Fourteen-year-old Jillian Bernstein
got herself published in the Journal of the American Medical Association
by comparing the transparency of medical costs at Philadelphia hospitals with the transparency of parking rates at the same hospitals. Out of 20 hospitals, 19 were happy to provide information on the cost to park a car. Only three, however, were willing to tell her how much it would cost an uninsured person to get an electrocardiogram, and those prices were ridiculously variable — $137, $600 and $1,200, depending on the hospital.
For once, the answer to a question in the headline is, "Well, quite possibly."
It's been 100 years since a well-documented case of penis captivus — i.e., penis-stuck-in-vagina syndrome — appeared in the medical literature. But that doesn't mean it's a total myth. The BBC's Health Check discusses the physiological mechanisms that could lead to such an unpleasant event and explains why there are lots of anecdotal stories surrounding something that's thought to be "vanishingly rare" from a medical perspective. Hint: While very, very, very few people end up needing medical treatment for penis captivus, there may be many more who get temporarily-but-disconcertingly stuck for a few seconds.
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Every year, more than 2000 Americans experience a serious negative effect (either death or illness) from taking over-the-counter dietary supplements. Since 1994, it's been legal to sell supplements without prior safety testing. Even when someone gets sick, the burden of proof is on the FDA to prove the supplement caused it, rather than on the supplement company to prove it didn't. The Dallas Morning News
reports on the lack of oversight and what it costs us.
In 1972, Franken Berry cereal, then a brand new product, was the subject of a paper in the medical journal Pediatrics because it caused a 12-year-old to have red poop. He had been hospitalized for several days for what appeared to be rectal bleeding but turned out to have been the red dye (FD&C Red No. 2 and No. 3) in the Franken Berry. In related news, Booberry can turn your stool green. "Benign Red Pigmentation of Stool Resulting from Food Coloring in a New Breakfast Cereal (The Franken Berry Stool)
" (Pediatrics via Smithsonian)
Mark Johnson of the Milwaukee Journal Sentinel has put together an amazing four-part story about medical students entering a human dissection lab
for the first time. Interweaving the stories of the students, their teachers, and people who have chosen to donate their bodies to science, the series really gives you a sense of how emotionally intense the experience can be for students, and how it brings together all these different lives. Powerful stuff.
Pap smears — the pre-cancer-screening that most women get annually when they visit a gynecologist — should only cost about $20 or $30, writes Dr. Cheryl Bettigole in The New England Journal of Medicine. So, why then, are more women (and/or their insurance companies) paying much, much more
— sometimes upwards of $1000? A big part of the problem is add-on tests — extra screenings that haven't been shown to make women healthier, but do add a lot to the cost of an annual exam. Turns out, medical laboratories have started marketing these pap+ tests, using some of the same techniques pharmaceutical companies have long used to sell more expensive treatments to doctors.
If the cells that make up your body are little factories, then the shipping department just picked up a Nobel Prize this morning with the award for physiology or medicine going to researchers Randy Schekman of the University of California at Berkeley, James Rothman of Yale University, and Thomas Südhof of Stanford. These scientists don't work together, but their research does overlap and play off each other in important ways. In fact, this isn't the first time some of these men have shared major research awards.
What makes their work so important? It's really all about increasing our understanding of how individual cells operate and participate in major bodily systems like immunity or hormone control. If you built little models of cells back in grade school, you probably have a mental image of them as a sort of lumpy sack with a couple of things inside — a big fat nucleus and some squirrelly little mitochondria, mostly. But it turns out that there's a lot more happening in the interior of a cell than that. Much of that activity is centered around vesicles — bubbles in the fluid that fills a cell. There are many different kinds of vesicles doing many different jobs, but one of the important things they do is move molecules, either within the cell or from the cell to the outside world.
Read the rest
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.
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.
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.
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.
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.
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.
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.