Cell 2 Soul: The Humane Health Care Blog

Marginal Notes: The Inflammatory Response

I sat next to the Chinese woman and stared out the salt-streaked window at the white-capped waves, conscious of the slight pitch and roll of the ferryboat.  She was a Ph.D. biologist who headed a lab devoted to pharmacological research for treatment of dermatological disease.

“Thirty years ago,” she continued, “we treated the pain of rheumatoid arthritis with almost no thought to attacking the disease at the root of the problem—autoimmune inflammation.  Now we have mapped the biochemical cascade of the inflammatory response—cytokines, prostaglandins, interleukins, complement—and we are in the process of designing drugs to block these agents to prevent tissue destruction.  It is all so fascinating.”  more»

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

Marginal Notes: Thought to Thought

Photons fly and strike the rods and cones of another human retina, triggering biochemical impulses transferred via the optic nerve to the occipital lobe of another human brain—reception of thoughts, ideas, concepts, emotions, problems, solutions—the stuff of life. >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

Marginal Notes: Of Cosmic Significance

Electrons, photons, butterfly wings—minute reverberations through a complex universe that extend well beyond our ken. >>more

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

How Microbes Defend and Define Us

by Carl Zimmer 

This NY Times article should interest anyone who takes a wide-angle view of health and disease.  It focuses on the "Microbiome:" which is defined as "the totality of microbes, their genetic elements (genomes), and environmental interactions in a defined environment. A defined environment could, for example, be the gut of a human being or a soil sample. Thus, microbiome usually includes microbiota and their complete genetic elements."

Zimmer's article is a fine introduction to this area and is a glimpse into a brave new world which determines how we are well and ill.  It is worth reading and rereading.  There is lots of basic science here, but also stuff of philosophy.  The microbiome is an important terra incognito, the understanding of which may help some of us to lead healthier lives.

This illustration shows the body sites that will be sampled from volunteers for the Human Microbiome Project, part of the NIH's Roadmap for Medical Research.

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Marginal Notes: What's Wrong, What's Right?

In his new book Wrong, science journalist David H. Freedman asks why scientific pronouncements often turn out to be misleading, exaggerated or entirely off the mark. Freedman ponders:  “If tests of the exact same idea routinely generate differing, even opposite, results, then what are we supposed to believe?”

 

Perhaps scientists themselves possess their own set of preconceived notions, which in turn dictate how they interpret the data they measure. >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."

Marginal Notes: Sufficient Depth

As a young man, Samuel Clemens spent two years learning the lay of the Mississippi River to become a licensed riverboat pilot.  No sooner had he completed his apprenticeship than he realized that the topography of the river had changed.  In order to maintain his proficiency, he would have to continue to study the waterway, which remained in a constant state of flux.

Rivers are not the only things that change over the course of time.  Medical knowledge morphs with each new piece of data that is discovered.  Just when we think we’ve got it all figured out, voilà—a piece of information gleaned from the latest research hints that we’re probably off the mark; and so we set off again, chasing a new lead.  >>more

 

Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years.  His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life." 

Medicine's Murky Frontiers

Almost anything the investigative reporter Barry Meier writes is worth reading.  His book, Pain Killer, which we reviewed in Cell 2 Soul in 2005, is a brilliant expose of Oxycontin and the company that hawked it to an unsuspecting public.

Mr. Meier's recent articles in the NY Times about a new device which may prevent stroke in people less than 55 years old should be read by all since it gives insight into the medical device industry and the murkiness of science.  Reading between the lines, I'd suspect that Mr. Meier's next book may be about such devices as there are a number of them being used without sufficient proof at great financial, and sometimes human, cost.

A Device to Avert Stroke Lacks Proof that it Works

"Every year, experts estimate, about 80,000 seemingly healthy people in this country under the age of 55 have a stroke for no apparent reason. Some researchers have long suspected that one culprit is a cardiac defect that 40 percent of those people share — a tiny congenital opening between the upper chambers of their hearts

Based on that theory, doctors in recent years have implanted a small flexible seal in the hearts of thousands of stroke patients. The idea is that closing the hole will prevent future strokes by blocking a pathway for blood clots."

 

Full article.

In a companion piece, Mr. Meier reports on a lawsuit brougt by this device maker agains a British researcher who claimed online that the device is flawed.  Meier does a fine job of reporting the shades of gray. Also see: Device Maker Sues Doctor Who Called Its Product Flawed.

Cell 2 Sport

The New Times Journal of Medicine has an interesting article about a genetic test for sports ability that will determine the athletic potential of a new born.  "The test’s goal is to determine whether a person would be best at speed and power sports like sprinting or football, or endurance sports like distance running, or a combination of the two.  Atlas Sports Genetics is marketing this."

This is a thorough well-researched article that discusses pros and cons.  We'd be interested in hearing from parents, grandparents and pediatric practitioners in the C2S cybersphere about this Brave New World.

NYT, November 29, 2008  Little Ones Get Test for Sports Gene

Comments:

Brian Maurer, Pediatric Practitioner:  So now we have the ability to test young children for a gene that might help to determine future athletic ability.  Depending upon the results, children can be channeled at relatively young ages into specific training venues to enhance their natural athletic prowess.  Amazing—and all for the cost of just $149!
     I note that the two chief proponents of the test—Mr. Reilly and Mr. Epley—happen to have vested economic interests in marketing both the test and the training venues.  In spite of this obvious fact, many parents will undoubtedly jump at the chance to have their toddler tested.  One mother’s words are telling:  “What if my son could be a pro football player and I don’t know it?”  What if indeed?
     I echo Mr. Morgan’s sentiment that not many parents are going to be clear-minded about this.  For years we’ve had parents squabbling about the caliber of their children’s preschool experience to improve the chances that their son or daughter would gain admittance to a top undergraduate school.  In a sense, evaluating children for athletic ability falls in line with such over-zealous thinking.
    I agree with Dr. Ray Howe, the general practitioner in Denver, who says he would rather see his 2-year-old find his own way in life and discover what sports he likes the best.  But then I’m old-fashioned:  I still believe in letting children enjoy their childhood.

Caitlin Stiglmeier, Medical Student: I like the idea of letting kids be kids, and testing their speed on Dr. Fowlers'  "line then up and let them run" method. A child should be able to pursue the type of sports they are passionate about, not what they're genetically capable of.  Ultimately, what really determines a person's success, athletic or otherwise, is tenacity, passion, determination and attitude. 

Your comments are welcome as well.