Boing Boing 

Why letting a pregnant woman's heart stop could save both her and her baby

I've been describing this Slate piece as the most awesome thing I really should not have read at 38 weeks pregnant. For decades, doctors thought that a pregnant woman whose heart stopped had pretty much no chance of survival. After trying to resuscitate her, attention would shift to rescuing the baby. But recent research suggests a better solution: Spend less time trying to get the mother's heart pumping again. Not only does it give the infants a better shot at survival, it also, insanely enough, saves more mothers. Turns out, once somebody removes the other human from your body, your failed heart will often just start pumping again on its own.

Man has replacement nose on his forehead

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Chinese surgeons constructed a replacement nose on a patient's forehead to replace his own that was injured. It will eventually be moved to the center of the man's face. This may look unusual but it surprisingly is fairly common practice. "The forehead is a traditional place to get extra tissue from to rebuild a nose," says Shehan Hettiaratchy, Chief of Plastic and Reconstructive Surgery at the Imperial College Healthcare NHS, who the BBC quoted as an expert on the matter. "The skin from there is a good match for nose skin. Most importantly, the forehead skin can be moved to the nose and keep its blood supply, which is essential otherwise the skin would die." This reminds me of body artist Stelarc's ear on his arm.

The One True Cause of all disease (All 52 of them)

A few years ago, Harriet Hall googled "The One True Cause of all disease", just to see what the Internet would come up with. She counted 67 One True Causes before she got bored (52 of them made it into the handy chart above).

Besides making for an amusing anecdote, this little exercise also helps illustrate why there's a problem with ideologically driven medical treatments — the sort that comes from people who are pushing a lifestyle or a philosophy along with ostensible healthcare. It's both intriguing and convenient to think that, if we just open the right secret door, we can find the thing that's actually causing all our problems. The truth, unfortunately, seems to be that our bodies and the world they inhabit are complicated and messy and that lots of of things can lead to disease (doctors typically learn to divide these things into nine different categories, Hall says). In fact, a disease we think of as a single entity can have its roots in more than one thing. All of this is pretty obvious but it's the kind of obvious that's worth rubbing our noses in on occasion. If somebody tells you that everything from obesity to bipolar disorder to allergies to cancer all stem from the same root and can be treated or prevented with the exact same treatment, there's probably good reason to question what they're telling you.

Auto-brewery syndrome: A medical mixed blessing if I ever heard of one

A gentleman in Texas briefly became an involuntary drunk (at one point ending up in the hospital with a blood alcohol concentration of .37, despite not having imbibed all day) when a colony of brewer's yeast took up residence in his gut and started converting every starchy food he ate into booze.

The dangers of Tylenol

ProPublica has an in-depth story about the hidden dangers of over-the-counter drugs, especially Tylenol. One of the key problems with Tylenol is that it doesn't take all that many extra pills to start experiencing harmful side effects. For instance, the maximum recommended daily dose is eight extra-strength tablets. Just two additional tablets a day, taken over a long period, can cause liver damage. All told, this isn't a massive risk — about 150 people die from Tylenol poisoning a year — but it does illustrate why you can't assume there are no risks, just because it's easy to buy something.

Why it's risky to be a bad-ass

At Matter, physical therapy professor Eric Robertson writes about a very rare condition called rhabdomyolysis — it's what happens when chronically overworked muscle cells rupture and overload your kidneys with massive amounts of protein. The results are painful, reasonably disgusting, and potentially deadly. Rhabdomyolysis used to be something you only had to worry about if you were, say, part of an elite military squad or a professional athlete. But as more average folks have gotten into elite physical training regimens through programs like CrossFit, the profile of people damaged by rhabdomyolysis is changing. Training like a bad-ass can bring along some of the physical risks of being a bad-ass.

Magnets! How do they work to relieve arthritis pain? LOL they don't.

In the NYT, an item on new research that reveals what many of us grumpy med-skeptics have self-righteously known all along: those copper bracelets and magnets your grandparents and arthritis-suffering friends are suckered into purchasing, to relieve their pain? Total quackery.

Medical terminology named after Nazis

Surprisingly, there are a good half-dozen medical eponyms that come from Nazi doctors who performed experiments on unwilling human subjects or used bodies of executed prisoners in their work — often in the course of discovering the very things that now bear their names. Clara cells, for instance, are a type of cell that lines small airways in your lungs. They're named for Max Clara, who discovered them by dissecting executed political prisoners.

The missing body of Addie Mae Collins

Yesterday was the 50th anniversary of the bombing of the 16th Street Baptist Church, a major event in the history of civil rights in the United States. Members of the Ku Klux Klan planted a box of dynamite at the church, which was a major organizing center for the black community and civil rights protests. The resulting explosion killed four girls — Addie Mae Collins, Cynthia Wesley, Carole Robertson, and Denise McNair.

That part of the story is pretty well-known. What isn't well known is the fact that one of those girls, Addie Mae Collins, may well have been a victim of racism after her death, thanks to a longstanding tradition where white medical schools raided black cemeteries for dissection cadavers. I happened to stumble across this story last week, while reading Harriet Washington's book, Medical Apartheid. The tale, and how it connects to racism both historical and modern, haunted me all day yesterday.

Read the rest

The history of zits

These are the ancient Egyptian hieroglyphs that are thought to refer to acne. They're part of a nifty piece by Hilda Bastian that looks at the history of our understanding about zits — where people thought they came from before we knew about their relationship to hormones and bacteria. And how some of the myths that originated in that pre-scientific understanding still affect our cultural attitudes about acne and the way anti-acne products are marketed to us today.

Snake wine drinker suffers bite

NewImage

A Chinese woman reportedly suffered a snake bite when the reptile jumped from her wine bottle and struck her hand. Apparently, the woman from Shuangcheng, Heilongjiang Province had been drinking pickled snake wine to treat her rheumatism, but this particular snake was still living. Snake wine is a common curative in traditional Chinese medicine. (Global Times)

(image: Genghiskhanviet/Wikipedia/CC)

Completely heartbreaking medical case report

A 3-year-old girl enters a hospital with severe Vitamin A deficiency and micronutrient malnutrition. The cause: Her parents had self-diagnosed her with so many food allergies that her entire diet consisted of chickpea milk, bison meat, and salicylate-free vegetables. (Which, basically, means very few vegetables.) An older sister on the same diet had developed scurvy and rickets. The case report is technical and dry, but the story you can see happening underneath is just heart-wrenching. Especially the point at which the parents refuse Vitamin A supplementation and the doctors have to call child protective services.

Don't listen to Mom (or observational data): Breakfast isn't necessarily the most important meal of the day

Here's a great piece by Anahad O'Connor that looks at the dozens of studies that are supposed to link the act of eating breakfast with weight loss — and the problems that very quickly arise when you look at them closely. The biggest issue: Most of the advice you get telling you to eat breakfast if you want to lose weight is based on observational studies — large collections of information about people's lives and health that scientists then comb through looking for correlations. Like any correlation, those associations should be thought of as jumping-off points for more research, not proof of how you should live your life. With breakfast and weight loss, the truth seems to be that the two things may not be connected at all. For every study that shows them inextricably linked, another found no relationship at all ... or even an inverse relationship, where skipping breakfast led to weight loss.

How much booze is too much booze?

At Forbes, Katie Kelly Bell has an interesting look at the extremely subjective measurements happening behind the seemingly objective instruction to drink only "in moderation".

16th-century nose jobs

Swords: A major cause of nose loss in 16th-century Europe. (Also a problem: syphilis.) The good news is that somebody had a plan for how to replace your missing nose. The bad news is that there was no anesthesia, the process could kill you, and you had to spend two weeks with your nose in your own armpit.

What would have killed your 19th-century doppelgänger?

Slate is doing a series of articles on life expectancy in the United States, both how it's changed and why. It kicks off with a piece that gives a broad overview of the medical and public health factors involved in our increased longevity — from clean water and the germ theory of disease, to generally increased wealth and nutrition, to vaccination. But author Laura Helmuth also offers up a morbidly fun challenge, asking you to think about how many times you might have already died had you been born before all these revolutionary changes happened.

It’s a fun conversation starter: Why are you not dead yet? It turns out almost everybody has a story, but we rarely hear them; life-saving treatments have become routine. I asked around, and here is a small sample of what would have killed my friends and acquaintances:

Read the rest

Placebos work, so how do we ethically use them?

The head of Harvard's placebo program is trying to figure out a good answer that question.

The Elephant Man's secrets

"The Elephant Man, Joseph Merrick, was an object of curiosity and ridicule throughout his life - studied, prodded and examined by the Victorian medical establishment. Now, 123 years after his death, scientists believe his bones contain secrets about his condition which could benefit medical science today." [Andrew Bomford / BBC]

A moving account of how hospitals negotiate complicated cases of patient rights

Yesterday, a story about human experimentation spurred an interesting discussion in the comments about patient rights — can somebody who is dying make the informed decision to accept a treatment that could lead to them dying sooner? At Scientific American today, an HIV doctor has written a moving account of dealing with a very similar question, as one of his patients made the choice to refuse food, and her family and doctors were faced with the task of deciding whether or not to feed her through a stomach tube.

China says it will stop harvesting organs from prisoners

More than half of China's donated organs come from executed prisoners. The Chinese government now says it will begin phasing out that practice, starting in November. All new organ donors must volunteer. Of course, there's good reason to be skeptical of this announcement. As Smithsonian points out, the practice has already been illegal since 2006 with not much done to change it. Meanwhile, a harrowing 2011 investigative report by Ethan Gutmann in the Weekly Standard revealed a system that leaves plenty of room for "volunteer" loopholes.

How the stethoscope was invented

The first stethoscope was a sheaf of rolled paper. It later evolved into a foot-long wooden tube. The inspiration: Possibly a couple of French street urchins playing on top of a pile of lumber.

Naming prescription drugs

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How do pharmaceuticals get names like fluoxetine, atorvastatin, modafinil, or sildenafil? Those are the generic names for some common prescription drugs. The drug company with the patent on the pill gets to choose the generic name. The U.S. Adopted Names Council has rules on such matters though, as The Week's James Harbeck writes:

• "Prefixes that imply 'better,' 'newer,' or 'more effective;' prefixes that evoke the name of the sponsor, dosage form, duration of action or rate of drug release should not be used."

• "Prefixes that refer to an anatomical connotation or medical condition are not acceptable."

• Certain letters or sets of letters also aren't allowed at the beginning of new generic names. These include me, str, x, and z.

Every name has two main parts. The back half of the drug name is the same for all drugs in a particular class — for instance, there are a whole raft of cholesterol-lowering drugs that end in -vastatin: atorvastatin (Lipitor), fluvastatin (Lescol), rosuvastatin (Crestor), simvastatin (Zocor), and several others.

"How do prescription drugs get such crazy names?" (via NextDraft)

image: detail of Damien Hirst's "In Search of Nirvana" (2007)

Evidence-based pregnancy should be about decisions, not hard rules

If there's one thing I'm learning from the crop of evidence-based pregnancy books I've been perusing, it's this: Pregnancy ought to involve a lot more complicated decision-making and less blind rule following. That's because the stuff that gets touted as "must-do" or "can't do" is often, in reality, just one way of interpreting a conflicting and correlation-heavy body of data. Usually there is more than one appropriate, evidence-based decision that you can make, depending on your personal beliefs, desires, and goals. At the Wall Street Journal, Emily Oster does a great job of writing about this, using taboo libations alcohol and coffee as the examples.

A big win for consent, privacy, and genome data

The family of Henrietta Lacks — a woman whose cervical cancer cells were harvested and used in scientific research for decades without her knowledge or consent — will now play a role in deciding who has access to the Lacks' cell genome data, and for what purposes. There are loopholes in the new system. For instance, the agreement only applies to scientists who receive National Institutes of Health funding. And the genome of the cells has been sequenced so many times, at this point, that anybody who wasn't NIH funded and didn't want to voluntarily abide by the agreement essentially wouldn't have to.

But it is a big step forward, both for the Lacks family (whose own genetic information is contained in those genome sequences) and for the idea that human genetic information belongs to the people it comes from — not to whoever happens to sequence it.

The happy selfie posted here features NIH director Francis Collins posing with some of Henrietta Lacks' descendants after the agreement was announced.

From the front lines in the fight against antibiotic-resistant bacteria

Bacteria are becoming resistant to one of the last classes of antibiotics available to treat them, writes Maryn McKenna at Nature. Carbapenem-resistant Enterobacteriaceae are a family of lung, blood, and bladder infections that can turn horribly deadly. Meanwhile, at Scientific American, Charles Q. Choi writes about other scientists looking for ways to turn bacteria against one another, unleashing predatory microbes that can destroy drug-resistant bacteria.

Gummi vitamins: Not all they've smooshed up to be

Not all vitamins are created equal. Especially troubling, gummi "prenatal" vitamins that don't contain any calcium, thiamin, riboflavin, or iron. As Joss Fong points out at Double X Science, not only are pregnant women one of the few groups that can be shown to statistically benefit from taking vitamins, the missing iron is also one of the key things those women need. So why can you label a vitamin "prenatal" if it doesn't contain nutrients that are crucial to pregnant women? Consider this another friendly reminder that the dietary supplement industry is largely unregulated and doesn't have to answer to the FDA, except in a few, very specific circumstances.

Beauty of disease

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Medical photographer Norman Barker captures the biological beauty of human disease -- microbes, cysts, diseased cells, as they appear out of context and close up. A professor of pathology and art at the Johns Hopkins University’s School of Medicine, Barker's new book is titled "Hidden Beauty: Exploring the Aesthetics of Medical Science." Above left, the Hepatitis B virus, and right, a fine collection of gallstones.

"Hidden Beauty: Exploring the Aesthetics of Medical Science" (via Smithsonian)

A smart knife for surgeons

Researchers at Imperial College London have invented an electric surgical knife that comes equipped with a built-in mass spectrometer. Electric knives cauterize wounds as they cut, which produces smoke. The iKnife will be able to analyze the chemistry of that smoke to determine, for instance, whether the tissue that was just cut was cancerous or not — allowing doctors to make decisions in the OR that would, today, require them to take samples, send those samples to a lab, and maybe schedule a second surgery.

If you have to take an antibiotic, should you take a probiotic, too?

It probably won't hurt, and it could help, says Scott Gavura at Science Based Medicine. But it's also worth taking a closer look at the nuance behind probiotics, too. These are promising medications and a fascinating field of research, but educating yourself on what we do know and what we don't (especially when it comes to purity of various products) is a really good idea.

Sawbones, an enjoyable medical history podcast

Maximum Fun, the outfit that produces two of my favorite podcasts (Bullseye and Judge John Hodgman) has announced a new show. It's called Sawbones. Jesse Thorn says: "It's about the history of medicine, particularly the crazy bits. It's hosted by Dr. Sydnee McElroy & Justin McElroy. Justin's also one of the hosts of My Brother, My Brother & Me, one of our most popular shows. And they're married. Sydnee's a medical history nut, and Justin good at bothering his wife about things, so they are a good team."

Sawbones