It’s discovery has implications for the treatment of chronic overwhelming infections such as HIV,t hat ‘exhaust’ and switch off the immune system, as well as for chronic inflammatory (also known as autoimmune) conditions such as rheumatoid arthritis and sepsis.

Read the journal article here.

This is close to my heart as someone who what born with what I can only describe as malformed knee joints. The cartilage I have has bony deposits, leading to lots of pain and almost certain bilateral knee replacement in the future, at a much younger age than the average recipient of the surgery.

I caution people all the time about their knees, take care of them!

Now this study from UCSF gives us some insight on how we can better protect our knees as we age.

Based on these results, moderate physical activity levels appear most beneficial to prevent cartilage degeneration in patients at risk for osteoarthritis,” said Link. “Lower impact sports, such as walking or swimming, are likely more beneficial than higher impact sports, such as running or tennis, in individuals at risk for osteoarthritis

I caution people all the time about their knees, take care of them! Now this study from UCSF gives us some insight on how we can better protect our knees as we age. Exercise, but not too much, especially limit high impact activity such as running. Sorry marathoners.

The new policy, which will be published in the December 2012 issue of the organization’s journal, Pediatrics, urges practitioners to counsel both male and female teens about the use of emergency contraceptives “as part of routine anticipatory guidance in the context of a discussion on sexual safety and family planning regardless of current intentions for sexual behavior.”

The new policy takes into account — and rejects — the idea that practitioners may have a moral objection to what could be seen as tacit approval of underage sex or use of a product some consider to cause very early abortion.

Since time is of the essence when a person needs the morning after pill, this policy is a welcome response to the current social landscape that requires those under 18 years old have a prescription for the morning after pill. 

Ranbaxy is one of six manufacturers of artovastatin, the generic name of Lipitor, in the US. According to WSJ.com, since October the company’s generic Lipitor sales accounted for 44% of the market for the drug in the US.

This bodes well for Ranbaxy’s US competitors.

Excess mucus production in diseases like COPD, asthma, and cystic fibrosis is what typically causes death in these patients according to Michael J. Holtzman, MD of Washington University School of Medicine. He and his colleagues have described the molecular pathway responsible for excess mucus production AND have designed drugs inhibiting that pathway.

Chronic respiratory disease, especially COPD, is the third leading cause of death in the United States and worldwide. Smoking and exposure to pollution are major causes of these diseases. Related conditions that affect the respiratory airways, like asthma and bronchitis, are also among the most common causes of human disease in adults and children. The morbidity and mortality from these conditions is closely linked to excess mucus production that blocks the airways and prevents normal breathing. However, there are no effective treatments to address the overproduction of airway mucus.

As part of the new research, the scientists discovered that a critical signaling molecule, CLCA1, has a special role in the mucus pathway. They showed that CLCA1 allows a protein known as IL-13 to turn on the major mucus gene in airway cells. The researchers also showed that CLCA1 needs help from an enzyme called MAPK13.

Research into the drugs showed reduction of mucus production in the lab by as much as 100 fold. The team asserts that the drugs have implications in the treatment for chronic and fatal diseases such as asthma, COPD, cystic fibrosis but they also see hope for treatment of more common ailments such as the common cold and bronchitis. I remember always being told that the only thing we could do for a cold was treat the symptoms. I would LOVE to be able to treat the cause of the symptoms. We can only hope.

The findings correct long-standing misperceptions that IUDs cause PID. Also, by evaluating the relationship between the timing of testing for gonorrhea and chlamydia (GC/CT) and the risk of developing PID within 90 days after IUD insertion, the study fills a large gap in the evidence base for the optimal timing and necessity of testing women who have no symptoms of gonorrhea and chlamydia.

Because gonorrhea or chlamydia infection is a risk factor for PID in any woman, there is a concern that inserting an IUD in someone who has an asymptomatic infection could increase that risk of PID. This study shows that protocols that test on the same day as IUD insertion, and then promptly treat women who test positive, do not increase the risk of developing PID compared to women who were screened ahead of time or not at all.

As the Affordable Care Act rolls out and there is increased access to birth control I hope this information is disseminated as well.

Our analysis suggests that field triage criteria can be used effectively to safely divert inebriated patients to a detoxification facility rather than an ED, with minimal adverse events. Use of the detoxification evaluation checklist resulted in substantial ED overtriage, and further refinement of the detoxification evaluation checklist criteria is needed to reduce it.

Limitations of the study are discussed in further detail here. While clearly, one study does not a rule make, I think this is an important aspect of emergency care that warrants exploration.

Fifteen healthy fetuses were scanned four times at 24, 28, 32 and 36 weeks gestation. Yawning was distinguished from non-yawning in terms of the length of time it took to reach the apex of the mouth stretch, with yawns being defined as more than 50% of the total time observed. To assess changes in frequency, a Poisson mixed effects model was fitted to the count of number of yawn and simple mouth opening events with age and gender as fixed effects, and person as a random effect. For both yawns and simple mouth openings a smooth varying age effect was significant. The number of yawns observed declined with age from 28 weeks gestation, whereas simple mouth openings were less frequent and the decline was observed from 24 weeks. Gender was not significant either for yawn and simple mouth openings.

So why is this even something to be researched? Well as I mentioned before, it has potential to be developed as a tool in determining fetal health and development. When yawning versus mouth opening occurs and how frequently it occurs varies with fetal age. It could be something akin to the Ballard Assessment for our in utero patients used, of course, in conjunction with other testing.

In order to prevent that wear down, she recommends Ultradex, a mouthwash that contains chlorine dioxide and which some studies have shown wash away bacteria.

Then, after brushing, she recommends a regular mouthwash, like Listerine, to enhance cleaning. Afterwards, she says that brushers should follow it up with Fluorigard, which helps to fortify and fix teeth.

She also recommends gum and lozenges that contain xylitol, a naturally occurring sweetener that many studies have shown to reduce tooth decay.
Read more at http://www.medicaldaily.com/articles/13247/20121123/dental-floss-useless-dentist.htm#PcS8zrP8Wi3PAcDK.99

The article states that no study has shown flossing to be effective against tooth decay in the long term. In fact, the one study that did show flossing to be beneficial had children’s teeth flossed professionally every day for two years. I’m going to emphasize some key words of that last sentence: professionally, every day, and two years. Yikes!

Personally, I’m still going to floss in the morning before brushing my teeth because I happen to like starting my day with that super smooth feeling.

They noted that anxiety before surgery can be a major problem, causing emotional trauma for both children and their parents. In some cases, the study authors said, anxiety before surgery can lead to lasting behavioral problems, such as separation anxiety, aggressiveness and nightmares.

The study confirms what many parents already know about the power of cartoons to distract children, according to an accompanying editorial by Dr. Franklyn Cladis and Dr. Peter Davis of the University of Pittsburgh.

They said further research is needed to determine if reducing children’s anxiety before an operation reduces the risk of behavioral problems after surgery.