Category Archives: Articles of Interest

Geriatrics

I have not been particularly interested in pursuing medicine that deals with the elderly. I have (to be honest) not had any good exposure to such medicine while in school. The lectures that I have attended have tried to emphasize the  and promote the positives, but the clinical aspect is usually based out of some kind of institution where the elderly are senile, demented and generally worse for wear. This is, almost the complete opposite of the image that we get in the lectures.  It’s not pretty, in fact it’s down right frightening at times … Regardless of how I feel, more emphasis should be put on the elderly in medical school given that in North America this is a population which is increasing. Creativity is needed in the presentation…such as can be found in the incredible photo-essay “Days With My Father” by Phillip Toldelano.  The photo-essay is sad and yet humorous, it makes one see into the elder Mr. Toldelano’s past, and the life he lead, as compared to the life he leads now. Phillip Toldelano has accomplished what the medical school lecturers failed to do, which is to make the face of aging look human.

Stroke – part 2

Last week I posted Dr. Bolte talking about her personal experience with a stroke and the profound effect that it had on her. I think anyone who watches her TED talk can see how greatly it affected her. I find it fascinating how she describes the different hemispheres and the feelings associated with each. It is a rare privilege to get a glimpse into the process of a stroke from a patient’s point of view.

Today I wanted to follow up with an article I found on Neurophilosophy which not only describes the the processes that occur during a stroke but also the cutting edge research being done looking into the healing process. It is a much more technical, but no less interesting, point of view and may help clarify some of Dr. Bolte’s talk (or at least I found it added to my overall understanding). Regardless it’s worth checking out …

The blog is Neurophilosophy the post “researchers watch brain rewire itself after stroke” can be found here. Enjoy!

Jill Bolte on the brain (from the TED talks)

Jill Bolte is a neuroanatomist who has dedicated her life to understanding how the brain works. She is an incredibly compelling speaker who is able to put complex ideas into terms that are easy for lay people, like myself, to understand. It would be interesting enough to hear her talk about her studies but what is perhaps even more interesting (if possible) is that she talks (in the video below) about her personal experience with a massive stroke. Imagine having the understanding to comprehend the processes of the stroke and the damage it is causing your brain as it is happening to you. To hear her describe it is absolutely amazing and it is worth watching. After finishing the Brain and Behaviour component of medical school I definitely have a new appreciation of the processes at play. To have someone so clearly articulate their experience with a stroke is a privilege. If the video doesn’t work try this link. I hope you enjoy it –

The sweet art of fertilization…

Watch and learn…

This is from Ads of the world (here), and is an ad for Centea, a banking company in Belgium. It seems to fit with the theme of the week. Enjoy!

Valentine’s Day

bleedingheartcupcakes.jpg

Check out the latest from the masters of illustration at Street Anatomy, a true selection of art and treats for your Valentine including these “bleeding heart” cupcakes.

To the two or three people that click on this site on a regular basis, will you be my Valentine?

of coffee and caffeine

The Caffeine Curve

Caffeine – good bad, ugly – I don’t know. All I know is that without that cuppa joe or two in the morning I am dysfunctional (see graph). I admit, it is a bit of a guessing game as I try and maximize the level of caffeine while trying to avoid the neurotic jittery feeling that follows an overdose. Luckily the good folks at Developing Intelligence have taken the time to describe how to get optimally wired. A must read if you are a coffee addict gourmand, like myself.

Boy! They can transplant anything these days …

… including (apparently) poop. In a recent article on the CBC.ca website, called “Don’t poo-poo technique: fecal transplant can cure superbug, doctors say” (follow the link at the end of the post to read the actual article) by ??, it was reported that doctors have performed several of these fecal transplants … I’m not sure how to react to this. It’s like part revulsion and part morbid curiosity and, like you, I proceeded to read on.

The treatment (the fecal transplantation) is used in cases of Clostridium difficile infection. C.difficile is a bacterium that infects the gut and causes diarrhea as well as other serious intestinal conditions including toxic megacolon which is a medical emergency. It is, unfortunately, the most common cause of acquired hospital infection in Canada (as well as the rest of the industrialized world). It is the type of bug that is opportunistic and when the normal flora of the intestine is disrupted by something like illness or antibiotics C. difficile can take advantage and colonize the gut leading to an acute illness.

“Clostridium difficile is a superbug that commonly spreads in hospital settings and has been linked to the deaths of at least 2,000 people in Quebec since 2003, as well as in other provinces.”

Problems begin to arise when you consider treatment. As far as I understand, the patient must discontinue using their current antibiotics and start an another (Metroidazole or Vancomycin) which is more specific to killing the bug. Even with treatment C. difficile infections can persist.

“The antibiotics sometimes wipe out the good bacteria but fail to completely kill the C. difficile – leaving enough of it that it later flourishes. “

Right – conventional treatments may not result in a complete cure and, up until now, I didn’t think there was an alternative type of treatment. How wrong I was! Some of the more scatologically inclined doctors in Scandinavia have been working on fecal transplants as a way to cure the infection. Not to be outdone the technique has found its way to the United States and now is even available in Canada.

“Calgary physician Dr. Tom Louie, head of infection control at Foothills Hospital, is one of the few physicians in Canada who treats patients with chronic C. difficile with fecal transplants, or fecal therapy. He has done 38 procedures to date.

Call me crazy but before you volunteer you may want to look at the studies out there …

Studies that have been published show that more than 90 per cent of patients are cured through fecal transplants – most of them after just one treatment.

Interesting … there is nothing in pubmed, nor UpToDate and a Google search doesn’t turn up any scientific literature. There are passing comments made on the Clinical Infectious Diseases 1999;29:000 hotpage.

A recent discussion from the EIN Bulletin Board raised an option of “fecal transplants” that was claimed to have extremely good results, often with complete relief, within 24 hours, of diarrhea of months’ duration.

At a lecture at the German Anaerobe Society meeting held in Leipzig, Germany, Prof. Carl Eric Nord (Sweden) noted that they too have performed successful fecal implants to cure recurrent C. difficile diarrhea. They even maintain their own collection of total fecal flora and various components.

There was also an article published online, 21 November 2006 titled “Emerging Therapies in the Treatment of C. difficile-associated disease from The Annals of Pharmacotherapy (Vol. 40, No. 12, pp. 2164-2169.), which mentions fecal transplantation as a nonstandard strategy.

Hmmm … so maybe I’m going to wait until more studies have been done before I volunteer. Regardless it’s an interesting idea of how to treat a serious infection in a rather non-conventional way.

Read the CBC article here for more information …