Wednesday, August 29, 2007
Docs, Read This Q.D.
Medical quality maven Avery Comarow has just posted an item that doctors should read q.d.--that is, every day--to remind them of an easy way to prevent one kind of medical error.
Monday, August 20, 2007
Climate Change Will Grip the Heavens' Spigots
An article in the Washington Post today describes the likely effects of global warming on precipitation patterns around the globe. It quotes (on the second page) Richard Seager of Columbia University's Lamont-Doherty Earth Observatory saying that Dust Bowl-like droughts in the first half of this century will create "climate refugees." That phrase still gives me the willies.
The graphic that appears with the story indicates that Europe and Mexico are going to get particularly walloped by the drying--and what little rain does fall will fall more intensely; the article also quotes Stanford's Stephen Schneider referring to "more gully washers."
The graphic that appears with the story indicates that Europe and Mexico are going to get particularly walloped by the drying--and what little rain does fall will fall more intensely; the article also quotes Stanford's Stephen Schneider referring to "more gully washers."
Thursday, August 16, 2007
Darklessness
I've been thinking about it a lot recently. Now I'm typing about it--in the darkness. Or at least as close as my world is going to get to darkness this morning. I woke up at exactly 5:00 a.m., according to the only artificial light in my bedroom, the three glowing red digits of my alarm clock. And yet I could see quite clearly: my closet, the door, the art on the walls. And, of course, the outlines of the blinds on my windows, which do not fully obscure the urban light spilling in from the street outside. Even with the alarm clock's face completely covered by my hand, I could see just as clearly as before, by the city's glow, the artificial world around me.
Hence my small rebellion: I'm typing by the soft light of my laptop screen, and that light from the windows--and nothing more. It's still too much, in a sense. I can almost feel the ebb of melatonin from my blood. Among other things, that nocturnal hormone protect people against cancer. But melatonin flees the light, so my level of it is presumably now falling because of the increased brightness of my immediate environment. (That said, I just took 3 milligrams of the stuff in a pill, in an artificial effort to offset the effect of the artificial light.)
Darkness-less (or is it darklessness?) rarely leaves my mind these days. It was hard not to think about it when, for example, I went stargazing--meteor-watching, actually--with some friends earlier this week. Sunday night was said to be the annual peak of the Perseid meteor shower, so we drove to the darkest spot we could find within a few miles of our Washington, D.C., homes. Our driver turned off the headlights as we approached the site, knowing that other stargazers with darkness-adjusted eyes would already be there. To help our own eyes adjust, we used no flashlights as we climbed out of the car and laid out a blanket. And even then, we saw only a few shooting stars in the hour-plus that we spent lying on our backs beneath the sky. How many did we miss, how many passed unseen before our eyes, obscured by the glow of our nation's capital?
David Owen offers an answer of sorts--and much, much more--in a beautiful piece he wrote for the current issue of the New Yorker:
Hence my small rebellion: I'm typing by the soft light of my laptop screen, and that light from the windows--and nothing more. It's still too much, in a sense. I can almost feel the ebb of melatonin from my blood. Among other things, that nocturnal hormone protect people against cancer. But melatonin flees the light, so my level of it is presumably now falling because of the increased brightness of my immediate environment. (That said, I just took 3 milligrams of the stuff in a pill, in an artificial effort to offset the effect of the artificial light.)
Darkness-less (or is it darklessness?) rarely leaves my mind these days. It was hard not to think about it when, for example, I went stargazing--meteor-watching, actually--with some friends earlier this week. Sunday night was said to be the annual peak of the Perseid meteor shower, so we drove to the darkest spot we could find within a few miles of our Washington, D.C., homes. Our driver turned off the headlights as we approached the site, knowing that other stargazers with darkness-adjusted eyes would already be there. To help our own eyes adjust, we used no flashlights as we climbed out of the car and laid out a blanket. And even then, we saw only a few shooting stars in the hour-plus that we spent lying on our backs beneath the sky. How many did we miss, how many passed unseen before our eyes, obscured by the glow of our nation's capital?
David Owen offers an answer of sorts--and much, much more--in a beautiful piece he wrote for the current issue of the New Yorker:
"Today, a person standing on the observation deck of the Empire State Building on a cloudless night would be unable to discern much more than the moon, the brighter planets, and a handful of very bright stars--less than one per cent of what Galileo would have been able to see without a telescope."
So, in another place, in another time, the three or four streaks of light that I glimpsed while watching the Perseids might have been complemented with several hundred other shooting stars. Instead, those glowing rocks, eclipsed by the spillage of light from the city, eluded my eyes. I returned home that night a bit disappointed. Like my vigil itself, the final glory of those meteors--the blazing arcs they traced in their self-destroying entry into earth's atmosphere--had been in vain. The light seared all.
Our world, it seems, has grown darkless.
Friday, July 6, 2007
A Bad Time to Blog
A short item buried in the Metro section of today's Washington Post offers a reminder, if we needed one, not to use corded electronic equipment when the weather is threatening.
On Wednesday, July 4, a D.C.-area fellow got a jolt when, during a thunderstorm, power surged into his house and into the computer perched on his legs. He's okay, thank Physics, but he -- and I -- relearned an important lesson: You don't have to be struck directly to be harmed by lightning.
Ironically, I, another D.C.-area resident, didn't even notice the July 4 storm. I was at my friend Stan's apartment, and we were too absorbed in setting up his blog, The Food Sleuth, to notice the storm outside.
We were using a corded desktop. Good thing we didn't experience a power surge.
On Wednesday, July 4, a D.C.-area fellow got a jolt when, during a thunderstorm, power surged into his house and into the computer perched on his legs. He's okay, thank Physics, but he -- and I -- relearned an important lesson: You don't have to be struck directly to be harmed by lightning.
Ironically, I, another D.C.-area resident, didn't even notice the July 4 storm. I was at my friend Stan's apartment, and we were too absorbed in setting up his blog, The Food Sleuth, to notice the storm outside.
We were using a corded desktop. Good thing we didn't experience a power surge.
Wednesday, June 13, 2007
Wheat Dust Can Cause Celiac Disease
In a brief, unusual report (password required) in Thursday's New England Journal of Medicine, researchers report a pair of cases of celiac disease in farmers who inhaled gluten while feeding their animals.
Celiac disease is condition that some people develop if they consume wheat gluten or certain related proteins. A gluten-free diet is the best way to reverse the abnormal reaction and prevent it from recurring. But a gluten-free diet, which was prescribed to the farmers by a doctor, didn't work. It was only after considerable investigation that researchers realized the farmers were still consuming the stuff: Gluten got kicked into the air each time they filled their animals' troughs, and they were swallowing enough of it to trigger symptoms.
When the farmers took additional precautions -- wearing a mask in one case and avoiding the task of filling troughs in the other -- the celiac disease resolved. Sounds like an episode of "House, M.D.," doesn't it?
Celiac disease is condition that some people develop if they consume wheat gluten or certain related proteins. A gluten-free diet is the best way to reverse the abnormal reaction and prevent it from recurring. But a gluten-free diet, which was prescribed to the farmers by a doctor, didn't work. It was only after considerable investigation that researchers realized the farmers were still consuming the stuff: Gluten got kicked into the air each time they filled their animals' troughs, and they were swallowing enough of it to trigger symptoms.
When the farmers took additional precautions -- wearing a mask in one case and avoiding the task of filling troughs in the other -- the celiac disease resolved. Sounds like an episode of "House, M.D.," doesn't it?
Sunday, June 3, 2007
As Cancer Drug, Shark Cartilage Fails Again
Yesterday, cancer researchers reported at a meeting in Chicago that a drug derived from shark cartilage is not an effective treatment against an aggressive form of lung cancer. That study is at least the second test of the putative cancer drug to produce disappointing results.
To date, no clinical trial has found shark cartilage to be effective against cancer in people. The accumulating evidence suggests that the lucrative market for shark cartilage supplements is based on, shall we say, shark oil.
Two years ago, Science News reviewed the evidence for and against shark cartilage. In lab tests, the substance has been found to counter angiogenesis, or the formation of new blood vessels, which is an important process supporting tumor growth. However, several previous trials involving cancer patients, including one that used the same drug as was used in the new study, have found no benefit associated with consumption of shark cartilage.
To date, no clinical trial has found shark cartilage to be effective against cancer in people. The accumulating evidence suggests that the lucrative market for shark cartilage supplements is based on, shall we say, shark oil.
Two years ago, Science News reviewed the evidence for and against shark cartilage. In lab tests, the substance has been found to counter angiogenesis, or the formation of new blood vessels, which is an important process supporting tumor growth. However, several previous trials involving cancer patients, including one that used the same drug as was used in the new study, have found no benefit associated with consumption of shark cartilage.
TB Scare: a Shot over the Bow
In an intelligent op-ed piece in yesterday's Times, Dr. L. Masae Kawamura, director of the tuberculosis control section of the San Francisco Department of Public Health, suggests that the attention-grabbing case of an Atlanta man with extensively drug-resistant tuberculosis could have a positive influence on public health.
Saturday, June 2, 2007
Most Mass. Hospitals Handle Acute Stroke
According to the Massachusetts Department of Public Health, 68 of Massachusetts' 74 hospitals offered "Primary Stroke Service" as of November 14, 2006. Unfortunately, the department neglects to name the PSS hospitals. But since the list includes most of the state's medical centers — and since ambulances are supposed to divert to the closest PSS if they suspect a patient has stroke — it's a good bet that any ambulance will get you to a place that can administer the acute stroke medicine known as t-PA.
That said, not all PSS centers necessarily have "neurosurgical backup" on hand, meaning that they may not have a neurosurgeon available to intervene if t-PA treatment causes bleeding in the brain. So, in an emergency, ask an ambulance technician to take you to the closest "comprehensive stroke center" or specifically request a stroke center than has 24-hour surgical backup available.
Note (ignore in an emergency):
About an hour ago, I posted the information below. While it is all accurate, it conveys incomplete information about the state of stroke care in Massachusetts and New York, because some stroke centers in each state have sought accreditation from state-run bodies rather than from the Joint Commission, a nationwide accrediting organization.
That said, not all PSS centers necessarily have "neurosurgical backup" on hand, meaning that they may not have a neurosurgeon available to intervene if t-PA treatment causes bleeding in the brain. So, in an emergency, ask an ambulance technician to take you to the closest "comprehensive stroke center" or specifically request a stroke center than has 24-hour surgical backup available.
Note (ignore in an emergency):
About an hour ago, I posted the information below. While it is all accurate, it conveys incomplete information about the state of stroke care in Massachusetts and New York, because some stroke centers in each state have sought accreditation from state-run bodies rather than from the Joint Commission, a nationwide accrediting organization.
St. Elizabeth's Has Boston's Only Stroke Center
Caritas St. Elizabeth's Medical Center is the only hospital in Massachusetts that has a primary stroke center accredited by the Joint Commission.
The hospital is located at 736 Cambridge Street in Boston.
In Washington, D.C., the only such stroke center is at Washington Hospital Center, at 110 Irving Street, N.W.
New York City has two such centers, both in Brooklyn. Lutheran and Maimonides medical centers, at 150 55th Street and 4802 Tenth Avenue, respectively, offer Joint Commission-accredited primary stroke care.
The Vampire Strikes Out
A Reuters story that appeared today in The New York Times reports the failure, in a late-stage clinical trial, of an experimental stroke treatment derived from vampire bat saliva. The drug, desmoteplase, showed promise in smaller, earlier trials. But it failed to outperform a placebo treatment in the recent trial, which involved 186 patients.
The disappointing outcome of the trial serves as a reminder that modern medicine has few drugs with which to treat stroke, the third-leading killer in the United States. While doctors have long used various anti-clotting drugs to prevent recurrent stroke, just one FDA-approved medication -- tissue plasmogen activator, or t-PA -- can aid recovery. And t-PA, which busts clots, is only approved for use within three hours of the beginning of a stroke.
Desmoteplase, by contrast, was being developed with a longer treatment window in mind. Had the recent trial proved it more effective than a placebo, it might have been used as much as nine hours after stroke onset.
The disappointing outcome of the trial serves as a reminder that modern medicine has few drugs with which to treat stroke, the third-leading killer in the United States. While doctors have long used various anti-clotting drugs to prevent recurrent stroke, just one FDA-approved medication -- tissue plasmogen activator, or t-PA -- can aid recovery. And t-PA, which busts clots, is only approved for use within three hours of the beginning of a stroke.
Desmoteplase, by contrast, was being developed with a longer treatment window in mind. Had the recent trial proved it more effective than a placebo, it might have been used as much as nine hours after stroke onset.
Sunday, May 27, 2007
Climate refugees
This morning's New York Times has an A1 story on the effects of climate change in the remote Alaskan town of Newtok. After the jump, a haunting clause appears: "[T]he people of Newtok ... are now among the first climate refugees in the United States."
Climate refugees. How many more will there be?
Climate refugees. How many more will there be?
Tuesday, April 24, 2007
NIH conference conveys to study smiling disorder
Did you know that there's a disorder called Moebius syndrome? Neither did I.
I just got an emailed press release from Jacob Licht, who writes that he is on the board of directors of the Moebius Syndrome Foundation and that he has a daughter with the condition, which he describes as follows:
"Moebius Syndrome is a rare neurological condition that causes facial paralysis, preventing its victims from smiling from birth. While Moebius Syndrome is not life-threatening, it is life altering, since those with Moebius Syndrome are unable to show any facial expressions and have speech impediments. Compared to other disorders, little is known about Moebius Syndrome. ... Moebius syndrome affects the 6th and 7th cranial nerves, preventing those afflicted with it from moving their faces and eyes, as well as sometimes causing hand/feet anomalies, respiratory problems, sensory issues and weak upper body strength."
Today and tomorrow, a panel of experts is assembling under the aegis of the NIH to discuss the challenges facing research into this disorder. I wish them luck.
I just got an emailed press release from Jacob Licht, who writes that he is on the board of directors of the Moebius Syndrome Foundation and that he has a daughter with the condition, which he describes as follows:
"Moebius Syndrome is a rare neurological condition that causes facial paralysis, preventing its victims from smiling from birth. While Moebius Syndrome is not life-threatening, it is life altering, since those with Moebius Syndrome are unable to show any facial expressions and have speech impediments. Compared to other disorders, little is known about Moebius Syndrome. ... Moebius syndrome affects the 6th and 7th cranial nerves, preventing those afflicted with it from moving their faces and eyes, as well as sometimes causing hand/feet anomalies, respiratory problems, sensory issues and weak upper body strength."
Today and tomorrow, a panel of experts is assembling under the aegis of the NIH to discuss the challenges facing research into this disorder. I wish them luck.
A millennium of metallurgy in the Andes
I came across an interesting study last night that I'm thinking about writing up for Science News. The upshot is that scientists have reconstructed the 1000-year history of metallurgy in the Andes.
In the process, they've gleaned some new insights into how and when ancient Andean peoples, including the Inca and their predecessors, used bronze and silver. Traces of metal-containing ash (spewed out by ancient forges) in the soil reveal that metal-working predated the Inca by about half a millennium.
However, the rise of the Inca coincided with a shift away from copper and toward silver production, which may have reflected the Incas' demand for tribute from their vassals.
From the ES&T press release:
An ancient Inca tax and metallurgy in Peru
Scientists in the United States and Canada are reporting the first scientific evidence that ancient civilizations in the Central Andes Mountains of Peru smelted metals, and hints that a tax imposed on local people by ancient Inca rulers forced a switch from production of copper to silver. Their study is scheduled for the May 15 issue of ACS’ Environmental Science & Technology, a semi-monthly journal. The University of Alberta’s Colin A. Cooke and colleagues point out that past evidence for metal smelting, which involves heating ore to extract pure metal, was limited mainly to the existence of metal artifacts dating to about 1,000 A.D. and the Wari Empire that preceded the Inca. The new evidence emerged from a study of metallurgical air pollutants released from ancient furnaces during the smelting process and deposited in lake sediments in the area. By analyzing metals in the sediments, the researchers recreated a 1,000-year history of metal smelting in the area, predating Francisco Pizarro and his Spanish conquistadors by 600 years. Their findings show that smelters in the Morococha region of Peru switched from production of copper to silver around the time that Inca rulers imposed a tax, payable in silver, on local populations.
In the process, they've gleaned some new insights into how and when ancient Andean peoples, including the Inca and their predecessors, used bronze and silver. Traces of metal-containing ash (spewed out by ancient forges) in the soil reveal that metal-working predated the Inca by about half a millennium.
However, the rise of the Inca coincided with a shift away from copper and toward silver production, which may have reflected the Incas' demand for tribute from their vassals.
From the ES&T press release:
An ancient Inca tax and metallurgy in Peru
Scientists in the United States and Canada are reporting the first scientific evidence that ancient civilizations in the Central Andes Mountains of Peru smelted metals, and hints that a tax imposed on local people by ancient Inca rulers forced a switch from production of copper to silver. Their study is scheduled for the May 15 issue of ACS’ Environmental Science & Technology, a semi-monthly journal. The University of Alberta’s Colin A. Cooke and colleagues point out that past evidence for metal smelting, which involves heating ore to extract pure metal, was limited mainly to the existence of metal artifacts dating to about 1,000 A.D. and the Wari Empire that preceded the Inca. The new evidence emerged from a study of metallurgical air pollutants released from ancient furnaces during the smelting process and deposited in lake sediments in the area. By analyzing metals in the sediments, the researchers recreated a 1,000-year history of metal smelting in the area, predating Francisco Pizarro and his Spanish conquistadors by 600 years. Their findings show that smelters in the Morococha region of Peru switched from production of copper to silver around the time that Inca rulers imposed a tax, payable in silver, on local populations.
Monday, April 23, 2007
Watchdog knocks EPA for putting fox on SOx panel
Couldn't resist the headline, since I was just blogging about puns. SOx, of course, are sulfur oxides, which are byproducts of fossil fuel use. The EPA's Clean Air Scientific Advisory Committee is tasked with evaluating the hazards of polluting air with SOx and NOx, or nitrogen oxides. But they've got a couple of foxes sampling the hen house's air quality, according to the Center for Science in the Public Interest.
CSPI issued a press release (fourth item) today that objects to the appointments to that advisory committee of Richard B. Schlesinger, who has received financial support from the American Petroleum Institute, and Christian Seigneur, who also works for an industry-funded organization.
CSPI issued a press release (fourth item) today that objects to the appointments to that advisory committee of Richard B. Schlesinger, who has received financial support from the American Petroleum Institute, and Christian Seigneur, who also works for an industry-funded organization.
Genealogy and nomenclature
It's probably worth taking a moment to explain the rather obscure origin of the name this blog bears.
When I was an undergrad, I spent a season on the sailing team, mostly as a 'crew' (the jib-handler) in a two-person sloop called a 420. One of the duties of the crew is to hike out -- that is, to lean as far out over the windward gunwale so that your weight counterbalances the force of the wind on the sail and keeps the boat from tipping too much.
I sometimes sailed with my team captain, a gregarious guy named Chris. One day, while sailing together, we got slammed by a sudden puff of wind and the boat listed precariously. I jumped up on the gunwale and starting hiking out, and Chris, worried that we were going to capsize in spite of my efforts, yelled, "Hike harder!" When he realized that he'd unintentionally punned on my surname, he started using the pun regularly. And so, in Rudyard Kipling fashion, I acquired the nickname "Hike."
Giving me a hard time
Incidentally, people still pun on my name. Most recently, I took a lot of flak for an article I wrote on erectile dysfunction. Most of the comments that Washington Post readers subsequently posted referred not to the content of the article but to the amusing connection between the subject matter and my byline. For all I know, the editors who assigned the story to me were laughing gleefully when they did so.
When I was an undergrad, I spent a season on the sailing team, mostly as a 'crew' (the jib-handler) in a two-person sloop called a 420. One of the duties of the crew is to hike out -- that is, to lean as far out over the windward gunwale so that your weight counterbalances the force of the wind on the sail and keeps the boat from tipping too much.
I sometimes sailed with my team captain, a gregarious guy named Chris. One day, while sailing together, we got slammed by a sudden puff of wind and the boat listed precariously. I jumped up on the gunwale and starting hiking out, and Chris, worried that we were going to capsize in spite of my efforts, yelled, "Hike harder!" When he realized that he'd unintentionally punned on my surname, he started using the pun regularly. And so, in Rudyard Kipling fashion, I acquired the nickname "Hike."
Giving me a hard time
Incidentally, people still pun on my name. Most recently, I took a lot of flak for an article I wrote on erectile dysfunction. Most of the comments that Washington Post readers subsequently posted referred not to the content of the article but to the amusing connection between the subject matter and my byline. For all I know, the editors who assigned the story to me were laughing gleefully when they did so.
Disclosures -- and protecting your hearing
Before I make my first substantive post, I need to draw attention to the fact that I have at least one conflict of interest. Namely, I'm a staff member at Science News magazine. And while my employer is not paying me to promote the work of my colleagues, I do plan to blog about it from time to time because I admire so much of their reporting.
With that preamble, I want to remark on the latest article by Janet Raloff. It suggests that a combination of magnesium and vitamins A, C, and E may protect against noise-induced hearing loss. As someone who has attended his share of rock concerts -- and whose loving parents have always reminded (and reminded and reminded!) him to wear earplugs -- I'm glad to know about this new bit of research. One of Janet's sources suggests in the story that the micronutrient combo could be used in lieu of earplugs, but I think I'll actually use both pill and plugs the next time I attend a loud show.
With that preamble, I want to remark on the latest article by Janet Raloff. It suggests that a combination of magnesium and vitamins A, C, and E may protect against noise-induced hearing loss. As someone who has attended his share of rock concerts -- and whose loving parents have always reminded (and reminded and reminded!) him to wear earplugs -- I'm glad to know about this new bit of research. One of Janet's sources suggests in the story that the micronutrient combo could be used in lieu of earplugs, but I think I'll actually use both pill and plugs the next time I attend a loud show.
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