Medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided.
—  Paracelsus

Pictured: what some scientists get to do for a living.

7 Medically Proven Treatments That Clearly Started as a Joke

#7. Tetris Can Correct a Lazy Eye

Until recently, the only societal benefit Tetris had given the world was a generation of people who are really, really good at packing for vacation. But that all changed when researchers at McGill University discovered that the game could be used to correct amblyopia, more commonly known as a lazy eye. Previously, the go-to treatment for a lazy eye was to patch the “good” eye and force the patient to use the “bad” eye until it shaped up, but success was limited at best and pirate jokes get old so, so fast.

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(Reuters) - U.S. health officials said on Tuesday the first patient infected with the deadly Ebola virus had been diagnosed in the country after flying from Liberia to Texas, in a new sign of how the outbreak

Ugh… let the mindless panic begin afresh. My condolences to every emergency room and urgent care clinic in the Dallas area this week.

Just remember, everyone:

"The risk of spreading Ebola to passengers or crew on an aircraft is low because Ebola spreads by direct contact with infected body fluids. Ebola does NOT spread through the air like flu.” — CDC.gov

Adermatoglyphia is an extremely rare medical condition which causes a person to have no fingerprints. There are only four known extended families worldwide which are affected by this condition.

Recently, the description of a case of a person from Switzerland lacking fingerprints as an isolated finding was published. The phenotype was mapped to chromosome 4q22. In the splice-site of a 3’ exon of the gene for SMARCAD1-helicase, a point mutation was detected. It results in a shortened form of the skin-specific protein. The heterozygous mode of mutation suggests an autosomal dominant mode of inheritance.

Other conditions can cause a lack of fingerprints, but unlike them, adermatoglyphia has no other side effects. Mutations in helicases are involved in other rare genetic diseases, for instance Werner syndrome.

Photo source and more information:http://1.usa.gov/1qOLZ1S

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Cancer Detection Inspired by the Deadly Mantis Shrimp

The incredible compound eyes of the mantis shrimp can see a great number of things we can only dream of, and apparently that includes cancer. A team of researchers from Australia are suggesting that not only can mantis shrimp see a variety of cancerous tissues in the human body, but technology can be adapted to emulate this remarkable ability.

Justin Marshall, from the Queensland Brain Institute at the University of Queensland, was involved in some recent remarkable research that closely examined the capabilities of a mantis shrimp’s “superbly tuned” compound eyes.

"We see color with hues and shades, and objects that contrast - a red apple in a green tree for example - but our research is revealing a number of animals that use polarized light to detect and discriminate between objects," he explained in a statement.

According to Marshall, his team found that in place of some tactile sensations, mantis shrimp can see the differences in surfaces and even tissues, noticing characteristics that humans wouldn’t be able to detect until breaking out tools and science.

Even cancerous tissue, which normally is only identified with biopsy, apparently reflects polarized light differently than healthy tissue, meaning that it’s very visible to the vibrantly colored shrimp.

And that’s because (in a very basic explanation) mantis shrimp can see a whopping 16 base colors. By comparison, the color-receptive cones in human eyes can see only three base colors - blue, red, and green - from which every other color we see is derived.

If the vibrant rainbow humans see is based off a mere three types of cones, imagine what the world would look like with SIXTEEN of them! Suddenly seeing cancer doesn’t seem like much of a surprise for the mantis shrimp.

Cancer Cam

But now so can we. According to a study recently published in the journal Proceedings of the IEEE, Marshall and his colleagues identified key components in mantis shrimp eyes that allow them to filter polarized light. They mimicked these components, called micro-villi, using aluminum nanowires and placed them on top of photodiodes, which convert light into electrical current.

But even after this process is complete, researchers still won’t be able to see the unimaginable color spectrum that the shrimp see for themselves. Instead, they will just be able to see interrupted images indicating important differences in how polarized light reflects.

"It converts the invisible messages into colors that our visual system is comfortable with," Marshall explained.

Interestingly, this isn’t the first time polarized light detection will be used in cancer identification. Current imaging systems use the same basic concept, but without the refined technologies inspired by the ocean’s most incredible shrimp. They lack accuracy and require relatively large equipment, thereby limiting how such systems can be used.

By replicating the eyes of mantis shrimp, the scientists hope to improve upon existing technology to the point that it could even be incorporated into a smartphone, creating a Star Trek-like reality in which simply passing a handheld device over a person’s body can detect the presence of a potentially life-threatening condition.

Inspiring War Machines, Too

Interestingly, if you were ever to meet a mantis shrimp for yourself, don’t believe for a second that it would be some enlightened guru of the aquatic world just because it sees more beautiful colors than we do.

Popular internet cartoonist and nature-lover The Oatmeal once called the mantis shrimp an “undersea nightmare, and one of the most creatively violent animals on Earth.”

The shrimp boasts two “fists” that fold much like the claws of a praying mantis (hence the name). Observations of this remarkable creature have shown that using these appendages, the shrimp can throw punches with 1,500 newtons of force - so strong that they cause tiny undersea shockwaves that kill prey even if the “fist” doesn’t make contact.

And because of this incredible predation strategy, the fists themselves have to be incredibly tough to withstand the full force of impact. In fact, research is currently being funded by the US Air Force to investigate the makeup of these super tough fists, in the hopes of one day replicating the material to craft light-but resilient aircraft and even body armor.

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During an infection, viruses spread from infected to uninfected cells and can be spread cell-to-cell. Here, murine leukemia virus undergoes cell-to-cell transmission via filopodial bridges to physically link the two cells.

Image: Cos-1 cells generating murine leukemia virus (MLV) expressing Gag-YFP (red) were co-cultured with uninfected XC target cells expressing the MLV receptor mCAT-1-CFP (green) and imaged using time-lapse fluorescence microscopy. Images were taken approximately every 2 minutes and compiled in a time-lapse movie. Learn more in Sherer et al.(2007) and Jin et al. (2009).

For months, the Ebola epidemic was a terrible problem Today, the CDC confirmed the first case of Ebola diagnosed in the U.S.: a man who was traveling in Liberia and is now at a hospital in Dallas. Should you panic about Ebola now? Nope, and here’s why.

The bottom line is that Ebola spreads only through the direct contact with bodily fluids—making it a whole lot harder to spread than the airborne common flu. We also know exactly how to stop Ebola; the crisis in Africa has gotten so bad due to lack of healthcare infrastructure.

#medblr/healthcare workers, know the facts — cuz you’re going to be bombarded with panic-laden questions about Ebola now.

An Unforgettable Feeling

With Alzheimer’s disease (AD), the greatest fear is what will be lost, how accumulating neurofibrillary tangles and amyloid plaques in the brain (like those pictured above, courtesy of Thomas Deerinck at the National Center for Microscopy Imaging and Research) will eventually erase one’s recollected life.

But maybe it’s worse (or better?) than that. Researchers at the University of Iowa suggest that persons with AD may feel lingering emotions about past events even when they no longer remember what actually happened.

In a published study, scientists played clips of sad and happy movies to AD patients. The latter no longer remembered ever seeing the films, but still experienced sustained states of sadness and happiness.

“This confirms that the emotional life of an Alzheimer’s patient is alive and well,” said study author Edmarie Guzman-Velez.

The findings have implications for how AD patients should be treated.

“Our findings should empower caregivers by showing them that their actions toward patients really do matter,” Guzmán-Vélez said. “Frequent visits and social interactions, exercise, music, dance, jokes, and serving patients their favorite foods are all simple things that can have a lasting emotional impact on a patient’s quality of life and subjective well-being.”

Apparently I now have a cancer black cloud.

I spent another weekend at the ER, and saw more people diagnosed with cancer.

I think I had one of my more frustrating cases too. There was a female in her 40s who presented with vague, diffuse abdominal pain and swelling for the past month. No PMHx other than obesity. I knew when I looked at the CT scan, but it was still difficult to read the radiology report saying that she most likely had peritoneal carcinomatosis from ovarian cancer.

We don’t have gyn/onc at our hospital, so we usually transfer to the academic centers for these types of cases. However, she didn’t have insurance. The doctors fought with the other hospitals for almost two hours to get her transferred, everyone turning her down because it was “an outpatient workup”. That was at least what they said when they found out she didn’t have funding. How the hell do they expect us to send this woman home with practically a death sentence, send her home with practically no ability to get follow up care. It took an extreme stroke of luck that at the last hospital we could try and transfer to, a very understanding and compassionate resident accepted the transfer right away. If they hadn’t, then I have no idea what this patient would be doing right now. Getting a cancer diagnosis out of the ER is a horrible experience. What’s even worse is when we have to send someone home with news that they could be dead within the next year or even the next few months. I don’t think physicians who work outside of an ER always understand how difficult it is to tell a patient they’re dying and then send them on their way with generic printed out instructions on how exactly this disease is killing them and giving them follow up to a physician they can never afford to see as an outpatient.

One of the things I have grown to love about Emergency Medicine is that we never have to worry about patient funding when we see patients in the ER. One thing I have also grown to dislike about it, however, is that when it comes to passing care along to another specialty or physician, funding has become such a huge issue that ER staff are the ones that give the patients horrible news and then unfortunately send them home to somehow cope with the news that they might die. 

This is really cool

I’m in clinic with some of my all time favorite people that I’ve met in the past year on rotation:

-my old CCU intern, now an R2
-my first medicine senior resident, now an R3
-the medpeds chief, an all around intelligent, pleasant person

And here I am, in my own clinic room, preparing to see patients myself.

It’s amazing where a year of training has taken me.

While most providers have installed some kind of electronic record system, two recent studies have found that fewer than half of the nation’s hospitals can transmit a patient care document, while only 14 percent of physicians can exchange patient data with outside hospitals or other providers. “We’ve spent half a million dollars on an electronic health record system about three years ago, and I’m faxing all day long. I can’t send anything electronically over it,” said Dr. William L. Rich III, a member of a nine-person ophthalmology practice in Northern Virginia and medical director of health policy for the American Academy of Ophthalmology.

Researchers at the University of California, San Diego School of Medicine have launched a Phase III clinical trial to evaluate the drug isradipine, a calcium channel blocker often used to treat high blood pressure, as a potential new treatment for Parkinson disease (PD). The goal of the study is to determine whether the drug can slow the progression of the disease by keeping the brain’s dopamine-producing cells healthier for a longer period of time.

“Isradipine has been demonstrated to be safe and tolerable in patients with Parkinson’s disease,” said Irene Litvan, MD, site investigator and director of the Movement Disorder Center at UC San Diego Health System. “This new study will determine whether the drug can be effective in slowing the progression of the disease and could, thereby, complement existing symptomatic treatments to improve the quality of life of individuals with the disease.”

PD is a progressive neurological disorder that affects an individual’s speed and amplitude of movements and decreases the speech volume.  Patients with PD experience stiffness or rigidity of the arms and legs and walking difficulties in addition to tremors in their hands, arms, legs or jaw. Patients with PD also experience vivid dreams, depression, and constipation.  

Isradipine is a Food and Drug Administration-approved drug to treat high blood pressure. Prior population studies have shown that people taking isradipine for high blood pressure have a lower incidence of PD. Additionally, isradipine is in a category of drugs called calcium channel blockers, meaning they inhibit certain cellular functions. Overactive calcium channels may play a role in the death of the dopamine producing cells in the brain that is one of the hallmarks of PD.

A Phase II evaluation of isradipine, which was conducted to determine the safety and appropriate dosage for the drug, was completed in 2012. The study was funded by a $2.1 million grant from The Michael J. Fox Foundation for Parkinson’s Research (MJFF), which also supported preclinical research into the effects of isradipine on Parkinson’s progression by D. James Surmeier, PhD, of Northwestern University.

The study, called STEADY-PD, is sponsored by the Parkinson Study Group and is co-lead by the University of Rochester Medical Center (URMC) and Northwestern University. UC San Diego Health System is one of the national research participants.

Patients who are eligible for the clinical trial will have been diagnosed with PD for less than 3 years and are not currently on any dopaminergic therapy such as levodopa, dopamine agonist, or MAO-B inhibitors.

“If it proves to be effective, this drug will change the way we treat Parkinson’s disease, and the major advantage of it is that isradipine is already widely available, inexpensive and will allow for rapid translation of our research into clinical practice,” said Tanya Simuni, MD, principal investigator of the study and professor of neurology at Northwestern University Feinberg School of Medicine. “Although we now have very effective symptomatic treatments to manage Parkinson’s, the development of a disease-modifying intervention remains the Holy Grail.” 

Patients with PD are advised not to take this medication if they are not part of this therapeutic clinical trial. 

For additional information about this clinical trial, please contact the UC San Diego Health System site coordinator at 858-822-5751 or rellam@ucsd.edu

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