Thursday, October 19, 2017

Gluten: Celiac disease discussion

Freakonomics discusses Gluten and celiac disease.

podcast link

old NYTimes article HERE.

both overdiagnosed (thanks to a sensitive lab test, mild cases are now being diagnosed) and under diagnosed (a lot of mild cases of irritable bowel disease probably never got diagnosed in the past).

the gene varies in different populations

CD has a worldwide distribution, being described in different ethnic groups from North and South America, Europe, south and west Asia, Australia and New Zealand[,]. The disease is rare among Africans and not expected among populations with no HLA DQ2, like Chinese and Japanese, except in individuals presenting HLA DQ8[].

west Asia and south Asians do have the problem.

but the low incidence in China might be from under diagnosis, or dietary, but the disease can be found in those with irritable bowel syndrome.

This article suggests it is "rampant"  and blames the westernization of the diet, (i.e. less breast feeding, earlier weaning, and the increased use of bread instead of rice in the diet) and notes that it is more common in areas with Caucasian genes (western China... they are presumably discussing the Uighur, who are Turkish in origin).

what you have to realize is that in places with primitive water supplies, diarrhea in children is common, and is indeed one of the major causes of death in young children. So a child with failure to thrive and diarrhea would just die, and everyone, including doctors, would assume it was from the many diarrhea causing diseases in the environment.

But now, with clean water, such cases are rare, so a child with constant diarrhea and failure to thrived would be seen by doctors and checked for food intolerance, including lactose deficiency and celiac disease.

a full review of the history of the disease can be read here.

this map from Dr Shar Institute shows incidence, but note all the blank areas.

 a new epidemiology of celiac disease, characterized by growth in the traditional fields and spread into new regions of the world

just like previous studies showed the disease was rare in Asia, but is now being diagnosed, one wonders about the low rate in Africans. Again, unsafe water supplies lead to lots of diarrhea deaths, and diarrhea from protein deficiency due to earlier weaning and/or using a baby bottle but not being able to afford powdered milk.

So who has money for an expensive lab test when children are more likely to die from norovirus, measles or malaria?

but as Africa follows Asia out of rural poverty to urban living, one suspects it will be found to be much more common, and it will be diagnosed more often.

and replacing traditional diets of sorghum, maize and rice in some areas with wheat based food might make cases more common.

Tice is, of course, gluten free, and might be one reason that so few cases of celiac disease were seen in rice eating areas, but what about maize, which is a staple in many areas, i.e. East Africa, Latin America?

Ironically, that is unclear: most lay sites say avoid it, but it seems to be less problematic.

This article says maybe

Hypothetically, maize prolamins could be harmful for a very limited subgroup of CD patients, especially those that are non-responsive, and if it is confirmed, they should follow, in addition to a gluten-free, a maize-free diet.

Monday, October 16, 2017

The Plague is still with us

an outbreak of plague in Madagascar : LATimes.

from occassional cases in the countryside, it has spread to the city.

ecause a man with the pulmonary form rode in a bus.

and you may not be safe:

The biggest problem for authorities trying to control the outbreak is that it took two weeks after the first case to detect it, and that most cases — 277 so far — have been a particularly virulent form of the disease.
Madagascar, an island off Africa’s east coast, is the country most seriously affected by plague, but others, including the United States, Russia, China, Peru, Bolivia and several African nations, regularly report cases.
By Monday, 387 cases had been reported, including 167 in the densely populated capital.
related item:

 Podcast on the Plague in ancient history

Sunday, October 1, 2017

Hepatitis out break (podcast)

PTSS and concussion

Because of better diagnostic tools and techniques, many other combat zone injuries could now be measured as well. These included over a quarter million cases of traumatic brain injury (more commonly called concussion) and over a hundred thousand cases of PTSD (Post Traumatic Stress Disorder) that were discovered among combat veterans since 2001. 
In the past these conditions were not considered “wounds” in the same sense as something that made the victim bleed. This was despite the fact that many soldiers were put out of action temporarily because of concussion and PTSD.
Physical injuries to the brain can now be detected using more precise instruments like MRI and can often be treated. In the last decade it has become clear that there are several sources of PTSD (post-traumatic stress disorder) and concussions from explosions were more of a factor than previously thought. Many troops, because of exposure to roadside bombs and battlefield explosions in general, developed minor concussions that, like sports injuries, could turn into long term medical problems.
Often these concussions were accompanied by some PTSD. Examining medical histories of World War II, Korea, and Vietnam War vets showed a pattern of later medical problems among many concussion victims. The same pattern has been found among athletes and accident victims who suffered concussions.

Plasma substitute and red tape

StrategyPage has an article on plasma that does not need refrigeration but the military can't order any because the FDA regulations stand in the way

U.S. SOCOM (Special Operations Command) is gradually getting access to freeze dried plasma (FDP) for use by their combat medics. Plasma is used to replace clotting and other essential blood components in emergencies. It is not whole blood but is taken from whole blood and must be kept refrigerated. FDP is not yet legally available in the United States so SOCOM has been using French FDP, which the French military has been producing and using since 1994...
The problem was that in the United States the FDA (Food and Drugs Administration) needed an American firm to produce FDP that they could put through their testing and approval process. There were problems with finding an American firm that would and could do it and then going through the FDA approval process. It was estimated that this would take until 2020 to complete. 
and that isn't the only battle field innovation saving lives:

Dealing with massive blood loss has always been a seemingly unsolvable problem. While tourniquets have been around for thousands of years, these devices only work on limbs. Preventing death from most other rapid blood loss situations was achieved after 2001 with the development and widespread use of powders and granules that could quickly stop the bleeding. First (in 2003) came special bandages like the Chitosan Hemostatic Dressing (more commonly called HemCon). This was basically a freeze dried substance that caused rapid clotting of blood and was incorporated into what otherwise looked like a typical battlefield bandage. This bandage greatly reduced bleeding, which had become the most common cause of death among wounded American troops. This device was a major breakthrough in bandage technology. Over 95 percent of the time, the HemCon bandages stopped bleeding, especially in areas where a tourniquet could not be applied. This did not work when the abdominal aorta was involved. HemCon was followed by WoundStat powder to deal with some of the bleeding that HemCon could not handle. While medics, and troops, prefer the bandage type device, there are situations where WoundStat (a fine granular substance) is a better solution (especially in the hands of a medic). Only the medics got packets (usually two) of Woundstat powder. That's because this is only needed for deep wounds and has a theoretical risk of causing fatal clots if it gets into the bloodstream.

Thursday, September 28, 2017

Making doctos scapegoats for drug cartel opiods.. And patients suffer

Inside Sources: Misdiagnosing the Opioid crisis.

Policymakers in Washington and in state capitals are misdiagnosing the opioid crisis as a doctor-patient problem. Their policies are coming between doctors and patients. They are preventing doctors from using their judgment and expertise to ease pain and suffering. They are making many patients suffer needlessly, with some turning in desperation to the black market.
yeah. Old ladies often sell or give each other their pain pills, not so their friends can get high, but so they can get pain relief. Ditto for tranquilizers. This doesn't bother me too much.

Then you have the stealing of grandma's medicines by druggies or by teenagers trying to get high. This can be a problem, especially if the one stealing the drug is the caregiver or friend who "helps" the old person (often they are not working and living off of grandma's pension, or stealing money from her).

This is low level crime, and hurts our patients.

But this is nothing new.

The real problem behind the "crisis" is the drug cartels. Again from the article.

On August 1, and September 5, two separate raids by combined federal and local narcotics police in New York City seized the largest haul of the powerful opioid fentanyl in New York history. This included 140 pounds of fentanyl (32 million lethal doses), 75 pounds of fentanyl mixed with heroin, and additional stores of heroin and cocaine.
New York City special narcotics prosecutor Bridget Brennan told reporters, “The sheer volume of fentanyl pouring into the city is shocking. It’s not only killing a record number of people in New York City but the city is used as a hub of regional distribution for a lethal substance that is taking thousands of lives throughout the Northeast.”

unfortunately, he then says: stop drug prohibition and the overdose problem will go away.

Nope. Because they will still go to illegal sources to get high. And Fentanyl is a much better "high" than marijuana. The dirty little secret is that marijuana is almost legal anywhere: it is rarely prosecuted (all those folks jailed for "marijuana possession" are often plea bargains for bigger crimes that might be hard to prove, maybe because the victim is afraid of being killed if they testify, and more often because the court system if overworked).

And of course, the societal problems from being high is huge, as we see in broken families, in car accidents, and in unemployment because who will hire such a person.

I have been saying this for quite some time: The "opioid crisis" is not from doctors prescribing opioids for pain, but from drug cartels smuggling in opioids, often fentanyl and analogs that are powerful and easy to overdose. And, like in the Philippines "Shabu" drug wars, a lot of it is from China.

That is why Duterte remains popular here, despite the  SJW complaining all the time and spreading their complaints all over the world. That is why the "huge" anti drug war anti Duterte demonstration that the MSM in the US lauded as showing people are starting to oppose his war last week only had 5000 demonstrators, even though you can hire people to demonstrate for ten dollars a day: because even the unemployed street people won't take your money. (and three times that many supporting Duterte, something that the MSM missed).

So where are the anti drug types in the USA?

A friend used to tell me about the huge amounts of cocaine etc. used by the elites in Washington back in the 1990's (a friend's daughter worked for the Justice Dept and was scandalized).

And of course, I worked on the Indian reservations, where alcohol was the drug of choice: Keep them drunk, and they won't be a problem. (which is why as the tribes get more sovereignty they often prohibit alcohol). Nowadays, of course, it is stronger drugs, but never mind.

Who was the black politician who blamed the CIA for the crack epidemic in the 1990's? Yup. Maxine Waters. She is still at her "Conspiracy theories" of course, but you know, most conspiracy theories arise from information that is not being reported, and then they exaggerate and/or twist the information, so easily get things wrong, but there is a core of truth underneath.

But who benefits from the drugging of America?

Place conspiracy theory here.

I know who "benefits" from Shabu trade here.

Politicians, and businessmen, and crooked cops, and crooked officials looking the other way when it is smuggled in (e.g. like the recent discovery of how a load was let thru customs at the airport).

Also, since Filipinos work all over the place, it is easy to find a drug mule to carry the stuff all over: So we have been a hub for distribution.

Who suffers? The poor who take it to get high, or to be able to work harder. And their families. And now, of course, a lot of the casualties are ordinary folks who were in the local distribution racket: When a tricycle driver makes 600 pesos ($12) a day, it is hard to support a family, so why not take that package and deliver it because you need the money for your family?

This is why many of the casualties of the drug war are "innocent": No, they are often in the wrong place at the wrong time when a raid is going on.

But the rich are the ones behind the problem, the rich who don't care about the casualties of taking drugs, they are still at large, and using the SJW types to try to take Duterte down before he finds enough evidence to put them away.

The Catholic bishops are busy condemning Duterte's drug war, but they don't seem to see the casualties of drug use here.

Like the lady across the street who died of "a heart attack" at age 37 (shabu/meth induced of course).

Or the teenage girl killed by her druggie boyfriend whose body was dumped in the cemetery near Lolo's grave (she was breaking up with him).

or the elderly people killed in ordinary robberies/home invasions (three in our area in recent years).

Or the many bodies that are found tied up and with evidence of torture (by drug gangs, usually for being a snitch: these bodies were commonly reported found before the drug war started, so don't blame Duterte).

so where are the churches in all of this?

The Catholic bishops here of course condemn the poor pushers killed in Duterte's drug war, but how many bishops have condemned the politicians who take bribes and kickbacks from the drug lords?

Maybe in private, or maybe in vague terms without naming names.

Or are they too busy pushing the Green agenda and the Francis church's idea of "mercy" to bother to see the casualties of corruption?

The old Testament prophets wrote a lot of stuff condemning such corruption in business and government.

Ah but mercy!

Those who insist Jesus meek and mild would never condemn someone, well, could I remind you he broke up the sellers in the Temple. The naive left wing types that run the church hint this was anti capitalism, but anyone who lives with corruption figures they were over-pricing and gouging customers, and giving kickbacks to the priests.

Wednesday, September 27, 2017

Disease in the headlines

From the UK Mail:

Fight against anal cancer. Yes, gay and Bi men problem.

probably related to warts/ human papilloma virus. And a depressed immune system from HIV.

And hopefully the vaccine will cut down the epidemic.

So exactly why did a feminist magazine aimed toward teenaged girls have an article about how to do anal sex?

Cancer cluster at a police station in Cincinnati

The District 5 police station sits just on the other side of Interstate-75 from Mill Creek, which was declared 'the most endangered urban river in North America' by American Rivers in 1997.

also from the UKMail.