QUICK POST: Digital Health Care - Denmark shows how it is done

Tiny Denmark is leading the way in digital health care, with patients being able to link into their own medical records and make data entries. This includes various test results such as vital signs (pulse and blood pressure), blood test monitoring (such as glucose levels) and other e health interactions. These interactions include online prescriptions, communications between patient and doctor regarding symptoms and some degree of online consultation. Of course, translating Denmark’s success to the United States is hardly easy. Denmark is a small country, with a homogeneous population which is highly literate. They also have a different sense of concern about privacy when it comes to health information. The Danish system is socialized and state controlled, which also allows for easier enforcement of uniformity.

While not all is to be emulated by us, the concept of online care is here to stay and will expand over time. It is a natural progression of the information age and the comfort that both patients and physicians are achieving with new technology . . . ben kazie md

Denmark Leads the Way in Digital Care – http://www.nytimes.com/2010/01/12/health/12denmark.html?emc=tnt&tntemail0=y

[Via http://benkazie.wordpress.com]

On Neglected Tropical Diseases

Malaria, HIV/AIDS, and tuberculosis are often considered the most pressing disease-related threats to individuals in the developing world and the quest to eradicate them receives a large portion of government and private funding. However, a group of conditions known collectively as neglected tropical diseases (NTDs) have a more widespread and devastating effect on the lives of people in many regions of sub-Saharan Africa, Southeast Asia, and Latin America. These regions account for up to 90 percent of the disease burden for this group of 13 parasitic and bacterial conditions. Reports from the Global Network for Neglected Tropical Diseases indicate that these parasitic and bacterial infections affect over 1.4 billion people, most of whom survive on less than US$1.25 per day. While NTDs may not necessarily kill those infected, they can lead to malnutrition, anemia, a range of disabilities (most often blindness), stunted growth, and greater susceptibility to other illnesses.

Clockwise from top left: An egg of the roundworm, which causes Ascariasis; a man with Lymphatic Filariasis being examined by a physician; the whipworm, which causes Trichuriasis; and a child receiving antibiotic treatment for Trachoma.

Individuals affected by NTDs live primarily in tropical and subtropical climates, and many experience more than one infection or parasite at a given time. According to the World Health Organization (WHO), the majority of individuals affected by NTDs live in remote and rural areas, urban slums, or areas experiencing conflict situations. Seventy percent of infections occur in low- or lower-middle income areas, and are frequently caused by unsafe water and poor housing and sanitation conditions. Further, NTDs contribute to a cycle of poverty in which children are likely to become infected due to their poor living conditions, and once infected they may experience delays in cognitive development inhibiting their ability to escape their impoverished conditions.

The seven most common NTDs are: Ascariasis, Hookworm, Lymphatic Filariasis, Onchocerciasis, Scistosomiasis, Trachoma, and Trichuriasis. These diseases, many of which are caused by parasitic intestinal worms known as helminthes, have the most devastating impact on those who contract them. For example, Ascariasis, resulting from roundworm infestation, affects 800 million people; and trichuriasis, resulting from whipworm, affects 600 million. Helminths rob children of nutrients and can lead to stunted growth, iron-deficiency anemia, and protein malnutrition. They are at an increased risk of contracting parasitic worms, as are the elderly and pregnant women. Over 40 million pregnant women are infected with hookworms, parasitic worms that attach to the small intestine and suck blood from their host, increasing vulnerability to malaria and additional blood loss during labor.

Based on Disability-Adjusted Life Years (DALYs), which refer to the years of healthy life lost to disability or premature death, NTDs are a greater health burden than tuberculosis or malaria, and approach the level of burden of HIV/AIDS. In addition, NTDs are the cause of approximately 534,000 deaths worldwide each year. Through programs to distribute medications, the WHO, pharmaceutical companies, government agencies, and international aid organizations hope to ensure fewer lives are lost. Coordinated efforts have allowed for the rapid deployment of inexpensive diagnostic tools, medications, and treatments, many of which can be administered by trained non-medical staff including teachers and community health workers. Medications are often distributed in “rapid-impact packages,” reducing costs and putting less strain on already weakened healthcare systems in the areas where NTDs are most prevalent. These packages also offer the opportunity to bundle life-saving drug treatments with other interventions such as antimalarial bed nets or nutritional supplements.

Through these and other similar efforts, it has been possible to reduce the occurrence of a number of conditions in many parts of the world. The number of cases of guinea worm disease, also known as dracunculiasis, has fallen from 3.5 million in the 1980s to just 4,619 in 2008, and the WHO has declared eradication in Nigeria and Uganda. Many other conditions are now found only in remote villages and are nearing total eradication through education programs, medication distribution, and improved sanitation.

Discuss this and other global health topics in the iCons in Medicine Forums

[Via http://iconsinmedicine.wordpress.com]

News From Around The Blogosphere 1.10.10

1. New evidence supports Egyptian pyramids being built by free workers but not slaves – What I love about this story is that it hurts three myths at the same time, the belief that the pyramids couldn’t have been built by man but had to involve extraterrestrial influence, the belief by some religious individuals that the pyramids were built by Jewish slaves, and the belief that the pyramids were built by slaves in general. Sorry, didn’t happen.

2. Violence breaks out over use of the word ‘Allah’ - The Malaysian High Court ruled to end a ban that prohibited a Catholic newspaper from using the word “Allah” when referring to God in their local-language publications because only Muslims were allowed to use that word. This of course led to Muslims “going” crazy. Shocker.

3. Apparently abstinence-only sex ed isn’t a lost cause…if you’re an ant…your species has eliminated men -

The complete asexuality of a widespread fungus-gardening ant, the only ant species in the world known to have dispensed with males entirely, has been confirmed by a team of Texas and Brazilian researchers.

Most social insects—the wasps, ants and bees—are relatively used to daily life without males. Their colonies are well run by swarms of sterile sisters lorded over by an egg-laying queen. But, eventually, all social insect species have the ability to produce a crop of males who go forth in the world to fertilize new queens and propagate.

I’d love to know Dr. Tatiana’s sex advice for them.

4. Research further suggests autism is a brain connectivity disorder -

Studying a rare disorder known as tuberous sclerosis complex (TSC), researchers at Children’s Hospital Boston add to a growing body of evidence suggesting that autism spectrum disorders, which affect 25 to 50 percent of TSC patients, result from a miswiring of connections in the developing brain, leading to improper information flow. The finding may also help explain why many people with TSC have seizures and intellectual disabilities.

5. Brain Imaging May Help Diagnose Autism -

Children with autism spectrum disorders (ASDs) process sound and language a fraction of a second slower than children without ASDs, and measuring magnetic signals that mark this delay may become a standardized way to diagnose autism.

6. $cientology’s claiming its a religion again – Their futile efforts to proselytize has angered some, and so the cult is insisting that as a religion, they’re doing nothing wrong. Of course when people resist $cientology on the grounds that it steals members of other religions, the $cientologists then insist that they’re not a religion, just a self help group that welcomes all faiths. But then when it comes tax time, they’re a religion again. Besides, it says so right on their buildings. They even have “churches.” Of course $cientology churches appear from both the outsiders’ perspective and former insiders’ perspective to be no different than any secular buildings and no spiritual services actually take place.

Captain Douchebag himself

7. $cientology digs up lost Hubbard works – I smell brand new OT levels requiring more expensive course work!

More than 1,000 unreleased recordings of lectures by L. Ron Hubbard and reams of corresponding writings have been unveiled in the culmination of a 25-year project to locate, restore and transcribe lost pieces of the Scientology founder’s work.

8. British woman arrested in Dubai for being raped – That’s right. A woman was RAPED! And the authorities decided to then charge her for the crime of having had illicit sexual intercourse. Even the Bible doesn’t advocate arresting rape victims; it merely demands they marry their rapist. Though I don’t exactly know what Bible’s policy is if one has more than one rapist. This is exactly the kind of insanity that could only exist because of religion.

9. Sylvia Browne continues annual tradition of predicting upcoming year’s events – I haven’t looked back yet on her predictions last year and I never got around to making my own annual predictions for 2009 in January. I’ll have to do it this. But the psychics seem really off and vague this year. Pat Robertson’s annual yearly predictions showed a complete lack of trying and Sylvia’s no exception this year either.

[Via http://skepacabra.wordpress.com]

Greener Pasteur

If Middle East has black gold, Philippines has untapped “green gold.” It can be found in almost any backyard and places in the Philippines. It is called “Moringa”  (popularly known as “malunggay” in the Philippines and “moringa oleifera” to many parts of the world).   It’s just one of Philippines rich natural resources but requires foreign investment and futher research to untapped its hidden potentials. 

Moringa is being called a “mirracle tree” due to its rich nutritional value. 

Further more, its other tree parts has its usage highly demanded in the organic and biofuel market: 

Pods

• Human Food
• Medicine

 Seeds

• Edible Oil
• Cosmetics and Skin care raw materials
• Perfume
• Oil lubricants
• Water purifier
• Animal Feeds
• Fertilizer
• Medicine

 Leaves

• Human Food / Cooking Ingredients
• Natural Fertilizer
• Medicine
• Domestic Cleaning Agent

 Flower

• Medicine
• Health Drink

 Roots, Bark and Gum

• Medicine
• Alley cropping

Philippines is actually one of the Pioneers of moringa processing.  Secura, a local biotech company, has pioneered in the extraction of oil from the seed of moringa.

The MIT team of ‘business experts’ validated the claim that malunggay oil has the potential of being a major source of biofuel, next to coconut.  A sudy shows that the massive cultivation of massive cultivation of Moringa can produce massive amounts of oil than jatropa and can boost the supply of raw materials needed to produce the amount biofuel needed.  The seed of malunggay is 36 percent oil.  In addition, moringa was also found low in transfatty acid which makes it a better ingredient of personal health care products, alternative cooking oil and fuel oil like what is found in coconuts.

With the fluorishing potentials in moringa trade, further study is needed for its product development and competitiveness to pass global quality standard requirement as what the European and U.S. is doing to vegetable oil.  This is how our desired firm will enter if given the right support and funding by an international investor or funding institutions.  We intend to utilize both foreign and local scientist in collaboration with organic NGO’s.

Just recently, the DA-CARAGA Region has adopted moringa as the chief crop for its “One house, One vegetable” program.  In Manila, the DA-BPO launched its urban farming program dubbed “Malunggay in the City” which encourages the massive planting of malunggay in the backyards of the metropolis. The local biotech company said it is willing to buy malunggay seeds for the production of Moringa oil, requiring at least 500,000 hectares of agricultural land planted to malunggay (excerpt information)

[Via http://fyi09.wordpress.com]

The Sparrow and the Medicine

They were almost yelling. Fiercely tearing the air between them–words sharp and hot, bursts of fire. Madeline had tears of anger sliding down her cheeks. Through a grimace and a bearing of teeth she said, ” I don’t want your medicine, I don’t need a sparrow in my heart.” With squared shoulders she stared at Vincent.
Vincent remarked the small distance between them, conversely thinking it an impassable abyss. Words seeped in a tangible yearning fell from his mouth, “you know every patch you sew onto my clothing; every thread goes through my heart. I want to be your medicine; to feed the sparrow in your heart.”
She quickly strode the two steps of abyssal distance between them–and slapped him.
Vincent heard the magnified sound of the blow, felt the soft of her hand grate across the rough of his stubble and he turned away–feeling nothing more.
Madeline sank to her knees;  debating whether give fully into sadness or anger.
It had begun to rain–cold and penetrating.
Vincent had no more words, his face ran with tears. Tears of pain, regret and the sting of her hand.
The day had started with such promise. Top down, the sun warm on his face, a beautiful day. A trip to the country, he and Madeline. Such promise.
Vincent’s love Madeline was unmatched, and very known. Madeline’s love for Vincent was vacant. Empty.
Earlier today Vincent was blind to this fact.
Currently, his eyes had been opened.
With a cold heart and cold hands he urged Madeline to her feet. They slogged to the car in silence, Vincent walking slowly in front with slumped shoulders–Madeline dawdling behind. They arrived. Vincent did not bother to open the door for the stranger he brought with him.
He started the car.

[Via http://smokeandoakum.wordpress.com]

Physicians and Faith

Sociologist Wendy Cadge believes physicians need to do a better job of handling faith issues that arise in patient care.

Many doctors see religion and spirituality as a barrier to medical care or, at most, a useful crutch when medicine has no more answers. But healing involves more than just medical diagnosis and treatment. Often patients and families see spirituality as a source of support when they are ill, or appear to be dying.

A holistic approach to medicine requires physicians to understand the complex role of spirituality and religion in compassionate patient care. The best prescription: Integrate these topics throughout medical education.

She urges physicians to educate themselves and pay closer attention to patients’ religious and spiritual traditions; she also wants chaplains and nurses more involved in educational programs highlighting spirituality.  Nurses especially have more contact with patients than physicians and are more open to talk with them about their spiritual concerns.

It’s not surprising there’s a disconnect between physicians and faith.  In terms of James Sire’s worldview categories, western medicine falls under naturalism — all that matters is matter itself.  But spirituality, by its very nature, belongs to a theistic or existentialist worldview.  So the starting point is different from medicine.  Different assumptions.

I’ve visited in hospitals for 15 years, and whenever the doctor has walked into the room, everything I do stops.  I become wallpaper.  I don’t mind so much because I’m on their turf.  But I recall one time — one time — when the doctor came in, realized a patient was talking with a pastor, and said, “I’ll come back a little later.”  It was surprising.  I was grateful.

[Via http://asthedeer.com]

Emergency Pain

Last night at Stanford Emergency Department, I helped a man in tremendous pain. I saw him standing up by his bed grimacing every minute or so. I asked him if I could help him with something, and he said stopping the pain would be helpful. Unfortunately, I cannot do much to stop the pain except for lending my ear and offering a conversation.

Over the next 30 minutes interrupted by short rounds to see if anything needed my attention, we talked. Turns out he watches football, “Doesn’t everyone.” Actually, I rarely do, but since we are entering the playoffs, my interest is higher than usual, and we talked about Indianapolis’s decision to preserve their star players for the playoffs sacrificing their undefeated season. The Miami Dolphins still own the only undefeated season.

We spoke about his medical issues which I will not divulge to honor his confidentiality. We talked about his life.

Over time he grimaced less often. Eventually, more pain medicine arrived. He didn’t notice a change in the pain, but as an observer, I could see a change in how often he had to stop to tense his jaw and squeeze his eyes. If the quality was the same, the quantity at least was less.

[Via http://sreinheimer.wordpress.com]