Boing Boing » medicine

Carl Zimmer's "The Girl Who Turned To Bone"

David Pescovitz — Fri, 24 May 2013 16:58:04 +0000

In The Atlantic, science writer extraordinaire Carl Zimmer wrote a fascinating long article about fibrodysplasia ossificans progressiva (FOP), a rare medical disorder in which the sufferer grows a second skeleton. (Above, the skeleton of FOP-sufferer Harry Raymond Eastlack, on display at the Mütter Museum.) Beyond a tale of medical curiosity, it's a genetic detective story that says a lot about the study of rare diseases. From The Atlantic:

A rare disease is defined as any condition affecting fewer than 200,000 patients in the United States. More than 7,000 such diseases exist, afflicting a total of 25 million to 30 million Americans.
The symptoms of these diseases may differ, but the people who suffer from them share many experiences. Rare diseases frequently go undiagnosed, or misdiagnosed, for years. Once people do find out that they suffer from a rare disease, many discover that medicine cannot help them. Not only is there no drug to prescribe, but in many cases, scientists have little idea of the underlying cause of the disease. And until recently, people with rare diseases had little reason to hope this would change. The medical-research establishment treated them as a lost cause, funneling resources to more-common ailments like cancer and heart disease.

"The Girl Who Turned to Bone"

Do science: The life you save may be your own

Maggie Koerth-Baker — Tue, 21 May 2013 14:08:59 +0000

One of the people who developed the pacemaker is now 86. And he has a pacemaker….

Poop transplants meet FDA bureaucracy

Maggie Koerth-Baker — Mon, 20 May 2013 20:24:51 +0000

The good news: Fecal transplants work well enough as a treatment for patients with Clostridium difficile infections that the Food and Drug Administration has decided to take them out of the grey area of legality in which they were previously being performed. Poop transplants for C. difficile will be legal, and the doctors doing the transplants will have to be approved by the FDA, to make sure they're getting the donor poop through safe means and not prescribing poop transplants for things that poop transplants don't help. The bad news: The approval process turns out to be ridiculously arcane and time-consuming — featuring a 30-day waiting period and requirements that are apparently secret.

Has your doctor taken money from drug companies?

Maggie Koerth-Baker — Mon, 13 May 2013 22:04:04 +0000

Mine hasn't. At least, he hasn't taken money from any of the 15 companies that have been forced to disclose information about gifts and cash they give to doctors. Pro Publica has put that information into an easily searchable database. It's not total transparency — the drug companies whose payouts are included here only represent 47% of the total market — but it's a good place to start if you want to know whether your doctor has any conflicts of interest that could affect your health.

What happens when a drug works — but only for one person?

Maggie Koerth-Baker — Fri, 10 May 2013 21:14:49 +0000

Really, really intriguing piece at Nature News by Heidi Ledford. It's all about a class of patients called "exceptional responders" — aka, the people who got a benefit (sometimes a big one) from a medication or treatment that otherwise failed the clinical trial process. When we do clinical trials, we're looking at group averages. We want to know whether a drug performed better than placebo when administered to lots of people. Sometimes, though, drugs that can't do that do seem to have a positive effect for a few lucky individuals. Now, scientists are trying to figure out why that is. What makes those people special? And how should this change the way we do research?

Stop homeopathic "vaccines" in Canada

Maggie Koerth-Baker — Thu, 09 May 2013 15:41:32 +0000

The Canadian government has approved the sale of nosodes — homeopathic alternatives to vaccines. I probably don't have to explain to you all why giving children a sugar pill that works no better than placebo is a bad, bad, bad idea when the diseases you're trying to prevent are things like polio, measles, and rabies. Here's what you can do to help stop this racket.

Strange ways to contract rare diseases

Maggie Koerth-Baker — Wed, 08 May 2013 22:48:00 +0000

The Body Horrors blog has a new recurring series called Microbial Misadventures — all about times when people met disease-causing microbes under less-than-normal circumstances. It starts with an interesting question: Given the fact that most anthrax infections come from eating tainted meat, how did a vegetarian end up with the disease in 2009? Two-word hint: Drum circle.

Not your great-great-grandfather's consumption

Maggie Koerth-Baker — Fri, 26 Apr 2013 21:40:02 +0000

Tuberculosis — aka, the reason everybody in 19th century literature is always coughing up blood, escaping to the countryside for "better air", or dying tragically young — is back. And this time, it's evolved a resistance to antibiotics. In fact, in a handful of cases, tuberculosis has been resistant to every single antibiotic available to treat it. Tom Levenson explains what's happening and why it matters at The New Yorker.

Blog full of fantastic (and often NSFW) medieval illustrations

Maggie Koerth-Baker — Thu, 18 Apr 2013 16:34:31 +0000

Here's a 15th century illustration of an English surgical procedure. Fun!

See the full blog — Discarded Image | Discarding Images.…

The Lancet: You do, in fact, know something, John Snow

Maggie Koerth-Baker — Fri, 12 Apr 2013 15:17:58 +0000

The editors of The Lancet (the long-running British journal of medicine) issued a correction this week for several rude statements and a rather terse obituary that it published in the 1850s. All of these relate to John Snow, the epidemiologist famous for figuring out that cholera was spread by contaminated water. The trouble with this: Snow's evidence-based arguments stepped on the toes of a former Lancet editor who believed strongly that such diseases were caused by bad air — and who had, as a consequence, led an initiative to ban tanners, soap makers, and other smelly professions from the city of London. Snow had testified before Parliament that bad air could not possibly cause disease. A feud ensued.

Snake Oil's secret ingredients

David Pescovitz — Tue, 09 Apr 2013 16:25:43 +0000

There was no actual snake oil in old timey snake oil (except when there was, of course). Rather, most of the lotions and potions sold by early 20th century miracle medicine salesmen actually contained mercury and lead. Now, don't you feel better? University of Detroit Mercy chemists recently analyzed the ingredients of several dozen patent medicine samples from the Henry Ford Museum's collection. From Smithsonian:

Their findings, which they presented yesterday at the annual meeting of the American Chemical Society in Atlanta, were that many of the pills, powders and ointments tested had beneficial ingredients like calcium and zinc—but that others had toxins such as lead, mercury and arsenic.
Back in the day, this was a very trial-and-error kind of field,” (chemist Mark) Benvenuto said in an interview. “The stuff that we think of as dangerous now, though it was dangerous, was as cutting-edge as they had at the time.”

"What’s in Century-Old ‘Snake Oil’ Medicines? Mercury and Lead"

Disease superspreaders and the new coronavirus

Maggie Koerth-Baker — Mon, 25 Mar 2013 16:43:59 +0000

Coronavirus — characterized by the halo of protein spikes that surround each individual virus particle — is the family that gave birth to SARS. Today, there's a new coronavirus stalking humans, especially in the Middle East. Scientists have documented 16 infections, and 10 fatalities. The good news is that there are probably lots of non-serious infections that aren't being reported, meaning the fatality rate probably isn't as high as it looks. Also, this coronavirus seems to have trouble spreading from person to person. But, in regards to that last factor, it's important to pay attention to a detail from the SARS outbreak that we still don't totally understand. Turns out, a handful of people were responsible for most of those infections. The Canadian Press' Helen Branswell writes about superspreaders and the scientists trying to understand how individuals can alter the course of an outbreak. (BTW: If you don't follow Helen Branswell on Twitter, you're missing some of the best infectious disease reporting out there.)

The other problem with fake vaccine scares

Maggie Koerth-Baker — Thu, 21 Mar 2013 20:53:37 +0000

It's not just that bad information on the "dangers" of vaccines is working to reduce the number of children getting vaccines — a fact that affects herd immunity. Now, there's evidence that the fake scares (and efforts to debunk them) are getting in the way of scientists publishing real evidence about actual problems with certain vaccines. These aren't the kind of broad "vaccines are poison" claims you're familiar with. Instead, we're talking about legitimate science documenting side effects that are usually very rare, but still have an impact on certain subsets of the population and need to be addressed.

Grapefruit + prescription drug = overdose

Maggie Koerth-Baker — Fri, 15 Mar 2013 15:45:46 +0000

There are 44 prescription drugs on the market today that should never be combined with grapefruit. That's because the sour fruit (and some other, closely related, kinds of citrus) contain chemical compounds called furanocoumarins that prevent your body from metabolizing certain prescription drugs. Essentially, the grapefruit creates an artificial overdose where one tablet packs the power (and side effects) of 20. The CBC has a full list of the drugs, which includes cancer drugs, cholesterol-lowering drugs, and drugs to treat problems of the urinary tract. Wikipedia has more about why this interaction happens.

What ovarian cancer can teach us about medicine, as a whole

Maggie Koerth-Baker — Tue, 12 Mar 2013 15:09:24 +0000

The New York Times has a story on problems with the treatment of ovarian cancer that holds lessons for many aspects of modern medicine. The big issue here: Local doctors, even local specialists, might not have the information necessary to properly treat patients who come in with problems those doctors don't have a lot of experience with. And those doctors don't always refer patients to people with more expertise. In a world with constantly changing information, how do you get that information to the people patients are most in contact with? In a world with more and more evidence available, how do you change traditions in the medical community that apply treatments based on "what my teachers did" and "what I've always done"? Big questions here, not a lot of answers.

From Seizure to Surgery: first-person account of what it's like to have a brain tumor

Xeni Jardin — Fri, 22 Feb 2013 20:46:37 +0000

Jess Hill has published the second part of a three-part series on what it’s like to have a brain tumor diagnosed, then surgically removed. Read: Magical Realism: From Seizure to Surgery. The earlier installment is here….

The trial of a 14th century female doctor

Maggie Koerth-Baker — Fri, 22 Feb 2013 19:45:08 +0000

In November 1322, Jakoba (or Jacoba) Felicie stood trial in her native Paris for the crime of practicing medicine without official sanction. Over the course of the trial, it became clear that her work as a doctor had been excellent. But Dr. Felicie was stuck in an unfortunate catch-22. She could not legally work as a doctor without first getting professional training. And she could not get professional training because she was a woman. The ScienceZest blog tells her story.

Drug OD fatalities up for 11th consecutive year; not one was due to marijuana

Xeni Jardin — Tue, 19 Feb 2013 23:26:48 +0000

Federal data to be released this week through the Journal of the American Medical Association shows that drug overdose deaths rose for the 11th year in a row. Most were accidents involving prescription painkillers: specifically, opioids like OxyContin and Vicodin which are commonly prescribed for pain management, and are widely abused. Those two drugs contributed to 3 out of 4 medication overdose deaths, according to the report.

Not one single death in the Centers for Disease Control and Prevention data set was due to overdosing on marijuana.

Why? Generally speaking, because of the way cannabis affects the human brain and nervous system, it is not medically possible to OD on marijuana—though you're welcome to try, and unconfined munchies could certainly cause some damage. Not that death by Doritos would be such an awful thing...

And yet in federal law, with the data once again proving that pot is non-lethal, cannabis remains classified as a schedule 1 drug. That classification means there are no federally-recognized medical applications for pot, while prescription drugs proven yet again to be potentially deadly when abused remain readily and legally available.

As an aside, it's lulzy to note that in the letter of the DEA's law, it's spelled "marihuana." Both the spelling of the law and the logic behind it are antiquated.

Photo: Shutterstock

Vaccine-resistant whooping cough found in Philadelphia

Maggie Koerth-Baker — Mon, 11 Feb 2013 22:09:06 +0000

When we talk about the resurgence of childhood illnesses, we tend to focus on vaccine-resistant people as the primary cause. And it's true that a large population of un-vaccinated kids can give a disease like whooping cough a foothold in a community, and allow it to spread to kids who haven't been vaccinated yet or who can't be vaccinated for various medical reasons. But there's another facet to this story, as well. Some of the strains of bacteria that cause whooping cough are also resistant to the vaccine. Those strains have been found in Japan, France, and Finland. Last week, The New England Journal of Medicine reported on 12 cases of vaccine-resistant whooping cough in Philadelphia.

Medical cures from the mouth of a mamba

Maggie Koerth-Baker — Tue, 05 Feb 2013 18:36:41 +0000

Here, scientists suck all the dignity out of a Jameson’s mamba — a snake capable of killing a human in just a few, painful hours. The photo is part of a story in the February issue of National Geographic, exploring the potential medical uses of venom. There are also more photos. And you will meet cobra farmers.

© Mattias Klum /National Geographic

Medicine or moralism: A psychotherapist questions "sex addiction"

Maggie Koerth-Baker — Mon, 04 Feb 2013 17:02:11 +0000

Can you actually be addicted to sex? Marty Klein doesn't think so. In an interesting article at The Humanist, he critiques the diagnostic criteria and common treatments behind this tabloid-ready psychological problem. …

Forget scarlet fever: What really blinded Mary Ingalls

Maggie Koerth-Baker — Mon, 04 Feb 2013 16:51:32 +0000

Anybody who has spent much time with children's literature knows that scarlet fever blinded Mary Ingalls.

But scarlet fever doesn't cause blindness.

Mary really did become blind, though, in real life as well as in the books, so what was the real culprit? A paper published this week in the journal Pediatrics speculates that it could have been viral meningoencephalitis — inflammation in the brain and in the membranes that surround the central nervous system.

There are several possible causes. In Europe and Asia, ticks can spread a virus that causes meningoencephalitis. West Nile virus can cause it, as well. So can the mumps. And so can herpes simplex type 1 — the oral herpes virus that is present in the vast majority of people.

Which means that this story not only has ties to the other Little House history pieces we've run here at Boing Boing — the meteorology of the Long Winter, and the crazy connection between the Ingalls' and a family of serial killers — it's also, possibly, another example of a heroine from children's fiction who had herpes.

The full paper, sadly, is behind a paywall. But The New York Times' Motherlode blog has a nice summary of it.

Image: Wikipedia editor Lrcg2012, via CC

The role of anecdotes in science

Maggie Koerth-Baker — Thu, 24 Jan 2013 21:40:37 +0000

Anecdotes aren't data — but they do make data memorable….

Anne of Green Gables had herpes (and you probably do, too)

Maggie Koerth-Baker — Thu, 24 Jan 2013 20:42:39 +0000

From Chapter 40 of Anne of Ingleside:

Anne sneezed. She began to be afraid she was taking a cold in the head. How ghastly it would be to sniffle all through dinner under the eyes of Mrs. Andrew Dawson, nee Christine Stuart! A spot on her lip stung . . . probably a horrible cold-sore was coming on it. Did Juliet ever sneeze? Fancy Portia with chilblains! Or Argive Helen hiccoughing! Or Cleopatra with corns!

Yes, Anne of Green Gables, by the time she reached middle-age, had apparently joined the majority of adults who test positive for the virus herpes simplex type 1 — the cause of the painful, little mouth blisters known colloquially as "cold sores". Estimates vary when it comes to how many of us are HSV-1 carriers. A 2006 study found evidence of HSV-1 infection in 57.7 percent of American adults, ages 14 to 49.* Bryan Cullen, a virologist at Duke University, told me he's seen studies showing that closer to 70 percent of adults are infected — although only something like 1/3rd of those will ever get cold sores.

Don't judge Anne of Green Gables. Chances are good that you're in the same boat.

But why is this virus so common?

Unlike herpes simplex type 2 — the virus you probably think of when you think "herpes" — HSV-1 isn't necessarily a sexually transmitted disease. Most people are infected when they're still little kids. And they're infected by really common behaviors that nobody wants to stop anytime soon — namely, the practice of adults kissing little kids because they're just so darn kissable. (There are several scenes in Anne of Ingleside where Anne probably passes HSV-1 on to her own offspring.)

Lots of people get it as kids. Lots more get it as teenagers when they start kissing the people who caught it in childhood. There's not an easy way to stop that spread. At least, not any way that doesn't make you look sort of stern, unaffectionate, and anti-social. With HSV-2, there are increasingly social influences in place that discourage the spread of the disease. For HSV-1, it's exactly the opposite. Our societal norms make the spread of the virus almost inevitable.

Worse, the virus has some quirks that allow it to really take advantage of those social norms. Young Anne might not have been willing to kiss Marilla right on a gross, weeping blister. But Marilla didn't need a blister to spread the virus.

In fact, the symptoms described in Anne of Ingleside — feeling a tingling pain in the lip where the sore would eventually appear — are a hallmark of herpes blisters. That's because, when it's not hard at work making obvious blisters, the herpes virus can live, silently, in your nerve cells. The virus bunkers down and releases a type of RNA that prevents the host cell from dying. Nobody is entirely sure what causes relapses to happen, but the appearance of new blisters has been associated with any number of things — from other illnesses to stress. (It's worth noting that, in this passage, Anne is on the way to have dinner with her husband's old girlfriend and has, in general, been feeling pretty emotionally distraught about the state of her and Gilbert's relationship.)

Whatever the cause, when a new outbreak happens, the virus begins replicating itself and travels along nerve fibers called axons to reach the epithelial cells — the cells that make up your skin. This is where the showdown happens between the herpes and your immune system, and it's kind of a messy battle. The pain Anne is experiencing is a byproduct of the inflammatory immune response, Cullen told me.

Anne would be most contagious when she has a cold sore on her lip. But that doesn't mean she wouldn't be contagious the rest of the time. The virus is always there. Even if you can't tell a person has HSV-1, they could still be shedding viruses and infecting you.

Which brings me to one final point. I don't want to speculate on Anne and Gilbert's sex life, or yours. But everybody should be aware that "oral herpes" isn't confined to the mouth. Truth is, HSV-1 can pass from one host to another via any mucus membrane, and that includes the ones on your genitals. If somebody with oral herpes goes down on you, there's a possibility that they could give you oral herpes in a place that is most definitely not your mouth. And cases of this happening are one the rise. The virus is common, but the social side-effects can be pretty awkward. So this is a reason to at least consider condoms and dental dams for oral sex.

There is one bit of silver lining to the bummer that is orally transmitted herpes on your genitals. It's possible that someone infected this way wouldn't have recurrent outbreaks on their junk. "Some studies have reported that genital HSV1, and oral HSV2, cause fewer lesions in the non-traditional location," Cullen told me. "But again," he added, "fewer is not always none."

*And, yes, I know Anne of Green Gables was Canadian. The rates seem to be similar up there.

What it's like to have a grand mal seizure

Xeni Jardin — Tue, 22 Jan 2013 22:35:41 +0000

Radio producer Jess Hill, who has been working in the Middle East, wrote an account of what the experience of having a grand mal seizure was like.

She wrote the post a week after the episode, and two weeks before having brain surgery to remove the tumor that caused it.

"At the time I was still having seizures every few days, and just the act of writing about the first seizure in such detail almost brought on another one," Jess explains. "I initially planned to keep this account private, but after two months, I’ve decided to share it, if only for the fact that it might be useful to others who have had or will have a similar experience."

It happened when she was in transit via plane from Yemen to Beirut.

My head resting against the window, I was swimming around somewhere between awake and asleep when I felt my mind fall through a trapdoor and into a vacuum. Suddenly, there was no ground for my mind to land on. No language. No concepts. Anxiously I grasped through the smothering black for an idea, a word, something I could articulate. Nothing. Just black.
Then I felt my eyes roll up in my head. On a slow, steady rhythm, they started jerking forcefully to the right. Language flooded back i’ve lost control! and jerk, jerk, jerk, further and faster my eyes pushed to the right. Breath quick and shallow now, eyes so far up and to the right they pushed painfully against their sockets. My head jerked too now, like it was being dragged by my eyes jerk, jerk, jerk, I tried to push out a sound, a grunt. Nothing but spittle.
In full seizure now, shaking uncontrollably, I could still see out of the very corners of my eyes. There was no-one sitting next to me, and the man two seats down was staring into his iPad.

Read more. Follow Jess on Twitter: @jessradio.

The science of flu season

Maggie Koerth-Baker — Fri, 18 Jan 2013 17:46:41 +0000

Flu season is in winter. Okay, great. But why…? (Consider this an open thread for all your favorite humidifier recommendations.)

An epidemiology alphabet

Maggie Koerth-Baker — Thu, 17 Jan 2013 20:41:59 +0000

The only alphabet guaranteed to make you want to wash your hands. Made by one, Jennifer Gardy.

In related news, this video taught me that the parasite giardia is sometimes called "beaver fever". Why? Because one of its major reservoirs — species that can comfortably host a parasite and pass it on to others — is, yes, the beaver.

Now here's the part you probably don't want to hear. Giardia is transmitted via what's known as the "fecal-oral route".

Now, nobody intentionally goes out and eats beaver shit. (One hopes. But this is the internet.) But beavers do shit in the woods. Near woodland streams. Which means that unwary hikers and backpackers can end up ingesting giardia when they drink from what appears to be crystal-clear waters.

Via the Worms and Germs blog

The protective power of antioxidants might be vastly oversold

Maggie Koerth-Baker — Wed, 16 Jan 2013 20:47:01 +0000

Scientists are beginning to question the idea that free-radicals cause aging… and, with that, the entire basis of the antioxidant industrial complex. Maybe, now, everything can stop tasting of acai berries.

FDA wants Ambien doses cut for women because users are crashing cars the morning after

Xeni Jardin — Thu, 10 Jan 2013 19:46:35 +0000

The Food and Drug Administration today announced it will require the makers of popular sleeping pills like Ambien and Zolpimist to reduce the recommended dosage in half for women, "after laboratory studies showed that the medicines can leave patients drowsy in the morning and at risk for car accidents." Women eliminate the drugs from their bodies more slowly than men. (NYT)

Another danger for astronauts: Super bacteria

Maggie Koerth-Baker — Mon, 07 Jan 2013 21:57:24 +0000

Bacteria living zero-gravity environments become more virulent. People living in zero-gravity environments have less-than-fully-functional immune systems. The result is a danger for space travelers that few of us on Earth ever think about — even though a lot of early astronauts, right up through the Apollo program, suffered severe infections in flight, or shortly after landing. Ed Yong's article for Wired UK from 2011 is a reminder that there's a lot of details that need to be worked out before humanity can become a space-faring species. We've got more worry about up there than just radiation.