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IME

Antibiotic Solutions in Soil

The first antibiotic, penicillin, was discovered almost by accident when Alexander Fleming left one of his petri dishes out while he was on vacation; he came back to find it covered in bacteria-killing mold. Now, as many infections have become resistant to antibiotics, scientists have had to wrack their brains to find more of what once was a chance discovery.

In labs around the world scientists are tasked to find new microbe-destroying molecules, but microbiologist Sean Brady has decided that maybe the answers lie outside the lab and in our own backyards.

In this article, Brady says “[His] idea is, there’s this reservoir of antibiotics out in the environment we haven’t accessed yet.” Brady and his colleagues are breaking new ground with their discovery of a new class of antibiotics they have extracted from living soil. They call it malacidins. Read more…

Full Face Transplant a “Success”

 

A man referred to only as Rafael was the recipient of the first full face transplant. The operation, which was done in March, was performed by 30 Spanish doctors in Barcelona. Mr. Rafael underwent the transplant after nine previous operations failed to help his neurofibromatosis, a genetic disorder that caused benign tumors to grow on his face.

Study: Brain Exercises Don’t Improve Cognition

A recent article in Time concludes “getting a good night’s sleep, excercise, and eating right” are more likely to “maximize a brain’s potential” than a computer game. The interesting thing about this is that neuroscientists can’t agree. Some believe these games can alter the dopamine receptors, which would theoretically aid in learning and cognitive functions, while others believe the phrase “practice makes perfect” better describes the improvement, and  does not carry over to cognitive functions.

Silk Brain Implant Could Aid Spinal Injuries, Epilepsy

Reuters posted a very compelling article about a silk chip that adheres to the brain that has the potential to help people with epilepsy or spinal cord injuries. The water-soluble silk dissolves onto the brain leaving only the electrodes behind. Going forward, this technology could have the potential to help other disorders like Parkinson’s Disease and Multiple Sclerosis.

Benefit for Uninsured May Still Pose Hurtle

With the passage of health reform, we are now seeing frequent reports of its shortcomings. The new legislation still relies upon a private insurance market and the expectation that individuals will buy insurance or suffer penalty. People, especially those with lower incomes, will behave rationally and in what they perceive to be their economic interests. This many for some include preserving scarce cash today, and not focusing on an uncertain and expensive need for future health care. Rather than argue that people should behave responsibly and address future health issues with insurance, this article, from April 20 in the NY Times, and the individuals describes speaks for itself.

Weighing the Evidence on Exercise

This is an important article from the NY Times of April 18, that outlines the relationship between exercise and weight. In a nutshell, it cites research that suggests that dietary intake is the determining factor on weight and the exercise in the absence of intake reduction will have little long-term impact. Mechanisms exist that lead individuals to eat more following exercise, negating the caloric of the activity. Gender differences making loss harder for women is also described.

“Wellness” – A Word I dislike

The New York Times Magazine of April 18 carried this article that addresses one of my pet peeves – the abuse of our beautiful language. Actually the article is too kind to the word, focusing on the first use and evolution of the term. What benefit is there to a word that has a perfectly fine equivalent called – health?

Wellness has become a buzzword and a marketing term to promote all sorts of expensive maneuvers and services, often in the workplace, to improve the health of individuals, often involving incentives, paid consultants and the like. I have yet to see a scholarly report that establishes the effectiveness of such programs and their cost benefit. I believe it most likely that those who wish to be healthy need no external incentive or program, and are already taking care of themselves, and those who can’t or won’t engage in healthy choices in their lives are unlikely to be significantly persuaded by a workplace program.

How many people are in the dark about what it takes to be healthy, especially adults in the workforce?

A Remedy for Troubled Doctors

Physicians from time to time have issues impacting their ability to practice. Many of these issues are temporary, relating to health or substance abuse, skill deficiencies and other matters. Others may become permanent. At MCN in the course of credentialing consultants, we review cases where regulatory action has taken place. This Wall Street Journal article describes one program’s approach to assessment and remediation of physicians who have practice issues leading to regulatory action in California.

The Nothing Cure

By Matthew Herper and Robert Langreth, From Forbes Magazine, Issue Date March 29, 2010

Instead of ignoring the placebo effect, doctors should try to enhance it, says a Harvard Medical School professor.

This interesting discussion on the placebo effect is worth a read. The presence of the placebo effect is well-known and generally accepted in medicine, though it may be frequently argued as to when it is taking place or not – especially when one’s own treatment is being questioned.

From a policy standpoint, a legitimate question is whether those treatments that have a significant placebo component are ethical to the degree there may be conscious deception on the part of the practitioner – on behalf of helping their patient. In addition, should third parties such as insurance or government be asked and expected to pay for placebo interventions?

Welcome to MCNtalk – a discussion group for you

MCNtalk, which has existed for many years as an email broadcast, is being converted into a blog. Advantages include the ability for prior articles to be stored, indexed and accessed by readers, as well as a robust ability to include many features and full user control of how or if they receive notifications of new postings or comments.

In addition, this blog will be readily available on the web for subscribers and non-subscribers alike.

It is a work in progress and we hope to add many enhancements over time.

The address is http://www.mcntalk.com

Your comments and ideas are welcome as well as requests to add a particular site or blog to the featured list. We also welcome links to articles of interest, or even your own idea pieces.

Our goal is to present articles of interest and potential relevance to those who deal with medical issues in claims management, disability, injury and related legal and administrative issues, as well as those who have a general interest in health-care issues. I am linking to blogs that focus on health care politics but we will do our best to steer clear of partisan and acutely political matters. We recognize that our readership is diverse and that there is no shortage of good sources for thoughtful comments, reflections and positions on current political issues.

This does not mean that the occasional article will not be controversial, and we welcome divergent comments. Inclusion of a particular article does not necessarily imply agreement with the stated position by MCN or it’s staff.

The original MCNTalk email list will be used for periodic reminders about the blog and recent articles. But we encourage direct subscription via the button on the upper left, which will provide immediate notice of new postings. You may change your subscription preferences or unsubscribe at any time.

We welcome comments but they should be signed, courteous and relevant to the posting. We will tread gently into the world of comments and initially screen them before posting, perhaps opening them up to non-screened postings for repeat commentators or all.

If you have ideas or thoughts about making MCNTalk more effective and relevant – send them to us at MCNTalk@mcn.com.

Thank you.

Brian L. Grant, MD
Chairman and Medical Director