Tag Archives: Health Care

Scientific Illiteracy Leaves Many at Risk in Making Health Care Judgements

Scientific literacy is important for many reasons and that importance has increased greatly over the last century. Medical research is often difficult to interpret. Often various studies seem to contradict each other. Often the conclusions that are drawn are far too broad (especially as the research conclusions are passed on and people hear of them overly simplified ways).

Many health care options are not obviously all good, or all bad, but instead a mix of benefits and risks, both of which include interactions with the individuals makeup. So we often see contradictory (and seemingly contradictory) advice. Without a level of scientific literacy it is very difficult for people to know how to react to medical advice.

We have numerous posts on the scientific inquiry process showing that acquiring scientific knowledge is complex and can be quite confusing in many instances. While understanding things are often less clear cut than they are presented it is still true that most often strategies for healthy living have far better practices that will provide far better results than alternatives.

The scientific illiteracy that has some think because their are risks no matter what is done that means there is no evidence some alternatives are far superior is very dangerous. As you can see in action now with those that risk their and others lives and health by doing things like not vaccinating their children, or driving when drunk, or driving when talking on a cell phone.

Without a scientifically literate society even completely obvious measures like not using antibiotics on viral infections are ignored.

Teen diagnoses her own disease in science class

Her doctors, no matter how hard they tried, couldn’t figure out the cause of Jessica’s abdominal distress. Then one day in January, Terry, 18, figured it out on her own.

In her Advanced Placement high school science class, she was looking under the microscope at slides of her own intestinal tissue — slides her pathologist had said were completely normal — and spotted an area of inflamed tissue called a granuloma, a clear indication that she had Crohn’s disease.

“It’s weird I had to solve my own medical problem,” Terry told CNN affiliate KOMO in Seattle, Washington. “There were just no answers anywhere. … I was always sick.”
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Crohn’s disease is often misdiagnosed or diagnosed very late, says Dr. Corey Siegel, director of the Inflammatory Bowel Disease Center at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. “Granulomas are oftentimes very hard to find and not always even present at all,” Siegel said. “I commend Jessica for her meticulous work.”

Surgeon-engineer advances high-tech healing

Catherine Mohr, 40, is herself a rare creature. Part surgeon, part engineer, she designs instruments and procedures for laparoscopic, or minimally invasive, surgery as well as the surgery curriculum at Stanford University School of Medicine.
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The spider – better known as the DaVinci surgical robot – was created by the Sunnyvale company Intuitive Surgical Inc., where her husband, Paul Mohr, is an engineer and she is director of medical research. She designed the special surgical instruments that attach securely to the DaVinci’s strong, wristed arms, and has helped to design the next generation of the robot.

She also designed a procedure for using the robot for gastric-bypass surgery. Her paper on the procedure was published in 2006 in Obesity Surgery, a medical journal. “Someone who needs a gastric bypass has a thick abdominal wall,” Mohr explains. “It can take months for incisions to heal, so you want to do the operation through the smallest incision you can.”

The operation is also ergonomically challenging for the surgeon. “What you’re doing inside is very challenging, and you can’t stand terribly close because these patients are so large,” she says. “It seemed to me that this was something we should do with the robot.”

The surgeon uses controllers to drive the laparoscopic instruments held by the robot, and a screen to view the action. “You don’t cut what you can’t see,” she says.

Influenza Pandemic Alert Raised to Level 5 (of 6)

WHO Director-General, Dr Margaret Chan, announced today that she has “decided to raise the current level of influenza pandemic alert from phase 4 to phase 5.” And she further comments:

Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour. WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.

WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels. All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.

At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production. I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.

The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?

It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.

From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.

No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.

Above all, this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.

As I have said, we do not have all the answers right now, but we will get them.
—- end of her remarks —-
The latest WHO Epidemic and Pandemic Alert and Response release puts the total number of confirmed cases at 148, in 9 countries, with 8 deaths. Mexico has many more suspected cases but just 26 confirmed cases. The CDC Swine Influenza site, puts the total number of confirmed cases in the USA at 91, in 10 states, with 1 death.

Cardiac Cath Lab: Innovation on Site

Photo of John Cooke at the Cardiac Catheterisation Labs at St. Thomas’ hospital in London

I manage several blogs on several topics that are related. Often blog posts stay firmly in the domain of one blog of the other. Occasionally the topic blurs the lines between the various blogs (which I like). This post ties directly to my Curious Cat Management Improvement Blog. The management principles I believe in are very similar to engineering principles (no surprise given this blog). And actual observation in situ is important – to understand fully the situation and what would be helpful. Management relying on reports instead of seeing things in action results in many poor decisions. And engineers doing so also results in poor decisions.

Getting to Gemba – a day in the Cardiac Cath Lab by John Cooke

I firmly believe that it is impossible to innovate effectively without a clear understanding of the context and usage of your final innovation. Ideally, I like to “go to gemba“, otherwise known as the place where the problem exists, so I can dig for tacit knowledge and observe unconscious behaviours.
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I didn’t disgrace myself and I’ve been invited back for another day or so. What did I learn that I didn’t know before? The key things I learnt were:

the guide wire isn’t just a means of steering the catheter into place as I thought. It is a functional tool in it’s own right
Feel is really critical to the cardiologist
There is a huge benefit in speeding up procedures in terms of patient wellbeing and lab efficiency
Current catheter systems lack the level of detection capability and controllability needed for some more complex PCIs (Percutaneous Cardiac Interventions)

The whole experience reminded me that in terms of innovation getting to gemba is critical. When was the last time you saw your products in use up-close and personal?

Scientists Target Bacteria Where They Live

Scientists Learning to Target Bacteria Where They Live

Scientists have learned that bacteria that are vulnerable when floating around as individual cells in what is known as their “planktonic state” are much tougher to combat once they get established in a suitable place — whether the hull of a ship or inside the lungs — and come together in tightly bound biofilms. In that state, they can activate mechanisms like tiny pumps to expel antibiotics, share genes that confer protection against drugs, slow down their metabolism or become dormant, making them harder to kill.

The answer, say researchers, is to find substances that will break up biofilms.
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Melander said “a throwaway sentence in an obscure journal” — the Bulletin of the Chemical Society of Japan — gave them another clue. They isolated a compound from the sponge that disperses biofilms and figured out how to synthesize it quickly and cheaply.
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But dispersing biofilms without understanding all the ramifications could be a “double-edged sword,” Romeo warned, because some bacteria in a biofilm could wreak worse havoc once they disperse.

“Simply inducing biofilm dispersion without understanding exactly how it will impact the bacterium and host could be very dangerous, as it might lead to spread of a more damaging acute infection,” he said.

Monoclonal Antibodies Found That Stop All Flu Types

Universal Flu Drug Stops All Flu Types

A new kind of drug cocktail kills all types of flu bugs and could protect against pandemic or seasonal flu. “I certainly believe that a therapy for all kinds of influenza may be within our grasp,” study researcher Robert Liddington, DPhil, director of infectious diseases at the Burnham Institute in La Jolla, Calif., said at a news conference announcing the finding.

The treatment is based on new monoclonal antibodies that attack flu viruses in a shared Achilles heel. Of the many different subtypes of flu, there are only two basic patterns for this vulnerable, essential part of the flu virus.

And despite heroic efforts, researchers could not breed a flu strain resistant to the treatment — suggesting that there’s only a very small chance that mutated viruses could render the treatment obsolete. The breakthrough finding is a joint effort from labs at the Burnham Institute; Dana-Farber Cancer Institute in Boston; and the CDC in Atlanta.

Like many breakthroughs, the finding was partly accidental. The researchers were, at first, trying only to create a treatment to stop the H5N1 bird flu virus, the most likely candidate for igniting the next worldwide flu pandemic.
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While monoclonal antibodies against flu are new, a wide range of drugs are based on this technology. That means the new, fully human anti-flu antibodies could become new human drugs relatively quickly…

“We hope these antibodies are in clinical trials during the 2011-2012 flu season — maybe earlier,” Marasco said. “This really is an important advance in the field of antiviral therapy. The possibility of having a universal therapy for flu is made more real and possible because of these discoveries.”

High School Inventor Teams @ MIT

Sadly MIT deleted the video after having it live for several years.

Lemelson-MIT InvenTeams is a national grants initiative of the Lemelson-MIT Program to foster inventiveness among high school students. The webcast above shows a high school team presenting a project they completed to create a solution to provide clean water. This stuff is great. I love appropriate technology. I love seeing kids think and create effective solutions to real problems. This is how you get kids to learn – not boring classes (at least kids like me).

The students are passing on the project to students at their school to continue to work on. (MIT TechTV used to have many more presentation by other InvenTeams – not anymore 🙁 ) InvenTeams and MIT deserve a great deal of credit for creating such great learning opportunities and great solutions for the world.

InvenTeams composed of high school students, teachers and mentors are asked to collaboratively identify a problem that they want to solve, research the problem, and then develop a prototype invention as an in-class or extracurricular project. Grants of up to $10,000 support each team’s efforts. InvenTeams are encouraged to work with community partners, specifically the potential beneficiaries of their invention.

One Sneeze, 150 Colds for Commuters

One sneeze, 150 colds for commuters

An analysis of the germs unleashed from a single commuter’s sneeze showed that within minutes they are being passed on via escalator handrails or seats on trains and underground carriages. At the busiest stations, one sneeze not smothered by a tissue or handkerchief will provide enough germs to infect another 150 commuters.
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A single sneeze expels 100,000 droplets of germs into the air at 90mph. Individual droplets get transferred to handles, rails and other areas frequently held or touched. Up to 10 per cent of all commuters will come into contact with an area infected by that one sneeze, Dr Henderson calculated.
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Researchers asked 1,300 workers about their health and found 99 per cent of commuters suffered at least one cold last winter. In contrast, just 58 per cent of those who work from home and 88 per cent of those who walk to work regularly caught a cold last winter.

It is amazing (or maybe not but I find it amazing) how well cold viruses have evolved to have us sneeze and send out personal virus jet packs to spread them all over and let them infect others. It is sad how impolite some people are as they go around potentially infecting hundreds of other people. Partially their ignorance of basic science may also be to blame for their behavior. It is too bad others have to suffer due to their bad manners and ignorance.

How Cells Age

A new study by Harvard Medical School researchers reveals that the biochemical mechanism that makes yeast grow old has a surprising parallel in mice, suggesting it may be a universal cause of aging in all organisms.
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In young organisms, SIRT1 effectively doubles as a gene-expression regulator and a DNA repairer. But when DNA damage accumulates—as it does with age—SIRT1 becomes too busy fixing broken DNA to keep the expression of hundreds of genes in check. This process is so similar to what happens in aging yeast that its discoverers believe it may represent a universal mechanism of aging.

Harvard researchers gain new insight into aging

Aging may be a case of neglect — an absentee landlord at the cellular level that allows gene activity to go awry, according to a study published today.

Scientists have long known that aging causes gene expression to change, and DNA damage to accumulate. But now, research led by Harvard Medical School scientists explains the connection between the two processes in mammals.

The paper, published in the journal Cell, found that a multi-tasking protein called SIRT1 that normally acts as guardian of the genome gets dragged away to DNA fix-it jobs. When the protein abandons its normal post to work as a genetic handyman, order unravels elsewhere in the cell. Genes that are normally under its careful watch begin to flip on.

“What this paper actually implies is that aspects of aging may be reversible,” said David Sinclair, a Harvard Medical School biologist who led the research. “It sounds crazy, but in principle it should be possible to restore the youthful set of genes, the patterns that are on and off.”

The study is just the latest to draw yet more attention to sirtuins, proteins involved in the aging process

Aging is fascinating. By and large people just accept it. We see it happen to those all around us, without exception. But what causes biological aging? It is an interesting area of research.