MetaFilter posts tagged with health and Medicine

The Science of Optimizing Your Health

Foci for Analysis — Fri, 10 May 2013 23:31:59 -0800

An in-depth talk at Google that sums up the scientific research on living a healthy life with lots of practical advice.

Not So Evergreen

vidur — Mon, 01 Apr 2013 12:26:21 -0800

"India's supreme court has ruled against Swiss drug giant Novartis in a landmark case that activists say will protect access to cheap generic drugs in developing nations." "Glivec sells in developed nations for more than $3,000 for a month's worth of treatment, but a generic version is sold in India for less than $200." "The Indian Patent Office in 2006 denied a patent to Novartis, a decision upheld by the Indian Intellectual Property Appellate Board. The board cited a provision of Indian law that aims to prevent “evergreening,” in which companies make an incremental change to a drug’s chemical makeup, without any real medical benefit, to extend its patent life and prevent the introduction of low-cost generic copies." Novartis says it will stop investing in R&D in India.

We are powerless buyers in a sellers’ market

zarq — Thu, 21 Feb 2013 08:12:48 -0800

Bitter Pill: Why Medical Bills Are Killing Us. Summary: Inside the Cover Story. Related video: The Exorbitant Prices of Health Care Time is soliciting reader stories about their experience with the high cost of US healthcare. CNN has been investigating the story with the magazine. Comments on the article.

A Cardiac Conundrum

latkes — Mon, 18 Feb 2013 08:05:32 -0800

“The gap between what patients and doctors expect from these procedures, and the benefit that they actually provide, shows the profound impact of a certain kind of mechanical logic in medicine,” he explains. “Even though doctors value randomized clinical trials and evidence-based medicine, they are powerfully influenced by ideas about how diseases and treatments work. If doctors think a treatment should work, they come to believe that it does work, even when the clinical evidence isn’t there.” Related: a recent Radiolab explores the "huge gap between what patients expect from life-saving interventions (such as CPR, ventilation, and feeding tubes), and what doctors think of these very same procedures".

RN Library, a library of nurses' practical tips

nickyskye — Thu, 07 Feb 2013 11:46:17 -0800

100 Really, REALLY Useful Web Sites for Nurses | 100 Educational Twitter Feeds for Med Students | What Really Happens on a Hospital Night Shift? | 10 Hotel Health Traps You Should Really Beware Of |The ABCs of Vitamins and much more.

"Medicine is a very religious experience"

hat_eater — Mon, 28 Jan 2013 17:47:50 -0800

The New Yorker's take on Dr Mehmet Oz.

Undue Burden

zarq — Thu, 03 Jan 2013 10:31:43 -0800

Jennie Linn McCormack "isn’t the only woman in recent years to be prosecuted for ending her own pregnancy. But her case could change the trajectory of abortion law in the United States": The Rise of DIY Abortions. Single page version of the New Republic article (triggers print queue) Background A week after her at-home abortion, Jennie Linn McCormack was arrested. "McCormack ran afoul of a 1972 Idaho law that makes it a felony for a woman to perform her own abortion" (in a manner not sanctioned by the state.) "Not only does the law pre-date Roe v. Wade, it pre-dates RU-486." Her case was dismissed. The court ruled there was no way to enforce a law which forbids women from inducing their own pregnancies. McCormack then appealed the decision, claiming the law itself was unconstitutional. This past September, the US Court of Appeals Ninth District agreed. The decision is here (pdf). An interesting read. From the New Republic article, above: "Written by Democratic appointee Judge Harry Pregerson, the ruling describes in detail the difficulty poor women experience in obtaining an abortion in Idaho. These restrictions, he argued, essentially outlawed the procedure for them, potentially violating the “undue burden” test sometimes invoked by the Supreme Court. He maintained that, since it was so hard for McCormack to obtain a legal abortion, it was unjust to charge her for having an illegal one."
McCormack's lawyer then filed a motion "that, if successful, would halt prosecutions of all women and doctors in Idaho for illegal abortion, and overturn the pain-capable law." The case has been heard. A decision is pending. Editorial from one of the experts called by McCormack's lawyer in New York Times Opinionator: Can Neuroscience Challenge Roe V. Wade?

Body.next() { Some Assembly Required }

Foci for Analysis — Sat, 15 Dec 2012 03:11:55 -0800

Feeling a little bit worn? Need to upgrade your body? We've been doing it for a long time. An overview of more recent advances (PDF) and a near-future timeline. Check out Upgrade Your Body's catalog of artificial eyes, exoskeletons, hearts (more hearts!), cryonic solutions, augmented reality products, bone repairing, implantable sensors, and more. Why not hack your medical devices or get your own printed prosthetics while you're at it. FPP background music: Deus Ex, Deus Ex: Human Revolution, System Shock 2, Syndicate, Shadowrun

291 diseases and injuries + 67 risk factors + 1,160 non-fatal complications = 650 million estimates of how we age, sicken, and die

hat — Fri, 14 Dec 2012 11:08:08 -0800

As humans live longer, what ails us isn't necessarily what kills us: five data visualizations of how we age, sicken, and die. Causes of death by age, sex, region, and year. Heat map of leading causes and risks by region. Changes in leading causes and risks between 1990 and 2010. Healthy years lost to disability vs. life expectancy in 1990 and 2010. Uncertainties of causes and risks. From the team for the massive Institute for Health Metrics and Evaluation Global Burden of Diseases, Injuries, and Risk Factors Study 2010. The data visualizations page also includes a large number of static figures from the GBD 2010 study. The GBD 2010 team at the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, "spent almost 5 years building [the database of causes of death]; we have included almost 800 million deaths from 1950 to 2010, and the data come from different sources," resulting in "the biggest database for cause of death analysis in the world," according to Rafael Lozano at the University of Washington. The GBD 2010 includes:

291 diseases and injuries
67 risk factors
1,160 sequelae (nonfatal health consequences)
Estimates for 21 regions
Estimates for 20 age groups

Takeaway points from the press release (emphasis mine):

Child mortality has dropped by more than 60%, falling "so quickly that it has beaten every published prediction," though diarrhea and other infectious diseases still kill well over a million children under the age of 5 every year.
Deaths among adults aged 15 to 49 increased by 44% between 1970 and 2010, "in part because of increases in violence and the ongoing challenge of HIV/AIDS."
Undernutrition has "successfully been cut by two-thirds," and now physical inactivity and macronutrient overnutrition contribute to a 10%-and-rising fraction of the disease burden.

However,

The trends identified in GBD 2010 occur across regions with one notable exception: sub-Saharan Africa, where infectious diseases, childhood illnesses, and maternal causes of death account for as much as 70% of the burden of disease. By comparison, these conditions account for only one-third of the burden in south Asia and Oceania, and less than 20% in all other regions.

Research findings from the main publication summary (emphasis mine):

In 2010, the three leading risk factors for global disease burden were high blood pressure [...]; followed by tobacco smoking, including secondhand smoke [...]; and alcohol use [...] This reflects a substantial change from 1990 when the leading risk factors were childhood underweight [...]; followed by household air pollution from use of solid fuels [...]; and tobacco smoking, including secondhand smoke [...].
Regional differences are significant. While much of the world is burdened by obesity and high body mass index, underweight is still the leading risk factor in sub‐Saharan Africa. Other prevalent risk factors in the region include household air pollution and nonexclusive and discontinued breastfeeding.
Although child undernutrition has fallen significantly as a risk factor for all ages, it remained the leading risk factor worldwide in 2010 for children under 5, accounting for 12.4% of global DALYs [disability‐adjusted life years], followed by nonexclusive or discontinued breastfeeding at 7.6%.
A number of risks that primarily affect childhood communicable diseases, including unsafe water and sanitation and micronutrient deficiencies, declined in significance in the past 20 years, with unsafe water and sanitation accounting for only 0.9% of global DALYs in 2010.
At the same time, GBD 2010 findings show the importance of household air pollution from solid fuels and ambient particulate matter pollution as major risk factors. One or both rank in the top 10 as causes of disease burden in 13 of the 21 regions. In south Asia, they are the leading cause of burden.

From the Guardian's reporting (more: 1, 2, 3):

Since 1970 the largest gains in life expectancy have taken place in the Maldives (27.3 years for men and 29.4 years for women) and improvements in life expectancy at birth in excess of 20 years were recorded in Bangladesh, Bhutan, Iran, and Peru. But life expectancy fell by one to seven years in Zimbabwe and Lesotho, where populations were severely affected by HIV/Aids, and for men in Ukraine and Belarus, where an alcohol crisis took hold.

If you'd like to read the papers themselves, the full text is currently available for free (but registration required) at The Lancet. In addition to the data visualizations, the IHME provides GBD 2010 publication summaries: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Age‐specific and sex‐specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010

Years lived with disability (YLDs) for 1,160 sequelae of 289 diseases and injuries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Disability‐adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010
Each of the data visualizations again:

Causes of death by age, sex, region, and year
Heat map of leading causes and risks by region
Changes in leading causes and risks between 1990 and 2010
Healthy years lost to disability vs. life expectancy in 1990 and 2010
Uncertainties of causes and risks

The Institute for Health Metrics and Evaluation adds,

The findings are being announced at the Royal Society in London on Dec. 14 and published in The Lancet, the first time the journal has dedicated an entire triple issue to one study.

The Lancet includes The story of GBD 2010: a “super-human” effort:

“Running the programs to map the data to our cause list of 291 causes and correcting the bias can take days, even using a powerful cluster of more than 100 computers. The data that we have to store after the modelling process can take 3 terabytes.” [Rafael] Lozano estimates that the storage needed for the causes of death data was 400 times bigger than that for GBD 1990 [...] Majid Ezzati, chair in global and environmental health at the School of Public Health, Imperial College London, UK, told The Lancet, As researchers, we tend to believe that more ‘data’ are better than less. I still believe so. But more data, but not all the perfect data we could wish for, means that we need to fundamentally think differently about when to stop searching for more and how to use it [...] The study brought out the well-known but far too frequently overlooked issue that people of different scientific traditions—clinicians, basic scientists, epidemiologists, and quantitative scientists—think and speak differently about the same problem. This can of course be a very powerful resource for bringing together different ways of looking at a problem and solving in the most comprehensive and interesting way—a true systems approach. It can also be a challenge, and at times a source of tension.

(Previously on the Institute for Health Metrics and Evaluation: Is there a market for years?)

.

zarq — Fri, 07 Dec 2012 15:13:56 -0800

On November 30, the Tampa Bay Times published a sympathetic profile of Spring Hill, FL resident Gretchen Molannen: "Persistent genital arousal disorder brings woman agony, not ecstasy." Her condition, also known as PGAD, is a rare sexual disorder (not recognized by the DSM,) 'characterized by spontaneous, persistent, unwanted sexual arousal unrelated to feelings of sexual desire.' The Times reported that Ms. Molannen's condition had virtually destroyed her personal and professional life and led to several suicide attempts. One day after the article was published, she successfully committed suicide. The first link in this post describes Ms. Molannen's suicide attempts, which some may find disturbing. CBS News: Gretchen Molannen's suicide spotlights debilitating effects of persistent genital arousal disorder. Ms. Molannen was able to identify her condition after watching a 20/20 report several years ago. The second Tampa Bay article mentions an online PGAD support group. and gives an timeline of the newspaper's involvement: Molannen agreed to tell her story in July. The Times interviewed her for a total of 10 hours, about half in person and half on the phone. In August, she went before a disability judge for a second time. He later rejected Molannen's disability claim and she gave that rejection letter to the Times. Last week, after the story had been written and edited but before it was published, it was read to Molannen word for word. Several small details were removed at her request. Before publication, the Times thanked her over the phone and in an email for her help. She replied by email on Nov. 28:
"Thank YOU for taking an interest in doing a story for me! I am flattered that you cared so much to want to help. I just hope this will educate people that this is serious and really exists, and that other women who are suffering in silence will now have the courage to talk to a doctor about it. If men have suffered with the shame of impotence or even priapism, now it's time for women to get help as well. Thank you for your patience with me and for devoting so much time to this. I'm sure your editor is very proud of your work and I'm excited to see my own story online."
The Times tried to reach Molannen over the weekend by text, phone and email to see how she was doing. She did not respond. On Monday, her boyfriend sent the Times an email, saying she had committed suicide and the story "won't help her now."

Pyridomycin: nature's isoniazid

Blazecock Pileon — Fri, 21 Sep 2012 02:52:35 -0800

Drug-resistant and "extensively" resistant strains make containment and treatment of tuberculosis ever more difficult. Fortunately, researchers based in Switzerland have (re-)discovered a naturally-made antibiotic called pyridomycin, which will kill isoniazid-resistant M. tuberculosis bacteria.

Vidoes on Health and Medicine

ferdydurke — Sat, 08 Sep 2012 15:52:35 -0800

The Medical School at the University of California, San Francisco “presents Mini Medical School for the Public, a series of programs providing an opportunity to learn about health and the health sciences directly from UCSF faculty members and other nationally-recognized experts.” Videos particularly geared toward integrative medicine and healthy living can be found here. (Most of the videos are between sixty and ninety minutes long.) There are hundreds of hours of videos, which may feel overwhelming to some. Two videos, available through youtube, but apparently not through the UCTV site linked above, particularly impressed me, though I’m sure others I haven’t viewed are as good or better. (1) Martin Rossman’s video, Worrying Well: How Your brain Can Turn Anxiety and Stress into Calmness and Confidence, uses mindfulness, guided imagery and other techniques to help prevent the self-defeating and destructive effects of worry, anxiety and stress. For those interested in trying a guided imagery exercise about an hour and five minutes into the talk, click here. (2) Rachel Naomi Remen, a Clinical Professor of Family and Community Medicine at UCSF, has worked for 25 years as a therapist to people with cancer. In her video, The Art of Living Every Minute of Your Life, she discusses how people in crisis, particularly those suffering from cancer, create meaning through the stories they tell. There are many, many videos on more traditional topics of medicine. For example, a control-f search for Alzheimer’s disease and related terms brings up the following: Updates in the diagnosis and treatment of Alzheimer’s disease. Approaches to caregiving. Preventing dementia, fact and fiction. Frontiers in the biology of Alzheimer’s disease and other dementias. Alzheimer’s disease and frontotemporal dementia. Healthy aging of the brain to mild cognitive impairment. Other topics include ADHD, Diabetes, menopause, depression, cancer, heart disease and so on.

The Cheesecake Factory as a model for the American health care system

Egg Shen — Mon, 06 Aug 2012 19:24:34 -0800

A new model for the American health care system: The Cheesecake Factory

SCIENCE!

wilful — Thu, 19 Jul 2012 18:33:21 -0800

Friends of Science in Medicine (FSM) is a new advocacy group of senior medical practitioners and researchers seeking to drive "complementary and alternative medicines" from universities around Australia, and to make non-evidence based therapies ineligible for private health insurance. Naturally, this has caused a fair degree of outrage and pushback from the CAM sector.

The future of medicine, as seen in 1987

escabeche — Fri, 25 May 2012 08:55:37 -0800

"Fairly predictive tests for Alzheimer's disease, schizophrenia, depression, some malignancies, heart disease, and most of the rest of the major killers and disablers will probably be in place by 2000 to 2010. Many if not most of these ailments will be assessable in terms of a very sophisticated genetic risk profile which it will be possible to generate in infancy or childhood (or in utero)." In 1987, cryonics advocate Mike Darwin wrote about the next twenty years of medicine.

A Coordinated Assault on Women?

bardic — Tue, 24 Apr 2012 01:22:55 -0800

In the wake of so many recent controversies over women and their right to safe, affordable health care and the supposed desire of working women to be "put in their place" by aggressive men in the bedroom, Penny Red suggests that "Right now, we are in the middle of a sexual counter-revolution." Recently Katie Roiphe wrote that the unexpected popularity of 50 Shades of Gray means that for all their advances in the workplace, women secretly want to be spanked and dominated by men. (Many on the internet LOL'd heartily.) Presidential candidate Rick Santorum had no shortage of comments regarding the evils of birth control and how they are "harmful to women." Meanwhile, members of the Catholic hierarchy are freaking out that in the 21st century, safe, affordable birth control is considered by an overwhelming majority to be an essential part of any woman's health care. And oh yeah, let's not forget Republican mouth-piece Rush Limbaugh's sensitivity to feminine issues. As we move further into the 21st century, are women's rights being left behind?

The French breast implant scandal

zarq — Sat, 18 Feb 2012 19:19:30 -0800

In March 2010, a pair of health inspectors responding to multiple tips paid a three-day visit to the factory headquarters of the Poly Implant Prothese (PIP) company, a leading international maker of breast implants. On their second day, the inspectors found something odd: six discarded plastic containers of Silopren, a liquid silicone designed for industrial, not medical use, lined up along the outside wall of the production site. The lead inspector estimated they had contained nearly 9 tons of liquid silicone. It now appears as if between 300,000 and 400,000 women throughout the world may have received potentially toxic, faulty breast implants containing ingredients never clinically tested on humans, manufactured and distributed by a company that knowingly deceived regulators, suppliers, distributors, medical professionals and ultimately, patients. Reuters photographer's Blog: Operating on an implant scandal. (Last link NSFW, graphic images that contain nudity.) PIP also sold chest and testicle implants for men which used the same non-medical, industrial grade silicone. Coverage from CNN, The Guardian. On February 7, 2012, BBC's Newsnight program featured a Q&A between 25 women who had been implanted with PIP breast implants and Anne Milton, a health minister for the UK coalition government. Evidence had apparently been available that PIP implants were likely defective for several years, yet the NHS had chosen not to inform patients of potential warnings. Milton stated, "The evidence to date is that they [PIP implants] are not [dangerous]." Response editorial by Naomi Wolf. There have been multiple demonstrations in London. Wikipedia's page on the company has a decent breakdown of the continuing aftermath of the scandal.

"Please state the nature of the medical emergency."

zarq — Thu, 02 Feb 2012 07:27:13 -0800

Qualcomm and the X Prize Foundation have launched a new contest: Envision and build the equivalent of Star Trek's medical tricorder, a portable health monitoring device that can remotely diagnose patients. The winner will receive $10 million. Competition details / FAQ / press release (from last May) More coverage from Forbes, bit-tech, neurologica blog. Tricorders: previously on mefi. (Link in latter post is broken. See here and here for details.)

A nation full of immortal poor people.

zarq — Wed, 25 Jan 2012 13:39:19 -0800

In 2002, Doug Monroe placed his parents in assisted living. A decade later, he's looking back at "the weighty financial and emotional costs that come with a parent's immortality": The Long Goodbye.

The pain is killing me

hat_eater — Sun, 27 Nov 2011 11:19:29 -0800

Even a little too much Tylenol over a few days can cause a liver failure. Paracetamol or acetaminophen, active ingredient of such over-the-counter painkillers as Tylenol, Panadol, Anacin-3 and many, many others, is considered safe - and it is, in prescribed doses. But even a single overdose can lead to liver failure despite treatment, and then only a liver transplant can avert a fatal outcome. In light of this, according to the recommendations of the FDA some manufacturers are reducing the dosage, as discussed previously. But now a study (abstract, pdf) published in British Journal of Clinical Pharmacology has found a higher mortality (37%) among patients with so called "staggered overdose" of paracetamol (on average 24 grams over three days) than among those who took one huge dose (28% mortality, on average 27 grams, or 54 Extra Strength Tylenols, 500 mg each). To ingest 24 grams in three days one still has to overdose heavily (16 extra strength pills per day, 10 over the limit), but "staggered overdose" cases are defined as having ingested 4 or more grams (8 or more pills) in the course of three or more days. So, if you feel safe because who's so crazy to take 50 Tylenols, consider an example - you have a really bad back, you pop just two extra strength pills over the limit and the pain goes away, only to return the next morning. If you repeat the pattern for the next two days, you risk liver failure - and for at least one of the patients in the above study such seemingly small overdose proved fatal.

Cigarette smoking: an underused tool?

nangar — Sat, 26 Nov 2011 17:17:13 -0800

Serum hemoglobin is related to endurance running performance. Smoking is known to enhance serum hemoglobin levels ... alcohol may further enhance this beneficial adaptation.

A recent paper by Kenneth Myers in the Canadian Medical Association Journal reviews the potential benefits of smoking for endurance atheletes. From the abstract:

The review paper ... when well executed by an expert in the field, can provide a summary of literature that generates useful recommendations and new conceptualizations of a topic. However, if research results are selectively chosen, a review has the potential to create a convincing argument for a faulty hypothesis.

Discussion by Travis Saunders on Obesity Panacea.

Antibiotics

zarq — Fri, 25 Nov 2011 09:33:19 -0800

The US Center for Disease Dynamics, Economics and Policy runs a non-profit, Extending the Cure, which conducts policy research to extend antibiotic effectiveness, and ResistanceMap, which generates interactive analysis tools and maps regarding antibiotic use in Europe and the US. The most recent ResistanceMap visualizations indicate that the US Southeast overprescribes antibiotics at a high rate compared with the rest of the country. Science journalist / "Superbug" blogger Maryn McKenna speculates (while acknowledging that correlation ≠ causation,) that the map might also indicate a link between overuse of antibiotics, obesity, diabetes and stroke. A recent commentary published in Nature raised additional/related concerns about antibiotic overuse. More.

"Attack me in the comments section -- GO."

zarq — Fri, 21 Oct 2011 09:07:00 -0800

Jane Pratt (formerly of Sassy Magazine and her eponymous Jane,) launched a website for women: xojane, earlier this year. Last week the site's Health and Beauty Director wrote a blog post explaining that she never uses condoms, birth control pills, or other contraception (for fear of becoming fat) and instead relies on the emergency contraceptive Plan B to prevent pregnancy. And a segment of the internet exploded. (Her responses to some of the comments seem a bit clueless for someone with her title.) Critics have noted that the post was filled with "ignorant" "inaccuracies and misconceptions" about womens' health, sex, Plan B and other forms of birth control. The Gloss responded with a post amusingly entitled, "XOJane Is Written By Monkeys With Typewriters" Ms. Pratt has apologized. (That has also been criticized.) Possibly as a response to the controversy, one of xojane's associate editors (Lesley Kinzel) has announced that their site is not appropriate for teenage girls, and offers them some advice. The Morning News added more advice.

Biting back at Malaria...

BobbyVan — Tue, 18 Oct 2011 12:24:40 -0800

A new malaria vaccine has been shown effective in large-scale field trials. After decades of disappointment, researchers think they're finally on track to unleash the first practical vaccine against malaria, one of mankind's ancient scourges. In the world's first large field trial of an experimental malaria vaccine, several thousand young children who got three doses had about 55 percent less risk of getting the disease over a year than those who got a control vaccine against rabies or meningitis. The vaccine was developed by British pharmaceutical company GlaxoSmithKline and the PATH Malaria Vaccine Initiative (MVI), a non-profit.

Aberrican Me - Ross Capicchioni

East Manitoba Regional Junior Kabaddi Champion '94 — Thu, 06 Oct 2011 13:21:07 -0800

Ross Capicchioni's story - Parts 1 and 2 - contains violent descriptions