Watch video here.
Friday, 30 September 2011
But we now know there's another reason why... they contain radioactive material, specifically polonium-210!
Tobacco companies also have known about it since 1959. As reported in ABC, historical documents reveal tobacco companies not only knew about the radioactive substance, but studied it, then refused to do anything about it!
They figured out that:
1) It caused "cancerous growths" in the lungs of smokers,
2) Calculated how much radiation a regular smoker would ingest over 20 years
Then they kept the research secret. The level of deception is breath-taking.
The radiation alone from cigarettes can account for up to 138 deaths for every 1,000 smokers over period of 25 years.
Even more disturbing, is that ALL tobacco products on the market today still contain radioactive polonium. This is in spite of washing techniques available since 1980 to remove the radioactivity but refused by tobacco companies to perform whether due to cost or the fact that washing would remove the addictive nicotine component as well.
Take home message?
STOP smoking! It's killing you through not only harmful chemicals, but also radioactivity!
Read the ABC article here.
Reference:
Cigarette Smoke Radioactivity and Lung Cancer Risk. Nicotine Tob Res (2011) doi: 10.1093/ntr/ntr145
Whether discus or hammer throwing, both require spinning on part of the athlete before letting the discus/hammer go for long distances.
59% report dizziness with discus throwing, but none with hammer throwing. Why?
This occurred even among athletes who did both sports eliminating individual susceptibilities to dizziness.
Based on slow-motion video analysis, it was conjectured that visual bearings can be used more easily with hammer throwing than during discus throwing. Moreover, less foot contact with the ground for ground-body tactile feedback and generation of head movements liable to induce motion sickness from acceleration were felt to be contributing factors.
How do these findings translate to patients who are dizzy?
1) Visual bearings - Fixate on objects that you know to be still
2) Increase body-ground contact - Wear flat shoes instead of stiletto heels as well as cane/walker use
3) Minimize sudden turning head motions - Turn with the body rather than the head, or turn the head slowly
Of note, this research project won the 2011 Ig Nobel Prize for Physics.
Reference:
Dizziness in discus throwers is related to motion sickness generated while spinning. Acta Otolaryngol. 120 (3), 390-5.
Tuesday, 27 September 2011
HIPAA, for those who don't know, is a law that requires patient information to be kept private with safeguards. Email (such as yahoo, gmail, aol, etc) is not considered a secure form of communication.
However, HIPAA does allow for such un-secured email communication under certain circumstances. I quote from the horse's mouth:
"Patients may initiate communications with a provider using e-mail. If this situation occurs, the health care provider can assume (unless the patient has explicitly stated otherwise) that e-mail communications are acceptable to the individual. If the provider feels the patient may not be aware of the possible risks of using unencrypted e-mail, or has concerns about potential liability, the provider can alert the patient of those risks, and let the patient decide whether to continue e-mail communications."As such, it may be worthwhile for a patient to acknowledge the following statements before an email can be sent from a practice website using un-secured email:
"I understand email is not considered secure and as such, is not considered a confidential method of communication."
"By your sending an email to us, you are giving permission for us to reply by email."Even if private health information may be included, that's fine if, I quote from the horse's mouth:
"Further, while the Privacy Rule does not prohibit the use of unencrypted e-mail for treatment-related communications between health care providers and patients, other safeguards should be applied to reasonably protect privacy, such as limiting the amount or type of information disclosed through the unencrypted e-mail."Read more about un-secured email communication as it relates to HIPAA here from the Department of Health & Human Services.
In both ears, there is a "gyroscope" called the labyrinth. Whenever the head turns or a force like gravity is exerted on this system, fluid moves within which tells the brain that motion has occurred. It's much like looking into a glass of water and based on the way the water tilts in the glass, you can guess which way motion is occurring.
In any case, the study took two groups of people, one with an intact labyrinth system and another without a functioning labyrinth system. Only those individuals with an intact labyrinth system suffered vertigo while getting an MRI. Furthermore, the stronger the MRI's magnetic field, the worse the vertigo.
Beyond the "that's interesting" trivia, these results are VERY important in any type of brain activity research. Why? Well, if a person is feeling dizzy, the brain activity you may be studying using the MRI may be attributable to the dizziness itself and the patient's coping mechanisms to deal with it rather than whatever brain activity research you may be investigating.
On a more science-fiction note, based on these findings, an MRI can theoretically be used to potentially diagnose and treat dizziness due to the inner ear. After all, if it can cause dizziness, it certainly can be used to help it as well!
Reference:
MRI Magnetic Field Stimulates Rotational Sensors of the Brain. Current Biology, 22 September 2011. doi:10.1016/j.cub.2011.08.029
Sunday, 25 September 2011
For a good physical exam, physicians use their senses (eyes, ears, nose) to detect disease processes that may not necessarily be obvious to a lay person. Beyond these obvious senses, fingers and hands are also utilized to feel for unusual bumps or masses that may not be obvious to the naked eye.Take a neck mass for example. Neck masses may not be necessarily visible, but by feeling the neck, may become obvious. To use an analogy, a bowling ball under a mattress may not necessarily be obvious, but if you lay on the bed, would become painfully obvious.
Physicians also use the hands/fingers to examine areas that may not be visible... such as the unpleasant digital rectal exam (inserting a finger up a bung-hole) which is done to detect blood in the stool, rectal/anal cancers, anal muscular incompetence, etc.
However, I find it odd that the mouth is a body area that is not often "felt" around... physicians included.
A finger can appreciate unusual mouth pathology that may not necessarily be appreciated by looking alone. Furthermore, just like the rectal exam, a finger can appreciate base of tongue pathology that cannot be visualized by having a patient go "ah".
I truly feel that actor Michael Douglas would have been diagnosed with his base of tongue cancer much earlier if only a doctor stuck a finger and swept that back area of the tongue. One can "feel" cancer as it is rock hard and very tender. True... it may cause a person to gag, but for a cancer test, it's dirt cheap, fast, and reliable.
However, it does not just have to be areas of the mouth that can not be seen. Even for those ulcerations and bumps of the mouth that one can clearly visualize (or not), it does help to touch it. Is it hard? Soft? Ulcerated? Tender? Grooved? Papillated? Fungating? Rubber-like? Blottable?
Each characteristic provides information to achieve a more accurate diagnosis.
To an ENT way of thinking, if a doctor regularly performs a digital rectal exam, than one can certainly do the same thing at the other end. It's less invasive and provides just as much information.
Say "ah"!!!
Saturday, 24 September 2011
That action was hinted at back in August 2011 after a scathing parliamentary report stating the initiative to be wasteful and incapable of delivery.
I'm not surprised...
It's hard enough to get a group of doctors in one hospital to agree with a treatment plan let alone agree to a medical records system. The problem is exponentially more difficult when applying it to an entire country.
Physicians practice medicine differently... just like teachers have their own unique way of teaching kids. A method that may work for one doctor or teacher will not work for another. Even the method may change depending on how "busy" things are (teacher with a class of 5 kids versus 30 kids) so a doctor in a busy inner-city emergency room will have different flows and needs from an electronic medical records than a rural family practice with a sedate pace. Furthermore, the needs of a dermatologist is very different from a pediatrician. One can't expect a single EMR system to meet the needs of both perfectly just like one cannot expect a math teacher to use the same teaching methods as a singing teacher.
Forcing physicians to use a single standard electronic medical records without adapting to these realities is bound to fail no matter how much time, training, software, and hardware you throw at it.
A better alternative (my opinion), is to treat electronic medical records like the computers they reside on. There should be many different types of EMR systems just like there are MANY different types of computer models, speeds, makes, cost, sizes, etc.
However, unlike current EMR systems, in spite of who makes a computer and what operating system software it runs, it has standardized components... USB, Firewire, HDMI, VGA, BlueTooth, etc. as well as a universal communication medium called the "internet" that works with phones, computers, laptops, etc regardless of who makes it and what software it is on.
You would think that an EMR system given its digital essence would be able to easily communicate with other systems... but no... they don't communicate at all... which is why paper reports still exist... which are than scanned into the EMR.
Rather than the government (whether the United Kingdom or the United States) dictating what physicians must do and mandating EMR initiatives, I believe the money would be much better spent on mandating inter-operability and communication standards. The free market will create the best EMR systems and physicians will pick the one that best meets their need.
The other more insidious side of EMR is the over-reaching health goal mandates which means well, but runs into the same problem of applying standards to all physicians. Take "meaningful use" set by the Centers of Medicare and Medicaid Services (CMS). One of the core measures of meaningful use is adult weight-screening and follow-up.
Now as an ENT specialist, I see patients specifically for earwax. Why in the world would I want to perform a weight-screening when all I want to do (and what the patient only wants me to do) is get earwax out???
Makes no sense.
Does it to you???
Reference:
U.K. Scrapping National Health IT Network. InformationWeek Healthcare. Aug 4, 2011
U.K. Ends Health-Service IT Upgrade. Wall Street Journal. Sept 23, 2011
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