But that there were exceptions and, hopefully, her husband would be one. Of course, wouldn’t an effective medicine be best? Read more »
*This blog post was originally published at Andrew's Blog*
March 9th, 2011 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
Tags: 33 Charts, Absence of Absolute Certainty, Children's Health, Doctor Patient Relationship, Dr. Bryan Vartabedian, Endless Testing, Less Care, Overdiagnosed, Overtesting, Patient Uncertainty, Patient's Fear, Pediatrics, Too Many Medical Tests, Too Much Testing, Unable To Diagnose, Underdiagnosed
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How comfortable are we with uncertainty? I struggle with this question every day. I treat children with abdominal pain. Some of these children suffer with crohns disease, eosinophilic esophagitis, and other serious problems. Some children struggle with abdominal pain from anxiety or social concerns. I see all kinds.
But kids are tricky, and sometimes I can’t pinpoint the problem. Trudging forward with more testing is often the simplest option since it involves little thinking. And some parents perceive endless testing as “thorough.”
The question ultimately becomes: When do we stop? Once we’ve taken a sensible first approach to a child’s problem and judged that the likelihood of serious pathology is slim, when and how do we suggest that we wait before going any further? This requires the most sensitive negotiation. It’s about finding a way to make a family comfortable despite the absence of absolute certainty. This is easier said than done. Parents can unintentionally advocate for themselves and their worries by insisting on the full-court press. Alternatively they may refuse invasive studies when absolutely indicated.
All of this is for good reason: You can’t be objective with your own kids.
Pediatrics is tricky business and managing parental uncertainty is perhaps my biggest preoccupation. As I’ve suggested before, sometimes convincing a family to do less represents the most challenging approach.
*This blog post was originally published at 33 Charts*
March 8th, 2011 by Medgadget in Better Health Network, Research
Tags: Benign Dermal Nevi, Cancer Detection, Cancerous Skin Moles, Diagnostic Imaging, Disease Detection, Duke University Center for Molecular and Biomolecular Imaging, Dysplastic Nevi, Eumelanin, Laser Technology, Medgadget, Melanocytic Nevi, melanoma, Oncology, Pheomelanin, Pump-Probe Imaging, Science Translational Medicine, Skin Biopsy, Skin Cancer, Skin Cells, Skin Pigment
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Duke University scientists have been successfully testing a new laser system they developed to identify cancerous skin moles. Two lasers in the system are used to identify the presence of eumelanin in biopsy slices and a future version of the device may work directly without having to sample the mole. According to an article in Science Translational Medicine, “the ratio of eumelanin to pheomelanin captured all investigated melanomas but excluded three-quarters of dysplastic nevi and all benign dermal nevi.” From the press release:
The tool probes skin cells using two lasers to pump small amounts of energy, less than that of a laser pointer, into a suspicious mole. Scientists analyze the way the energy redistributes in the skin cells to pinpoint the microscopic locations of different skin pigments.
The Duke team imaged 42 skin slices with the new tool. The images show that melanomas tend to have more eumelanin, a kind of skin pigment, than healthy tissue. Using the amount of eumelanin as a diagnostic criterion, the team used the tool to correctly identify all eleven melanoma samples in the study.
The technique will be further tested using thousands of archived skin slices. Studying old samples will verify whether the new technique can identify changes in moles that eventually did become cancerous.
Malignant melanoma under the new laser light. Clear deposits of eumelanin (red) appear in unhealthy tissue.
Press release: Lasers ID Deadly Skin Cancer Better than Doctors …
Abstract in Science Translational Medicine: Pump-Probe Imaging Differentiates Melanoma from Melanocytic Nevi
Flashback: Diagnosing Skin Cancers with Light, Not Scalpels
*This blog post was originally published at Medgadget*
March 6th, 2011 by Paul Auerbach, M.D. in Better Health Network, Health Tips
Tags: C. Jejuni, Campylobacter, Dr. Erik McLaughlin, Dr. Paul Auerbach, E. Coli, Escherichia Coli, ETEC, Gastrointestional Medicine, Gastrointestional Tract, Health Tips for Travelers, healthline, Infectious Disease, International Medicine, International Travel, Medicine for the Outdoors, Norwalk Virus, Outdoor Safety, Outdoors and Health, Parasitic Infections, Remote and Expeditionary Medicine, Rotavirus Infection, TD, Travel Health, Traveler Safety, Traveler's Diarrhea, Tropical Medicine and Hygiene, Viral Infections, wilderness medicine
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This is a guest post by Dr. Erik McLaughlin.
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Traveler’s Diarrhea: The Basics
Known around the world by many names including “Montezuma’s revenge,” “Delhi belly” and “mummy tummy,” traveler’s diarrhea (TD) is the most common illness faced by travelers. Nothing can slow down a fun trip as easily as TD — and it can also have serious health implications. TD typically lasts four to six days, and 90 percent of cases occur within the first two weeks of travel.
Anatomy You Need to Know
The gastrointestinal tract starts at the mouth and ends at the anus. After food enters the mouth, it passes through the esophagus to the stomach, where it sits for approximately 45 minutes. After being broken down by gastric secretions, food matter enters the small intestine (duodenum, jejunum, and ileum in order). The small intestine is the site where most nutrients are absorbed by the body. From the small intestine, food matter begins to look more like feces as it progresses to the large intestine or colon. The colon absorbs water from the food material before the material passes through the anus and exits the body as feces.
Symptoms
Recognizing the warning signs of TD, such as blood in the stool, fever, or abdominal cramping, can help a savvy traveler know when to seek medical help.
TD has many definitions; the presence of three or more loose-formed stools in one day is a good one. Abdominal cramping, nausea, vomiting and fever may also occur. The presence of blood in the stool can indicate that infection has directly damaged the intestinal wall and should be taken seriously. Read more »
This post, Traveler’s Diarrhea: The Basics, was originally published on
Healthine.com by Paul Auerbach, M.D..
