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Showing posts from February, 2010

How to Live to 100

Research from Denmark shows that life expectancy is increasing steadily and there is a good possibility that by controlling life factors, most everyone can live to be 100. Of course, living in a high income, first world country is the first factor. The Danish experts report that since the 20th century, people in developed countries are living about three decades longer than in the past.

Check out the list (click on it for a better read) to see what factors you can control.

Tip: Don't eat the nuts if you have an allergy. That would definitely lower your chances! And having a baby "later in life" does not mean with IVF or infertility drugs. And a "little" wine doesn't mean a bottle a day.

Answer to Medical Challenge.

The answer to yesterdays Medical Challenge is...drumroll....
#4 - Intraabdominal Cancer.

The nodule is called a "Sister Mary Joseph's" nodule and is a lymphatic metastasis to the umbilical region. This 12 year old girl had decreased appetite, vomiting and weight loss. A CT scan showed a large pelvic mass originating from the ovary, hepatic metastasis, ascites and a mass through the umbilicus.

Sister Mary Joseph Dempsey (born Julia Dempsey; 1856-1939) was the surgical assistant of Dr. William J. Mayo of Mayo Clinic. She drew Dr. Mayo's attention to the nodule and he published the first article about it in 1928.

What is the Diagnosis?

How good of a diagnostician are you? This challenge from the New England Journal of Medicine is tough. (I missed it the first time).
Q: This 12 year old presented with decreased appetite and vomiting. What is the most likely diagnosis?
1. Endometrioma
2. Hernia
3. Keloid
4. Intraabdominal cancer
5. Urachal duct cyst.

Click on the image for a better view and make your guess. The answer will be posted tomorrow.

King Tut Died From Malaria

In 1922 the intact tomb of King Tut was discovered in Egypt. Technology shows us that the boy died around 1324 BC and was probably around 19. Anthropologists from Egypt, Germany, Italy and other countries studied DNA and performed tests on 16 royal mummies and found that four, including King Tut, had contracted a severe form of malaria called Plasmodium falciparum. Tut also had a broken leg and they believe malaria killed him.

It is amazing that scientists are able to take a mummy and find out so much about his life after studying the DNA for two years. Here is what we now know about King Tut:
He had a cleft palate, a left clubfoot and other bone ailmentsHe suffered from Kohler disease, which can cause foot bones to collapse from lack of bloodHe probably needed canes to walkTwo of the other mummies were Tut's father, Akhenaten and his grandmother, Tiye, based on shared blood groups.His parents were brother and sisterThere was no foul play in his death
King Tut ruled during a 1…

Anthem Blue Cross Receives Shame Award

EverythingHealth feels justified in awarding this weeks Hall of Corporate Shame Award to California Anthem Blue Cross. California Insurance Commissioner Steve Poizner said Anthem Blue Cross "violated state law more than 700 times over a three-year period by failing to pay medical claims on time and repeatedly failed to respond to state regulators as they investigated complaints over the last year". They uncovered 133,000 violations of state law over payments for medical care.

In addition, Anthem Blue Cross raised rates on their private paying customers a shocking 39%, stating the recession and people losing coverage made it happen. They said the shifting demographics took a big bite out of their profits.

Hmmm...somehow Anthem's parent company, Wellpoint outpaced inflation 10 to one and posted $2.7 billion profit in the last quarter of 2009 alone!

Anthem is the largest for-profit insurer in California. The rate hikes would affect many of the 800,000 individual policy h…

Mother's Diet May Prevent Infant Allergies

Why do some kids get allergies and some don't? A new study published in Allergy 2010 may give us some answers. The women who ate more green and yellow vegetables, citrus and high beta carotene while they were pregnant had fewer babies with eczema. They also found that foods high in vitamin E lessened the risk of having a wheezy baby.

The researchers from Fukuoka University in Japan studied 763 pregnant women and evaluated their fruit and vegetable intake during pregnancy. The women averaged 30 years of age and were 17 weeks pregnant at enrollment. (average gestational time is 40 weeks). After controlling for exposure to smoke, number of older siblings and breastfeeding history, they found that women who ate more vegies, citrus fruits or beta carotene were less apt to have an infant with eczema. (54 vs 32 infants).

Like other studies from the U.S. and U.K., these researchers showed higher intake of Vitamin E reduced the likelihood of having a wheezy infant.

These are pretty easy…

Genius On The Edge is a Great Read

I am one who loves medical history and Genius On The Edge - the bizarre double life of Dr. William Stewart Halsted, was a captivating read. For those who don't know, Dr. Halsted is known as the "Father of Surgery" and practiced medicine after the civil war. Written by author physician, Dr. Gerald Imber, the medical facts are sound and the story is fascinating for any reader.

We learn that in 1850 there was no anesthesia, no knowledge of germs, no IVs or blood transfusions and no more than 200 surgeries a year were performed because the outcomes were usually disastrous. The patient who needed emergency surgery died of overwhelming infection, gangrene or shock from blood loss.

Dr. William Halsted, like all physicians of that time, was born into wealth and privilege. He began his training in 1875, ten years after Louis Pasteur showed sour milk was caused by a bacteria and when Robert Koch was able to cultivate the anthrax bacillus. At a time when surgeons were not washi…

Winter Blog Break

EverythingHealth will have a blog hiatus for the next week. For great reading, check out the links on the right side of this blog. The other health bloggers are excellent...but make sure you come back.

Stuttering Caused by a Genetic Mutation

Stuttering has always been a fascinating phenomenon to me. Stuttering is a speech disorder where the person repeats or prolongs a sound and doesn't have a normal flow of speech. I have known severe "stutterers" who have undergone speech therapy without much help. There have been famous singers (Mel Tillis is one) who stuttered severely when they spoke, but not when they sang.

Now for the first time, a study led by researchers from the National Institute on Deafness and other Communication Disorders, and published in the New England Journal of Medicine, has identified three genes that they believe are involved in stuttering. Three million Americans stutter and until now the cause has been a mystery.

The researchers found the same gene mutation in unrelated families in the United States, Britain and Pakistan.

When I read about these discoveries that link disorders to genes it makes me feel a little sad. Like autism and bed wetting, doctors in the past would blame …

Modest Hospital Gowns

While the U.S. argues about health care reform and Blue Cross Anthem raises rates a shocking 39%, somehow our "socialist" brothers across the Atlantic are able to implement better hospital gowns.

The British government of Bristol, England commissioned designers to develop a better hospital gown. The U.S. born designer Ben deLisi, who has designed for Kate Winslet and other stars came up with a luxury cotton wrap around gown that limits exposure.

Health Minister Ann Keen said the designer gowns would be introduced into NHS hospitals in England by early 2011.

The hideous, ill fitting old gowns will be replaced by the new gowns

Colon Detoxification

The internet is full of colon cleansing methods that tout the benefits of colon detox. I saw one website that showed long "worms" that live for years in the colon that "need" to be removed with special expensive potions. One of the most common questions for GI doctors is about colon cleansing and if it is beneficial. I don't know any physicians who believe the colon needs "detoxification" or special cleansing, but until now I didn't have a scientific way to answer that question from patients.

A study from the Am J. Gastroenterology now gives us the answer. The study authors looked at all relevant articles published between 1966 and 2008. They blinded the articles and measured outcomes and adverse events.

No research articles addressed the effect of colon cleansing on general health or on specific conditions such as hypertension, asthma, irritable bowel syndrome, arthritis, sinus congestion or alcoholism, despite the fact that these conditions …

Report a Doctor and Go to Jail

Two nurses in Texas reported a physician to the Texas Medical Board for unethical and unsafe behavior toward patients. They directed the Medical Board to six cases where Dr. Rolando Arafiles should be investigated for improper prescribing and surgical procedures. In one case he performed a failed skin graft without surgical privileges. He also sutured a rubber tip to a patient's crushed finger for protection. This was so unconventional that it was flagged as inappropriate by the Texas Dept of State Health Services. The nurses believed the hospital administration (and presumably the medical staff too) were not properly monitoring him so they made their anonymous report to the Medical Board.

It seems Dr. Arafiles has friends in high places. His friend is the Winkler County sheriff and he used his power to find out who the nurses were and Dr. Arafiles has filed suit against them for "misuse of official information," a third-degree felony in Texas. The 2nd nurse was d…

Can I Eat It Off The Floor?

Michael Jackson's Doctor Charged with Manslaughter

Dr. Conrad Murray, the Huston, Texas cardiologist celebrity doctor to Michael Jackson will be charged with involuntary manslaughter today in the Los Angeles courtroom when he voluntarily surrenders.
He has been virtually underground since June 2009, after he gave the singer a powerful anesthetic (Propofol) and other sedatives that were blamed for his death.

Propofol is a strong anesthetic that is usually given in a hospital, by medical doctors that are trained in its administration and with rescue equipment close by. Also known as Diprivan, it is an injectable that is used in intensive care units for patients that are intubated (on respirators) or for patients that are undergoing surgical procedures where sedation is required. In healthy patients, Propofol causes a decrease in blood pressure, depending upon the dose and the speed of infusion.

Propofol is never given as an injection and the patient left alone. It is a drug that requires constant monitoring of the vital signs and resp…

Beleagred Health Care Providers

I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen. One insurer even told him (the owner of the business) to just "make the sessions shorter and don't give as much care." As if that is how it works..."You get little just do a little".

Clearly the insurance intermediaries, who never actually see a patient or deliver any care, haven't got a clue how this whole health thing works. They are happy with mediocre doctors that cut time and care. Those doctors (and physical therapists) run mills, but the insurance companies are happy with them. Quality and quantity of time are not rewarded, and in fact are punished in the health care environment we have.

He asked me if Primary care had any problems like that. I felt like screaming "Aren't you …

Blog Followers

If every visitor to EverythingHealth signed up to be a "follower of the blog", I would have over 1,000 new followers a day.

Come-on. Make my day!!!

Health Insurers Boom

One patient informed me today that her Anthem Blue Cross insurance premium went up by $89.00 this month. She is responsible for a large up front deductible and she is (thankfully) healthy and ends up paying out of pocket for her health care because she seldom meets the deductible.

A 2nd patient sent me this from the Wall Street Journal:

UnitedHealth Group Inc.'s fourth-quarter earnings rose 30%, helped by prior-year litigation-related charges, higher enrollment than the company expected and subsiding costs related to the H1N1 flu outbreak.

The company reported a profit of $944 million, or 81 cents a share, in the fourth quarter, compared with $726 million, or 60 cents, a year earlier. Results for the prior year included $350 million in litigation settlement-related costs.

With the failing economy I guess we should be happy that there is an industry that is booming. Unfortunately it is booming at the expense of the customer paying outrageous premiums.

It turns out that the CEO of Uni…

Detecting Ovarian Cancer is Difficult

The thought of ovarian cancer strikes fear for many women. Although it is not the most common cancer for women (Breast, Lung, Colon and Skin Cancer are more common), it is one of the most deadly because we have no early screening tests for ovarian cancer and it is usually advanced when detected. Women have been told that paying attention to "symptoms" and informing their physicians may be the best way to detect early ovarian cancer.

A new study published in the Journal of National Cancer Institute unfortunately shows that symptoms are a poor way of detecting early ovarian cancer. The study included over 800 women with ovarian cancer matched against a control group. The women were questioned about symptoms a year before diagnosis. The symptoms were abdominal pain, bloating or urinary urgency...symptoms that women are told to be vigilant about.

The study found that women with cancer were 10 times more likely to experience those symptoms. But there was no difference between detec…