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“My breast has fallen off. Can you reattach it?”

Atlanta Magazine has an interview with Otis Webb Brawley, M.D., and an excerpt from his new book "How We Do Harm: A Doctor Breaks Ranks About Being Sick in America."

The excerpt tells the story of 53-year-old Edna Riggs, of Atlanta, Georgia. Fear of cancer, medical debt, and losing her job caused her to not seek treatment for her breast cancer until it reached a very advanced state.

(Graphic content, may be upsetting; via @rogersmatthew)

Suicide by nail gun more common, less successful, than you might guess

Vaughn Bell pointed out this case study of a patient who tried to commit suicide via nail gun, and how medical personnel decided to treat the injury. The case study is impressive, but so is the addendum: Nail gun wounds—specifically, intentionally self-inflicted nail gun wounds—are a lot more common than you might expect.

As with any tool, some people will use a power tool for something other than its intended use, causing unusual injuries. And with the advent of the ˙weekend warrior,Ó more injuries have been caused by power tools. Specifically, the Centers for Disease Control and Prevention reports a dramaticincrease in nail gun injuries. From 2001Ï2005,there were 37,000 injuries caused by nail guns. Of those, 40% were to non-construction workers.

Care for these injuries is usually the same as for any patient with an impaled object. If possible, and if the object is still visible, secure the object. If the projectile isn_t visible and is lodged in the skull, there_s no way to secure the object, and the injury is likely more severe. In this case, because of the unknown location of the projectile, preventing head movement was the primary goal.

Multiple reports of self-inflicted intracranial foreign bodies are documented in the literature. The majority of these are reportedly from suicide attempts. Because the entrance wound may be extremely difficult to see, prehospital providers and ED personnel need to be suspicious of a suicide attempt or psychiatric illness when a patient presents with any blood on the head.

Fatality is reported in up to 40% of cases involving penetrating head trauma. Compressed air nail guns, specifically, are reported to fire at up to 425 meters per second and can cause significant brain injury.

Comparison of good and bad reporting on leukemia gene therapy

Gary Schwitzer, whose Health News Review should be your first stop for evaluating health and medicine journalism, has a quick line up of the good and the ugly in the coverage of the recent leukemia gene therapy study. Notice I didn't say "cure for cancer." Notably, neither did the good reporting that Schwitzer highlighted on his blog. More to come...

Want to live a long life? Ignore centenarians, watch Seventh Day Adventists

If a centenarian jumped off a bridge while eating a bag of jelly donuts and chain-smoking, would you do it, too?

That's basically the message in a new column by LiveScience's Christopher Wanjek, which looks at why the people who live the longest should not necessarily be health role models for the rest of us.

It seems that longevity goes hand-in-hand with some funny yesbuts. What you eat and how active you are doesn't seem to matter ... if you're one of the very, very lucky folks with a genetic predisposition toward surviving into extreme old age. For everybody else, there's pretty good evidence that healthy habits actually do extend your lifespan. Part of what fascinates me about the studies that show that is that they often compare Seventh Day Adventists to the general population. Why? Because Seventh Day Adventists generally don't eat meat (the first time I ever saw lentil loaf, it came from SDA cookbook), and are discouraged from booze, cigarettes, drugs, and caffeine. It also doesn't hurt that they run a massive, and well-respected, healthcare system, centered around Loma Linda University. Makes 'em easier to study like that.

For the general population, there is a preponderance of evidence that diet and exercise can postpone or ward off chronic disease and extend life. Many studies on Seventh Day Adventists — with their limited consumption of alcohol, tobacco and meat — attribute upward of 10 extra years of life as a result of lifestyle choices.

Image: Elderly People - sign on Warwick Road, Olton, a Creative Commons Attribution (2.0) image from ell-r-brown's photostream

Colonoscopy video (with worm)

Hey look, everybody! It's Ascaris lumbricoides! How you doin'?

Sorry. I'm so sorry. It's fascinating. But I'll find something quick to take the edge off.

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