revere | January 2, 2008Egypt continues to be the country outside of Asia with the highest case total of H5N1 disease. Last year there were 23 cases, 18 the year before. A year ago there were 3 confirmed cases each in December and January, with the big month being later, March (7 cases). Flu season (including bird flu) is starting again there with four deaths at the end of December, the first since July. The flu sites newshounds are doing their usually diligent job and they report an additional confirmed but still living case. In addition there are the usual spate of "suspect" cases, a fluctuating number that can…
revere | January 1, 2008I guess there are a lot of things in the newspapers that leave you shaking your head, but a recent Op Ed by surgeon Atul Gawande left both Mrs. R. and me shaking our heads simultaneously, accompanied by jaws headed south and and eyes bulging. Quite a visual, I admit. But consider the source. I'll let Gawande describe it:
In Bethesda, Md., in a squat building off a suburban parkway, sits a small federal agency called the Office for Human Research Protections. Its aim is to protect people. But lately you have to wonder. Consider this recent case.
A year ago, researchers at Johns Hopkins…
revere | January 1, 2008Yesterday I indulged myself and took a personal look backward. It was New Year's Eve, after all, the end of a year. Today is New Year's Day, the day we look to the year ahead. Is this the Year of The Big One (pandemically speaking)? Or another year of Waiting for the Other Shoe to Drop? If we can't figure out what will happen over the next year (who will be President-elect?), how about the next hundred years? That will average out the inconsequentialities and get down to The Big Things. The New York Times did a story the other day where they interviewed a bunch of alleged experts about what…
revere | December 31, 2007Year's end. We don't disclose how many Reveres there are or where they are (we don't even correct the rife speculation and usually incorrect assumptions in the Comments), but one thing we/I will reveal: there's only one Revere at a time. So it falls to this one to look back on the past year, which for me, personally, was a year of milestones. A new grandson came into our lives. He is beautiful and 7 months old. It helps make up for the one that didn't quite make it. On the other side of the ledger, my mother died this year. It was the day before Thanksgiving. She, too, was a beautiful person…
revere | December 31, 2007What the hell. It's the end of the year. Always fun to look back at those events which alter and illuminate Our Times. And You Were There:
revere | December 31, 2007Everyone seems to have an opinion about whether bird flu will be the next terrible global pandemic. In current parlance "bird flu" means human infection with the highly pathogenic avian influenza/A subtype H5N1. There is no doubt that this is the 800 pound gorilla in the global health room at the moment, but not because it is more likely to become a pandemic (NB: pandemic by definition is a globally dispersed sudden increase in infection among humans; the same situation for animals is called a panzootic, and it is plausible to say we have an H5N1 panzootic for birds now). On the basis of…
revere | December 30, 2007After spending more time than I wished "defending" WHO against what I considered a particular kind of scurrilous attack (it also seemed to raise the hackles of some unintended as targets, but the dialog with them was at least rational) -- after all that, I now have to turn around and complain about WHO (again). Let me be constructive and offer their spokesperson, John Rainford (or whoever writes the statements he mouths), a little biology lesson. A mutation of a virus is a technical term that describes a replicable change in the sequence of bases that constitute the virus's genetic blueprint…
revere | December 30, 2007One of my guilty pleasures used to be indulging in End-of-the-Year wrap-ups on network news. I'm not exactly sure why and it's been decades since I've enjoyed what has become a sterile exercise in hindsight spin doctoring. There are still specialized areas, though, where the judgments of the cognoscenti are still interesting to me. One of them is religion. What do religion journalists consider the big stories of the past year? A comparison of the "Top Ten Stories" in 2005, 2006 and 2007 according to Christianity Today presents a picture that is, dare I say it, Enlightening. (NB: The Top Ten…
revere | December 29, 2007This both made me laugh and made me mad. Corey Doctorow over at Boingboing relates how he was contacted by a new online service to write a letter of recommendation for a former student applying to graduate school. Using a web-based interface the same letter could be submitted to multiple universities. Good idea. Like a lot of professors I have to write a lot of these and making it easier is good for me and good for students. The catch was that this one came with an end user license agreement (EULA) requiring the submitter (who is doing everyone a favor, including the web-based application…
revere | December 28, 2007I learned emergency cardiopulmonary resuscitation (CPR) in medical school more than forty years ago and it hasn't changed much until now. It was always hard to do, but now it's half as hard and not as unaesthetic, at least if the results of several studies are taken into account.
The problem was that you had to do two things simultaneously: maintain circulation by chest compression (usually pushing on the sternum) and aerate the mechanically circulated blood by artificial respiration (usually mouth to mouth resuscitation). This meant you stopped compression while inflating the lungs, then…
revere | December 28, 2007Former Pakistani Prime Minister Benazir Bhutto, despite a bevy of bodyguards, was assassinated yesterday. Pakistan is a dangerous place, especially for pro-American politicians or those thought to be pro-Western officials. It's something to think about when you read that WHO and the US reference laboratory NAMRU-3 each sent teams to the politically unstable and hostile-to-the-West northern regions of Pakistan to gather information about the recent cluster of bird flu cases. WHO's team was in Peshawar, north of Islamabad. Here's what Middle East expert Juan Cole said about Peshawar the other…
revere | December 27, 2007If you have heart disease or diabetes and you are uninsured you are worse off than those who are insured by several measures. Those are the kinds of health conditions that usually worsen with age, too, so you would expect this to be a bigger problem for the uninsured near elderly. But they don't worsen for this group because when they hit 65 in the US they are no longer uninsured: they have the near universal health insurance coverage called Medicare, and as a result their health improves. Those are among the findings in a paper in the Journal of the American Medical Association (JAMA) by a…
revere | December 27, 2007Bird flu is still flu and one expects an uptick of cases during "flu season" which usually gets underway in earnest in December. So from that perspective it isn't a surprise that December has seen human fatalities from bird flu in six countries: Pakistan, China, Vietnam, Egypt, Burma and, of course, Indonesia. Once the Pakistani cases are officially confirmed and added to the December tally for this flu season it will make it the worst December yet, but we shouldn't read too much into this. Flu seasons are notoriously variable and the numbers bounce around a lot from year to year. But . . .…
revere | December 26, 2007There's a lot of stuff about tainted food in the news, whether it is toxins in imports or questionable additives in US products (e.g., bisphenol A in hard plastics). This stuff is not on any food label, of course, but there is a lot of detailed stuff that is on labels and increased concern about food seems to have made label reading more common. I've always wondered if the detail was encouraging or discouraging people from reading labels. How many people read labels really? Quite a few, it turns out, at least if you believe a new report, Label Reading from a Consumer Perspective, by the…
revere | December 26, 2007The Toronto Sun has another one of the "such and such a city/state/country isn't prepared for a pandemic" stories. The judgment comes from the 2007 Auditor General of Ontario's annual report. Yawn. Like it's so easy to know what to do, right? Maybe not. So the Report has some recommendations:
The report says the ministry "does not have assurance that all members of the health system knew what to do in planning for and during a pandemic."
As a result, the report lists recommendations that would serve to help prepare Ontario for such a catastrophic flu bug. The recommendations include, among…
revere | December 25, 2007Forty years ago I was the only doc in a bioengineering lab in a famous technical university. We had our own computer -- it took up a giant room -- and had attached to it a rare device in those days, a scanner for converting transparencies to computer readable form. It was really a cathode ray tube with a sensor on the other side of the transparency. The CRT scanned and the sensor sensed and an analog to digital converter converted. About that time I got interested, along with an engineering colleague, in taking two-dimensional x-ray images, which were really projections or shadows of the…
revere | December 25, 2007In my Christmas stocking this morning I found a Season's greeting from the excellent down-under medical/public health blog impactEDnurse. Here's the card and the link to the little present that goes with it:
I offer you up a nurses public service video on the best way to detect avian influenza: http://impactednurse.com/?p=428
Merry Christmas. And Gesundheit.
revere | December 24, 2007There are computers on a chip and labs on a chip and now explosives on a chip. Explosives on a chip? WTF?
This wonderful tech breakthrough is brought to us by Georgia Tech Research Institute and reported, straight-faced, by the Press Release service, Science Daily:
Developed by a team of scientists from the Georgia Tech Research Institute (GTRI) and the Indian Head Division of the Naval Surface Warfare Center, the highly-uniform copper structures will be incorporated into integrated circuits -- then chemically converted to millimeter-diameter explosives. Because they can be integrated into…
revere | December 24, 2007We've discussed the scandal over the use of Avastin and Lucentis for wet macular degeneration several times (here, here, here). If you've missed it, here's the gist. Avastin is a drug approved to treat colon cancer. It works by choking off blood vessels to the tumor. It turns out, however, that a tiny dose of the same drug, when injected into the eye can also stop the uncontrolled growth of blood vessels behind the retina that produces a leading cause of blindness in the elderly, macular degeneration. The good news is a compounding pharmacy can take the large dose in the Avastin package and…
revere | December 23, 2007The recent report of a novel influenza virus in pigs, the H2N3 subtype, has been raised some alarm in certain quarters. I just read the paper itself (doi: 10.1073/pnas.0710286104) and then the account in CIDRAP News, which is both accurate and complete. I recommend it highly as a summary of this work. I have a bit to add, but first their concise summary of events leading to the investigation:
The discovery of the new virus began with an illness outbreak in pigs at a Missouri swine nursery in September 2006, according to the report. The pigs' lungs showed obvious signs of pneumonia, and tests…