From Our Contributors
For days, even weeks, he had been relentlessly asking anyone who would listen to help reposition him in his bed. Move him up. No, turn him more to the left. Wait, lift the right leg higher, lower. It was non-stop. The nurse tried to do her best, but could only shake her head, because he was never content.
To be fair, he did look very uncomfortable all the time, but we didn’t know how to make him feel better; until one day, we didn’t have to worry any more.
Let’s rewind the clock.
I didn’t know this patient very well, because I wasn’t his assigned physician, although I did round on him every morning with my team. What I knew was that he was very, very sick. Only in his forties, he was missing one leg from an amputation at age fourteen due to osteosarcoma, a type of bone cancer found in the pediatric population. On top of that, he suffered from diabetes and hypertension, two diseases so common in my patient population that we call them part of the “Lincoln package,” Lincoln being the name of the hospital where I work.
Less than one year ago, our patient had trouble passing urine, and was diagnosed with metastatic prostate cancer. The disease had already spread to his vertebral column, compressing his spinal cord, requiring surgery to relieve his excruciating pain.
When I saw him, he was cachexic, a syndrome characterized by extreme weight loss, weakness and muscle atrophy, all hallmarks of someone suffering from advanced cancer. The oncologists had already done everything they could; they had used their whole armamentarium of chemotherapeutic drugs including casodex, zometa, and taxotere, as well as radiation. There was no improvement. Not that I know much about cancer treatment, but apparently, all the big guns had already been tried. Read more
The 25-year controversy involving BPA in food packaging won’t go away. It continues to hang ominously like a black cloud over the food industry.
Bisphenol A, more commonly known as BPA, is a chemical used primarily in the production of polycarbonate plastic and epoxy resins. The polycarbonate is used in food contact materials such as food containers and processing equipment. Epoxy resins are used in protective linings for a variety of canned foods and beverages, including infant formula.
Over the years Health Canada (HC) conducted periodic reviews of BPA to determine whether dietary exposure to it could pose a health risk to consumers. Based on the overall weight of evidence, including reaffirmation by other international regulatory agencies (notably the U.S., Europe and Japan), HC’s Food Directorate has concluded again unequivocally that the current dietary exposure to BPA through food packaging uses is not expected to pose a health risk to the general population, including newborns and infants. In response to growing consumer concern, HC hosted a huge expert meeting in November 2010 in collaboration with several national regulatory authorities and international bodies such as the World Health Organization (WHO) and the Food and Agricultural Organization of the United Nations (FAO) to review the current science. The clear conclusion of this expert meeting confirmed th at BPA was safe for food packaging. Moreover, HC has continued to do a number of studies, reports and surveys, all of which are posted online. HC has made a real effort to make the science available to the lay public and to try to interpret it in ways that the ordinary consumer can understand. HC’s study of BPA levels in canned drinks, for example, notes that a person would have to consume 940 canned drinks in one day to reach the tolerable daily intake.Read more
Moore’s Law is a well-known trend in the computing industry, which suggests that hardware capabilities double every two years. Until recently, genome sequencing costs were following about the same pattern as Moore’s Law, decreasing at a steady rate. In 2008, however, a shift occurred, and the cost of DNA sequencing became dramatically lower than what Moore’s Law would have predicted, making sequencing DNA much more affordable and accessible.
This accessibility is likely due to a surge of new companies that are involved in genetic sequencing. It seems like everyone and their dog is doing it (just wait for it). One of the more striking of these new companies is PooPrints, based out of Knoxville, Tennessee. The mandate of PooPrints is to help you catch the nasty neighbors who are leaving dog poop around your community by sequencing the DNA of any stray feces.
The company supplies property managers and homeowners’ associations with DNA oral swab kits, which are then submitted to the global pet registry. When property managers find poop lying around, they use the analogous test kit to gather a sample, which can be sent to the BioPet Vet Lab to match the DNA to the culprit in the pet registry system. PooPrints returns their findings to the property managers, who can use the information to fine or otherwise publically humiliate careless owners.Read more
Michael Douglas is currently trying to backtrack on statements made during an interview with The Guardian, where he discounted his history of smoking and excessive alcohol consumption as contributing factors for his cancer. When asked about his cancer, Douglas replied, “without wanting to get too specific, this particular cancer is caused by HPV (human papillomavirus), which actually comes from cunnilingus.” The issue with this statement isn’t linking HPV to throat cancers; rather, it is pinpointing cause. Although there is a correlation between HPV and some forms of throat cancer, it should be made clear that pinpointing a definitive singular cause is impossible.
HPV enters into epithelial cells (cells that line human extremities and cavities, including the walls of our throats, genitals, and anus), where it begins to make proteins that affect cell cycle regulation. Cell cycle regulation helps to determine the growth and division of the cell. Cells that are infected by HPV have their cell cycles manipulated, which can put them at an advantage for growth compared to other cells. This seems great, but it is really the root of all cancers. Too much growth is bad, and these viruses enable rapid growth which can cause major problems when unrecognized by our immune systems. As these HPV infected cells continue to grow and divide, smoking would only exacerbate the problem, potentially causing mutations that also affect the cell cycle. All things considered, identifying a cause of cancer is incredibly difficult and part of the reason why cancer research is so complex. Increased exposure to carcinogens certainly doesn’t help and could potentially lead to mutations that cause even greater cell proliferation and tumours.Read more
It may be difficult for some to picture a time where advice given by many of the foremost thinkers in nutrition was as simple as a catch phrase. Admittedly, much of the council our Victorian ancestors received is now easily dismissed. “Guinness is good for you”, the aphorism that revolted Gordon Comstock by its inanity in Orwell’s Keep the Aspidistra Flying is now a relic of the time of the advertising firm. One of my personal favourites from the era of Victoria and Dickens comes from an American fellow by the name of Horace Fletcher.
Known by his followers as The Great Masticator, Fletcher advocated a peculiar dietary regimen. To put it tersely, “Nature will castigate those who don’t masticate.” And those Fletcherizers, who in their homes, or at restaurants, day and night, chewed each and every piece of their meal thirty-two times before swallowing; every piece of steak, chunk of potato, spoonful of soup, or swig of wine (indeed, he advocated that liquids receive the same treatment) believed that this had a direct and positive effect on their health. Understandably, the man probably saved several people from choking to death, but one must ask, “at what cost?”
If any of you have by chance, unsuspectingly popped a faulty piece of chewing gum into your mouths, perhaps from a batch that had the ingredients mixed in the wrong proportions, you may remember the feeling of revulsion that slowly crept over you, as the once materially sound and robust stick began to lose its integrity and crumble into an abject slurry of grainy material sloshing around, sticking to your teeth, forcing you to void the contents of your mouth in a substantial loogie. This, I can only suspect, must be the feeling that comes over a man when Fletcherizing his meal. Since musing on the subject can only take you so far, I decided to try fletcherizing my meals for a day.Read more
As we stepped out of the front door at 06.15 this morning, a few raindrops were starting to fall. The entire sky was aglow with an orange-brown hue. Turning to the west, we were startled by the dramatic sight of a bright, very colourful rainbow stretching over 100 degrees of sky.
We know that rainbows are caused by the reflection and refraction of light rays from the Sun through circular drops of water that are suspended in or falling through the atmosphere. The required conditions are (i) early morning or late afternoon, so that the Sun is low in the sky - no more than about 30 degrees elevation above the horizon - (ii) an approaching or departing rainstorm, and (iii) a sharp demarcation between the storm and the sky conditions that precede or follow it, so that there is a clear path between the Sun and the water droplets in the air.Read more
There are a few standard questions we ask our patients in order to assess their mental status. Sometimes patients come in confused, either because they have baseline dementia from old age, are hypoglycemic (low serum glucose or sugar level), have had a stroke, or perhaps are acutely intoxicated with alcohol or drugs. The differential diagnoses for “altered mental status”, which doctors like to shorten to AMS, or confusion, are vast.
First, we want to know if the patient is awake, versus drowsy, or obtunded. Then we qualify the patient’s responsiveness. Is the patient responsive to verbal stimuli? Will they respond to their name? Or do they react only to noxious stimuli, such as inflicting pain by say rubbing their sternum.
Once a patient is responsive, you want to assess their level of orientation. Here come the questions. The quickest way to assess orientation is by asking three simple questions: What is your full name and date of birth? Read more
You have to be careful what you read these days. With the plethora of social media platforms infiltrating our screens (wherever they may be) and the ability to do a simple one-click and get all the information you need, applying a critical eye has never been so – well, critical.
One of the most influential sources of news these days is not that of traditional media sources, but rather those that can be found in the blogosphere. Manufacturers of products depend on bloggers to test and review their products just as much as consumers of such products go to these same bloggers for reviews. But where do these lines get mirky? How do we know where credibility lies and nonsense rears its ugly head? Which sources are legitimate and which are, to say the least, totally full of it?
Let’s take the The Onion, for example, an online daily publication that covers world, national and local issues. Unlike other popular online news sources, The Onion is a satirical news forum, entertaining its readers with a variety of stories poking fun of daily news events, both real and fictional. The Onion has garnered quite the following since its 2007 inception and it is widely known for its work. Following in the steps of its popularity, other satirical news outlets have also sprouted. The problem with this, however, is that these sources are not as widely known and consequently, can be taken totally out of context. (At least initially, until the reader realizes that they’ve basically been “punked.”)Read more
Behind every bad mood, sad emotion or untimely face pimple, is a hormone. Hormones are what Simon Cowell is to the American Idol contestant, what The Joker is to Batman, and what Biff Tannen is to Marty McFly. Hormones are bullies who always seem to have it in for us. Nobody likes a bully, but we always forget that they are central characters that play very important roles. Without Biff Tannen, Marty McFly would never have become a hero, and as much as nobody likes Simon Cowell, he efficiently weeds out the good singers from the ones who should stick to their day jobs. Similarly, hormones play a critical role in keeping our bodies running smoothly.
Hormones are part of what is called the endocrine system, a complex network of cells that work together to regulate a wide variety of our bodily functions such as our hunger, growth, and reproduction. When a cell in one part of the body needs to communicate with a cell in another part of the body, it releases a hormone. This hormone will travel through the bloodstream from one cell to the other, relaying information and stimulating certain types of cellular activity. It’s kind of like a smoke signal except instead of using smoke from a fire, to communicate a message, the body uses hormones. For example, when a person gets frightened the cells in the adrenal glands sound the alarm by releasing a hormone called epinephrine which travels to other cells in the body and stimulates the "fight or flight" response.
Sometimes, I feel like my life comes straight out of a movie.Imagine this opening scene: A young woman who appears to be in her late teens to early twenties hails a passing ambulance in the middle of the night, says she has done cocaine for the first time and isn’t feeling well. She then has a seizure and collapses. The EMS (Emergency Medicine Services) transports her to the closest Emergency Department (ED), which happens to be Lincoln Medical Center where I work. Upon arrival to the ED, the patient had another seizure before going into cardiac arrest. It took the emergency team seven attempts to shock her heart back to a detectable and regular rhythm, after which the now unconscious and intubated (a tube was inserted into her airway and connected to a ventilator to breathe for her) girl was transported up with all her tubes and ventilator to the Medical Intensive Care Unit (MICU) where I was assigned to be one of her doctors. Read more
The report by Consumer Reports is a compelling look at the quantities of arsenic found in various types of rice and rice products that they tested. Arsenic is found naturally all over the world in soil. Some plants happen to take up more arsenic than others and that’s how arsenic ends up in certain foods, such as rice. The truth is that arsenic being found in rice is not really something new. In fact, the U.S. Food and Drug Administration (FDA) and U.S. Environmental Protection Agency (EPA) have been monitoring arsenic in rice for over 20 years. The new report by Consumer Reports has got the attention of the FDA and in response they are currently undertaking a wide-scale survey of over 1,000 samples of rice to verify the findings. The most recent FDA statement claims that it is premature for adults and children to modify their diets and completely avoid rice due to potential levels of arsenic.
In terms of feeding your infant rice cereals and rice products, the American Academy of Pediatrics recommends “offering children a variety of foods, including products made from oats and wheat, [to] decrease children’s exposure to arsenic derived from rice”. Should one be concerned? Read more
On September 13th 2012 the Colombian Police confiscated over 1 million dollars in merchandise from the FARC guerrilla, in a historic operation. What made it a first in history was not the value of the seized goods, or the amount of material found, but rather the nature of what they discovered, as it did not turn out to be any sort of narcotic. Instead the police forces found 17 tonnes of greyish, dull looking rocks. Why would lumps of dust and stone be as or more profitable than illegal drugs, which the FARC have historically used to finance themselves? The answer, quite literally, lies at the tip of my fingers, in the computer I’m using to write this article.Read more