Tag Archive: medicine

Tools of the Trade: 10 Things You Need for Rotations

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Luke Skywalker has a lightsaber. Batman has a utility belt. You have a white coat. Here are some things you should carry in it: 1. Stethoscope- A no-brainer for anyone attempting a physical exam, don’t get caught without one on a medical rotation. You need this piece for any heart and lung exam and it…

Advancement in Flu Shot Technology

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  Every year, come October/November, it’s that time of year that many dread – time to get your annual flu shot. Like it or not, in my opinion it’s a small price to pay for protection against the flu, which isn’t fun for anyone. Some people resist every year saying that it’s pointless or “I got one last year!” The truth is, the annual flu shot typically produces antibodies for 75% of people, giving protection against infection with influenza to the majority of those who receive the vaccine. However, despite these good odds, how nice would it be to never have to get another flu shot again? Well, except for just one more! The University of Texas Medical Branch (Woot! Way to represent!) is currently working on a universal influenza vaccine that would eliminate the need to create an annual vaccine due to the changing surface antigens of the virus. According to the Galveston County Daily News: “The vaccine candidate, VAX102, targets a protein known as M2e, found on the surface of the influenza A virus, that has remained completely unchanged from 1918 until the recent pandemic, making it of interest to researchers searching for a target for the immune response to influenza that would be stable through many seasons.”

How "Shape Ups" Shape Up to the Experts

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Sketchers Shape Ups Everyone has seen those trendy, yet funky-looking shoes with the chunky soles that claim to help you lose more weight in less time. Sketchers “Shape Ups” and Reebok “EasyTone” are just a few brand name examples. The celebrity endorsers of these products — Kim Kardashian, Kris Jenner, and Mel B of the Spice Girls — make it seem like a thin, healthy body is just a pair of shoes away. And in this day and age in which so many people want to lose the most weight with the least amount of effort, the popularity of special shoes that claim to increase weight loss and improve health is not surprising. 

Pediatrics :)

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A great  article  and  video  I saw on Medscape mentioned the uniqueness of working in pediatrics and also tips for advising parents regarding vaccines. Pediatrics can be seen as “every specialty in a tiny body”, as Cristina Yang of  Grey’s Anatomy  fame once said, but yet in many ways it is not at all comparable to any other medical specialty. We cannot treat sick children the same way we would treat adults with the same illness. It’s not that their actual medical treatments will necessarily differ, but that they require special care and attention that adults don’t. They have parents who must be informed, curious siblings, and their own need to understand what’s going on, which can be difficult to explain to the four-year-old child with leukemia. I can’t wait to spend time in pediatrics since I think that’s the field I want to work in as a Physician Assistant. I love children and helping to treat children everyday is my dream job.

A Bioethical Dilemma

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A popular topic of conversation lately among my friends, as well as an issue in a recent episode of  Grey’s Anatomy , has had me thinking about the following bioethical dilemma: in the event of a situation that requires choosing to save the life of a woman or her unborn infant, what should one do? What are the implications of both choices? Is it possible to save both lives? Of course, situations like these are  completely  dependent on the circumstances of both mother and infant. However, some generalizations can be made. I feel very strongly on this issue, so I thought I would share my thoughts. :) I am a strong advocate of preventing harm to the baby, while saving the life of the mother. Now, when this gets tricky is when treatment to the mother will be harmful to the baby. In this particular episode of  Grey’s Anatomy  (Season 7, Episode 18), Callie’s heart stopped beating on the operating table. The baby was only 23 weeks along, making delivery of the baby risky and viability of the baby questionable. Arizona and Mark argue about whose life should be their first priority. Arizona advocates for Callie’s wishes, since she so desperately wanted a baby, saying: “What is her life going to be like  without this baby ?” Mark quickly retorts: “What is her life going to be like if she’s  DEAD ?” This is a valid point. However, what is important here is that there are  two  human lives at stake, not just one. We know the risks associated with severe trauma such as that found in an adult in a car accident—brain swelling, internal bleeding, broken bones, etc. If these injuries are so severe that delivery of the baby is required to save the baby’s and/or the mother’s life, what are these risks associated with delivery of a pre-term infant? Here are some facts about premature infants from the  March of Dimes : “Premature babies [born before 37-40 weeks gestation] face an increased risk of lasting disabilities, such as mental retardation, learning and behavioral problems, cerebral palsy, lung problems and vision and hearing loss. Two recent studies suggest that premature babies may be at increased risk of symptoms associated with autism. Studies also suggest that babies born very prematurely may be at increased risk of certain adult health problems, such as diabetes, high blood pressure and heart disease.” Look at just the physical differences between a 26-week preemie (left) and a full-term infant (right):    If the baby is born  before reaching 28 weeks , these risks are greatly increased: “Most of these babies are born at extremely low birthweight (less than 2 pounds, 3 ounces). Almost all require treatment with oxygen, surfactant and mechanical assistance to help them breathe. These babies are too immature to suck, swallow and breathe at the same time, so they must be fed through a vein until they develop these skills. They often cannot cry and they sleep most of the day. These tiny babies have little muscle tone, and most move very little. These babies are at high risk for one or more of the complications discussed above [respiratory distress syndrome, apnea, intraventricular hemorrhage, patent ductus arteriosis, necrotizing enterocolitis, retinopathy of prematurity, jaundice, anemia, chronic lung disease, and infection]. However, most babies born after about 26 weeks gestation do survive(about 80% survive at 26 weeks), although they may face an extended stay in the newborn intensive care unit (NICU). Factors that can improve survival rates include higher birthweight, female sex, history of prenatal treatment with corticosteroids and singleton birth. Unfortunately, about 25 percent of these very premature babies develop serious lasting disabilities, and up to half may have milder problems, such as learning and behavioral problems.” So if this baby is not only going to have to fight for its life in the short term in order to grow and develop outside of the mother’s womb, but will also have increased risk for health problems later in life, what’s the point of trying to save the baby? Wouldn’t it be easier to devote all resources to trying to save the mother’s life? I would argue that the baby’s life is just as important as the mother’s. Just because the baby could have problems later in life does not make his or her life less worth saving than that of the mother. Besides, who are we to say that one human life is worth more than another? The baby is a new person with infinite possibilities in his or her life. While some will argue that a special needs child often breaks apart a family, I have seen firsthand the exact opposite. I know several families with children that have autism, Down syndrome, and other birth defects or diseases (due to prematurity or otherwise), and the special care and love that these children require brought their families together in a way they never thought possible. This baby is a human person that has unique DNA, fingerprints, and will develop a unique personality, if only given the chance to grow and mature. So the bottom line is—yes, do whatever is necessary to save the life of the mother. But in doing so, do not forget the life of the tiny infant that is so much more vulnerable and dependent on his mother, doctors, and family for support and medical care to grow into a strong and healthy baby, child, and adult.

Amino Acids and…Medicine?

As I am typing now, I am also attempting to study for my molecular biology test tomorrow. I must admit in studying for this test, I asked myself how important this information  really  is. Yes, I understand that proteins, DNA, and RNA are crucial to life and we could probably not exist without them. Understanding how they work and function in the human body is definitely very important to know. But do I really need to know the  structures  of the twenty amino acids and DNA and RNA to become a good clinician? I’m not sure. You know all those prerequisite classes that pre-health students have to take? What’s so important about general biology, organic chemistry, microbiology, and all the other prerequisite classes anyway? I think I finally figured it out. Not only will it be beneficial to already understand the physiology of the kidneys, the anatomy of the heart, the laws governing genetics, and the basics of microbiology upon entering PA school, but there is also another reason for requiring these prerequisites before even beginning the application process. They  have  to make it hard. Why?  People’s lives will be in our hands!  If it was easy, anyone could do it. Instead, they weed out the uncommitted out gradually—general biology at 8 am, difficult upper-level courses, the GRE/MCAT, the application process, and finally the interview process—all before even opening a book in PA school! But of course there are benefits to this difficult journey. I am constantly being pushed to achieve greater knowledge and grow as a person. I honestly do love learning about this stuff. This is the life that I chose! And I wouldn’t change it in a minute. Would I prefer to not have to memorize the twenty amino acids today? Yes. In the big picture, is it beneficial to me that I am going the extra mile and taking a difficult biology course that requires so much extra studying? Yes. Will it help me to become a better health care provider and provide better patient care in the future? In a roundabout way, yes! Mission accomplished!

The Great MMR-Autism Fraud

In the news this morning was  breaking news  that the link between autism and the MMR vaccine was found to not only be nonexistent but also fraudulent. The research behind this supposed link was fabricated to create fear that the vaccine was causing autism in young children that received it. The real tragedy in this situation is that so many children are now at risk for getting measles, mumps, rubella, and other diseases because parents feared that vaccines would put their child at risk for autism. This also puts countless other children at risk who haven’t been fully vaccinated due to age or immune status, as well as creating many more reservoirs for the viruses and bacteria that cause these diseases that could create a potential outbreak. It is interesting that this story should come out so timely, since vaccines have been on my mind for the past few months, and the past week in particular. I just purchased (and read in a matter of days) the new book  Deadly Choices: How the Anti-Vaccine Movement Threatens Us All , by Paul Offit, M.D. ( see here at Amazon ). The book details the emergence of the anti-vaccine movement, including court cases, scientific studies, and individuals’ experiences. I thought it was very informative, and proves how incorrect the “evidence” against vaccines really is. I had expected the book to be more on the scientific side, but it actually appeals to a wider audience since it is written in language easy to understand by someone with a basic knowledge of science. I thought the book was very logically organized and pointed out the facts well. In reality, this is an issue that I am very passionate about. I truly believe that vaccines prevent serious diseases that have devastated previous generations in our country and throughout the world. I have recently read a lot of research on vaccines and the arguments against them—not because I questioned vaccines, but rather because I wanted to know what to say to people who would argue against having their children vaccinated. The truth is, vaccines make biological sense. It is a complex problem—infectious diseases—that has come down to a simple solution—vaccines. No one will disagree that vaccines are not 100% effective. However, this is due to the very nature of vaccines and their interaction with the body’s immune system. However, by having a large percentage of the population vaccinated against preventable diseases, we protect those most vulnerable—infants not yet vaccinated, children not fully vaccinated, and the immune compromised. As health care providers, it is our job to help provide reliable information about vaccines to patients and parents to help prevent the spread of infectious diseases in our country and the world.

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