Stem cells

after all the hype on why we have to kill embryos, it turns out that fat can supply stem cells.

Historically, stem cells can come from a variety of tissues. These include umbilical cord, fetal tissue, bone marrow, or the best source as adipose or fat cells.
Adipose derived stem cells have the highest numbers of cells when collected and tested compared to all others . This is by far the preferred method of stem cell therapy because of sheer numbers and the fact that they are coming from your own body. This is called autologous therapy.

CDC on drug deaths

Fentanyl and its analogues are indicated in half of the "opioid" deaths, not to mention heroin, cocaine, meth and "other" drugs.

LINK

In other words, druggies, not people getting medicine for pain.

I wonder if the OD's are now higher because the "pill pusher" docs, who gave out percocet are now out of business so the addicts no longer buy the pills from someone who got them for "pain", or from the drug pipelines who got them from pharmacies (often just across the Mexican border)

The opioids are from China and sent up via the Mexican drug gangs. Building the wall might help.

And yes, making Naloxone over the counter will help.

The problem? often the Naloxone wears off before the drug used in the overdose wears off (and it won't work when the drugs are mixed with non opioids). So an hour later, they die anyway.

Sigh.

and I also wonder how many cases are patients in chronic pain who accidentally overdose, or people who use these type of drugs to kill themselves.

Poio (take three) could be eliminated?

Bill Gates is using his money to push vaccinations, and now says the goal of eliminating the Polio virus is at hand.

• Billionaire and co-founder of Microsoft said the polio cases worldwide have decreased from 350,000 in 1988 to only 12 
•  The infectious disease is spread from human-to-human contact where its most severe cases causes paralysis 
•  Critics remain skeptical saying the symptomless virus can live in a person's intestines for years and then spread to someone else.

good news.

Polio take two

StrategyPage has this about the polio edification effort in Pakistan and Afghanistan:

There is another major effort this year to vaccinate vulnerable Afghan and Pakistani children against polio. In 2016 there were 20 cases of polio in Pakistan and 13 in Afghanistan. There were four in Nigeria, a country that is expected to be free of polio this year or next. In Pakistan and Afghanistan there are still religious problems with vaccination. The Afghan Taliban have openly supported the vaccination program but there still some rural areas where local Moslem clerics or teachers continue to denounce the vaccinations. There is a similar situation in Pakistan, where some fringe Islamic groups will still try and kill members of the vaccination teams. Despite this continued resistance polio cases in both nations continues to decline....

 In the last decade the main obstacle has been Islamic terror groups who ban polio vaccinations and attack anyone trying to deliver the vaccine to vulnerable children. Islamic terrorists in general tend to believe the vaccination teams are spying for the government and that the vaccinations are a plot to sterilize Moslems. 

New age placebo, polio, and other medical stories in the news.

UCIrving is pushing medical nonsense, and the press finally noticed it.

medical professionals who believe that healthcare should be based on treatments validated by science view the very term “integrative medicine” as a path to introduce unproven or disproven therapies into medicine. UC Irvine has hewed very close to that line in relation to an earlier gift from the Samuelis, which was used to fund a center at the university that actually offered homeopathy to patients. (The mention of homeopathy disappeared from one of the college’s web page after I asked about it; but a naturopath on the staff is still promoting homeopathy under the UC Irvine imprimatur even now.)

yeah. Read the whole thing. It's quackery.

When I got an "Audiodigest" tape pushing this nonsense I actually complained (and apparently other docs did too, because they emailed me back thanking me for my 'opinion').

Hopefully this will get a "headsup" from the NYTimes Health editor who tend to push this trendy pseudoscience.

and not noted in the article: These practitioners tend to attract a cerain type of person who is open to these magical ideas.

placebo, suggestion, and hypnosis do work on 30 percent of people: 

about the same percentage of people who test high or moderately high on the neurological test for ability to be hypnotized.

The "art" of medicine is in the sympathy that we docs bring to our care, and in the "laying on" of hands: because the comfort and sympathy helps even when we can't "help".

But notice that this type of "medicine" tends to stress New Age ideas like "meditation" or similar scams like Reiki, yoga or acupuncture? (the last two are included because they often stress the religious aspects on patients.. yes you can do yoga exercises for back pain, but if the teacher starts talking about awakening your kudalini point you know it's religion).

This is religion: and what disturbs me is that we docs are not supposed to push our religious beliefs on people.

When I did stress control or advise folks on coping, I took my patient's belief system into consideration.

Quiet Bible study, saying the rosary, spending an hour in "Eucharistic adoration", doing art or music, having a "Sing" or traditional ceremony or having the local prayer group pray over you all are ways that people integrate their souls, minds and bodies in times of stress and illness.

But these aren't part of the curriculum. I wonder why (/sarcasm).

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awhile back I referred to the "Black Legend" of Spanish atrocities.

TeaAtTrianon links to a post at CountingStars with the facts that the legend ignores.

Remember that in 1512, when the first news of mistreatment of the Indians, King Fernando II signed the Laws of Burgos that considered Indians “free men” and the obligation to pay them a fair wage for their work. In 1542 the Emperor Carlos V dictated the New Laws, which expressly prohibited the submission of Indians to slavery and forced labor. To this we must add that between the Spanish population and the Indians there was a great miscegenation, even among the nobles. On the contrary, in British North America, the miscegenation between colonists and Indians was almost non-existent, and the Indians were robbed of their lands and confined to reservations, which did not occur in Spanish America. (Read more.)

and of course, the epidemics, not atrocities,, that killed people were not deliberately spread by the Spanish soldiers who, like everyone in those days, had little knowledge of how disease is spread. (athough the British, not the Spanish, gave gifts of smallpox infested blankets).

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letter in LATIMES:



This country has no use for John Kelly's nostalgia

because respecting those who die to defend civilians from terrorists is soooo yesterday.

As I pointed out a few days ago: Often patients and their families are angry and upset, so they mis hear what you are trying to say, and turn their anger on you, the healer, not on the disease or cause of the death (in this case, some very bad terrorists who attack local civilians in the area).

AnneAlthouse points out that

If we make it too hard to talk to a person in dire circumstances, a lot of people will play it safe and not speak at all.

From "Half Empty" by David Rakoff (who was facing the cancer treatment of amputation of his left arm and shoulder): 

But here’s the point I want to make about the stuff people say. Unless someone looks you in the eye and hisses, “You fucking asshole, I can’t wait until you die of this,” people are really trying their best. Just like being happy and sad, you will find yourself on both sides of the equation many times over your lifetime, either saying or hearing the wrong thing. Let’s all give each other a pass, shall we?

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eu plans to ban another weedkiller because it might cause cancer.

Chemicals often have subtle adverse effects. But banning them might cause more problems.

Is there an alternative that is cost effective, or will it result in higher food cost and less food available, both of which will cause poor people to starve?

so how many will die of malnutrition related disease vs how many will die (at a much older age) of cancer? CNN report here says they found 800 cases that might be associated with the chemical... the number of people dying of poverty related malnutrition because there is enough food around, but they can't afford to buy it?

it is sort of like the massive arsenic poisoning of Bangladesh: They dug deep wells to eliminate cholera and other causes of diarrhea that killed thousands every year, but the ground water has arsenic and that is the major problem.

but by eliminating diarrhea, a major cause of death in small children, it means moms are now willing to use birth control and have more kids, and since they have fewer kids, they can afford to send them to school... and Bangladesh is slowly eliminating poverty. 
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great books podcast of the week: The Gulag Archipelago

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Instapundit links to
NYTimes the Long War on Polio.

it is still going on, ,and remember: the Taliban and other Islamicist types kill those trying to wipe it out. Not because they want the kids to die but because they read "anti vaccine" articles in the UK Guardian etc and believe the non scientific Hollywood types that push these ideas.

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[6,7]. 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[2].

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.

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

Hepatitis out break (podcast)

PTSS and concussion

from StrategyPage. 

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.