19
Oct 2011

New Bill Aims To Unite Disabled Veterans With Shelter Dogs

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The House of Representatives last week passed a bill introduced by NY Congressman Michael Grimm, himself a Marine veteran, that will help both dogs and servicemembers. The legislation establishes a pilot program in VA medical centers whereby veterans with PTSD will receive instruction in the handling and training of shelter dogs. 

Abandoned dogs in animal shelters will therefore be saved from euthanasia, while veterans with PTSD receive beneficial therapy through training them. Once trained, the dogs will then become service animals for disabled veterans – thus providing a two-pronged approach to helping servicemembers in need.
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PTSD
PTSD is a serious anxiety disorder that can arise as a consequence of exposure to situations such as a traumatic or life-threatening event. It is especially common in servicemembers returning home from combat deployments. Not everyone who experiences a traumatic event will develop PTSD, although it is not fully understood why some develop the condition but others don’t. While many sufferers will improve over time, about 1 in 3 people will continue to experience symptoms. 

The severity of symptoms can vary between sufferers, but they can seriously interfere with everyday life, affecting work, social activities and relationships. Symptoms typically fall into four categories:
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  • Re-living the experience: This typically occurs when something happens to trigger memories of the traumatic event, often causing flashbacks. 
  • Avoidance of situations: Some people may avoid dealing with the emotions of the traumatic event by avoiding anything that reminds them of it.
  • Numbness: Sufferers may no longer have positive or affectionate feelings, and may report a general feeling of numbness.
  • Feeling Keyed-Up: Sufferers often describe feeling constantly jittery or on alert.

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Although medications can be useful to help combat PTSD, counseling therapies tend to be most effective, especially cognitive behavioral therapy. With veteran suicide rates currently high, and increasing numbers of servicemembers returning from deployment with symptoms of PTSD, this bill meets an important need for additional treatment options.

Grimm remarked: “As a veteran, and an American, I am thrilled that this legislation has passed the House, and I urge my colleagues in the Senate to pass it without delay, so that it can be signed into law and allow us to begin providing assistance to our returning veterans.”

All in all a win-win solution that will help homeless dogs and support our deserving veterans.

Isn’t that the least we can offer?
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Image Credit Website Of US Congressman Michael Grimm
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Categories: Medical, Military, Veterinary
14
Oct 2011

Take Your Vitamins?

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In a world where we’re frequently being advised to take our vitamin supplements, a recent scientific study has produced results that are interesting and confusing at the same time, at least for women with breast cancer. It suggests that some vitamin supplements may be detrimental to women who have survived breast cancer.

The Antioxidant Study
Scientists at New York’s Columbia University investigated 2,300 women with early stage breast cancer for five years. They found some opposing results for different types of vitamin supplements:

  • Vitamins C and E: They discovered that those taking regular supplements of vitamins C or E had a reduced risk of the cancer recurring within 5 years, compared to women who did not take them.
  • Carotenoids: Women who regularly supplemented with carotenoids (vitamin A, beta-carotene, and lutein), however, had a higher risk of dying from recurrent breast cancer than those who did not take them. Interestingly this seems to echo a previous report of a higher risk of lung cancer in smokers taking beta-carotene supplements.
  • Multivitamins: There was no link between breast cancer recurrence or death associated with antioxidants taken within multivitamins.

Dr. Heather Greenlee who led the study commented: “My main take home message here is that we’re seeing antioxidant supplements working in one direction and the carotenoids working in another.” She did, however, also stress that it’s still unclear why vitamins C and E might have beneficial effects for cancer survivors – if in fact they actually do.

Although vitamins C and E have antioxidant properties that help to protect cells from injury, Greenlee remarked that the women taking these supplements could have practised other healthy behaviors in general that contributed to improved survival. So the benefit might not have been due simply to taking these supplements.

While this research does not prove that carotenoids are harmful to cancer patients, it does raise some concern about them. And this highlights the fact that we should be more thoughtful about the supplements we take. Many people believe we have become a pill-popping nation of people who consider vitamins to be beneficial without really paying any thought as to what they are taking in. 

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Breast Cancer Awareness
Remember that October is Breast Cancer Awareness month, so if you haven’t already done so, please consider speaking to your doctor about screening, or even persuade a loved one to seek advice about it. 

Feel like helping others? If you literally have $2 to spare (or more!), please consider donating to the Susan G. Komen “3 Day For The Cure” – Cathy Miller is about to embark upon her 8th of these walks in the fight against cancer.  She still needs a wee bit more by way of donations to allow her to undertake the walk, so dig around under the sofa or in that old never-used-teapot! Any spare few dollars that you can find will be massively welcomed! Visit her page to make a small donation today. Your few dollars will make a world of difference.

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Greenlee H, Kwan ML, Kushi LH, Song J, Castillo A, Weltzien E, Queensberry CP Jr, Caan BJ: Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer (2011) Sept 27 [Epub ahead of print]


Image Credit Kittikun Atsawintarangkul @FreeDigitalPhotos

Categories: Medical Tags: , , , ,
12
Oct 2011

Milk Of Amnesia

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Have You Heard Of Propofol?
Propofol is one of the most widely used anesthetic agents worldwide, in the medical and veterinary fields. Up until a few years ago, however, it wasn’t exactly a household name. Now it’s a drug name that most people recognize, sadly as a result of the tragedy surrounding the death of Michael Jackson.

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As a veterinarian myself, I have had first-hand experience using propofol when anesthetizing my patients in general practice. As with all general anesthetic agents, it is a very useful and versatile drug, and when administered by trained medical personnel (I’m talking about anesthesiologists, nurse anesthetists, and veterinarians here), it can be used safely. As is also the case with all anesthetic drugs, however, it is not without risks.

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How Does Propofol Work?
It’s a very rapid and short-acting hypnotic agent (causing almost instantaneous sleep). Although its mechanism of action isn’t completely understood, one of its proposed actions is to potentiate GABAA receptors in the brain. GABA is an inhibitory neurotransmitter that is essential for proper brain functioning – it binds to its receptors in the central nervous
system and reduces excessive brain activity, promoting a state of calm.

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What Are The Risks?
Propofol not only reduces a patient’s blood pressure, but it also depresses their respiration. In this short video, CNN’s Dr Sanjay Gupta watches an anesthesiologist colleague at work in the operating room. You can see for yourself how the patient stops breathing when given propofol anesthesia.

The respiratory depression is a known, and expected effect of the agent. This is the reason why patients receiving propofol anesthesia are mechanically ventilated, as is the case in a hospital operating room. Let’s not forget that an important aspect of anesthesia involves not just putting patients to sleep, but recovering them and waking them from the procedure.

So you can understand how it can be a deadly agent when used by untrained personnel, or if used inappropriately and without the necessary ancillary equipment. If propofol is used without a patient being adequately monitored by trained medical professionals, and without intubation, the effects can be fatal.

If an intubated patient suffers from respiratory distress during anesthesia, the stage is already set for medical staff to be able to respond rapidly and mechanically ventilate him, hopefully to resuscitation. Without intubation and monitoring, however, a patient in respiratory distress can progress to respiratory failure and death very quickly due to the rapid action of the drug. Additionally, when combined with other drugs that also cause respiratory depression, such as the benzodiazepines (the class of drugs that Valium belongs to), these adverse effects are exacerbated.

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Milk Of Amnesia
Its milky white color has led to propofol being jokingly referred to by medical professionals as the “milk of amnesia”. But on the contrary, medical professionals using the drug typically respect its potency and take their role as a patient protector very seriously. This is not a drug to be dispensed for at-home use, and neither is it considered a sleep aid.

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Image credit Wikipedia

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10
Oct 2011

What Is Colorectal Cancer?

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I work in a cancer research group at MIT that investigates the development of gastrointestinal cancers in particular. Consequently colorectal cancer is just one such type of this disease that has become a regular part of my everyday work life. This deadly condition, however, is anything but routine.pp

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What Is Colorectal Cancer?
This form of cancer develops in the large intestine. The colon is the first 4-5 feet of the large intestine, and represents the largest portion of it – it is divided into ascending, descending, and sigmoid regions. The rectum comprises only the last few inches of the large intestine.

The colon acts to remove water and nutrients from partially digested food that enters the colon from the small intestine, turning the remainder into waste material. This waste material is the stool that passes through the colon into the rectum, then leaving the body via the anus.

Collectively, cancers arising at either location are known as colorectal cancer. Cancer begins when cells lining these regions of the large intestine are transformed and begin to grow abnormally and out of control. These abnormal cells continue to proliferate, and eventually form a mass of tissue that we know as a tumor. A tumor can be benign or malignant. The adenomatous polyps that can arise in the large intestine are typically benign. They can, however, progress to become malignant (cancerous) if they are not removed.
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Incidence Of Colorectal Cancer
It is estimated that in 2011, over 140,000 people in the USA will be diagnosed with colorectal cancer, and at least 49,000 of them will die as a result of the condition. This is the 3rd most common type of cancer in this country, and represents the third most common cause of cancer-related deaths. Over the past 20 years, however, the death rate from colorectal cancer has been decreasing, largely due to increasing use of established diagnostic screening techniques, among other factors.

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Categories: Medical Tags: , , , , ,
07
Oct 2011

The Problem with Dialysis

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“Long Interdialytic Interval and Mortality Among Patients Receiving Hemodialysis”
Robert N. Foley et al, N Engl J Med 2011; 365:1099-1107

This article in the September 22nd edition of the New England Journal of Medicine stirs up further controversy over the traditional schedule of hemodialysis for patients with end-stage kidney failure.

For most patients who require it, maintenance dialysis tends to be performed three times a week – typically “Monday, Wednesday, and Friday”, or “Tuesday, Thursday, and Saturday”. This leaves most patients with two 1-day intervals between sessions, and one 2-day interval (either between Friday and Monday, or Saturday and Tuesday).

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Some Background
Since the occurrence of cardiovascular complications is high in these patients, the group of researchers hypothesized that the risk of such problems would be heightened after the longer, 2-day interval between dialysis sessions.

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What They Found
They studied 32,065 patients with end-stage renal disease who were receiving hemodialysis three times weekly from 2004-2007. They compared the rates of death and cardiovascular-related hospital admissions on the day after the 2-day interval. They found an increase in morbidity and mortality on the day after the long dialysis weekend. Events that were increased at this time included:

  • Mortality (all-cause mortality in general, as well as death due to infection, myocardial infarction, and other cardiac events in particular)
  • Hospital admissions (for problems such as stroke, congestive heart failure, abnormal heart rhythym, myocardial infarction)

So clearly a longer interval of 2 days between dialysis presents an increased risk for patients. What the study didn’t address, however, was whether what the patients were doing on that “day off” could have played a role in the events leading up to morbidity or mortality. Regardless, however, the long dialysis weekend still seems to spell trouble for patients.

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What Does It All Mean?
Consequently, it seems that more dialysis is better – although this is not a new concept to healthcare professionals who deal with such patients on a daily basis. Despite being widely known that the end of the long dialysis weekend is a time of heightened risk to dialysis patients, relatively few studies have actually evaluated the association. It has gained more interest in recent years, however, allowing some clinical trials to demonstrate improved outcomes in patients as a result of daily dialysis sessions. 

Although the answer seems to lie in providing daily dialysis sessions, it probably isn’t as simple as it sounds. Inevitably, problems such as patient compliance, and the mechanics of providing daily dialysis will likely come into play. Additionally, as is the case with all-things-medical, no doubt the sheer business and financial implications of such daily treatment will continue to hinder the situation.

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05
Oct 2011

How Low Can You Go?

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Continuing in the spirit of this month being Breast Cancer Awareness Month, the lovely Cathy Miller invited me to write this guest post on breast cancer risk factors on her Simply Stated Health Care business blog. I was delighted that she invited me back into her blogosphere – it must mean I was well-behaved enough when I was her guest for the first time a few weeks ago when I discussed the health benefits of volunteering!

If you’re someone who should have a mammogram (whether because of your age group or risk factors), but haven’t already done so, don’t delay any longer – speak to your doctor about screening.

How Can You Help Others?
Again, if you literally have $2 to spare (or more!), please consider donating to the Susan G. Komen “3 Day For The Cure” – Cathy Miller is about to embark upon her 8th of these walks in the fight against cancer.  She still needs a wee bit more by way of donations to allow her to undertake the walk, so dig around under the sofa or in that old never-used-teapot! Any spare few dollars that you can find will be massively welcomed! Visit her page to make a small donation today. Your few dollars will make a world of difference.

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Image credit Free Digital Photos.

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04
Oct 2011

HIV/AIDS and the Girl Effect

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THIRTY YEARS AGO
Do you remember the summer of ’81? Right now, chances are some of you may be conjuring up fun and pleasant memories to share.

Doctors in New York City, Los Angeles, and San Francisco at that time, however, would have some very different memories. Strange clusters of cases of pneumonia and cancer were arising there in gay men – diseases typically only seen before in immunosuppressed patients. Diseases that were killing these patients.

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FAST FORWARD TO TODAY
Thirty years on, however, and we now know that these were not primary conditions in their own right, but were secondary, in association with the disease that we now know as AIDS.

Thankfully a diagnosis of HIV infection today no longer has to represent the kind of death sentence that it did 30 years ago, but millions of people do continue to suffer around the world. Despite decades of promises of a vaccine, this sadly still remains but a promise.

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THE GENDER EPIDEMIC
We now also know that AIDS is not just a disease of gay men. In contrast today, women account for almost half of all people with HIV/AIDS. Tragically, this condition represents the leading cause of death in women or reproductive age.

HIV contraction thus clearly poses very different risks and consequences for girls and boys around the globe. Frighteningly, there is an escalating risk of HIV infection/AIDS in young women and girls, with half of all new infections arising in the 15-24 year old age group. And in sub-Saharan Africa, for example, young females in this age group are twice as likely to have HIV/AIDS than their male counterparts.

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WHY THE ESCALATION IN YOUNG GIRLS?
The feminization of the epidemic highlights the gender inequalities at the root of this trend, with socioeconomic issues, as well as biological factors coming into play.

Socioeconomic Issues:

  • Young girls may be forced into commercial sex
  • Power imbalances in some populations leave girls subjected to non-consensual sex
  • Young girls often have sex with older males who are more likely to have HIV/AIDS
  • Girls have less access to general life skills-based education and resources, thus leaving them more vulnerable to infection
  • Girls tend to know very little about all matters of sex education, including how to protect themselves against STDs, increasing their risk of infection

Biological Factor

  • The immature genital tract of a young girl is more susceptible to damage during sexual activity, increasing the risk of HIV transmission

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WHAT CAN BE DONE?
Women have inevitably now become the face of HIV/AIDS across the world, constituting an increasing proportion of adults (15-49 years of age) living with the condition. To help protect women across the globe, and reduce the unique effect that the AIDS epidemic has on them we must:

  • Improve women’s general, sexual and reproductive health education
  • Promote and protect the human rights of women
  • Introduce better post-exposure treatment

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WHAT MOVES ARE UNDERWAY TO IMPROVE THE SITUATION?
UNAIDS  for example has various strategy goals in place for 2015, which include addressing HIV-specific needs of women and girls, as well as a zero tolerance for gender-based violence.

The World Health Organization (WHO) is in agreement, and similarly aims “to achieve universal access to HIV prevention, diagnosis, treatment and care interventions for all in need”, through their Global Health Sector Strategy on HIV/AIDS (2011-2015).

The WHO rightly calls on the world “to build on the collaboration, innovation and investment that have forged hard-won progress to date, establishing the foundation for success over the next five years.”

Read more about the Girl Effect, and see what you can do for the movement.

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Image Credit morgueFile

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03
Oct 2011

Get Your Screening On!

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This month is National Breast Cancer Awareness Month, representing an opportunity to promote and encourage screening for, and therefore aid early detection of breast cancer. p

What is Breast Cancer?
Breast cancer is a malignant tumor of the breast. It arises in the tissues of the breast, most commonly in the ducts that drain milk to the nipple, as well as the milk-producing cells. Approximately 1 in 8 women in this country will develop breast cancer – it is the second most common form of cancer in women, with skin cancer leading the list.

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Warning Signs
It is important to remember that breast cancer may have no signs or symptoms, and may not be painful, especially in its early stages. Any changes in the breast should be reported immediately to a physician, including findings such as:

  • A lump in the breast or underarm region
  • Any changes in the skin covering the breast
  • Pain in any region of the breast
  • Any change in breast shape or size
  • Abnormal discharge from the nipple
  • Nipple inversion

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Screening Guidelines

  • Breast Self-Examination: Women in their early 20s should practice this regularly in order to become familiar with how their breast tissue and underarm regions feel. This may enable early detection of some abnormalities that can be immediately reported to a physician.
  • Clinical Breast Examination: In addition to breast self-examination, a breast exam by a physician should also be incorporated into an annual physical examination.
  • Mammography: The American Cancer Society recommends that women begin receiving an annual mammogram starting at 40 years of age. Although not perfect, mammography is an extremely accurate means of detecting breast cancer. This low-dose x-ray procedure can detect up to 90% of cases of breast cancer that occur in women without any symptoms.

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How Can You Help Yourself?
Unfortunately there is currently no way to prevent breast cancer, which is why regular screening mammograms remain important for early detection. Thanks to this, as well as improved treatments, however, the news isn’t all bad for patients diagnosed with breast cancer. And in fact, millions of women now survive breast cancer, living longer than ever after a diagnosis. And although we can’t totally prevent breast cancer developing, we can take steps to keep the risks low as possible by not smoking, eating nutritious food, maintaining a healthy weight, exercising routinely, and limiting alcohol.

All in all, you have a much better chance of surviving breast cancer if it’s detected early. So if you haven’t done so already, talk to your physician about your risk for this disease, especially if breast cancer or ovarian cancer runs in your family.  Your doctor will be able to help you decide when to have a mammogram, and also how frequently you should be screened.

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How Can You Help Others?
If you literally have $2 to spare (or more!), please consider donating to the Susan G. Komen “3 Day For The Cure” – Cathy Miller is about to embark upon her 8th of these walks in the fight against cancer.  She still needs a wee bit more by way of donations to allow her to undertake the walk, so dig around under the sofa or in that old never-used-teapot! Any spare few dollars that you can find will be massively welcomed! Visit her page to make a small donation today. Your few dollars will make a world of difference.

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Image credit Free Digital Photos.

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26
Sep 2011

Check Your Skin

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Even if you don’t spend much time in the sun, your skin has likely still suffered damage over the years. Naturally this problem is exacerbated in people who do spend a significant amount of time in the sun, especially if they do not use sunscreen or take other precautions to protect their skin outdoors.

Skin damage is also particularly prevalent in those who use tanning salons. Although many people believe that tanning beds are a healthy alternative to direct sunlight for a beautiful tan, we know with certainty that this is absolutely not the case.

Tanning beds produce UVA and also UVB rays, which can contribute to skin cancer, eye damage, aging changes in the skin, and immune suppression. Consequently, the US Department of Health and Human Services has declared that UV rays from tanning beds are known cancer-causing substances. And additionally, the American Academy of Dermatology opposes indoor tanning.

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The Importance Of Self-Checks
It is important to check yourself regularly for changes in your skin that could represent early signs of skin cancer. Get into the habit of checking your skin on the same day each month, for example. The more you become accustomed to examining your skin, the sooner you are likely to recognize any changes.

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How To Examine Your Skin

  • Check your skin thoroughly each month – do this in a brightly lit room, and in front of a full-length mirror.
  • Examine your entire body surface as best possible, looking for any changes from the last examination.
  • Ask a partner to help you examine difficult-to reach areas, or use a smaller hand mirror in addition.

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What To Do If You See Any New or Changed Skin Lesions
You may find it helpful to make notes each month when you perform your self-examination. Record all changes that you find:

  • Location of lesion
  • Overall appearance of lesions, including size, shape and color

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Some Warning Signs In Particular That Require Attention

  • Any mole that appears to change in size, shape, color, texture or sensation
  • A smooth growth with a raised outer rim
  • A smooth growth with a central dimple
  • Sores that don’t heal adequately
  • Red patches of skin that don’t disappear
  • Yellow or waxy scar-like patches of skin 
  • Sores that ooze fluid, or become blistered or crusty

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What To Do If You See Any New or Changed Skin Lesions
If  you do notice any new moles or any other skin lesions, or if any pre-existing lesions start to change in any way, be sure to alert your physician or dermatologist as soon as possible.

And in addition to getting accustomed to examining your skin every month, be sure to visit your dermatologist annually – regular skin examinations by a specialist could just save your life.

Image Credit Ambro at FreeDigitalPhotos

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23
Sep 2011

Feline Phosphorescence

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It’s no longer just a cat’s eyes that glow in the dark! Researchers at the Mayo Clinic have created luminescent, genetically modified cats in an effort to learn more about AIDS.

Feline immunodeficiency virus (FIV) causes feline AIDS, a condition in cats that produces almost identical symptoms to those of AIDS in people infected with human immunodeficiency virus (HIV). Despite the similarity of the viruses, however, it should be noted that people cannot become infected with FIV, and cats cannot be infected by HIV. The similarity of both viruses, however, allows FIV to be used as a model for studying AIDS.
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In this most recent study, the Mayo group inserted two genes into the cats’ eggs prior to fertilization with sperm:

  • An FIV-resistance gene that makes a protein called restriction factor
  • A jellyfish gene to produce GFP, a protein that causes the modified cells to glow green

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Restriction Factor Proteins
Restriction factor proteins usually help the body to block viral infections. But in the case of HIV and FIV infections, these viruses have developed ways to evade attack by the proteins. The rhesus macaque version of restriction factor, however, is able to fight the viruses, so this monkey provided the source of restriction factor.
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Gamete-Targeted Lentiviral Transgenesis
Since cross-breeding of cats and monkeys is not an option, this genetic engineering process was used to introduce the monkey genetic material into cats. Insertion of the monkey restriction factor into the cats was so successful that almost all kittens produced from the genetically modified eggs had the genes for the protective restriction factor protein.

This protein was found all over the body, being tracked by virtue of its green glow, courtesy of the jellyfish gene that had also been introduced at the same time. The GFP protein produced by this gene acts as a marker – it allows the restriction factor proteins to be easily located in the body because it causes them to glow green.

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So What Was The Big Deal About This?
Cells that were subsequently taken out of the cats were found to be resistant to FIV infection when tested.

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The Future?
Although the research is still in its early stages, it certainly shows some exciting potential that could benefit both HIV-infected people, and FIV-infected cats. The Mayo team aims to further study these cats as a means to develop new therapies for people and cats infected with these viruses.

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Photo Credit BBC

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