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Should you diagnose a stranger?

ringworm

Let us say that you meet a person who has visible symptoms of a curable disease that you can easily recognize. Should you say something about it? I am not talking about something like a birth defect or Down's syndrome that really cannot be treated, but an ordinary infectious disease like warts or a fungus infection. You may be able to help the person get treatment by being open and frank, but you run the risk of becoming a meddler whose intentions are misinterpreted.

Bearers of bad news are seldom appreciated. I remember reading a story many years ago about a doctor who was shot in a hospital emergency room when he told a woman that she was pregnant. It was not the doctor's fault that the woman was pregnant. He just said something that the woman intensely disliked and she directed her rage toward the innocent doctor. Generally, it is a bad idea to give bad news or meddle in other people's affairs.

Yesterday, at a restaurant, I saw a waiter with a bad case of Tinea Capitis. His hair was completely shaved, probably in an attempt to minimize an unsightly appearance. However, his scalp had patches of red and irritated skin typical of a Tinea fungal infection. I knew that with proper treatment his skin would be normal in a few weeks, but I kept quiet. It was not my business. This incident reminded me of a conference that I attended many years ago. I happened to sit behind a woman wearing a dress with an open back. The skin in her back had larva migrans tracks from hookworms. Obviously, she had bathed in contaminated water or lain on a contaminated beach. I did not say anything then either.

I feel somewhat guilty for not actively going out of my way to help these people. However, I provide information so that those who seek it will find it.
Learn more about infectious diseases

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2008-08-05 

The PSA test does more harm than good

The U.S. Preventive Services Task Force has published new guidelines for prostate cancer screening. The report in the Annals of Internal Medicine points out that the benefits of the Prostate Specific Antigen (PSA) test are uncertain or minimal, whereas the risks are large and dramatic. The PSA test itself is just a simple blood test; it is what happens after an elevated PSA result is obtained that causes the harm.

The level of PSA which indicates cancer is not the same for every man. Therefore, it is necessary to do surgical biopsies to determine if there is cancer. A positive PSA test causes anxiety and may lead to unnecessary surgical biopsies which can be painful and cause serious complications. Several studies have shown that men age 65 and older who were not treated for prostate cancer were equally likely to survive as those who were treated. Many of the ones who were treated ended with impotence, incontinence or other undesirable side effects. The new recommendation basically concludes that if the therapy is not providing substantial benefit, the screening is not beneficial either.

In the US, prostate cancer is diagnosed in about 186,000 men each year, and about 29,000 die from it. There is some evidence that the phytonutrients and polyphenols in pomegranate fruit juice and green tea can reduce PSA levels and prevent prostate cancer.[1,2]
Learn more about cancer

[1] Arshi Malik, Farrukh Afaq, Sami Sarfaraz, Vaqar M. Adhami, Deeba N. Syed, and Hasan Mukhtar, Pomegranate fruit juice for chemoprevention and chemotherapy of prostate cancer, Proc Natl Acad Sci U S A. 2005 October 11; 102(41): 14813-14818.

[2] Gupta S, Ahmad N, Mukhtar H., Prostate cancer chemoprevention by green tea, Semin Urol Oncol. 1999 May;17(2):70-6. PMID: 10332919

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Highest sunflower in Maryland

sunflower

My sunflower just started blooming. It grew from some seeds that were thrown in a flower pot two years ago. The sunflower is probably the highest in Maryland because it is on top of a 20-story building.

One of the trick questions when I was in elementary school was: "Where is the highest skyscraper in the world?" At the time, the Sears tower had not been built, so the Empire State Building was the logical answer. WRONG! The highest skyscraper is in Mexico City. Since Mexico City is 2250 meters or 7400 feet above sea level (about one and-a-half miles up in the sky), the highest skyscrapers have to be there. If the question had been "Where is the tallest skyscraper in the world?" the answer might have been different.

Exercise your mind with some puzzles

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2008-08-01 

Goldfinches in my flower pots

goldfinches

This morning, I woke up to the cheerful chirping of some goldfinches in my flower pots. In the springtime, I harvested some lettuce from these flower pots. When the lettuce was trimmed, I found some Thai basil growing from seeds scattered by the wind. I let these plants grow around my petunias.

Every time that I water the pots, the basil releases a wonderful sweet aroma. Both the petunias and the basil stems are a great attraction for the bees, but now that the basil blooms are forming seeds, finches are perching on the stems to feed. The birds probably scatter some seeds as they feed, and this is how the basil came from the penthouse to the flower pots in my balcony. My neighbor downstairs will probably have basil in her flowerpots next year.

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2008-07-26 

Will we be safer after Carbofuran?

Carbofuran

Carbofuran

The Environmental Protection Agency (EPA) will no longer allow carbofuran pesticide residues on domestic or imported food. In making the decision, the EPA explained that carbofuran is a neurotoxin which poses a high safety risk for small children and sensitive individuals. A 2006 EPA document reported the death of 84 percent of a flock of mallard ducks that landed on an alfalfa field that had been treated with carbofuran the week before.

Carbofuran is used worldwide to combat insects on bananas, coffee, rice, sugar cane, alfalfa, corn, potatoes, sunflowers, and soybeans. Carbofuran has one of the highest toxicities to humans of the insecticides commonly used on crops. One quarter of a teaspoon can be lethal for humans. Some of the symptoms of carbofuran poisoning include muscle weakness, dizziness, sweating, headache, salivation, nausea, vomiting, abdominal pain, diarrhea, blurred vision, incoordination, muscle twitching and slurred speech.

Carbofuran is just one of the chemicals to which we may be exposed by living in modern society. Many people buy "organic" produce because they fear the effects of chemical residues, but they may not be aware of the harmful effects of chemicals in fire retardants, fabric softeners, cleaning products, and cosmetics that can be found in every home.
Learn more about Environmental Toxins and Poisons

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2008-07-24 

Calorie Restriction of Mice and Men


It turns out that mice and men are not that different after all, at least regarding the correspondence between Calorie Restriction (CR) and body weight. It has been known for a long time that mice or rats allowed to eat only 60% of the control animals, i.e. 40% CR, starting at weaning, grow to be adults which weigh only 50% of the control animals, but they live 30% longer. The longevity figures have been widely publicized, but the stunting effect of the low calorie diets has not received much attention. Masoro had some tables documenting the weights of his experimental rats [1], and Mattson [2] provided the following growth chart for mice:

In a recent blog entry about the Effect of Calorie Restriction on Body Size, I provided a graphic illustrating the silhouettes of humans corresponding to the various degrees of calorie restriction to which mice are subjected. Of course this was just speculation, or so I thought. However, after tabulating the Mifflin-St Jeor Energy Equations which are used to calculate Basal Metabolic Rate (BMR) for humans, I found that for proportionally shaped bodies with a Body Mass Index (BMI) of 22, the dependency of weight vs. CR for the humans was identical to the results for the mice. I had previously discussed this anecdotally in my Calorie Restriction page, but with some additional mathematical analysis, I found that the mouse equations could be derived from the human Mifflin-St Jeor equations.

I think that there is something intrinsic in the three-dimensional proportions of an organism. Our genes, or Mother Nature, try to balance the way in which our bodies grow based on the level of nutrients. A certain amount of muscle is required for every inch of bone growth, and during our growth, we are not overly lanky or overly squat. If you plant a maple seedling in a big field it will grow to be many feet high, whereas a similar seedling planted in a one-gallon flower pot will grow to be a miniature version of the big tree - a bonsai. And just like you cannot replant the big tree in the small pot, we cannot cut our calories to levels that cannot support our size.

The correspondence of the mice and human CR equations are discussed here:

Effect of Calorie Restriction on Body Weight

[1] E J Masoro, et al, "Action of food restriction in delaying the aging process", Proc Natl Acad Sci U S A., 1982 July; 79(13): 4239-4241.
[2] Mattson, et al. "Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake, Proc Natl Acad Sci USA, 2003 May 13; 100(10):6216-6220.

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2008-07-21 

Social Impact of Parkinson's Disease

As a natural instinct, I always avert my eyes from someone who is visibly handicapped. I suppose there are several reasons for this reaction. I do not want the handicapped person to feel self conscious from my attention, and at the same time I do not want the person to notice my feeling of pity for his or her affliction. Sometimes, it is not possible to avoid a direct encounter.

I went to the cash register of a department store and the clerk who helped me had a serious case of Parkinson's Disease. Her right hand was shaking quite uncontrollably and her left hand was somewhat better. The muscles in her arms were emaciated from the repetitious involuntary motions. As she tried to scan the bar code of my item, her hand kept jerking and the scanner could not read the code. At one point I felt like reaching to hold the bar code in front of the reader, but I resisted the impulse. She was persistent and eventually the cash register beeped an acknowledgment. You could see some frustration in her face, although her face also twitched.

I realized that she would not be able to work much longer. I wondered why she was still working in her condition, but in the back of my mind, I knew that she had to work because the health care system in the United States had failed her. I felt admiration for the department store that had hired her with her visible handicap in a position where she had so much public exposure. Hopefully this work entitled her to some medical benefits.

The cause of Parkinson's disease is not known, there are no cures, and no preventive measures. Parkinson's disease affects 2 in every 1,000 people, most often after age 50. The possible causes for the disease could be genetic or environmental, but nobody knows for sure. We can only hope that we don't become victims of this progressive, degenerative ailment.

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2008-07-19 

Running out of gas - My lucky day

I have only run out of gas twice in my life. The first time, I had been moving from one apartment to another, and I had a very busy schedule. I completely forgot that cars ran on gas. Lo, and behold, as I was driving down the street, my car started to sputter. Dazedly, I looked at the gauges, and sure enough, the gas tank was completely empty. This was in the days before there were red little warning lights on the gauges that let you know that your gas was low.

Fortunately, it was my lucky day! The car stopped right in front of a house where the owner was mowing his lawn and he had a can of gas right there. Seeing my predicament, he poured his gallon of gas into my tank and would not take any money. Of course, gas cost about 50 cents per gallon in those days. It was not a major investment like today. I thanked him profusely and went on my merry way - directly to the gas station.

The second time I ran out of gas was because of an accident. I was driving in my Buick Century down a freeway with my son, and all of a sudden, the car in front swerved to the left. By the time I realized why he had swerved, I was on top of a big chunk of metal that probably had fallen off a truck. Clink! Clank! Thunk! These were the sounds that I heard as the metal hit the underside of my car. My tires were OK, but as I continued further, I noticed that my gas gauge was dropping quite fast. I looked back in the mirror and saw a trail of gasoline. My first thought was "I hope the car doesn't catch on fire", as I kept going. There was an exit coming up. I ran out of gas as I entered the exit and coasted right into a gas station that was in the right place at the right time. I was really lucky! The gas station specialized in gas tank repairs. I called a neighbor to give me a ride home and lived happily ever after.
Check out your horoscope and lucky numbers

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2008-07-12 

Rates of Melanoma increase in Women

Melanoma

Melanoma

An analysis of cancer statistics from 1973 to 2004 by the National Cancer Institute found that the rate of new melanoma cases in women from 15 to 39 years of age had increased by 50%, but the rate for men of the same age had remained unchanged.

Melanoma is a type of skin cancer characterized by black skin tumors. Melanoma usually starts from excessive exposure to the sun or from the frequent use of tanning salons. Some sun exposure is necessary for the production of Vitamin D in the skin, but sun exposure that causes sunburn damages the skin. Skin specialists recommend using sun block lotions to prevent sunburn and avoiding being outdoors in the middle of the day when the sun's rays are strongest.

Melanoma lesions are usually black with irregular shape. Any unusual or bleeding moles should be checked by a dermatologist.
Learn how to reduce cancer risks

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2008-07-05 

Balancing Exercise and Calorie Restriction

Building abdominal muscles

Calorie Restriction (CR) reduces the nutrients available to the body and limits its growth. We lose weight when the nutrients that we eat are insufficient to meet the requirements of the body. Conversely, we gain weight when we eat more calories than we burn through our activities.

Exercise stresses the muscles and stimulates them to grow. With adequate nutrition, the muscles will strengthen and gain mass. Since the muscles consist mostly of protein, they need additional protein to grow.

Exercise tones the muscles while Calorie Restriction keeps their growth in check. The combination of dietary restriction and exercise establishes an equilibrium that can be monitored with a bathroom scale. If your weight increases, you are eating too much. If your weight decreases, you are not eating enough.

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