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Why Should You Get An HIV Test? National HIV Testing Day

Note: Yesterday President Obama issued a statement on National HIV Testing Day

Thirty years ago, at the beginning of the HIV/AIDS epidemic, there was no test for HIV, the virus that causes AIDS. For many, there was only the long and worrisome wait for the signs of infection. Once those signs appeared, no treatment for the virus was available. I personally cared for many, many patients in this era, and I am thankful that those days are over. Today, HIV testing is accurate, widely available, and often free—and treatment can help people living with HIV enjoy long, healthy lives, especially when they get diagnosed early.

The good news is that more people are being tested for HIV than ever before. It is estimated that almost 83 million American adults between 18 and 64 have been tested for HIV, as of 2009. That’s an increase of more than 11 million from 2006 when the Centers for Disease Control and Prevention (CDC) recommended that HIV testing become a routine part of medical care for adults and adolescents.

However, more than half of American adults still have never taken an HIV test. That’s why we need to spread that message that HIV testing saves lives and why Read more »

*This blog post was originally published at Centers for Disease Control and Prevention (CDC)*

Tension Between Physician Autonomy And Adherence To Protocols

Doctors are professionals.  But are doctors cowboys or pit crews?  Recently, physician writer, Dr. Atul Gawande, spoke about the challenges for the next generation of doctors in his commencement speech titled, Cowboys and Pit Crews, at Harvard Medical School.  Gawande notes that advancement of knowledge in American medicine has resulted in an amazing ability to provide care that was impossible a century ago.  Yet, something else also occurred in the process.

“[Medicine’s complexity] has exceeded our individual capabilities as doctors…
The core structure of medicine—how health care is organized and practiced—emerged in an era when doctors could hold all the key information patients needed in their heads and manage everything required themselves. One needed only an ethic of hard work, a prescription pad, a secretary, and a hospital willing to serve as one’s workshop, loaning a bed and nurses for a patient’s convalescence, maybe an operating room with a few basic tools. We were craftsmen. We could set the fracture, spin the blood, plate the cultures, administer the antiserum. The nature of the knowledge lent itself to prizing autonomy, independence, and self-sufficiency among our highest values, and to designing medicine accordingly. But you can’t hold all the information in your head any longer, and you can’t master all the skills. No one person can work up a patient’s back pain, run the immunoassay, do the physical therapy, protocol the MRI, and direct the treatment of the unexpected cancer found growing in the spine. I don’t even know what it means to “protocol” the MRI.”

Despite all of the advancements in medicine, the outcomes and consistency in treatment and care are not as good as they could be.  Doctors are not doing basic things.  The fact that Gawande, author of The Checklist Manifesto, spoke at one of the finest medical schools in the country indicates how much more the profession needs to go.

“We don’t have to look far for evidence. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Human Breast Milk For Sale Without FDA Regulation

The June issue of Wired carries a feature on the Booming Market for Human Breast Milk. You can read about the under-the-counter and over-the-Internet sale of “liquid gold” with a typical asking price in the range of $1 to $2.50 an ounce.
Here’s a taste, from the article:

…“rich, creamy breast milk!” “fresh and fatty!”… Some ship coolers of frozen milk packed in dry ice. Others deal locally, meeting in cafés to exchange cash for commodity…

Late last year, the FDA issued a warning about feeding your child human milk from strangers. Still, the stuff’s barely regulated.

milk containers, Wired Magazine, June 2011

As much as I think it’s a good idea for women to breast feed their babies as best they can, I was pretty shocked to learn about this unregulated industry.  Mainly because if a woman who donates milk is infected with a virus, like HIV or HTLV-1, the milk often contains the virus. The infant can absorb the virus and become infected. Feeding human breast milk from an unknown donor is kind of like giving a child a blood transfusion from a stranger, unchecked by any blood bank.

I’m not sure why Wired ran this story, which is admittedly interesting. Maybe it’ll push the FDA to take a more aggressive stance on this matter, as it should.

*This blog post was originally published at Medical Lessons*

Molecular Condoms And Controlling The Spread Of HIV/AIDS In Women

National Women and Girls AIDS Awareness Day, a nationwide observance that raises awareness and promotes action in the fight against HIV/AIDS, took place on March 10. As the nation turns its attention to this important cause, women and girls around the world continue to be affected by HIV/AIDS in high numbers. According to reports from the Joint United Nations Program on HIV/AIDS, HIV is the leading cause of death and disease among women of reproductive age across the globe.

HIV is a virus that can cause acquired immunodeficiency syndrome, or AIDS, a disease that diminishes the body’s ability to fight off infection. Unprotected intercourse is the primary way HIV is spread, but it can also be shared through IV drug use, blood transfusion or from mother to baby during pregnancy, childbirth or breastfeeding.

Despite the fact that HIV/AIDS-related deaths are significantly lower in the United States when compared with other regions of the world, the disease remains a serious public health issue. According to statistics from the Centers of Disease Control and Prevention (CDC) in Atlanta, roughly 280,000 women are affected by AIDS in the United States today. Read more »

*This blog post was originally published at Society for Women's Health Research (SWHR)*

Teleporting The DNA Of HIV?

Luc Montagnier received the 2008 Nobel Prize for his discovery of the human immunodeficiency virus (HIV), but now he’s come up with a more-than-strange theory. He thinks DNA can teleport from one tube to another via electromagnetic signals. Is this the so-called “Nobel disease?”

French virologist Luc Montagnier stunned his colleagues at a prestigious international conference when he presented a new method for detecting viral infections that bore close parallels to the basic tenets of homeopathy.

Although fellow Nobel prize winners — who view homeopathy as quackery — were left openly shaking their heads, Montagnier’s comments were rapidly embraced by homeopaths eager for greater credibility.

Montagnier told the conference last week that solutions containing the DNA of pathogenic bacteria and viruses, including HIV, “could emit low frequency radio waves” that induced surrounding water molecules to become arranged into “nanostructures.” These water molecules, he said, could also emit radio waves.

He suggested water could retain such properties even after the original solutions were massively diluted, to the point where the original DNA had effectively vanished. In this way, he suggested, water could retain the “memory” of substances with which it had been in contact — and doctors could use the emissions to detect disease.

*This blog post was originally published at ScienceRoll*

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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