Wednesday, December 27, 2006

My new AIM buddy icon based on status of my brain cells. Per my brother:

"Greek tragedy meets acid indigestion."
Tired, grumpy, facing another blizzard in the forecast and the end of my daughter's visit, I dressed without care for the drive to the airport this a.m. Gray fleece, black pants, red and green striped socks, blue suede shoes. Never thought how that would appear to Subaru service department which was stop number two after dropping off the kid at DIA.

Worse yet, problem with rear window defroster was merely this...I was pushing the wrong button. Dressed like a middle-aged frump AND pushing the wrong button! Am I losing my buttons here?

Turns out what I always told my children as they slinked self-consciously through adolescence is true: No one cares how you look. The service rep never even looked up from his computer screen as I sheepishly retrieved my car.

Thursday, December 21, 2006

It may take a village to make you overweight. New evidence suggests that those bacterial hangers-on living in your gastrointestinal tract may be partly to blame for the state of your waist.

Microbiologists at Washington University in St. Louis checked out the gut bugs in mice of various sizes. The docs found that the resident GI fauna differed predictably based on the size of the host.

Furthermore, when the researchers analyzed the intestinal microbes of obese people, they found the population skewed heavily towards Firmicutes and short on Bacteroidetes compared with normal weight controls. After weight loss, the little Firmicutes lost ground to a growing group of Bacteroidetes, assuming a pattern more consistent with that of their leaner colleagues.

If mousy microbes are at all indicative of those that we carry through life, here's what your little gut friends may be doing to you:

Microbes from the obese mice had more genes for processing starches and complex sugars and produced more simple sugars and fatty acids--that is, calories--for the gut to absorb.

Things to do in Denver when you're snowed in

Wednesday, December 20, 2006

If we go back on our four legs and get down on the ground, we may be able do things we had no idea we could do.
--Neuroscientist Gordon Shepherd, Yale University

Dr. Shepherd was commenting on a recent informal study out of California that tested a group of undergrads with respect to their ability to track prey using their sense of smell. The Berkeley researchers conducting the experiment dipped 10 meters of twine in a distinctive scent and outfitted the 32 volunteers in earmuffs, gloves and kneepads so they couldn't use sensory cues other than smell.

Two-thirds of these game subjects successfully followed the 'game' trail, scooting on hands and knees across the grassy knoll like dogs in pursuit of a squirrel (There's actually a brief film clip of the merry chase on the ScienceNOW web-site!).

And the scent? Chocolate, of course. So if you ever need to track a chocolate bunny in the night, chances are good you'll not go hungry.

Monday, December 18, 2006

Happy Hanukkah from Femail Doc and her brother Bob
Attention can act as a beam of spotlight. A good mood broadens that beam.
--Psychologist Adam Anderson of the University of Toronto

So if you don't want a broad beam? Narrow it, says Dr. Anderson, by working yourself into a nasty snit, then go balance your checkbook. Or help your son study for his anatomy test. Or do the day's charting. Bring 'em on, I'm in the mood.

Saturday, December 16, 2006


My friend Anita says this should be an inner mantra for aging ladies. Yesterday, I forgot to be mindful of toe positioning at the Cherry Creek Mall, and got caught up instead with the shopper's mantra: IwannagohomeIwannagohomeIwannagohome

Worse yet, was carrying a shopping bag with six champagne flutes when I hit the unforgiving floor in front of six thousand other people (many of whom were kind enough to inquire about my well-being post-kneeplant). Now, IgottagobackIgottagobackIgottagoback.
This from Dr. Peter Ravdin of the M.D. Anderson Cancer Center on newly released data that showed a decreased incidence of breast cancer within one year of the termination of the Women's Health Initiative hormone therapy study:

What we think is going on is that about half of the cancers that were just below the detection range in 2002 in women who were taking hormone replacement therapy actually stopped growing or regressed when they stopped [HRT].

Friday, December 15, 2006

Big news about hormones and breast cancer today. For more information, see Not forever, not for everybody.

Tuesday, December 12, 2006

Good genes, bad circumstances

I had the pleasure of eating lunch out today with a friend. We sat on an enclosed patio, roasting pleasantly under a heat lamp, chatting over a delicious lunch of pasta and bread. This is not your ancestors' dining experience.

The human genome was perfected during the Ice Age, and the humanoids that survived to pass their perfected genes on to future generations assembled genetic material perfectly suited to cold, famine, and obligatory exercise.

So toasty, overfed, and happily seated is not what brings out the best in our bodies. Good for the soul, however.

Monday, December 11, 2006

Screening wars

And forty-something breasts caught in the crossfire. A large study of nearly 17,000 UK women in their 40's again highlights the risk/benefit considerations of regularly screening youngish women--with smaller cancer risks--for breast cancer.

The benefit, of course, is the chance to catch a cancer before it catches on. The risks include the significant possibility of 'false positives,' cancerish sorts of changes on the mammogram that turn out, after much anxiety, expense, and biopsy procedures, to not be cancer. But here's a comment from the commenters (editorialists in the Lancet journal about another dilemma:

Every woman, with her physician's guidance, should decide whether regret will be greater if she develops breast cancer that could have been detected earlier by screening mammography, or if she develops breast cancer later in life as a result of screening mammography itself.

Saturday, December 09, 2006

Greens against cancer

Gotta love those greens. Per the women of the Iowa Women's Health Study, those in the highest quartile of greens consumption had less than half the ovarian cancer risk of those eschewing greens.

But there's the problem, how to cook the greens so you can chew them? A patient of mine says boil them for 2 and 1/2 hours. She favors turnip greens, or green turnip green pudding after cooking that long. After all that cook cook cooking, is there any goodness left for the fight against cancer?

Thursday, December 07, 2006

Blink-proof holiday photos

Just in time for group shots of the fam' at Christmas dinner, this from the June issue of Velocity magazine. Physicist Dr. Piers Barnes explains the chances that all the folks will have their eyes open when the shutter snaps:

Piers says the probability of one person spoiling a photo by blinking equals their expected number of blinks (x), multiplied by the time during which the photo could be spoilt (t) - if the expected time between blinks is longer than the time in which a photo can be spoilt, which it is....

Piers then figured out how many shots I'd need to be 99% certain of getting a good one. He found that photographing thirty people in bad light would need about thirty shots. Once there's around fifty people, even in good light, you can kiss your hopes of an unspoilt photo goodbye.

Tuesday, December 05, 2006

Holding on to your teeth

I'm always gathering data on how to make it to the finish line with all parts intact. Information from the Leisure World Study--can you imagine living in a community with that name?--suggests that estrogen therapy helps women hang on to their teeth.

This study of nearly 9,000 old ladies in the Laguna Hills of southern California found that those women who reported long term use of estrogen were more likely to have their own teeth a decade or more after the study began. They were also one-third less likely to lose their minds to Alzheimer's Disease.

Monday, December 04, 2006

Remember your dreams

I recently found a blog that recommended a three step approach to remembering more dreams: 1) Make a conscious decision to remember your dreams, 2) Write them down as soon as you awaken, even if it's the middle of the night, 3) Become more aware of the details of your environment during the day.

I've done tips 1) and 3). And while I'm aware that I am dreaming more, I can't remember a thing about them. Guess tip 2) is critical, but I think writing in a dream log would wake me up completely.

Meanwhile, a word or two on drugs and dreams. Nexium gives me vivid, dreadful nightmares. I've heard that from one other person. Melatonin gives me a weird night's sleep and weird dreams--too bad, the sleep aid is supposed to be crazy good for your brain. Progesterone also enhances dreams.
We've got LDL-cholesterol lowering down, easily and safely accomplished through the use of statins. HDL-cholesterol--that's the good stuff as in the more the merrier--is a different matter. At the same time that HDL levels are hard as hell to budge, this worthy high density lipoprotein (responsible for toting cholesterol from the peripheral cells back to the liver for elimination) is increasingly in the spotlight as equally if not important than LDL levels in determining cardiac risk.

I was hopeful that a new drug would soon be available to hoist up HDL effectively; early clinical trials indicated that torcetrapib could boost HDL by nearly 50%. Not going to happen; recently halted clinical trials also indicated that significantly more persons in the active treatment group died compared to those on placebos. Back to the drawing board on HDL-raising drugs. Meanwhile: exercise, wine, and weight loss are the best approach currently available to do the job.

Saturday, December 02, 2006

Spotty physician counseling

Ouch, that hurts. The authors of this particular article published in the Archives of Internal Medicine do, however, have a point. They found that we physicians fail to communicate important points about medication use to our patients. This includes duration of use, possible side effects, and potential interactions with other drugs.

Shoot, guilty as charged. More than once I have discovered that a patient quit her new meds after the first prescription's worth, thinking a single month of therapy would take care of a chronic problem such as elevated cholesterol or hypertension.

Thank heavens for pharmacists who pay attention to the drugs you're on and possible conflicts between all those that you take. We are often called to clarify dose or drug name, or given a heads up that a drug we've prescribed may interact with therapy already underway (just last week because I added the antibiotic Zithramax for a patient already on Zocor).

I know my part: pay attention to the entire picture and take the extra time to explain. Your part as drug-using patient according to the authors of this article?

Ask questions about the medication name, dose, and purpose; how, when, and how long to take the medication; possible adverse effects and what to do if they arise; what food, drinks, other medicines, or activities should be avoided while taking the medication; and what should be done if a dose is missed.

And I would add that you should use one pharmacy for all your prescriptions. These well-trained pharmacists do pay attention to all your meds and do notify me when I've made a choice that may not fit with your health history.

Friday, December 01, 2006

It's a wonder I get anything done. I did shovel the walk, do two loads of wash, and register a car at Denver Motor Vehicle today. But this evening, all I've accomplished is to follow a meandering line through the web that led from an article about tamoxifen and wound healing to an interesting new product for wrinkles.

My journey started with an article from the Archives of Facial Plastic Surgery about tamoxifen. Apparently, physicians have noted that women on tamoxifen have delayed wound healing but better scars. Tamoxifen delays cellular division in skin cells called fibroblasts by decreasing the production of various growth factors (GFs). These GFs are a good thing if you happen to slice your thumb open with the cat food can. But if you are an exuberant GF producer, even piercing your ears can result in an unsightly pile-up of skin known as a keloid or exuberant scar.

Now plastic surgeons hate exuberant scars, and the authors of this article proposed that tamoxifen may some day prove clinically useful in their profession to minimize scar formation. But I'm thinking a dense layer of fibroblasts below aging skin might be the very anti-wrinkle solution. So off to PubMed to check out whether anyone but me had the bright idea of putting transforming growth factor (TGF) into a topical cream.

And yes indeed, Topix pharmaceuticals had that very notion, and they combined TGF with vitamin C and black cohosh extract into Cell Rejuvenation Serum (aka CRS which also stands for Can't Remember S*** amongst women of a certain age). Preliminary studies suggest this dandy CRS significantly increases collagen production and decreases the appearance of wrinkles.

Shall I order some for sale through the office?