Med Head

Since my head is going to be filled with medicine for the next four years, this is my attempt to stay connected to the outside world. Hi Family and friends!
bpod-mrc:

10 April 2014
Oral Fungal Fight
Oral candidiasis, usually called thrush, is a fungal infection of the mouth that often affects people with HIV. By cataloguing oral microbiomes in healthy people and HIV patients, scientists might have found a new way to tackle the problem. There was little difference in oral bacteria between the two groups, but clear disparities when it came to fungi. A fungal family called Candida was more abundant in HIV-infected individuals than healthy people, while another family, Pichia, was less plentiful in HIV patients than others. This suggested the two types of fungi might be engaged in battle. Sure enough, as the image shows, the tongues of mice treated with Pichia (right) hosted hardly any Candida (magenta flecks) compared with those of untreated mice (left). If scientists can work out exactly how Pichia inhibits its fungal foe, they could potentially develop new ways to manage oral thrush and other, more dangerous fungal infections.
Written by Daniel Cossins
—
Image courtesy of Mahmoud Ghannoum and colleagues Case Western Reserve University, USAOriginally published under a Creative Commons Licence (BY 4.0) Research published in PLOS Pathogens, March 2014
—
You can also follow BPoD on Twitter and Facebook

bpod-mrc:

10 April 2014

Oral Fungal Fight

Oral candidiasis, usually called thrush, is a fungal infection of the mouth that often affects people with HIV. By cataloguing oral microbiomes in healthy people and HIV patients, scientists might have found a new way to tackle the problem. There was little difference in oral bacteria between the two groups, but clear disparities when it came to fungi. A fungal family called Candida was more abundant in HIV-infected individuals than healthy people, while another family, Pichia, was less plentiful in HIV patients than others. This suggested the two types of fungi might be engaged in battle. Sure enough, as the image shows, the tongues of mice treated with Pichia (right) hosted hardly any Candida (magenta flecks) compared with those of untreated mice (left). If scientists can work out exactly how Pichia inhibits its fungal foe, they could potentially develop new ways to manage oral thrush and other, more dangerous fungal infections.

Written by Daniel Cossins

Image courtesy of Mahmoud Ghannoum and colleagues
Case Western Reserve University, USA
Originally published under a Creative Commons Licence (BY 4.0)
Research published in PLOS Pathogens, March 2014

You can also follow BPoD on Twitter and Facebook

radiologysigns:

radiopaedia:

What is it? Where is it? And… how did it get there?
ANSWER: http://goo.gl/bAU9pm

Any person wondering “is that a cucumber?” does not appreciate the great utility of CT density. A cucumber is mainly water and so would appear grey on CT but this vegetable is black and so contains a lot of air. Can you think of a vegetable that is a similar shape to a cucumber but is a lot less dense? If you can then you have just learnt one answer to this quiz question. The next thing to learn is that this vegetable is best taken orally!

radiologysigns:

radiopaedia:

What is it? Where is it? And… how did it get there?

ANSWER: http://goo.gl/bAU9pm

Any person wondering “is that a cucumber?” does not appreciate the great utility of CT density. A cucumber is mainly water and so would appear grey on CT but this vegetable is black and so contains a lot of air. Can you think of a vegetable that is a similar shape to a cucumber but is a lot less dense? If you can then you have just learnt one answer to this quiz question. The next thing to learn is that this vegetable is best taken orally!

jayparkinsonmd:

I really, really hate going to the doctor. As a doctor, you know exactly what you should be afraid of having. You’ve seen it all happen to other people. Personally, when something new and weird happens to me my fears always irrationally gravitate toward the following three things:
Cancer of any kind (despite the fact that there are almost zero cases of cancer in my immediate or extended family
Brain tumor
Multiple Sclerosis
This is called nosophobia, “fear of disease.” And I’ve got it. Absolutely. So much so that about two years ago I developed this little blind spot in my left eye (that little red spot up in the photo of my second favorite dog in all the world, Doctor Teeth, is how it looks to me). I’m a regular migraineur and typically get all kinds of blind spots in my vision almost every day due to these migrainey things that happen to me. But my normal spots come, and go. This one stuck. Like a region of dead pixels on my computer screen. Two years ago, I was convinced I had some sort of eye/brain tumor. So I didn’t go see a doctor, I just waited it out knowing that time will tell if it’s going to be something bad. Nothing changed in two years, despite the two years of unnecessary anxiety of “knowing” that something bad was happening to me. 
So I finally went to the ophthalmologist yesterday and got a thorough exam, which was absolutely 100% perfectly normal. I saw the photo of my retina which didn’t show that retinal melanoma I was convinced I had. The doctor reassured me that this is extremely common and she “sees this at least once a week.” 
But then I asked her, “But what is it?” She said she doesn’t know nor does she feel the need to know. The course of my spot hadn’t changed in two years. It’s there and she can’t see it with a comprehensive exam. She said she could do a very specific test and look for microscopic variations on my retina, but what would that do? There’s really nothing to be done for the spot. It’s just there. It always will be. It’s never coming back. And it’s really not big enough a deal for me to want some doctor to do something about it. 
But, again, “What is it?” I wanted the doctor to give me a diagnosis. I left the office without a diagnosis. The diagnosis she gave was “You’re fine. You’re not going to die. You don’t have a brain or eye tumor. Although you’ve never seen this happen to you, I see this all the time and my experience is that it’s absolutely nothing to worry about.” That was comforting to me, but I still wanted a diagnosis— something that could 100% completely alleviate my anxiety.
So many people (including myself, friends, and patients I’ve seen) have had weird, scary things happen to them only to go to the doctor to be told “We have no idea what’s happening to you. We just have to wait this out and see what happens. You may be completely fine or you may have to face death.” The psychological comfort of having a diagnosis, something to hang your hat on, is far, far better than an unknown. A diagnosis gives us something concrete. It’s an answer. Answers give us comfort. As humans, we’re actually really great at dealing with stuff, even when it’s horrible stuff. And we’re even better at dealing with stuff if we can define what that stuff is. It’s very similar to a family who has a child go missing. The pain and anxiety that stems from the immediate days, to months, to years of the questions, the unknown fate, the fear of bad news and the hope of a safe return. It’s psychological torture.
So, doctors, never underestimate the psychological power of a diagnosis. Even when it’s bad, it provides a framework for us, as patients, to wrap our heads around, and build the skills we need to deal with whatever’s thrown at us.
 

jayparkinsonmd:

I really, really hate going to the doctor. As a doctor, you know exactly what you should be afraid of having. You’ve seen it all happen to other people. Personally, when something new and weird happens to me my fears always irrationally gravitate toward the following three things:

  • Cancer of any kind (despite the fact that there are almost zero cases of cancer in my immediate or extended family
  • Brain tumor
  • Multiple Sclerosis

This is called nosophobia, “fear of disease.” And I’ve got it. Absolutely. So much so that about two years ago I developed this little blind spot in my left eye (that little red spot up in the photo of my second favorite dog in all the world, Doctor Teeth, is how it looks to me). I’m a regular migraineur and typically get all kinds of blind spots in my vision almost every day due to these migrainey things that happen to me. But my normal spots come, and go. This one stuck. Like a region of dead pixels on my computer screen. Two years ago, I was convinced I had some sort of eye/brain tumor. So I didn’t go see a doctor, I just waited it out knowing that time will tell if it’s going to be something bad. Nothing changed in two years, despite the two years of unnecessary anxiety of “knowing” that something bad was happening to me. 

So I finally went to the ophthalmologist yesterday and got a thorough exam, which was absolutely 100% perfectly normal. I saw the photo of my retina which didn’t show that retinal melanoma I was convinced I had. The doctor reassured me that this is extremely common and she “sees this at least once a week.” 

But then I asked her, “But what is it?” She said she doesn’t know nor does she feel the need to know. The course of my spot hadn’t changed in two years. It’s there and she can’t see it with a comprehensive exam. She said she could do a very specific test and look for microscopic variations on my retina, but what would that do? There’s really nothing to be done for the spot. It’s just there. It always will be. It’s never coming back. And it’s really not big enough a deal for me to want some doctor to do something about it. 

But, again, “What is it?” I wanted the doctor to give me a diagnosis. I left the office without a diagnosis. The diagnosis she gave was “You’re fine. You’re not going to die. You don’t have a brain or eye tumor. Although you’ve never seen this happen to you, I see this all the time and my experience is that it’s absolutely nothing to worry about.” That was comforting to me, but I still wanted a diagnosis— something that could 100% completely alleviate my anxiety.

So many people (including myself, friends, and patients I’ve seen) have had weird, scary things happen to them only to go to the doctor to be told “We have no idea what’s happening to you. We just have to wait this out and see what happens. You may be completely fine or you may have to face death.” The psychological comfort of having a diagnosis, something to hang your hat on, is far, far better than an unknown. A diagnosis gives us something concrete. It’s an answer. Answers give us comfort. As humans, we’re actually really great at dealing with stuff, even when it’s horrible stuff. And we’re even better at dealing with stuff if we can define what that stuff is. It’s very similar to a family who has a child go missing. The pain and anxiety that stems from the immediate days, to months, to years of the questions, the unknown fate, the fear of bad news and the hope of a safe return. It’s psychological torture.

So, doctors, never underestimate the psychological power of a diagnosis. Even when it’s bad, it provides a framework for us, as patients, to wrap our heads around, and build the skills we need to deal with whatever’s thrown at us.

 

skunkbear:

These are the disease outbreaks that could have been prevented by proper vaccination according to the Council on Foreign Relations. You can explore the interactive map here.

Check out the thousands of whooping cough cases in the United States in 2011 and the measles outbreaks plaguing Europe.

Patient encounters…if only

(Source: iraffiruse)

oupacademic:

Misquotation: ‘The English are a nation of shopkeepers’
An assessment now generally attributed to Napoleon, and certainly the comment was attributed to the ex-Emperor by his personal surgeon, Barry O’Meara, who was part of his houseful on St Helena. However, the association of English political power with commerce was already established, as is shown by this passage from The Wealth of Nations (1776) by the Scottish economist Adam Smith:

To found a great empire for the sole purpose of raising up a people of customers, may at first sight appear a project fit only for a nation of shopkeepers. It is, however, a project altogether unfit for a nation of shopkeepers; but extremely fit for a nation whose government is influenced by shopkeepers. 

 From the Oxford Dictionary of Quotations. For other previous common misquotations, take a look at our Misquotation of the Week feature.
Image credit: ‘Shrewsbury, Old House On Pride Hill’, c. 1880, National Media Museum Collection, via Flickr Commons.

oupacademic:

Misquotation: ‘The English are a nation of shopkeepers’

An assessment now generally attributed to Napoleon, and certainly the comment was attributed to the ex-Emperor by his personal surgeon, Barry O’Meara, who was part of his houseful on St Helena. However, the association of English political power with commerce was already established, as is shown by this passage from The Wealth of Nations (1776) by the Scottish economist Adam Smith:

To found a great empire for the sole purpose of raising up a people of customers, may at first sight appear a project fit only for a nation of shopkeepers. It is, however, a project altogether unfit for a nation of shopkeepers; but extremely fit for a nation whose government is influenced by shopkeepers.

 From the Oxford Dictionary of Quotations. For other previous common misquotations, take a look at our Misquotation of the Week feature.

Image credit: ‘Shrewsbury, Old House On Pride Hill’, c. 1880, National Media Museum Collection, via Flickr Commons.