February 16th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
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Over the weekend I went to see “The King’s Speech.” So far the film, featuring Colin Firth as a soon-to-be-king-of-England with a speech impediment, and Geoffrey Rush as his ill-credentialed but trusted speech therapist, has earned top critics’ awards and 12 Oscar nominations. This is a movie that’s hard not to like for one reason or another, at least most of the way through. It uplifts, it draws on history, it depends on solid acting.
What I liked best, though, is the work’s rare depiction of a complex relationship between two imperfect, brave, and dedicated men. At some level, this is a movie about guys who communicate without fixating on cars, football (either kind), or women’s physical features. Great! (Dear Hollywood moguls: Can we have more like this, please?)
The film’s medical aspects are four, at least: The stuttering, the attitude of physicians toward smoking, a closeted sibling who had epilepsy and died at an early age (just mentioned in passing), and the king’s trusted practitioner’s lack of credentials.
At the start, Prince Albert (young King George VI) has a severe speech impediment. It’s said that he stutters, and on film Firth does so in an embarrassingly, seemingly extreme and compromising degree. He’s the second of George V’s sons, and might or might not succeed to the throne depending on events in history, his older brother’s behavior, and his capacity to serve the Empire at the brink of war. Being effective as the king of England in 1936, and especially at the start of war in 1939, entails speaking confidently.
Prince Albert’s been through the mill with doctors who’ve tried to help him talk. Some recommend he smoke cigarettes — these, they advise, would help him to relax because they’re good for the nerves, they say. One asks him to speak with a mouthful of marbles, on which this doctor watching the film worried he might choke. Eventually Albert’s wife, Elizabeth (Queen Mother to be), finds a speech therapist in London, Lionel Logue, who uses unorthodox approaches with, by rumor, exceptional results. Eventually Prince Albert — or “Bertie” as the therapist insists on calling him — trusts and accepts help from this peculiar Australian who, it turns out, developed his methods of assisting stutterers through his work with shell-shocked soldiers in WWI. Read more »
*This blog post was originally published at Medical Lessons*
February 16th, 2011 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Research
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Humans are the only living things that cry when they are overcome with emotion. Why do we do this?
A study by Noam Sobel and colleagues at the Weizmann Institute provide part of the answer, at least as it relates to women. The scientists showed that when men get a whiff of women’s tears, they experience a temporary, generalized loss of libido and a dip in testosterone. Really. (And you thought that red, runny nose was the turn off, didn’t you?)
Scientists have known for decades that the chemical composition of “emotional tears” differs from tears shed due to simple irritation. But now, it appears that some of the chemicals contained in the former are actually pheromones; biological substances that create behavioral changes in others who are exposed to them. Such chemicals were known to exist in urine in anogenital gland secretions (dont ask), but not in tears.
Sobel’s team began its study by posting ads on Israeli college campus bulletin boards in which they sought volunteers who cried easily. Seventy-one people responded. All but one were women. From that group, the scientists identified six who were profuse criers and who could return to their labs every other day.
The scientists then asked each one to select a movie that was guaranteed to make them break down, to watch it in private, and to collect their tears in a vial. For the controls, Sobel’s group trickled a saline solution down the same women’s cheeks and collected that. Sobel’s group subsequently asked male volunteers to sniff the contents of the two vials and ran a battery of psychological and physiological tests to measure their responses. Read more »
*This blog post was originally published at Pizaazz*
February 15th, 2011 by Medgadget in Better Health Network, Research
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What do you do when you’re one of the world’s biggest food companies and you’re looking to explore what happens after your products get chewed and swallowed? Apparently you build a large refrigerator-sized, million dollar model of a human gut, complete with valves, injection ports for enzymes, and a transparent window for visibility, of course.
Nestle, in their quest to create foods that trick your body into feeling even more satisfied after eating than you otherwise would be, has a research and development center that holds this artificial gut, tucked next to the mountains in Lausanne, Switzerland. Here they’re busy studying and trying to commercialize gastrointestinal phenomenon such as the “ileal break,” a peptidal feedback mechanism that both slows transit through the GI system and reduces food intake by triggering feelings of satiation. They hope to release products based on this science within five years.
From the Wall Street Journal:
Tracking the movement of food in a person’s gastrointestinal tract isn’t easy. So at a “digestion lab”—part of Nestle’s sprawling research and development center here—scientists use a million-dollar model of the human gut.
The machine is about the size of a large refrigerator. It has several compartments linked by valves, and it is carefully calibrated to the body’s temperature. The entire setup is controlled by a computer. The front is glass, allowing observers to watch as food travels through the system.
On a recent day, the “stomach” section at the top slowly squeezed and churned a salt solution, just like the real thing. The liquefied result then wended its way down the other tubes, representing other sections of the digestive tract. At each stage, tiny valves released the appropriate salt, bile and enzymes, which helped to digest the food.
The question still stands: What comes out the other end?
The Wall Street Journal article: Hungry? Your Stomach Really Does Have a Mind of Its Own…
*This blog post was originally published at Medgadget*
February 15th, 2011 by RyanDuBosar in Better Health Network, Research
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Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits.
On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent.
Similar amounts were spent on prescription medicines ($1.4 billion) and emergency room visits ($1.5 billion). Hospital stays amounted to $9.1 billion. Medicare paid 40 percent of the total expenditures to treat kidney disease.
*This blog post was originally published at ACP Internist*
February 15th, 2011 by KevinMD in Better Health Network, Opinion
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Abdominal pain is the bane of many emergency physicians. Recently, I wrote how CT scans are on the rise in the ER. Much of those scans look for potential causes of abdominal pain.
In an essay from Time, Dr. Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a lot of proverbial prizes.
One reason is the myriad of causes that lead bring a patient to the hospital clutching his abdomen. It can range from something as relatively benign as viral gastroenteritis where a patient be safely discharged home, to any number of “acute” abdominal problems necessitating surgery.
But more importantly, we need to consider how limited doctors actually are in the ER. Consider the ubiquitous CT scan, which is being ordered with increasing regularity:
The pros: CT scans are readily available, able to look at every organ in the abdomen and pelvis, and very good for ruling out many of the immediately life-threatening causes of belly pain. CT scans can also reduce the need for exploratory surgery. The cons: Often, CTs can’t diagnose the actual cause of ER patients’ abdominal pain. Worse, CTs deliver significant doses of radiation to a patient’s abdomen and pelvis (equivalent to between 100 and 250 chest X-rays). Over a lifetime, patients who receive two or three abdominal CT scans are exposed to more radiation than many Hiroshima survivors.
Add that to the fact that patients expect a definitive diagnosis when visiting the hospital — one that doctors can’t always give when it comes to abdominal pain. Read more »
*This blog post was originally published at KevinMD.com*
