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More germs found on desk tops than toilet seats

Microbiologist Charles Gerba has made a career out of scaring people with news of how dirty seemingly innocent surfaces can be.  Dr. Gerba has taken media on germ tours of kitchens, bathrooms, and offices, and now in his new research study he finds that office desks have 400x more bacterial colonies than toilet seats.  Moreover, he found that women’s desks generally have 4x more bacteria than men’s.  He attributes this to women having more makeup and food products in their desks, as well as having greater contact with small children.

Well, before we all become totally grossed out and paranoid, lets think for a minute about this.  If there are so many bacteria all around us (even on our desks) and we’re generally not sick, then I guess we shouldn’t all rush out to buy bleach and sanitizers.  Other studies suggest that sanitizers disrupt the natural ecosystem around us, creating resistant organisms that are harder to kill.

Personally, I think that precautions should be taken to reduce transmission of viruses and bacterial infections (especially in the hospital environment) but that it is unreasonable, and perhaps even harmful, to wage an indescriminate war on all bacteria everywhere.

If your loved ones are sick, minimize your exposure to their droplets, wash your hands frequently, and sanitize surfaces that they are in direct contact with.  Otherwise, if you’re feeling well, I wouldn’t worry too much about bleaching your desk surface.

As one microbiology lab says,

“Support bacteria.  It’s the only culture some people have.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Why would price transparency be a good thing for health consumers?

One of my readers recently asked for some examples of how price transparency might improve his lot. A great question! The people who stand to benefit the most from price transparency are the uninsured and those with high deductible health savings accounts. Price transparency is globally valuable because it allows people to understand the true cost of healthcare, making them more informed consumers. It also promotes accountability of hospitals, healthcare providers, and insurance companies.

Naughty Hospitals

Arbitrary fees:

“The cost for a total hip replacement in the greater Seattle area varied between $13,996 at one local hospital and $46,758 at another. Furthermore, there wasn’t necessarily any correlation between the cost of the procedure and the hospital’s quality or experience doing it. …Why would anyone pay a higher price for lower quality and potentially more complications, especially when it concerns your health?”

Where does a non-profit put its profitsDr. Feld knows where:

“We are unable to know the hospital’s actual overhead. If we did, we could to find out what the hospital’s actual costs are. We could then calculate the hospital’s profit. These numbers are totally opaque.

Most hospitals are non profit hospitals. They can not post a profit at the end of the year. Therefore, they have to pour the extra money into something. Executive salaries and capital expenditures are a prime avenue for getting rid of their profit. A key question is how is the hospital’s overhead calculated? Maybe reducing costs to the consumer would be a good idea?”

Predatory hospital billing:”

Over the past year, aggressive billing practices have been exposed at a number of hospitals in the United States. Despite the fact that a widower had paid $16,000 of his late wife’s bill of $18,740, some 20 years after the incurrence of the bill a teaching hospital held a lien on his home for $40,000 in interest. Many years earlier the hospital had seized his bank account, and now the 77-year-old man was destitute. Only tremendous publicity caused the hospital to back down. In California, a patient was forced into bankruptcy in 2000 by a for-profit hospital from a day-and-a-half stay in the hospital that did not include any surgery but totaled $48,000 in hospital bills. These have become common stories as hospitals aggressively market, bill, collect, and foreclose, just like any other corporation. The uninsured are facing the brunt of the hospital industry’s billing practices.

Naughty Outpatient Facilities

“Mr. Smith needs to get an MRI. He has a high deductible HSA, with a $2000 deductible, much of which he has not yet spent. So he will likely have to pay for 100% of this service himself. Without access to cost information by facility, he would simply go to a convenient, local facility and might pay up to $1300 for this single test. If he had access to health care cost information on the web, he could look up the cost of his service across different facilities and choose to go to the one that only charges $450 – a very meaningful difference for Mr. Smith.”

“More than 3 million people have already signed up for HSAs, and 29 million are projected to do so by 2010. Forty percent of the people who bought HSAs have family incomes below $50,000. More than a third of those who bought HSAs on their own had previously been uninsured.”

Naughty Doctors

What happens when 2 procedures have been shown (through careful research) to have equal efficacy, but one is reimbursed at a much higher rate? Docs will choose to perform the more expensive one, of course.

“Prostate cancer patients’ biggest concerns — after cure — are the possible side effects of surgery, including urinary incontinence and sexual impotency. Data on these side effects from robotically assisted prostatectomy were sketchy at best, and no evidence was available to indicate that any surgical method emerged as better than another for these side effects… Open radical prostatectomy costs $487 less a case than non-robotic laparoscopy and $1,726 less than robot-assisted prostatectomy.”

Naughty Insurance Companies

Insurance companies don’t want to make their pricing public because they don’t want their competition to know how much (or how little) they’re compensating physicians. Therefore, consumers are prevented from seeing costs as well – which can hinder their ability to make informed decisions about their care.

I bet others can think of some excellent reasons why price transparency is beneficial to consumers. Care to contribute?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Sniffing sweat might put you in a better mood?

A small pheromone study made a big splash in the media this week, announcing that male sweat contains a chemical that causes arousal in females.

The media’s sensationalization of the study made me feel dubious about the science behind it. I thought to myself, here we go again – some shoddy research and a lot of hand waving… I was determined enough to get the story straight, that I paid my $15 to the Journal of Neuroscience to get my hands on the original data. And I’m glad I did because my suspicions were NOT confirmed.

Claire Wyart et al. at UC Berkeley designed this study well. They took great pains to control the variables, account for confounders, and provide the appropriate environment for the study. “All testing was performed in a temperature and humidity controlled, stainless-steel-coated, 5 x 8 foot room equipped with HEPA (high-efficiency particulate air) and carbon filtration.” Wyart’s team also made meticulous note of previous research on the subject. They also repeated the study just to make sure that their findings were reproduceable. A total of 48 women participated.

In this double blind, placebo-control study they found that exposure to one of the chemicals in male sweat, androstadienone (AND), produced increased cortisol levels, elevated mood, and increased sexual arousal (when combined with provocative videos) up to an hour after the AND was inhaled.

Now, instead of focusing on the enhanced sexual arousal observation (that triggered the media blitz), Wyart suggested an interesting twist: what if AND could be used as a therapy for those suffering from cortisol deficiency (Addison’s disease)? Current standard therapy requires cortisol replacement which may cause peptic ulcers, osteoporosis, weight gain, mood disorders, and other pathologies. But AND is a potential “natural” solution.

Of course, I’m somewhat skeptical of this alternative since Addison’s is generally caused by an autoimmune attack on the adrenal gland cells – and I’m not sure that stimulating what’s left of them (with AND) would result in enhanced cortisol production. Still, Wyart raises an interesting point: what if we could learn how to positively influence the endocrine system with scent stimulation? Could this be a new method of treatment for women with anxiety, depression, or low libido but with far fewer side effects than our current methods?

Well, it’s too early to tell, but I think Wyart’s on to something. As she notes in her research article, AND is only one of hundreds of chemicals found in human sweat, and it is unclear if it is the most potent chemical in the arousal arena. It will be interesting to see if AND is eventually added to perfumes, cosmetic products, and the like as a means of tricking the body into feeling happier, sexier, and more balanced. Science meets aromatherapy? What do you think?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Relationships and weight gain: Valentine’s Day musings

My friends in the Revolution Weight Management Center asked me to blog about weight and relationships… at first I wondered if they were trying to stage an intervention or something: have I gained that much weight since I started working here? Ha ha. No, I haven’t… but maybe that’s because I have such a skinny husband?

As it turns out, research suggests that married couples are influenced by one another’s dietary habits. If you marry a person with poor eating habits, you are much more likely to adopt them yourself. Also, they say that marriage leads to more regular (read frequent), larger meals and increased financial pressures, stress levels and decreased exercise frequency.

Well, I guess choosing the right spouse has never been more important for weight control? Marriage doesn’t automatically lead to weight gain, but you should eye your boyfriend/girlfriend/fiancé(e) with suspicion at the dinner table. When I was dating my husband I noticed that he ate small portions, never finished his plate, and didn’t like dessert. He liked to run, had good sleeping habits, drank in moderation, and wouldn’t notice a super model if she fell in his lap. Sound too good to be true? I still ask myself that every day. They don’t make too many like Steve, I’ll tell you!

Anyway, I must confess that before our wedding I was in the best shape of my life, running about 20-25 miles a week, shunning all products containing high fructose corn syrup, and taking good care of my health. Now I exercise irregularly, sneak in rich dining experiences, and skip meals. I weigh about the same, but have (I’m sure) exchanged fat for muscle.

What do I make of this? Well, I need to force myself to go running again with my husband (he patiently runs at my pace as I lumber along next to his gazelle-like frame) and be more mindful of my eating habits. This is a never-ending battle for me, but it is made so much easier by having a supportive spouse who never deviates from good health practices.

So as Valentine’s Day approaches, observe your loved one’s eating and exercise habits with a critical eye. You are likely to be influenced by them more than you know. And for those of you who have a “Steve” in your life, thank your lucky stars, put down the box of chocolates, and show him how much he’s appreciated!

P.S. Steve would like to tell you that he (thanks to me) now enjoys dessert and craves ice cream from time to time. I guess my influence on him hasn’t been as positive.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Mice take one for the human team… again

Gone are the days of Beaver Cleaver – and apparently the days of Mickey & Minnie mouse are numbered as well.

In this new study, humans give LSD to the little rodents:

“Of course, we don’t know what the mice experience when they are treated with these drugs,” Sealfon said. “But we do know that there is a head twitch response in the mice that provides a good correlation with drugs that are known to be hallucinogenic in humans.”

So um… why are we doing this?

The Onion spoofed animal research very nicely, picturing an obesity study lab rat nestled among snickers bars and M&Ms.

And in another recent study, we gave mad cow disease to our furry friends:

“As expected… at 9 weeks of age they developed sponginess in the brain tissue, all the mice developed behavior and memory problems, for example they stopped burrowing.”

Hey, I have an idea for a new study – let’s see what mice infected with mad cow disease do if we also give them LSD?

I feel a bit sad for the tiny critters, don’t you?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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