Hacking For Health

From Wired:

Modern humans are bacteria-killing machines. We assassinate microbes with hand soap, mouthwash and bathroom cleaners. It feels clean and right.

But some scientists say we're overdoing it. All this killing may actually cause diseases like eczema, irritable bowel syndrome and even diabetes. The answer, they say, is counterintuitive: Feed patients bacteria.

"Probiotics (pills containing bacteria) have resulted in complete elimination of eczema in 80 percent of the people we've treated," says Dr. Joseph E. Pizzorno Jr., a practicing physician and former member of the White House Commission on Complementary and Alternative Medicine Policy. Pizzorno says he's used probiotics to treat irritable bowel disease, acne and even premenstrual syndrome. "It's unusual for me to see a patient with a chronic disease that doesn't respond to probiotics."

Clinical trial data on probiotics is incomplete, but there are many indications that hacking the body's bacteria is beneficial.

We say: Maybe this explains the recent explosion of probiotic based yogurts that started with Activia. While the public is responding positively with sales, the health benefits so far are somewhat questionable. Then again, the yogurt tastes fine, so why not?

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Be Wary of Reps Bearing Gifts

From MSNBC:

Four out of five doctors surveyed said they let drug and device makers buy them food and drinks despite recent efforts to tighten ethics rules and avoid conflicts of interest.

The national survey also found that family doctors were more likely to meet with industry sales representatives, and that cardiologists were more likely to pocket fees than other specialists.

The study is the first to document the extent of the relationships between doctors and sales reps since 2002 when a leading industry group adopted voluntary guidelines discouraging companies from giving doctors gifts or tickets. In general, researchers found hardly anything had changed since previous studies a couple years earlier.

We say: It takes a lot more than a slice of pizza or handful of pens to influence what drugs I prescribe, or what devices I use. Patients also need to realize that the hospital formulary restricts what drugs a doctor can use in the hospital to a limited set that the hospital can procure, often based on price. For outptient care, insurance companies do the same thing with their own formularies of approved drugs that they will pay for. The drug reps do provide less perks than years ago, and now put the money into direct to patient advertising which helped fuel the Celebrex/Vioxx/Bextra debaucle so that was hardly an improvement.

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How About a Hawaiian Punch?

From CNN:

A fruity cocktail may not only be fun to drink but may count as health food, U.S. and Thai researchers say.

Adding ethanol -- the type of alcohol found in rum, vodka, tequila and other spirits -- boosted the antioxidant nutrients in strawberries and blackberries, the researchers found.

Any colored fruit might be made even more healthful with the addition of a splash of alcohol, they report in the Journal of the Science of Food and Agriculture.

We say: Drink up, and keep a copy of this study to justify it.

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Origami Cast

From MedGadget.

We say: Looks like a great idea for having a portable splint in a remote location. We should send one up to the International Space Station, or the next Everest expedition.

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Artificial Snot

From New Scientist Tech:

A substance that mimics mucus has been used by UK researchers to improve the performance of odour-sensing "electronic noses". The enhanced devices can pick apart more complex smells, the team says.

Humans detect smells using more than 100 million specialised receptors on the roof of the nasal cavity, just behind the bridge of the nose. The complex manner in which multiple receptors react to a molecule is used to identify and differentiate them.

Electronic smell sensors work on the same principal but have just tens of sensors. They are used commercially, in food manufacturing quality control, for example, and can sometimes even detect diseases like cancer.

We say: Gee, the only thing that comes to mind is sometimes science is messy. Maybe this can be featured in an upcoming episode of Dirty Jobs.

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Not So Lethal Injection

From Fox News:

The drugs used to execute prisoners in the United States sometimes fail to work as planned, causing slow and painful deaths that probably violate constitutional bans on cruel and unusual punishment, a new medical review of dozens of executions concludes.

Even when administered properly, the three-drug lethal injection method appears to have caused some inmates to suffocate while they were conscious and unable to move, instead of having their hearts stopped while they were sedated, scientists said in a report published Monday by the online journal PLoS Medicine.

No scientific groups have ever validated that lethal injection is humane, the authors write. Medical ethics bar doctors and other health professionals from taking part in executions.

The study concluded that the typical "one-size-fits-all" doses of anesthetic do not take into account an inmate's weight and other key factors. Some inmates got too little, and in some cases, the anesthetic wore off before the execution was complete, the authors found.

We Say: They use a combination of a barbituate, pancuronium, and potassium. The first two drugs are very commonly used in anesthesia, and the last throughout the hospital. If there is this concern, the simple answer is to simply give more.

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Say Yes To Carbs

From MSNBC:

When it comes to losing weight, the number of calories you eat, rather than the type of carbohydrates, may be what matters most, according to a new study.

The findings, published in the American Journal of Clinical Nutrition, suggest that diets low in “glycemic load” are no better at taking the pounds off than more traditional — and more carbohydrate-friendly — approaches to calorie-cutting.

We Say: So much for counting carbs. Now we can have our pasta, and have a study to prove it. Then again, it's only a half a cup of pasta, but at least it's better than none. I'll eat pasta over bacon any day personally.

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Raven Comes To the OR

From Daily Tech:

NASA researchers have spent a large amount of time looking into different forms of technology that would allow them to conduct potentially life-saving operations on patients in remote areas. To help, researchers from the University of Washington have been working on a portable robotic surgeon that can allow surgeons to operate while being remotely located miles away. The surgeon -- which researchers named Raven -- will begin testing in May.

We say: Maybe this is turning into Robot Day here at Doc To Doc. A lightweight, and portable mobile robot that can perform surgery could have applications for both space, military, and disaster situations. While I look forward to the day that surgeons can operate from home, I think we're quite a way off from that.

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And More.

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Heart Caterpillar

From BBC News:

A robotic caterpillar has been designed which can crawl across the surface of the heart to deliver treatment.
New Scientist reports a prototype of the HeartLander device, created by US researchers, has been tested on pigs.

The tiny robot, just a few centimetres long, can move at up to 18 centimetres per minute, controlled by "push and pull" wires from outside the body.

The British Heart Foundation said the "caterpillar" could one day be useful, but much more research was needed.

We say: So far this little robot can "only" hook in epicardial pacemaker leads, and inject dye into blood vessels. However, there is a ton of potential here, and one day this could have application into all types of surgery. It would probably require a few of these robots working as a networked team though.

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Chondroitin For Osteoarthritis...NOT!

From the Annals of Internal Medicine:

Frequent knee pain affects about 25% of adults, at least half of whom have osteoarthritis. Persons with knee and other joint pain often take over-the-counter nutritional supplements available in grocery stores, in drug stores, or online for treatment of their joint pain. The most popular supplement is a pill containing a combination of glucosamine and chondroitin. The demand for the chondroitin component of this pill alone constitutes a $1 billion-per-year market in the United States.

The primary pathology of osteoarthritis is loss of hyaline articular cartilage. Chondroitin sulfate, a glycosaminoglycan, is a constituent of a large macromolecule in cartilage called aggrecan. Glycosaminoglycans like chondroitin have a high negative charge. During cartilage compression, the negatively charged glycosaminoglycan molecules are forced into proximity, increasing the electrostatic repulsive force among them. As compression ends, the electrostatic force predominates and they move away from each other, allowing cartilage to reassume its usual thickness. Thus, aggrecan and its constituents—including chondroitin—provide compressive stiffness to cartilage. The concept of ingesting a molecule found in cartilage so that it might be incorporated into cartilage is appealing, but the logic is misleading: Glycosaminoglycans are not synthesized from intact chondroitin molecules; therefore, it is unlikely that ingested chondroitin would be incorporated intact into cartilage.

So much for the naturopathic cure. The article goes on to say that if the patient perceives a benefit, than we as the physician should encourage them to keep taking it for the placebo effect. Serious science there!

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Coco Pills

CHOCOLATE — that traditional antidote for broken hearts — now has another use. Foods rich in cocoa appear to reduce blood pressure, according to researchers at the University Hospital of Cologne in Germany.

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Fill the Script!

From MSNBC.com:

Druggists who believe “morning-after” birth control pills are tantamount to abortion can’t stand in the way of a patient’s right to the drugs, state regulators have decided.

In a unanimous vote Thursday, the state Board of Pharmacy ruled that drug stores have a duty to fill lawful prescriptions despite an individual pharmacist’s personal objections to any particular medication.

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We Say: The last time I checked, the Docs wrote the scripts, and the pharmacists fill them. Why are they reinventing the wheel here? Then again, couldn't the pharmacist with an objection simply not stock a particular medication at their pharmacy?

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Ain't Nothing Like the Real Thing

From MSNBC.com:

Depending on the particular choice, juice can be a good source of important nutrients, including vitamin C, beta-carotene, the B vitamin folate and the mineral potassium. Juice also contains other antioxidants that protect the body. It’s no surprise that when people who eat low amounts of fruit and vegetables add several servings of juice daily, the antioxidants in their body increase, reducing risk of heart disease, cancer and perhaps even age-related eye disease and dementia.

However, studies show that most fruits and vegetables contain antioxidants in the skins and peels, which do not make it into juice. For example, one study reports that a whole orange contains up to five times more of one major antioxidant than a glass of orange juice. The antioxidant is found in the white pulp and membranes that separate the orange segments from each other.

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We Say: So much for "I could have had a V-8!" I think this goes back to the old adage that it is hard to improve on Mother Nature. According to this research, juice is clearly second best.

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Broccoli Or a Beer With Your Next Cigarette: It's Up To You

From IT Wire:

Fruits, dairy products such as cheese and cold milk, vegetables such as broccoli, and non-caffeinated drinks such as water and juices made cigarettes taste worse while alcohol such as beer, caffeinated beverages such as coffee, and various meats increased the desire for tobacco.

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We Say: I guess that's why cigarettes are so common in bars, and not at health food stores.

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DIY Nail-gun Injuries

From ABC News:

There has been a huge spike in the number of consumer nail-gun injuries as more and more do-it-yourselfers arm themselves with the powerful tools.

A study published by the Centers for Disease Control and Prevention shows annual nail-gun injuries to consumers treated in U.S. hospital emergency rooms have soared by about 200 per cent since 1991.

Lead author Dr. Hester Lipscomb says that of 37,000 annual nail-gun injuries, about 40 per cent were among consumers.

We Say: I've seen one that went right into the tibia, and another that went through the sternum, missed the heart, but ended up needing heart-lung bypass to get it out from behind the right pulmonary vein. Seriously, if folks don't know what they're doing, they should just stick with a hammer.

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Hospital 2.0

From Business 2.0 Magazine:

Windowless corridors, drab paint and crowded rooms have typified hospitals for more than a century - and the effect can be downright depressing.

Get ready for a radical shift.

By embracing a new school of thought called evidence-based design, a few pioneering hospitals have shown that more creatively planned facilities can lead to satisfied patients, a happier staff, and a healthier bottom line.

The model for these new medical centers: high-end hotels.

Hey, anything to liven things up and keep the patients satisfied. On the other hand, let these hospitals not complain their reimbursements are being cut...

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Blood Type Conversion

Daily Yomiuri has an interesting breakthrough in blood banking technology:

They say:

Enzymes that can transform red blood cells of type A, B, and AB blood to type O have been developed by an international research team, it was announced Sunday on the online edition of the magazine Nature Biotechnology.

Because type O blood can be transfused to any patient regardless of blood type, it is hoped that someday the new technology can fix the problem of blood shortages caused by a bias of blood types in blood supply.

The surface of red blood cells are covered by sugar chains resembling fine hairs. Blood types are categorized as A, B, and AB, according to the types of sugars that are connected to the end of these chains. Type O blood does not have any sugar connected to the chains

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We say:

This could be a great breakthrough if it works as advertised. With our chronic shortage of blood, it's getting harder and harder to match patient's blood types to donated units of blood. Also, in emergent situations, such as traumas, there never is enough of blood type O, the universal donor available. This enzyme process could fix this big time.

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