Kary Mullis, who won the 1993 Nobel Prize in Chemistry for the discovery of PCR (polymerase chain reaction), presents a brief overview of his novel strategy to combat bacterial infections in the body.
The foundation of Dr. Mullis’s revolutionary idea is based on the alpha-Gal epitope. This molecule is recognized by human bodies as a foreign object and will trigger an immune response against it. So, if one were able to link the alpha-Gal epitope to a target bacterial pathogen, the presence of this foreign molecule would theoretically recruit the body’s immune system to attack both the epitope and the bacteria of interest.
I am not familiar with Mitchell and Webb, but a brief Bing search reveals that they are British comedians known for starring in several popular comedy sketches and sitcoms. In one of their shows, The Mitchell and Webb Look, they satirize homeopathy and its impotence in treating serious diseases.
“A&E” stands for “Accident & Emergency” and is more commonly used in the Commonwealth countries. It is analogous to the “ED” (Emergency Department) or “ER” (Emergency Room) acronym used in the United States.
Scientific research has so far not found any superiority in homeopathy above placebo, but it is a brand of therapy more readily accepted in some countries. Several European health services will reimburse the use of certain homeopathic remedies. In India, homeopathy is an officially recognized form of medicine.
One could argue that if homeopathy were not doing any harm, why bother? There can nevertheless be great potential for harm when homeopaths counsel against the use of conventional treatments (see article in Telegraph with follow-up in BBC). Having obtained degrees in biochemistry, molecular biology, and medicine, I know I’m biased, but that is why we have double-blinded randomized control trials.
Catherine Mohr, research surgeon and instructor at the Stanford University School of Medicine, presents a TED talk on the history of surgery and the exciting visions for the future.
The journey begins 10,000 years earlier with the illustration of a trephanated skull and rapidly traverses eons to talk about the seemingly barbaric operations preceding the development of anesthesia. The demonstration of ether as an anesthetic at the Massachusetts General Hospital in 1847 heralded a new era in pain-free surgery, but the triumphs were marred with poor mortality rates. Dr. Mohr then highlights the revolution in surgical outcomes after the introduction of the sterile technique. She briefly discusses laparoscopic surgery and fast forwards to the invention of robotic surgery … and beyond.
To avoid spoiling the whole talk, I will let you view the video and hear for yourself some exciting new developments in the field of surgery.
Given the prevalence of video-sharing sites, such as YouTube and its niche derivatives, it was only a matter of time until there would be one devoted to echocardiography. This week, Medgadget announced the launch of EchoJournal, “an online ultrasound video sharing website and discussion board”. Despite the site’s description, it solely focuses on echocardiograms (i.e., cardiac ultrasound via transthoracic or transesophageal approaches), as opposed to general body ultrasound videos. EchoJournal is already populated with 50+ echocardiograms featuring a diversity of cardiac pathologies, such as severe left ventricular hypertrophy, cardiac tamponade, and lipomatous hypertrophy of the interatrial septum. The site is moderated by Dr. David E. Winchester, a cardiology fellow at the University of Florida.
Similar to its brethren in the social networking genre, EchoJournal permits users to create profiles and avatars, upload videos, maintain a list of “friends”, subscribe to video feeds, rate videos, join groups, and discuss cases. Its target audience includes “current and future physicians as well as health care professionals who use echocardiography as part of their practice”. There is also a feature to embed videos on external websites (as seen below).
The concept of video-sharing is not new, but the medical profession has been slow in adapting such technologies. The field is ripe with endless untapped possibilities. It would only be a matter of time until we see similar video sites sprout for capsule endoscopy, bronchoscopies, laparoscopic surgeries, VATS, etc. As for gastrointestinal endoscopy, there is the The DAVE (Digital Atlas of Video Education) Project from the Massachusetts General Hospital … sans the social networking features.
Mr. Jones is a 65 year-old gentleman with a past medical history significant for hypertension (HTN), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD), who presents from OSH with … who-knows-what?
OSH denotes an “outside hospital” from where a patient was transferred. These hospitals are generally smaller medical centers that do not have the advanced specialists, equipment, or support facilities to manage the evolving complexity of a patient’s disease. Consequently, they request from a higher-level care center (i.e., tertiary hospital, major academic institution) to have the patient transferred there. In rare instances where patients carry cryptic or immensely challenging clinical diagnoses, a tertiary center may even refer the patient to another hospital where supposed “world experts” of a particular field may practice.
A common complaint at tertiary centers receiving transferred patients is that they arrive with poor supporting documentation. That is, what had been done for the patient while at the other hospital? What happened whereby the patient now requires higher level care? Discharge summaries sometimes appear as if they were drafted on the fly; at other times, they are replaced by randomly copied chart notes or nothing altogether. In worse scenarios, patients may arrive with such dearth of information that the admitting physician is left dumbfounded about the real reasons for admission.
In response, a group of medicine residents from the University of Pennsylvania created the following video to critique–with gross exaggeration, of course–the infamous OSH.
Disclaimer: the video is intended to be a comedic satire and does not reflect the standard of care at OSH. Training programs, practicing medical professionals, and health care organizations are closely monitored by an army of acronyms, such as the ACGME (Accreditation Council for Graduate Medical Education), ABIM (American Board of Internal Medicine), JCAHO (Joint Commission on Accreditation of Healthcare Organizations), etc.
