Dangerous When Drunk!

While we all understand the dangers of drinking and driving, how many people realize that drinking and walking is just as dangerous?  So, if you’ve decided to leave the car at home and just celebrate locally this New Year’s Eve we’d like to bring you a cautionary tale.

According to trauma surgeon Dr. Thomas Esposito at Loyola University Health Systemalcohol impairs your physical ability, period.”

A trauma surgeon for more than 25 years, Esposito has witnessed the tragic aftermath of drunkeness many times. A quarter of all pedestrian struck cases seen in his department, were found to have blood-alcohol concentrations at or above the accepted level for intoxication.  In 2005, the journal Injury Prevention reported that New Year’s Day is more deadly for pedestrians than any other day of the year. From 1986 to 2002, 410 pedestrians were killed on New Year’s Day. 58% of those killed had high blood-alcohol concentrations.

If they had been driving and were stopped by police, they would have been arrested for driving under the influence,” Esposito said.

And it’s not just walking outside. Working, as I do, in Emergency Medicine, I often see people who have fallen down the stairs or tripped and injured themselves after drinking. Others have unwisely chosen to mix alcohol with guns, knives, bottles and fists, invariably with tragic consequences.

To avoid becoming a 2011 statistic, SRXA’s Word in Health brings you the following tips:

  • Don’t wear dark clothing that can make it difficult for drivers to see you
  • Stay out of the road. Use sidewalks and cross at designated crosswalks
  • Walk in a group, preferably with a designated chaperone or escort

Stay safe & have a Happy New Year. We look forward to welcoming you back in 2012.

Wouldn’t You Like to Know!

If you had a family history of developing Alzheimer’s disease, would you take a genetic test that would give you more information about your chances?

Increasingly it seems, people are saying ‘yes’. The controversial genetic test is based on Apolipoprotein E (APOE).  Having certain variants of the APOE gene has been found to significantly increase a person’s risk of developing Alzheimer’s disease.

However, possession of the APOE variant is neither necessary nor sufficient to cause Alzheimer’s disease. This limitation, along with a general lack of treatment options for Alzheimer’s, has raised concerns that the genetic information could burden rather than benefit patients. Consequently, there are a lot of consensus statements and articles against the use of APOE genotyping for predicting Alzheimer’s risk.

Nevertheless, a recent study has shown that patients want to learn about their APOE test results and are not overtly distressed by them.  The Risk Evaluation and Education for Alzheimer’s disease Study (REVEAL), showed that even if the test does not have clinical utility it has personal utility.  Study participants who discovered they have an elevated risk, not only accepted the news but were more likely to initiative preventative life-style measures and more likely to consider retirement planning and purchase long term care insurance.  Knowing their risk also helped patients to have informed discussions with their partners and families.

SRxA’s Word on Health would like to know:

I Resolve to Lower My Expectations!

After the over-indulgence of the past few days, are you planning to make New Year’s resolutions? If you’re like the rest of us, chances are, you’re probably going to break them too! Most resolutions, although fuelled with good intent, are little more than clichés and empty promises.

How many of us, wake up a little groggy on January 1st swearing we’re never going to drink /smoke/stay up all night/ (*******) again?

If, like thousands of others, your noble intentions fall by the wayside before January is out, we have some advice that might just help.

William McCann, Psy.D, a clinical psychologist at Wake Forest Baptist Medical Center says “I think most people make resolutions that they don’t achieve because they seem so overwhelming.”

He recommends that we should make resolutions that we are sure to be able to follow through on. In other words if you want to be able to say “I did it!” next December 31st, you need to lower your expectations.

McCann’s sample list of attainable New Year’s resolutions:

  • I will eat a little less fried food this year.
  • I will drive a little more slowly this year.
  • I will help others a little more this year.
  • I will interfere in my children’s lives a little less this year.
  • I will talk a little less and listen a little more.
  • I will smile a little more this year.
  • I will be a little better person than I was last year.

Me?  I’m going to try a little of all of the above!  Share your resolutions with us – those you’ve tried, those you’ve failed. We’d love to hear from you.

I Spy an AED

SRxA’s Word on Health loves a good challenge – and they don’t come much better than this.  A group of researchers from the University of Pennsylvania are set to save lives with cell phone cameras… and they need help.

The MyHeartMap Challenge, will be a month-long contest starting in mid January. It will invite Philadelphians to the streets and social media sites to locate as many automated external defibrillators (AEDs) as they can. AEDs are lifesaving devices used to deliver a controlled electric shock and restore normal cardiac rhythm following a heart attack.  AED’s are widely used in hospitals and by pre-hospital providers such as EMT’s; but they can also be used by people with no medical training since they provide audio instructions that talk users through the process of performing CPR and defibrillation.

There’s an estimated one million AEDs across the nation. Some are hung clearly on the walls in airports and casinos, but others are tucked away in restaurant closets and under cash registers in coffee shops. Since  AEDs are not subject to regulations that would allow their makers to know where or when their devices are being used there’s currently no uniform system to track their location.

The contest hopes to change that.  Furthermore, it’s just a first step in what the Penn team hopes will grow to become a nationwide AED registry project that will put the lifesaving devices in the hands of anyone, anywhere, anytime.

Armed with a free app on their mobile phones, contest participants will snap pictures of the lifesaving devices wherever they find them in public places around the city. Contestants will then use the app to geotag the photos with their location and details about the device and send them to the research team via the app itself or the project’s web site.

The data collected will be used to create an updated app linking locations of all public AEDs in the city with a person’s GPS coordinates to help them locate the nearest AED during an emergency.

Better still – the person or team who finds the most AEDs during the contest will win $10,000. Additionally, people who find various pre-located “golden AEDs” around the city will win $50.

More and more, scientists are learning that we can benefit from the wisdom of the crowd,” says MyHeartMap Challenge leader Raina Merchant, MD, Assistant Professor of Emergency Medicine. “Participation from ordinary citizens will allow us to answer questions and make the city safer than our team could ever do on its own.”

MyHeartMap Challenge participants can register as individuals or teams, and the Penn researchers suggest participants develop creative ways to maximize their chances of winning. If, for instance, a team can figure out how to use their social networks via Twitter and Facebook to engage people who work in public locations in Philadelphia to take photos of AEDs, the team could win $10,000 dollars without even leaving their desks. These “virtual teams” could prove to be faster and more efficient than any individual working alone. Participants can also organize AED scavenger hunts or mini-contests to locate all the AEDs in a workplace building, or compete against friends to see who can find the most devices. The researchers encourage participants to start strategizing and forming teams now so they can be first out of the gate to win.

What are you waiting for?

Staying Safe During the Holidays

For most of us, the holiday season is usually a time of glad tidings and great joy but alas it also brings the potential for poisonings. No, we’re not talking about offing your annoying aunt, we’re referring to the accidental kind!

To help keep our Word on Health readers safe during the festivities we’ve teamed up with our friends from the Drug and Poison Information Center at Cincinnati Children’s Hospital Medical Center, to bring you the following tips:

  • While the odd eggnog or glass or two of champagne may be good, providing you’re not driving, too much, or the wrong sort of alcohol may be toxic. And remember, alcohol is found not only in adult beverages but in gifts such as cologne and perfumes. We recommend you remove all alcoholic drinks and gifts that contain alcohol out of reach of children.
  • Poinsettias may be pretty but they can cause irritation. Children who play with the Poinsettia plant leaves and then rub their eyes can experience redness and irritation.
  • Though berries may add a festive touch to your table centerpiece, a few, of the 400+ varieties of holly are said to be poisonous. Nausea, vomiting, diarrhea and a slowing down of breathing and heart rate can occur after ingestion of holly berries.
  • Toys can contain button or disc batteries. These small, shiny coin-shaped objects are often found in handheld games, watches and other portable devices. If swallowed they can become lodged in the esophagus and cause serious injury and death.
  • Jerusalem Cherries allegedly contain solanine, the same poison found in deadly nightshade. Reported signs and symptoms of solanine poisoning include dilated pupils, salivation, nausea, vomiting, headache, bloating, diarrhea, respiratory depression, central nervous system depression, confusion, irregular heartbeat, coma and death. Not nice!  Probably better to keep these out of your house this yuletide.
  • Essential oils can be used with great effect to scent the house over the holidays. However ingredients in some essential oils such as salicylates in oil of wintergreen, menthol, camphor, eucalyptol, can be extremely toxic if ingested.
  • Similarly, although you can create all sorts of cool effects with dry ice, whether you cook or decorate with it, be careful to avoid skin contact. Dry ice is composed of carbon dioxide which can cause tissue damage to the skin, and burns to the mouth if ingested.

And while you’re thinking about safety don’t forget to protect your pets during the holidays. Our four-legged friends can get into every bit as much mischief as their owners.

So here’s to a safe and happy holiday….but if it does all go horribly wrong, remember you can call the National Poison Center any time of day or night.

Do You Hear What I Hear?

Jingle bells and carol concerts are sounds that help make the holiday season special. But, they may also give people an opportunity to recognize if they are having trouble hearing.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 36 million American adults report some type of hearing loss. Of these, an estimated 26 million have high-frequency hearing loss caused by too much exposure to loud sound.

Noise-induced hearing loss (NIHL) is usually painless, progressive, permanent, and completely preventable. NIHL happens when a person is exposed for too long to sound pressure levels of 85 decibels or more. And we’re not just talking about exposure to endless rock concerts or pneumatics drills.  85 decibels is roughly the sound of heavy city traffic.  Prolonged exposure can result in damage to the sensory hair cells of the inner ear. The process is so gradual that people often do not realize they have a hearing loss until it affects the ability to carry on conversations in daily life.

With NIHL, softer high frequency sounds are difficult to hear, which means a person can hear what is said but they cannot understand what is said.

So how can people recognize if they have noise induced hearing loss?

When a person frequently has trouble understanding conversations at holiday parties, family gatherings, and in noisy restaurants it might be a good time for a hearing test and ear examination,” says John House, MD, president of House Research Institute.

The holidays give family and friends the opportunity to notice a change in a loved one’s hearing as well. People with hearing loss may have trouble participating in conversations because they miss key words.

“We hear from our patients that they first noticed a change in their hearing several years before they finally come in to the Clinic to have their hearing checked,” said Dr. House. “Often it is a spouse or family member who urges a patient to get their hearing tested.”

There are some forms of hearing loss, which are not noise-induced, that can be treated with surgery. The sooner a hearing loss is identified, the sooner the patient can learn about the treatment options that may help.

So if you know someone who is having trouble hearing, maybe you can consider giving the gift of hearing this holiday season by encouraging them to schedule a hearing test.

Fascinating Facts for Festive Fun

Yes, it’s that time of year again!  Along with A Charlie Brown Christmas, over-eating, and an abundance of unwanted  bath salts and socks, the holidays will no doubt involve a family game of Trivial Pursuit. This year, although we can’t control bad gift giving, SRxA’s Word on Health is happy to give you a head start when it comes to the green Science and Nature questions of that most festive of board games! And,  if you’re planning to skip board games this Christmas for more romantic pursuits we invite to use or adapt any of the little known human body facts below as your opening chat-up line!

  • Women blink nearly twice as much as men
  • Relative to size, the strongest muscle in the body is the tongue
  • Human thigh bones are stronger than concrete
  • When you sneeze, all bodily functions stop – even the heart
  • Nerve impulses to and from the brain travel at up to 170 miles per hour
  • Children grow faster in the springtime
  • It takes 72 different muscles to produce speech
  • Kissing burns about 2 calories a minute
  • Humans shed about 600,000 particles of skin every hour – about 1.5 pounds a year
  • Every square inch of the human body has an average of 32 million bacteria on it

If you have any more weird and wacky human body facts we’d love to hear them. In the meantime we wish you success in both luck and love.

A Very Happy Christmas for Patients with Christmas Disease

SRxA’s Word on Health couldn’t resist this story. Not only did it provide us with a seasonal healthcare title but it allowed me to blog about a condition that I have been passionate about for most of my life. As a college student, one of my friends and mentors had hemophilia. He taught me a lot about the disease, about courage and dignity and hope and despair. His death from AIDS left me saddened but determined to pursue a career in healthcare. A few years later I had the opportunity to head up a hemophilia research project in the UK. One thing led to another and I spent the next 20 years of my life involved with transfusion medicine and blood products therapies. Although I’m no longer working directly in that field, later today, I will be running a training course on hemophilia.  I guess you could say it’s in my blood!

For those of you wondering what the above recollections have to do with Christmas Disease, let me explain.

Hemophilia B, a deficiency of coagulation factor IX (FIX) is also known as Christmas disease. Hemophilia is an inherited, potentially life-threatening disorder affecting an estimated 20,000 Americans, almost all of them males. Their blood doesn’t clot properly because of a faulty gene. In severe cases, they can spontaneously start bleeding . Internal bleeding in the joints leads to debilitating movement problems and intense pain.

Unlike most diseases that were named after the doctor that discovered them, hemophilia B is rather special because it was named for the first patient described to have it. Stephen Christmas was born in London, UK in 1947.  He emigrated to Canada at a young age and was diagnosed with hemophilia at age two by Toronto’s Hospital for Sick Children. The family returned to London in December 1952 to visit relatives and, during the trip, young Stephen was admitted to hospital. A sample of his blood was sent to the Oxford Hemophilia Centre where it was discovered that he was not deficient in Factor VIII, which is normally decreased in classic hemophilia A, but a different protein, which received the name Christmas factor in his honor (and later Factor IX).

Now, almost 60 years later, scientists have described the first unequivocal evidence of successful gene therapy for hemophilia. Past gene therapy experiments improved blood-clotting for only a few weeks.

This week, the New England Journal of Medicine reports that a single intravenous injection of an adenovirus-associated virus (AAV) vector that expresses FIX  was successfully used to treat 6 patients  with hemophilia B for more than a year. This is a remarkable breakthrough, given that patients normally need to infuse FIX two or more times every week.

The six men each got a single, 20-minute infusion of AAV. Each saw the amount of clotting proteins in their blood increase from less than 1% of normal levels to at least 2%, and in one case as much as 11%.  Although that may not seem like a lot, it was enough to allow all the men to cut back on the number of regular FIX treatments, and four stopped conventional treatment altogether.

Because their prophylactic use of factor concentrate was either eliminated or reduced, dramatic cost savings were achieved. In the United States, annual costs for a single adult patient with hemophilia B are approximately $300,000. Over a lifetime this adds up to a staggering $20 million. Whereas, the AAV is estimated to cost $30,000 per patient

An editorial that accompanied the study asked: Should the practicing hematologist rush to order this gene therapy vector if it is approved by the Food and Drug Administration?

Their answer – “probably yes!”  Still, they caution that the risks of this procedure are not yet totally clear. In one patient, liver enzyme levels were found to be about five times the upper limit of normal 2 months after gene therapy.

Nevertheless this gene therapy trial for hemophilia B is truly a landmark study, since it is the first to achieve long-term expression of a blood protein at therapeutically relevant levels. If further studies determine that this approach is safe, it may not only replace the cumbersome and expensive protein therapy currently used for patients with hemophilia B, but also translate into applications for other disorders, such as alpha1-antitrypsin deficiency, and hyperlipidemias.

Now, that really would be a Christmas gift.

The battle of bone marrow versus breast cells

Forget who’ll win the X-Factor, Dancing with the Stars or even the Superbowl.  SRxA’s Word on Health brings you hot, breaking news from a world class content of microscopic mobility. We have to admit we almost missed this story and want to thank one of our regular readers, Jeff Boulier, for bringing it to our attention.

In an astonishing fear of athleticism, a line of bone marrow stem cells from Singapore beat out dozens of competitors to claim the title of the world’s fastest cells. They whizzed across a petri dish at the breakneck speed of 5.2 microns per minute — or 0.000000312 kilometers per hour!

Results of the World Cell Race were announced last week at the annual meeting of the American Society for Cell Biology in Denver, Colorado. Organizers declared the competition a success: “50 participating labs all over the world! 70 cell lines recorded! Without a single dollar to fund the project!” said Manuel Théry from Institut de Recherche en Technologies et Sciences pour le Vivant (iRTSV) in Grenoble, France. Behind the fun is a serious goal: looking at how cells move. Ultimately, it is cell migration that helps embryos and organs to develop and allows cancer to spread. The contest provided a lot of new information.  For example, stem cells and cancer cells seem to be faster than their mature and healthy counterparts. Rather than actually racing the cells, teams shipped frozen cells to designated laboratories in Boston, London, Heidelberg, Paris, San Francisco, and Singapore. Thawed cells were placed in wells containing “race tracks”. Digital cameras then recorded the cells for 24 hours to determine the fastest run down the track for each cell line. In total, about 200 cells of each cell type were timed to see how long it took the fastest individual cell of each type to reach the end of its track.

The key to victory?  According to Théry, who co-organized the race with colleagues from Institut Curie in Paris, the secret is to  avoid changing direction.  Cells that went back and forth along the track took longer to finish. Coming in second were a line of breast epithelial cells from France, with third place going to the same cell type tweaked to reflect patterns observed in cancerous cells. They clocked 3.2 and 2.7 microns per minute respectively.  Finishing fourth, at a still respectable 2.5 microns per minute, was the UK team of cultured human skin cells derived from patients with a rare genetic skin disorder. The winners received Nikon digital cameras and coveted World Cell Race medals.

What next?  Cellular showdowns in swimming and weightlifting or perhaps a full scale Cyto-lympics!