Lets call this a link Thursday
http://www.nytimes-se.com/ [The future (crossing fingers)]
http://nymag.com/daily/intel/2008/11/fake_new_york_times_has_a_conn.html [How cool]
http://www.nytimes.com/2008/11/14/health/14hiv.html?_r=1&hp&oref=slogin
[Cure for AIDS, groundbreaking work showing that a stem cell transplant with blood that lacks a co-receptor for HIV, specifically CCR5, can provide immunity to already diseased patients. This is, however, a very risky procedure and too expensive and difficult for most people with HIV. Still pretty incredible]
http://pubs.acs.org/cen/news/86/i45/8645notw1.html[The scientific world has been waiting for Obama]
http://www.vimeo.com/993998 [Pretty neat]
A joke at every end:
Why did the chicken NOT cross the road?
Because it was chicken.
11.13.2008
11.11.2008
Flu and Google sitting in a tree
Well this is pretty neat: New York Times has noted that Google is getting in on flu tracking. http://www.google.org/flutrends represents Google's non profit side. The company will use key words, relating to flu like symptoms, typed online to track regional outbreaks of influenza.
The flu is caused by a genera of the RNA virus family Orthomyxoviridae. This virus genome is composed of a single negative sense RNA strand, broken into many segments (8). The strains differ every year based on the glycoproteins found in the virus's envelope (or outer cell structure). These glycoproteins allow the viral cell to bind to a human cell (hemagglutinin) and release of the viral cell from the host cell (neuraminidase). A mutation in either one of these "peplomers" creates a new strand of virus.
Ultimately, it is very important to track the influenza virus to implement appropriate vaccine measures and also to identify the most prevalent strand in the years flu outbreak. One of the biggest difficulties in vaccination is that three strains of virus have to be selected 6 months prior to flu season. While Google has validated their keyword based tracking system with the tracking system currently used by the CDC, there is still much more work to do to be able to predict not only where but which strain of the flu is coming for us.
A joke at every end:
A famous champion is in bed with flu. A doctor visits him.
“You’ve got a high fever, my friend,” says the doctor.
“How high?” – asks the champion.
“39.5˚C,” the doctor nods.
“Yeah? And what is the world record?”
The flu is caused by a genera of the RNA virus family Orthomyxoviridae. This virus genome is composed of a single negative sense RNA strand, broken into many segments (8). The strains differ every year based on the glycoproteins found in the virus's envelope (or outer cell structure). These glycoproteins allow the viral cell to bind to a human cell (hemagglutinin) and release of the viral cell from the host cell (neuraminidase). A mutation in either one of these "peplomers" creates a new strand of virus.
Ultimately, it is very important to track the influenza virus to implement appropriate vaccine measures and also to identify the most prevalent strand in the years flu outbreak. One of the biggest difficulties in vaccination is that three strains of virus have to be selected 6 months prior to flu season. While Google has validated their keyword based tracking system with the tracking system currently used by the CDC, there is still much more work to do to be able to predict not only where but which strain of the flu is coming for us.
A joke at every end:
A famous champion is in bed with flu. A doctor visits him.
“You’ve got a high fever, my friend,” says the doctor.
“How high?” – asks the champion.
“39.5˚C,” the doctor nods.
“Yeah? And what is the world record?”
11.09.2008
Noted
Heparin seized from Cincinnati-based Celsus Laboratories Inc. The WSJ reports that the FDA, after issuing two recommendations for recall, seized two lots of Heparin worth $112,000. While an impressive move, it is quiet alarming that the first letter was sent to Celsus in April.
"The FDA said companies who may have purchased heparin from Celsus should contact the company to determine whether the heparin they purchased was from the seized lots." When it comes to very expensive medication, it seems that these companies might not chose to contact the FDA.
A hospital in Detroit is using the automobile industry to improve efficiency. The Detroit News reports that "lean production" is being applied to the medical system. The Detroit Medical Center, for example, hired automotive consultants to review the patient's trip through the medical system to identify inefficiencies. This has helped save the hospital hundreds of thousands of dollars. Other hospitals, using a similar model of critique, has shortened the average ER wait to under 30 minutes.
A joke at every end:
Little Nancy was in the garden filling in a hole when her neighbor peered over the fence. Interested in what the little girl was up to, he politely asked, "What are you up to there, Nancy?"
"The FDA said companies who may have purchased heparin from Celsus should contact the company to determine whether the heparin they purchased was from the seized lots." When it comes to very expensive medication, it seems that these companies might not chose to contact the FDA.
A hospital in Detroit is using the automobile industry to improve efficiency. The Detroit News reports that "lean production" is being applied to the medical system. The Detroit Medical Center, for example, hired automotive consultants to review the patient's trip through the medical system to identify inefficiencies. This has helped save the hospital hundreds of thousands of dollars. Other hospitals, using a similar model of critique, has shortened the average ER wait to under 30 minutes.
A joke at every end:
Little Nancy was in the garden filling in a hole when her neighbor peered over the fence. Interested in what the little girl was up to, he politely asked, "What are you up to there, Nancy?"
"My goldfish died," replied Nancy tearfully, without looking up, "and I've just buried him."
The neighbor was concerned, "That's an awfully big hole for a goldfish, isn't it?"
Nancy patted down the last heap of earth and then replied, "That's because he's inside your stupid cat."
10.30.2008
Heparin II
Previously, I had written about contamination that occurred in a batch of Heparin and caused the death of a number of patients undergoing dialysis. Free Yevgeniy: Heparin To review, Heparin is a natural anticoagulant found in the intestine (lumen) of pigs. Heparin is a variably-sulfated proteoglycan that consists of repeating disaccharide units (pictured to the right). The compound inhibits binding to the clotting factor ATIII and stops the blood clotting process.
Last year there were pediatric deaths that created a commotion in the community and led to the FDA issuing an investigation. One of the academic specialists on Heparin, called to assist in to identify the contaminant, was professor Robert J. Linhardt, at Rensselaer Polytechnic University.
Dr. Linhardt, working with a larger group, helped isolate the contaminant as persulfonated chondroitin, a compound that mimics heparin activity in vitro but causes extreme damage, even death, in vivo.
Heparin is used in dialysis and for invasive hospital tools. Therefore a contaminant was a disaster for the health care community
Dr. Linhardt discussed the need for laboratory made Heparin so that we could better monitor the drug making process and avoid Heparin shortages.
Interesting points made during the talk:
- Pigs in china made four doses of Heparin vs. one dose in America. Turned out Chinese farms are dirtier and cause an increase in mast cell Heparin production as Heparin levels are elevated during a parasitic response
- Heparin was first used in 1926 (prior to FDA existence) and as a compound can not be patented
- While the current process for Heparin production is gruesome (filthy slaughterhouses --> large unregulated factories --> US markets), the contaminant was purposely added to the mix sometime during the process. This is important as the FDA can not allow any inserted contaminant to be present (non process derived), therefore purification is not an option
- France continued to use contaminated Heparin, since the alternative was to stop dialysis
This meeting was targeted to chemists and business people. Yet, it is an essential concept for all medical doctors to understand. It seems amazing that doctors have so much faith in the prescription pad to provide the right drug. Often generics are recommended because similar efficacy has been shown in trials and cost is decreased. Is quality lost? Cheap sneakers are often of poorer quality then more expensive ones. As a society, we expect our medication to be treated with higher regard then sneakers. However, the FDA is underfunded. Less then 10% of imported drugs are checked when shipments arrive. Until this Heparin crisis occurred, there were no full time FDA officials in China reviewing the manufacturing process. Can physicians rely on the drug market to provide what is prescribed? This continues to be a pivotal issue.
A joke at every end:
Why is Cinderella bad at baseball?
She runs away from the ball and has a pumpkin for a coach.
5.07.2008
Who you calling Fat
This week it seems that fat has taken NY by storm.
The May 6th Edition of the Science NY Times had an assortment of fascinating articles that related to fat in some way.
New research is showing that 10% of your fat cells die and are replaced every year. Oddly enough, nuclear bomb testing helped move this stuff forward. The radioactivity released by above ground bombs created a spike in Carbon 14 isotopes in the atmosphere. C14 has 8 protons and 6 electrons (2 more than usual). The natural abundance of C14 in the atmosphere is one in a trillion, therefore, spikes in the atmosphere made an imprint in all things created at that time. The half life of C14 is 5700 years (long enough to not make a difference).
This principal was applied to the whole body, and showed that certain fat cells were very young.
2. A high fat diet showed itself effective in a randomized trial to decrease epilepsy seizures in children. This diet has been evaluated for a long time now. 38 % of kids had 50 % less seizures as compared to only 6% of kids in the control group. On a personal note, my professor and I researched the effects of a high ketone diet on seizure patterns in Mongolian Gerbils.
Ketosis is the state of metabolism when the liver uses fats (instead of glucose) for energy and converts fat into fatty bodies and ketones. Fatty tissue becomes an important source of energy and diet has to maximize fatty intake to maintain ketosis.
To review our basics, a fatty acid is a carbon chain (with double/triple bonds - unsaturated, no double/triple bonds - saturated). Fat tissue tends to be composed of three fatty acids bonded to a carbon backbone. Adipose cells store a lot of fat.
3. This article discusses the important benefits of our fat cells. They protect our organs (visceral fat), provide the bulk under the skin (subcutaneous), store an important energy source, and are critical to supplement disruptions in diet. In addition, these fat cells release different hormones. Too much fat causes a release of inflammatory hormones to decrease obesity, they also release leptin (a compound involved in reproduction). Clearly fat is no joke (line might be stolen from NY Times).
4. Everything is interconnected. Everything. Obesity, Epilepsy, Bipolar disorder, Chronic Fatigue Syndrome. Our gene make up is so complex that undoubtedly relationships can be found and made in disease never before associated by their outward symptoms.
Muscular Distrophy and Heart Attacks share a gene in common. Two genes connect diabetes and prostate cancer.
Nosology - the field of disease classification - is about to get its head knocked. For example, Jonathan Kerr and company [J Infect Dis. 2008 Apr 15;197(8):1171-1184] have published a study of a genomic signature of 55 patients with Chronic Fatigue Syndrome. 88 genes are up regulated. 6 of them have previously been targeted by drugs.
Looking at everything floods the blackboard with an assortment of random thoughts. Once a pattern can be elucidated, though, the most powerful answers can be found.
Ideas:
A joke at every end:
What do you call a fish with no eyes?
Fsh!
- better said then read [no i(s)]
The May 6th Edition of the Science NY Times had an assortment of fascinating articles that related to fat in some way.
- Study Finds That Fat Cells Die and Are Replaced
- Evidence a High-Fat Diet Works to Treat Epilepsy
- Its Poor Reputation Aside, Our Fat Is Doing Us a Favor (older - Aug 7, 2007)
- Redefining Disease, Genes and All (separate topic - somewhat related)
New research is showing that 10% of your fat cells die and are replaced every year. Oddly enough, nuclear bomb testing helped move this stuff forward. The radioactivity released by above ground bombs created a spike in Carbon 14 isotopes in the atmosphere. C14 has 8 protons and 6 electrons (2 more than usual). The natural abundance of C14 in the atmosphere is one in a trillion, therefore, spikes in the atmosphere made an imprint in all things created at that time. The half life of C14 is 5700 years (long enough to not make a difference).
This principal was applied to the whole body, and showed that certain fat cells were very young.
2. A high fat diet showed itself effective in a randomized trial to decrease epilepsy seizures in children. This diet has been evaluated for a long time now. 38 % of kids had 50 % less seizures as compared to only 6% of kids in the control group. On a personal note, my professor and I researched the effects of a high ketone diet on seizure patterns in Mongolian Gerbils.
Ketosis is the state of metabolism when the liver uses fats (instead of glucose) for energy and converts fat into fatty bodies and ketones. Fatty tissue becomes an important source of energy and diet has to maximize fatty intake to maintain ketosis.
To review our basics, a fatty acid is a carbon chain (with double/triple bonds - unsaturated, no double/triple bonds - saturated). Fat tissue tends to be composed of three fatty acids bonded to a carbon backbone. Adipose cells store a lot of fat.
3. This article discusses the important benefits of our fat cells. They protect our organs (visceral fat), provide the bulk under the skin (subcutaneous), store an important energy source, and are critical to supplement disruptions in diet. In addition, these fat cells release different hormones. Too much fat causes a release of inflammatory hormones to decrease obesity, they also release leptin (a compound involved in reproduction). Clearly fat is no joke (line might be stolen from NY Times).
4. Everything is interconnected. Everything. Obesity, Epilepsy, Bipolar disorder, Chronic Fatigue Syndrome. Our gene make up is so complex that undoubtedly relationships can be found and made in disease never before associated by their outward symptoms.
Muscular Distrophy and Heart Attacks share a gene in common. Two genes connect diabetes and prostate cancer.
Nosology - the field of disease classification - is about to get its head knocked. For example, Jonathan Kerr and company [J Infect Dis. 2008 Apr 15;197(8):1171-1184] have published a study of a genomic signature of 55 patients with Chronic Fatigue Syndrome. 88 genes are up regulated. 6 of them have previously been targeted by drugs.
Looking at everything floods the blackboard with an assortment of random thoughts. Once a pattern can be elucidated, though, the most powerful answers can be found.
Ideas:
- Studies show that African Americans and Caucasian populations lose different types of adipose tissue during diet and tend to have different adipose tissue for the same body mass index . These two groups also have different insulin patterns and different diabetic profiles. Fat cells are created every year - can we direct them to different locations? Will they excrete different hormones more conductive to a proper glucose response? What effect will a high fat diet (ketosis) have on the diabetic population (I have a feeling it will be different for African American and Caucasian communities).
- Personal story, patient with Chronic Fatigue just started a south beach diet (avoid bad fats and sugars), feels great. How does all this fit in? Separately, if Chronic Fatigue Syndrome is characterized by some inflammation, might fat cells be involved?
A joke at every end:
What do you call a fish with no eyes?
Fsh!
- better said then read [no i(s)]
4.13.2008
Methotrexate - some thoughts
Today I wanted to write about a specific. It hasn't been in the news recently but caught my interest because it did something unexpected.
Methotrexate (shown at left) is a very interesting compound. Its history began with FDA approval in 1953 f
or oncology use.
It gets the job done by inhibiting folic acid breakdown.
Folic Acid or Folate is water soluble vitamin B9 (pictured right). [Note the similar structural elements of methotrexate and Folic Acid] Folic Acid is broken down to form tetrahydrofolate, a metabolite necessary for DNA synthesis, by the enzyme dihydrofolate
reductase. Due to their similar structure, methotrexate can bind dihydrofolate reductase, block folic acid breakdown, and slow DNA synthesis. This is preferentially damaging cancer and immune system cells as they grow particularly fast and rely on DNA synthesis for their growth.
Methotrexate therefore has been used for chemotherapy (high dose) and as a treatment for inflammation associated with the autoimmune response (low dose).
A patient mentioned that Methotrexate relieved her symptoms of Fibromyalgia (a disease defined by chronic pain, abnormal pain processing, fatigue, brain fog, etc...). Why did this happen?
The etiology of fibromyalgia is still unknown. However, methotrexate has been used for a similar disease. Behçet's syndrome is characterized by generalized inflammation that causes ulcers, arthritus, and cardiac problems to a name some symptomes. Behçet's syndrome, like Fibromyalgia, is not well understood. The two diseases have overlapping symptoms of pain, fatigue and cognitive difficulties.
Something still doesn't add up. Methotrexate decreases inflammation and relieves symptoms associated with Behçet's syndrome and yet also pain associated with Fibromyalgia?.
Pain is caused by the activation of a nociceptor (pain receptor) by a mechanical or chemical stimuli. The message is passed by the nervous system through the spinal cord to the brain which responds by understanding the impulse as pain. Inflammation, among a variety of things, is known to cause the release of algesic substances which activate the nociceptors. The pictures comes full circle.
The overlap is there. A compound used for anti inflammatory disease helps with pain in disease states that are associated with inflammation. The difficulty is of course to really know whats happening. The woman who mentioned pain improvement was taking the methotrexate for retinal inflammation and happened to have fibromyalgia.
How do we make this connection faster? Is it smart to push for a clinical trial for methotrexate as a pain treatment when resources in the Fibromyalgia community are limited? Yet, it is these random observations that seem important. I guess thats why these are just some thoughts.
A joke at every end:
A blind man walks into a pharmacy with his guide dog.
He lifts his dog and starts spinning the dog by its leash.
A store employee runs up to the man and asks "hey, what are you doing?"
The blind man replies "just looking around."
Methotrexate (shown at left) is a very interesting compound. Its history began with FDA approval in 1953 f
or oncology use.It gets the job done by inhibiting folic acid breakdown.
Folic Acid or Folate is water soluble vitamin B9 (pictured right). [Note the similar structural elements of methotrexate and Folic Acid] Folic Acid is broken down to form tetrahydrofolate, a metabolite necessary for DNA synthesis, by the enzyme dihydrofolate
reductase. Due to their similar structure, methotrexate can bind dihydrofolate reductase, block folic acid breakdown, and slow DNA synthesis. This is preferentially damaging cancer and immune system cells as they grow particularly fast and rely on DNA synthesis for their growth.Methotrexate therefore has been used for chemotherapy (high dose) and as a treatment for inflammation associated with the autoimmune response (low dose).
A patient mentioned that Methotrexate relieved her symptoms of Fibromyalgia (a disease defined by chronic pain, abnormal pain processing, fatigue, brain fog, etc...). Why did this happen?
The etiology of fibromyalgia is still unknown. However, methotrexate has been used for a similar disease. Behçet's syndrome is characterized by generalized inflammation that causes ulcers, arthritus, and cardiac problems to a name some symptomes. Behçet's syndrome, like Fibromyalgia, is not well understood. The two diseases have overlapping symptoms of pain, fatigue and cognitive difficulties.
Something still doesn't add up. Methotrexate decreases inflammation and relieves symptoms associated with Behçet's syndrome and yet also pain associated with Fibromyalgia?.
Pain is caused by the activation of a nociceptor (pain receptor) by a mechanical or chemical stimuli. The message is passed by the nervous system through the spinal cord to the brain which responds by understanding the impulse as pain. Inflammation, among a variety of things, is known to cause the release of algesic substances which activate the nociceptors. The pictures comes full circle.
The overlap is there. A compound used for anti inflammatory disease helps with pain in disease states that are associated with inflammation. The difficulty is of course to really know whats happening. The woman who mentioned pain improvement was taking the methotrexate for retinal inflammation and happened to have fibromyalgia.
How do we make this connection faster? Is it smart to push for a clinical trial for methotrexate as a pain treatment when resources in the Fibromyalgia community are limited? Yet, it is these random observations that seem important. I guess thats why these are just some thoughts.
A joke at every end:
A blind man walks into a pharmacy with his guide dog.
He lifts his dog and starts spinning the dog by its leash.
A store employee runs up to the man and asks "hey, what are you doing?"
The blind man replies "just looking around."
4.11.2008
Memory and Anesthesia
Sevoflurane (shown to the right) is used in the induction or maintenance of general anesthesia. It boils at 58 degrees Celsius and is administered through an anesthetic vaporizer with a mixture of nitrous oxide and oxygen.
The mechanism of action for sevoflurane is yet unknown. It is one molecule in a class of fluorinated methyl ethyl ethers and fluorinated methyl isopropyl ethers that are currently being used for anesthesia. These anesthesia compounds must have at max 4 carbons as their volatility (decreased with increased molecular weight) is necessary for action (Anesthesiology. 2008 Mar;108(3):531-3.) Interestingly, soda lime is used in anesthesiology to absorb exhaled carbon dioxide (reaction shown below) and the anesthetic agents need to be monitored for side reactions with soda lime.- CO2 + H2O --> H2CO3
- H2CO3 + 2 NaOH (or KOH) --> Na2CO3 (or K2CO3) + 2 H2O + Energy
- Na2CO3 (or K2CO3) + Ca(OH)2 --> CaCO3 + 2 NaOH (or KOH) (source)
I wanted to talk about memory, which is thought to be made through a neurobiological mechanism involving the amygdala. What was really cool about the study mentioned above is that they used no more than 0.25% sevoflurane doses in the study. To make this story short, subjects remembered less traumatic images with this low dose of anesthesia as compared to placebo. The article shows that the anesthesia lowered the metabolic rate of the thalamus (not amygdala) but the suppression was in areas of the brain that "interact with the amygdala and are known to play a role in mediating arousal and controlling the level of consciousness during anesthesia."
Furthermore, two doses 0.2% and 0.25% decreased memory of emotional slides while the o.10% enhanced this recollection. Further work is definitely going to be done to figure out whats going on. This has been mentioned as having the potential to relieve post traumatic stress disorder by breaking the connection of a certain image or thought with the amygdala. There is definitely more work to be done as the implications are very exciting!
A joke at every end:
A panda walks into a bar and orders spaghetti.
After the panda finishes he takes out a bow and arrow and shoots the bartender in the heart.
Next night, the panda walks into the same bar and orders lobster.
After the panda finishes he takes out a gun and pops the new bartender.
The next night, the panda walks in and orders pork chops.
The new bartender says "woh, I am not gonna serve you, you've injured the two previous bartenders, what's your problem panda."
"But I am a panda" says the panda.
"Hey, since when do pandas cause so much trouble! No panda I know" replies the bartender.
"Oh yea, look it up," says the panda "in that dictionary behind you"
The bartender pulls down the dictionary, opens to Panda and reads aloud.
"Panda: eats shoots and leaves."
4.04.2008
Heparin
February 28th: Baxter International Inc. requests a voluntary recall of its anticoagulant medication heparin. This molecule is derived from animal (commonly pork) organ tissue. As seen on the right, heparin is a disaccharride with varying sugar constituent
s. The most comm
on disaccharide combination (left) contains an amide and a sulfate group, both of which are de-ptrotected and attract a positive sodium ion. It is sodium heparin that is injected as medication to thin the blood of patients for a variety of indications.
So what happened? Well, over 700 people had adverse reactions after receiving heparin for dialysis or venous thromboembolism (blood clot) to name two indications.
Baxter International Inc. sells the drug and has something like 50% of America's market share. The company receives the main active ingredient from a company called Scientific Protein Laboratories. SPL, for short, is based out of Wisconsin but relies on a factory in China for extraction of the api (active pharmaceutical ingredient) from pig organs. To make a long story short, China's State FDA did not inspect this particular factory because it only produces exports. USA's FDA accidently inspected the wrong factory due to a mix up in database input and the fact that the other factory had a like sounding name(C&EN, Feb 25, 2008, Vol 86, #08, p.8).
More recently, the contaminant has been identified as Chondroitin Sulfate (right - C&EN, Mar 19, 2008). The molecule is commonly found in cartilage of animals (like pigs) and has been used by the alternative medicine community to treat arthritis. In this case, the Chondroitin Sulfate, had more sulfate groups than are commonly found in nature and is considered a purposely introduced contaminant. The over sulfated Chondroitin Sulfate is cheap and because of its structure it mimics heparin in
regulatory and potency tests.
Chinese companies, that rely on SPL for this API, have also recalled the drug. Other heparin producers are being encouraged to increase output (their API producers have been approved by the FDA).
This is a growing concern. The trend of the chemical industry has been to expand its laboratory work to international ground (cheaper labor, more supportive government). The burden on the FDA to ensure the authenticity of imported drugs grows. This will be an ongoing challenge and a very important one.
A joke at every end:
What did the bra say to the hat?
"You go on ahead, I'll give those two a lift."
s. The most comm
on disaccharide combination (left) contains an amide and a sulfate group, both of which are de-ptrotected and attract a positive sodium ion. It is sodium heparin that is injected as medication to thin the blood of patients for a variety of indications.So what happened? Well, over 700 people had adverse reactions after receiving heparin for dialysis or venous thromboembolism (blood clot) to name two indications.
Baxter International Inc. sells the drug and has something like 50% of America's market share. The company receives the main active ingredient from a company called Scientific Protein Laboratories. SPL, for short, is based out of Wisconsin but relies on a factory in China for extraction of the api (active pharmaceutical ingredient) from pig organs. To make a long story short, China's State FDA did not inspect this particular factory because it only produces exports. USA's FDA accidently inspected the wrong factory due to a mix up in database input and the fact that the other factory had a like sounding name(C&EN, Feb 25, 2008, Vol 86, #08, p.8).
More recently, the contaminant has been identified as Chondroitin Sulfate (right - C&EN, Mar 19, 2008). The molecule is commonly found in cartilage of animals (like pigs) and has been used by the alternative medicine community to treat arthritis. In this case, the Chondroitin Sulfate, had more sulfate groups than are commonly found in nature and is considered a purposely introduced contaminant. The over sulfated Chondroitin Sulfate is cheap and because of its structure it mimics heparin in
regulatory and potency tests.Chinese companies, that rely on SPL for this API, have also recalled the drug. Other heparin producers are being encouraged to increase output (their API producers have been approved by the FDA).
This is a growing concern. The trend of the chemical industry has been to expand its laboratory work to international ground (cheaper labor, more supportive government). The burden on the FDA to ensure the authenticity of imported drugs grows. This will be an ongoing challenge and a very important one.
A joke at every end:
What did the bra say to the hat?
"You go on ahead, I'll give those two a lift."
3.20.2008
Carnitine
Carnitine
Carnitine is important in the metabolism of fatty acids in the mitochondria. A defect in the carnitine cycle can cause various deficiencies including cardiac arrythmias, weakening, and confusion. Supplementing the bodies pool of carnitine with L-Carnitine can help with a decreased carnitine amount.
A joke at every end:
An elephant walks up to a naked man and says
"It's cute but can you breathe through it?"
A joke at every end:
An elephant walks up to a naked man and says
"It's cute but can you breathe through it?"
3.10.2008
Quick Thoughts
N Engl J Med. 2008 Jan 24;358(4):353-61 --> 4/5 patients with end stage renal disease were weened off immunosuppressive therapy 9-14 months after receiving a kidney from a mismatched donors.
Ideas: Bone marrow transplantation from the donor helped diminish the recipients immune response against the foreign organ. The bone marrow transplant achieved a "lymphohematopoietic chimera".
Why do farts smell?
To make deaf people laugh.
Ideas: Bone marrow transplantation from the donor helped diminish the recipients immune response against the foreign organ. The bone marrow transplant achieved a "lymphohematopoietic chimera".
- Treat Chronic Fatigue Syndrome (CFS) with a bone marrow transplant of a healthy same match donor. Some believe that CFS is an immune system disorder where the immune system is up regulated. One particular virus, HHV-6, has been recently linked to CFS and is known to preferentially infect CD4+ T lymphocytes. Could a full bone marrow transplant regenerate functioning CD4+ cells or just reboot the immune system?
- There is a theory that Chronic Fatigue Syndrome is caused by an improper cycle in the brain. It is hypothesized that stress causes the amygdala to be highly sensitized to any negative physical symptoms arising from the body. The amygdala assigns significance to cognitive or sensory input and creates a network of neurons that amplify the bodies response to physiological events. One proposed treatment method is cognitive therapy. Verbal stimulation and meditation should theoretically activate the amygdala and weaken the correlation between certain physiological or mental events and the negative symptoms associated with CFS. As music has been shown to activate various networks in the brain, maybe we can use musical therapy to rebuild the neuronal connections that might be involved in this disease?
Why do farts smell?
To make deaf people laugh.
3.03.2008
Fatigue
Thank you anonymous reader for the comment to my previous post.
Per your excellent comment, the correct version of the Buddha joke is as follows:
Buddha walks up to a hot dog stand
The vendor asks "what would you like?"
Buddha replies "make me one withe everything."
In regards to the news, an important study has been highlighted recently. Dr. Andrew R. Marks (Proc. Natl. Acad. Sci. USA 2008, 105, 2198) at Columbia University has shown that
the complex (RyR1 macromolecular complex) that shuts the calcium channels found in the sarcoplasmic reticulum (pictured right) is looser after strenuous exercises. The calcium leak causes a smaller force from contracting muscle and activates a protein, calpain, that could lead to muscle damage.
The authors commented that this is a possible explanation for long term muscle fatigue unexplained by lactic acid build up (causes the short term pain following bursts of exercise).
Marks et al. identified a compound that improves the RyR1 integrity during exercise and minimizes fatigue in muscle. A compound named S107 decreased the depletion of Calstabin1 from the RyR1 complex, thus improving overall stability during exercise.
This study is of interest for many reasons. As mentioned by the authors, a similar calcium leak has been found in heart failure patients. Implications for a treatment are clear.
Other disease entities should be considered at this point. For example, Chronic Fatigue Syndrome, is characterized by prolonged fatigue and malaise 24-36 hours post exertion. The 24-36 hour absence of fatigue is intriguing in the context of this study.
In further posts I hope to explore the mechanism of action for S107 and the implication of differentiating the fast and slow twitch muscle fibers.
A joke at every end:
A couple goes on a trip to Israel. They bicker at the wailing wall and the dead sea. In Jerusalem, the bickering continues. Every visit to a synagogue is marked by a fight. One day the wife passes away. The husband goes to a Rabbi and asks for options. The Rabbi says, "You can ship the wife back to America for 15 thousand dollars or bury her body in the holy land of Israel, your historic birth land, for only $150."
The husband, without hesitation, says "I'll ship her back to America."
The Rabbi is stunned "why would you spend all this money to send her away from this holy land."
The husband replies, "this is the same holy land where a man was buried for three days and came back to life. I am not taking any chances."
Per your excellent comment, the correct version of the Buddha joke is as follows:
Buddha walks up to a hot dog stand
The vendor asks "what would you like?"
Buddha replies "make me one withe everything."
In regards to the news, an important study has been highlighted recently. Dr. Andrew R. Marks (Proc. Natl. Acad. Sci. USA 2008, 105, 2198) at Columbia University has shown that
the complex (RyR1 macromolecular complex) that shuts the calcium channels found in the sarcoplasmic reticulum (pictured right) is looser after strenuous exercises. The calcium leak causes a smaller force from contracting muscle and activates a protein, calpain, that could lead to muscle damage.The authors commented that this is a possible explanation for long term muscle fatigue unexplained by lactic acid build up (causes the short term pain following bursts of exercise).
Marks et al. identified a compound that improves the RyR1 integrity during exercise and minimizes fatigue in muscle. A compound named S107 decreased the depletion of Calstabin1 from the RyR1 complex, thus improving overall stability during exercise.
This study is of interest for many reasons. As mentioned by the authors, a similar calcium leak has been found in heart failure patients. Implications for a treatment are clear.
Other disease entities should be considered at this point. For example, Chronic Fatigue Syndrome, is characterized by prolonged fatigue and malaise 24-36 hours post exertion. The 24-36 hour absence of fatigue is intriguing in the context of this study.
In further posts I hope to explore the mechanism of action for S107 and the implication of differentiating the fast and slow twitch muscle fibers.
A joke at every end:
A couple goes on a trip to Israel. They bicker at the wailing wall and the dead sea. In Jerusalem, the bickering continues. Every visit to a synagogue is marked by a fight. One day the wife passes away. The husband goes to a Rabbi and asks for options. The Rabbi says, "You can ship the wife back to America for 15 thousand dollars or bury her body in the holy land of Israel, your historic birth land, for only $150."
The husband, without hesitation, says "I'll ship her back to America."
The Rabbi is stunned "why would you spend all this money to send her away from this holy land."
The husband replies, "this is the same holy land where a man was buried for three days and came back to life. I am not taking any chances."
2.04.2008
Priorities
What is more important: the quality of our detergents or hospital borne infections?
Seventh Generation is a company specializing in "green" cleaning products and has 100 million dollars in yearly sales. The success of the environmentally friendly cleaners has pushed bigger companies like Clorox to invest in renewable and less toxic technologies.
Detergents are stored for long durations and require preservatives to retain their chemical integrity. Some
preservatives, used by Seventh Generation, in their detergent line released small amounts of formaldehyde (C&EN, January 21, 2008). The EPA considers formaldehyde, pictured, a probable carcinogen, but the compound is found in trace amounts in the environment. This molecule, weighing only 30 grams/mole, caused great concern among consumers and has led to a search for alternative preservatives.
One collaboration specifically is of great interest. Seventh Generation is working w
ith Agion Technologies to utilize Agion's antimicrobial silver technology. Silver ions are natural microbial killers, and have been harnessed by Agion with their patented slow release coatings. Other companies have pursued this natural path as well. 
Bio Signal has developed furanones, pictured to the right and copyrighted to Bio Signal, to disrupt the effect of bacteria released quarom sensing molecules. Disruption of these molecules interferes with biofilm formation and ultimately with bacterial growth. An explanatory video is available on the Bio Signal website.
These developments are promising as our society is fighting with microbial infiltration. The Centers for Disease Control and Prevention estimate that 1.7 million healthcare associated infections (HAI) occur annually in the United States and lead to 99 thousand deaths. These infections are due to a variety of invisible, to the naked eye, organisms that make their living by taking advantage of the immune system. Two common organisms affecting hospital inpatients are methicillin resistant staff aureus (MRSA) and vancomycin resistant enterococci (VRE). While the health care team is constantly focused on providing care, any lapse in cleanliness can lead to inadvertent contamination of sterility. Fortunately, there is a growing effort on the part of many healthcare facilities to limit nosocomial infections through intensive staff education.
What if the interior of a hospital was coated by natural antimicrobials that disrupted bacterial growth? The research at Bio Signal might lead in this direction. To our benefit their furanones disrupt localized growth but do not kill individual bacteria, therefore forced selection is avoided and bacteria does not develop resistance. Silver technology is also promising as it is natural and has less side effects for patients.
While Bio Signal is not in the cleaning business, it would be interesting if the problem of nosocomial infections were solved by a detergent company like Agion. I don't think our medical community will be picky.
A joke at every end:
Buddha walks into a bar.
Bartender asks him "what would you like?"
Buddha says "Make me one with everything."
Seventh Generation is a company specializing in "green" cleaning products and has 100 million dollars in yearly sales. The success of the environmentally friendly cleaners has pushed bigger companies like Clorox to invest in renewable and less toxic technologies.
Detergents are stored for long durations and require preservatives to retain their chemical integrity. Some
preservatives, used by Seventh Generation, in their detergent line released small amounts of formaldehyde (C&EN, January 21, 2008). The EPA considers formaldehyde, pictured, a probable carcinogen, but the compound is found in trace amounts in the environment. This molecule, weighing only 30 grams/mole, caused great concern among consumers and has led to a search for alternative preservatives.One collaboration specifically is of great interest. Seventh Generation is working w
ith Agion Technologies to utilize Agion's antimicrobial silver technology. Silver ions are natural microbial killers, and have been harnessed by Agion with their patented slow release coatings. Other companies have pursued this natural path as well. Bio Signal has developed furanones, pictured to the right and copyrighted to Bio Signal, to disrupt the effect of bacteria released quarom sensing molecules. Disruption of these molecules interferes with biofilm formation and ultimately with bacterial growth. An explanatory video is available on the Bio Signal website.These developments are promising as our society is fighting with microbial infiltration. The Centers for Disease Control and Prevention estimate that 1.7 million healthcare associated infections (HAI) occur annually in the United States and lead to 99 thousand deaths. These infections are due to a variety of invisible, to the naked eye, organisms that make their living by taking advantage of the immune system. Two common organisms affecting hospital inpatients are methicillin resistant staff aureus (MRSA) and vancomycin resistant enterococci (VRE). While the health care team is constantly focused on providing care, any lapse in cleanliness can lead to inadvertent contamination of sterility. Fortunately, there is a growing effort on the part of many healthcare facilities to limit nosocomial infections through intensive staff education.
What if the interior of a hospital was coated by natural antimicrobials that disrupted bacterial growth? The research at Bio Signal might lead in this direction. To our benefit their furanones disrupt localized growth but do not kill individual bacteria, therefore forced selection is avoided and bacteria does not develop resistance. Silver technology is also promising as it is natural and has less side effects for patients.
While Bio Signal is not in the cleaning business, it would be interesting if the problem of nosocomial infections were solved by a detergent company like Agion. I don't think our medical community will be picky.
A joke at every end:
Buddha walks into a bar.
Bartender asks him "what would you like?"
Buddha says "Make me one with everything."
1.13.2008
Politics
I noticed something today. If you go to the websites of the republican and democratic candidates running for president you will notice something interesting. Scroll on the issue bar and scan which issues are listed and the order in which they are presented.
Hillary Clinton has the following top 3 on her list:
1. strengthening the middle class
2. providing affordable and accessible health care
3. ending the war in Iraq
Mitt Romney:
1. keeping Americans safe
2. confronting radical Jihad
3. combating nuclear terrorism
John McCain:
1. McCain tax cut plan
2. Government spending, lower taxes and economic prosperity
3. straight talk on health care reform
Barack Obama:
His issues are in alphabetical order
Out of all the websites, Mr. Obama's is the most elegant. Check it out for yourself http://my.barackobama.com
Both Clinton and Obama provide PDFs (15 and 16 pages respectively) for their health care plan. I could not find one for Romney, McCain or Huckabee. I will look further. Next time, I hope to comment on the health care ideas coming from Clinton and Obama
A joke at every end:
How do you fit four elephants in a van?
Two in the front, two in the back.
ten second pause
How do you know if an elephant has been in your fridge?
There is a track in the butter.
How do you know if two elephants have been in your fridge?
There are two tracks in the butter.
How do you know if three elephants have been in your fridge?
There are three tracks in the butter.
How do you know if four elephants have been in your fridge?
There is a van outside.
Hillary Clinton has the following top 3 on her list:
1. strengthening the middle class
2. providing affordable and accessible health care
3. ending the war in Iraq
Mitt Romney:
1. keeping Americans safe
2. confronting radical Jihad
3. combating nuclear terrorism
John McCain:
1. McCain tax cut plan
2. Government spending, lower taxes and economic prosperity
3. straight talk on health care reform
Barack Obama:
His issues are in alphabetical order
Out of all the websites, Mr. Obama's is the most elegant. Check it out for yourself http://my.barackobama.com
Both Clinton and Obama provide PDFs (15 and 16 pages respectively) for their health care plan. I could not find one for Romney, McCain or Huckabee. I will look further. Next time, I hope to comment on the health care ideas coming from Clinton and Obama
A joke at every end:
How do you fit four elephants in a van?
Two in the front, two in the back.
ten second pause
How do you know if an elephant has been in your fridge?
There is a track in the butter.
How do you know if two elephants have been in your fridge?
There are two tracks in the butter.
How do you know if three elephants have been in your fridge?
There are three tracks in the butter.
How do you know if four elephants have been in your fridge?
There is a van outside.
| |
1.01.2008
Resolutions
Happy New Year,
This 2008 I hope to be a good year. The last was surely memorable. The next should live up to its sisters and brothers. The year started with a book by an incredible writer by the name of Atul Gawande.
This man is a cool man. He proposes the following five suggestions to live a better life as a doctor of medicine, but this should apply to life:
This 2008 I hope to be a good year. The last was surely memorable. The next should live up to its sisters and brothers. The year started with a book by an incredible writer by the name of Atul Gawande.
This man is a cool man. He proposes the following five suggestions to live a better life as a doctor of medicine, but this should apply to life:
- Ask unscripted questions
- Change
- Don't Complain
- Count Something
- Write
Interestingly and relevantly, the most recent issue of Chemical and Engineering News
highlights a new polymer that is potentially well suited to connect live tissue with artificial limbs. PEDOT or poly(3,4-ethylenedioxythiophene) should be able to carry electric current from biological ions in tissue to synthetic electrons in artificial limbs. This technology is being developed by Biotectix, a University of Michigan spin off company.
A joke at every end:
What did the momma Buffalo say to her son when he went to college?
BiSon
highlights a new polymer that is potentially well suited to connect live tissue with artificial limbs. PEDOT or poly(3,4-ethylenedioxythiophene) should be able to carry electric current from biological ions in tissue to synthetic electrons in artificial limbs. This technology is being developed by Biotectix, a University of Michigan spin off company.A joke at every end:
What did the momma Buffalo say to her son when he went to college?
BiSon
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