public health
mikethemadbiologist | April 2, 2008Over at denialism blog, PalMD has two posts which, to me anyway, are related. The first has describes how sexually transmitted diseases (STDs) are actually treated with antibiotics:
After hours, we see walk-ins, and that's where the STD fun really begins. For whatever reason, I see STDs daily at the walk-in clinic, but almost never in my private practice. Most commonly, we see only one partner, and, at least in my state, treatment of the absent partner is prohibited. Basically, we only get one shot at folks, and we don't have access to rapid tests. So what do we do? We order a lot of "…
tsmith | April 2, 2008Sent off yet another grant, so I'm still (once again) catching up on everything. Meanwhile, some posts for you to check out:
I thought I was self-sacrificing by submitting myself to Kentucky's creation museum for your amusement. Guess I could have stayed home and wasted 2 1/2 hours of my life as Drek did, live-blogging an anti-vaccine movie he was challenged to watch.
Or, if you've had it with vaccine naysayers (and oh look, CNN gave more space to Jenny McCarthy to gush about how chelation and diet allowed her son to recover from autism), head over to Mike's place for a refreshing post on…
mikethemadbiologist | March 25, 2008
If you missed my talk, then you missed this slide
I leave to give a talk for a few hours, and suddenly all hell breaks lose on ScienceBlogs over the whole PZ Myers getting expelled from the movie Expelled incident, you damn kids! So I thought I would peeplay too.
First, I'm not sure the charge that this helps the movie is true: since the Great Expulsion, there have been cancellations of some pre-release showings. But this incident, and various ScienceBloglings' reactions to it, to me, appears to be functioning as a Rorschach blot for a whole host of larger issues.
One of the things that…
tsmith | March 25, 20081980 marked a milestone in infectious disease epidemiology: the World Health Organization declared the smallpox virus eradicated in the wild. However, while smallpox currently exists only in frozen stocks, poxviruses as a class certainly haven't disappeared. A related virus, monkeypox, regularly causes illness in Africa, and even spread half a world away in the American midwest.
Additionally, Africa isn't the only area with endemic poxvirus infections. Brazil has been dealing with their own poxvirus outbreak, and poxviruses have popped up in Europe as well. More on both of those after…
tsmith | March 24, 2008In this NY Times article on parents who are opting out of vaccinations, one mom notes her objections:
"I refuse to sacrifice my children for the greater good," said Sybil Carlson, whose 6-year-old son goes to school with several of the children hit by the measles outbreak [in San Diego]. The boy is immunized against some diseases but not measles, Ms. Carlson said, while his 3-year-old brother has had just one shot, protecting him against meningitis.
"When I began to read about vaccines and how they work," she said, "I saw medical studies, not given to use by the mainstream media, connecting…
tsmith | March 24, 2008 As I mentioned Friday, the good folks from Google were part of the crowd at this year's ICEID. This included a talk by Larry Brilliant, described on his wikipedia page as "...medical doctor, epidemiologist, technologist, author and philanthropist, and the director of Google's philanthropic arm Google.org." His talk discussed not only stopping outbreaks in their tracks--as current outbreak investigations seek to do, and Brilliant himself as worked on, as part of his background in vaccination campaigns for polio and smallpox--but to pay attention to "the left of the epidemic curve" as part…
tsmith | March 21, 2008If one over-arching theme came out of this conference, it was the concept noted in the title: "one medicine, one health." In one of the early lectures, a speaker polled the audience to find out how many attending were veterinarians, and how many worked in human health. The room was divided pretty evenly, which attests to the importance of animals in the emergence of new diseases in humans. Regular readers, of course, will know that these diseases that cross species boundaries--zoonoses--make a large proportion of the emerging diseases we see (~75% by several estimates). Early Monday…
mikethemadbiologist | March 20, 2008OK, last post about this bozo, and then I'm done (famous last words...). In the previous post, I dealt with Egnor's claim that the evolution of antibiotic resistance by selection of resistant genotypes is obvious, and not germane (namely, that it wasn't obvious at one point in time). What bothered me with not just Egnor's claim (which I'll get to a minute) and ScienceBlogling Mike's response is that evolutionary biology does have a significant role to play in combating the evolution and spread of antibiotic resistance.
First, what Egnor said:
The important medical research on antibiotic…
mikethemadbiologist | March 13, 2008No, that's accurate:
The first national study of four common sexually transmitted diseases among girls and young women has found that one in four are infected with at least one of the diseases, federal health officials reported Tuesday.
Nearly half the African-Americans in the study of teenagers ages 14 to 19 were infected with at least one of the diseases monitored in the study -- human papillomavirus (HPV), chlamydia, genital herpes and trichomoniasis, a common parasite.
The 50 percent figure compared with 20 percent of white teenagers, health officials and researchers said at a news…
mikethemadbiologist | March 12, 2008I've written before about CTX-M-15 beta-lactamases which make bacteria resistant to most cephalosporin antibiotics--those antibiotics that begin with cef- (or ceph-) or end with -cillin. I've also discussed the role of clonal spread in the rise of antibiotic resistance: most (but obviously not all) resistant infections are not the result of a sensitive strain evolving resistance during the course of infections, but rather due to colonization by a previously resistant strain. A recent article in Emerging Infectious Diseases discusses the role of clonal spread in the dissemination of CTX-M-…
tsmith | March 11, 2008 After Karl Rove's appearance here Sunday night, Laurie Garrett's talk on Monday was downright uneventful--despite a talk which included discussion of AIDS, abortion, and welfare, among other things.
Garrett, for anyone who may be unfamiliar, is currently a senior fellow for global health at the Council on Foreign Relations. She's the author of The Coming Plague and Betrayal of Trust: The Collapse of Global Public Health. She's reported on infectious disease and global health for almost 30 years, writing for a variety of publications in addition to her own books. Her talk last night…
tsmith | March 7, 2008It's just not been Vegas' week. First a ricin-laced hotel room, then a clinic-associated outbreak of hepatitis C virus (and potentially hepatitis B and HIV) that could become enormous. Meanwhile, an outbreak of hepatitis E is raging in Uganda. So what are these virues, and how in the world could a medical catastrophe of this magnitude happen in the U.S.? More after the jump...
The group of hepatitis viruses (A, B, C, D, E, and G) are related in name only. They've all been either associated with or found to cause hepatitis--inflammation of the liver. This can be acute inflammation (short…
mikethemadbiologist | March 5, 2008
Yes, this is O157:H7, not ExPEC. Bully for you.
One thing regarding popular accounts of antibiotic resistance I've noticed is that there is an overemphasis on the evolution of resistance, and an underemphasis on the spread of resistant bacteria. While the evolution of resistance is important, most of what we see in a hospital is not the de novo change of a sensitive strain into a resistant one (i.e., evolution), but, instead, the survival and spread of already resistant bacteria in this antibiotic-laden environment.
What this means is that changes in the frequency of resistant organisms,…
mikethemadbiologist | March 3, 2008In the most recent edition of the New England Journal of Medicine, there is a perspective piece by Sara Rosenbaum that bluntly describes how the Bush Administration's opposition to S-CHIP (the State Children's Health Insurance Program) is based on ideology and not economic cost (italics mine):
Why would the President veto bipartisan legislation that does precisely what he insisted on -- namely, aggressively enroll the poorest children? One might blame the poisonous atmosphere that pervades Washington these days, but other important social policy reforms have managed to get through.
One answer…
j7uy5 | March 2, 2008One of the darker chapters in the history of the
title="American Medical Association">AMA is
their historical opposition to universal, single-payer health care
coverage. The term socialized
medicine came into use in the post-World-War-II period, in
an attempt to falsely conflate such a health care plan with the menace
of Communism.
Evidently, many people did not bother to discern the distinction
between socialism and Communism; nor did they appreciate the fact that
we have a mixed
economy anyway.
I recall those days. That is, I recall the days when the
invocation of Communism…
mikethemadbiologist | February 29, 2008One piece of infection control legislation moving (slowly) through Congress is the Healthy Hospitals Act, H.R. 1174 (it's so slow that it's, erm, an act of 2007). H.R. 1174 would amend "the Social Security Act to require public reporting of health care-associated infections data by hospitals and ambulatory surgical centers and to permit the Secretary of Health and Human Services to establish a pilot program to provide incentives to hospitals and ambulatory surgical centers to eliminate the rate of occurrence of such infections."
There are many good provisions in this legislation:
Hospitals…
terrasig | February 29, 2008Bisphenol A (BPA) is currently one of the major lightning rods for controversy in consumer products and public health research. The compound is used in the manufacture of plastic bottles, polycarbonate (PC) in particular, as well as in the lining of many food and beverage cans. The compound has been recognized since the 1930s as having estrogenic activity but it appears to have developmental, carcinogenic, and neurotoxic effects at concentrations well below those at which it binds to the two forms of estrogen receptor.
Confused?
US governmental advisory committees can't even agree on BPA…
tsmith | February 27, 2008This is the sixth of 6 guest posts on infectious causes of chronic disease.
By Ousmane Diallo
I was dumbfounded when I read this news article relating HPV to the increase of lip and oral cancers because of oral sex.
It reminded me my younger years, as a med student, debating with my professor of psychology the fundamentals of Freudian psychoanalysis, the Id, the Ego and the Super-ego. It was a rather philosophical debate more than anything else, a combination of religious and cultural reciprocal statements of beliefs. At that time, we were exposed to the new French "sexual education"…
mikethemadbiologist | February 27, 2008And that includes the pets. Since I saw the 'TV version' while at the gym yesterday, that spurred me to get around to discussing this article about the transmission of E. coli within families.
In the article, the authors sampled at least seven isolates* of E. coli from 152 people and 76 pets, and then genetically typed them. Within households, pets were most likely to share genetically identical E. coli (58% of possible 'pet-pet' pairs), followed by adult-child (34%), child-child (33%), adult-adult (24%), adult-pet (18%), and child-pet (15%). What's interesting is that only 12% of shared…
tsmith | February 27, 2008This is the fifth of 6 guest posts on infectious causes of chronic disease.
By Rachel Kirby
There are about 500,000 (or approx 1 in 544 people) in the United States who suffer from Crohn's disease, and is most prevalent in both men and women between the ages of 20-30. Crohn's Disease is an autoimmune disease which causes a chronic inflammation of the digestive tract. It can affect the entire digestive tract but is most prevalent in the lower small intestine and in the ileum. It will cause swelling, causing pain and diarrhea.
More after the jump...
Though a lot is known about the disease;…