Hughesair (Inflection Point)

 Cancer cells have specific epigenetic methylation patterns which can potentially identify many cancers.* Current study shows accuracy detecting cases of renal cell carcinoma vs bladder cancer and detecting gliomas by plasma methylation patterns. If such epigenetic studies can lead to the early diagnosis of different cancers with blood or urine samples, it will result in a significant advance in clinical care and early screening, if not a test made directly available to patients. *JW Gen Med, Feb 1 2019

According to retrospective studies of three nationwide cohorts in Europe, young women with BRCA1 and BRCA2 are at greater risk from diagnostic radiation. Any exposure before the age of 30, increased breast cancer risk 90%. In another study reported in BMJ, any mammography before the age of 30 raised the risk by 43% (question of statistical significance?) The American Cancer Society recommends MRI screening for BRCA mutation carriers. No mention was made of physician breast examination. Mammography suffers in silence from a lack of sensitivity. Women are given to believe that mammography will protect them whereas it occasionally misses the diagnosis of a palpable lesion. In my practice, it angered me to find four patients with negative mammograms who came to me with palpable lesions much further advanced than they might have been but for a simple breast examination. Admittedly, four in my practice was probably a skewed series. The women involved, however, would not think so. Sadly, ...

A draft genome of Yersinia pestis from victims of the Black Death maps the genome from the plague of 1347-8. Researchers obtained DNA from the teeth of plague victims buried in a mass grave in East Smithfield, (originally the Churchyard of the Holly Trinity) near the Tower of London. Alexander Yersin linked Y. pestis to bubonic plague in 1894. However, controversy and doubt exist over the identity of the plague organism in part because today’s plague does not match the virulence of the Black Death that ravaged Europe in the 1300s. The sequencing by an improved technique (molecular capture assay) apparently establishes that the organism of the Black Death is the same as today’s plague with minor differences. The bubonic plague existed in Asia with appearances in the Middle East and the Justinian plague in Rome and Constantinople in 541-542. Hippocrates describes a plague in Athens in 430-426 BC. Sanskrit tablets describe plague in Asia as early as 600 BC. Jewish physicians even asso...

A preliminary review of the literature on electronic medical records, EMRs and health information technology (HIT) initiatives raise a couple of doubts. One is the apparent lack of accommodation for new bio-medical and genomic advances. The lack of a current medical diagnostic database with criteria, frustrates the accommodation for new science. Such a comprehensive medical information database needs to be infinitely scalable, dynamic and freely accessable at least by the providers. Although stage II envisions decision support, -- such is already the case in the best of the EMRs deployed so far -- stage II does not include differential diagnosis. There again the lack of a current medical information terminology / database frustrates any attempt to correlate patient data with outcome or the genome with medical illness. Also, the plan underestimates the resistance and distrust that both patients and providers might have in relinquishing their proprietary right to the inherent value...

Quick Pitch We build electronic medical records (EMR)s in many ways, but until we post patient data including genomic material into databases as discrete data points, it will not be possible to analyze the data in a meaningful way. Patient records repeat the same words and phrases many times. The chart could be three inches thick, but if one were to reduce it to only the repeated words and phrases and index them in a database, the record might cover only a couple of pages. In a sense, this is compression, but the compressed elements are now accessible and correlated with other information in a relational database. The same strategy applies to current medical information and terminology. As data points on a modern relational database, specific terms defining diagnosis, criteria or treatment become available for programmed analysis, statistical use, machine logic, artificial intelligence (AI), research and data mining. New biomedical information floods the system to the point where...

An electronic health record (EHR) should first of all serve the priority of patient care. Information is the key. Unbiased medical information is difficult to access, closely held by patent and copyright. Clinicians need a continuously updated database of all medical knowledge, especially the rapidly unfolding genomic information. Researchers need to correlate that new bio-medical knowledge with clinical pathology. Both patient and clinician must feel secure in the handling of that data. Click through for more information and a unique proposal.

I share this openion regarding the relative hazards of soft radiation used in the scanner. Once again the government agencies know little about what they speak. The quote from a Stanford blog speaks with a bit more authority. "So it seems that a blog post by Jason Bell, a molecular biology and biophysics PhD candidate in Steve Kowalczykowski's lab at UC Davis, may still be relevant. Referencing a letter by four UC San Francisco faculty, he wrote early last week: In order to really understand these concerns, I think its important to consider the type of radiation used in these scanners, which the TSA has described as 'soft' and 'safe'. First, we need to clarify the definition of 'soft' vs 'hard' X-rays. The TSA has been stating that the X-rays used in the back scatter machines use 'soft' X-rays, which are defined as radiation between 0.12-12 keV (or kilo electron volts) and are generally stopped, or absorbed, by soft tissue or low dens...

From a USA Today survey: who do you trust to fix health-care. Doctors, 77% Hospitals, 64% University professors or researchers who study health care policy, , 61% Obama, 49% Democratic leaders in Congress, 37% Republicans leaders in Congress, 32% Pharmaceutical companies, 30% Health insurance companies, 26% Well I'm not so sure about doctors, less so hospitals , both play the escalation game with insurance companies. I would trust even less the legislators and would give 0% for Pharmaceutical and Insurance companies -- both major problems. A fix would require a Warren Buffet or Bill Gates --half morphed int an Alexander Haig -- at NIH and there is no such person. My proposal, for what little it is worth: let the states tackle the problem utilizing their medical schools. You would have 50 different solutions. One or more of them would work. It's the scientific method for a solution to what basically amounts to a scientific problem -- that is, once you chase the clarion vulchers...

I received this in the mail last night. The email may be phishing but even so may foreshadow events to come. More and more Americans are choosing overseas hospitals for major surgical solutions rather than risking bankruptcy here in the US. This is not an overstatement. Between the lines in this schema lies a promise of a brain drain with US doctors and nurses migrating to Europe or where ever for salaried positions in a more relaxed and scientific atmosphere --- without so much of a threat of being sued. None of the present health-care proposed solutions take into account the complete paradigm change in our understanding of disease --- developing in the genetics and bio-medical laboratories. The translation of this new information to clinical medicine requires mass population screening in order to equate the genetic tags with disease. We now know much but there is far more to learn. Europe is way ahead of us in these screening projects with multi-national databases. We lag far b...

Raw Video: Specter Faces Angry Town Hall - washingtonpost .com Health Care reform is not an option!Can anyone look at these orchestrated disruptions of Town Hall meetings and not wonder? Are special interests are promoting and paying for them? The last time a serious Health Care Reform came along, highly sophisticated TV skits defeated it. Today the gloves are off; a raw, mean spirited fear campaign is afoot. The demonstrations and the fear campaign fall on fertile ground. The talk show personalities, one especially have preached hate and untruth to the point of sedition* The sad fact remains, the US does not have the best health care by any measure unless you are fortunate to have the top tear of insurance and choose your specialty clinic or university hospital wisely. --- We are in fact 16th, right after Ireland. Glitzy claims to the contrary, the US did not invent health care or scientific medicine. However, we did carry the profession to incredible heights of humanitarian, scientif...

Leading investigators present to the National Institute of Health - (2000 GMT on Wednesdays starting September 16th.) http://videocast.nih.gov/ >

Circadian rhythms: Of owls, larks and alarm clocks : Nature News Distortion of circadian rhythm clearly causes human illness, even if not well investigated. Why do we continue with this nonsense when leaving time alone is the safer bet. DST may save energy in DC, but elsewhere it works the other way, and DST is related to some of our most troubling non infectious diseases.

COMPUTER SCIENCE: The Ethical Frontiers of Robotics -- Sharkey 322 (5909): 1800 -- Science In his article above N. Sharkey regrets the lack of ethical guidelines for robots. Sharky raises serious questions about maternal deprivation and attachments only to inanimate surrogates. One might consider Isaac Asimov's -- the science fiction writer: I Robot -- hard wired ethical programs for robots. Doing so might negate the military use of robots altogether. I would suggest the same for robots as infant caregivers. In a letter to the editor Guo and Zhang suggest that cultural differences, " in the value placed on the development of independence in infant and toddlers could lead to totally divergent views of the use of robots as care givers for children." Pediatricians and psychologists are aware of Miasma, an infant failure to thrive condition, brought on by sterile hospital like environments for infants. The spectacular example was a South American Orphanage in which supposedl...

Recently a division of HICFA is offering voluntary guidelines for health care providers, consisting of 150 key determinants. The offer promotes physician participation by suggesting a premium for compliance. Reading the guidelines, they follow algorithms already promoted as standard best practices for health care providers. This offering suggests the kind of standardization that will likely come with universal electronic medical records and a National standard of care. There is a problem, however. No question, our health care delivery system is broken. Ireland now provides better medical care than the US. The Public Health driven solution to correct the problem with standardized federal guidelines has three deleterious and unintended consequences. These consequences should be thought through before going any further down the line of a single National standard. 1. One set of guidelines fails completely to take into account regional differences in both the incidence and nature of disease...

The white horse signifies conquest, military misadventure. The red horse stands for war. Black is for famine, persecution and injustice. The pale horse and rider spreads plague and death . Cholera, albeit a minor plague, not yersinia pestis but can be nearly as bad, given the wasteland of bad water and bad sanitation, which is Baghdad today. Cholera is moving into Baghdad as the doctors and nurses move out. Tired of being ransomed I suppose. Cholera is a short curved highly motile vibrio that produces a protein enterotoxin. The toxin attacks the mucous membrane of the small intestine causing an out poring of serous body fluid, isotonic salts, in copious volumes of a liter or more an hour . Unbelievable diarrhea in other words, vomiting and rapid dehydration, hemoconcentration, weakness and circulatory failure. That's bad --- sunken eyes, wrinkled dry skin, kidneys shut down and potassium drops to lethal levels --- w ithout fluid replacement death with in only a few hours . Most c...