- Del Meyer, MD - https://delmeyer.net -

Medical Science

A 20-year-old college student is the first known person to survive a rare operation in which surgeons completely removed his heart, cut out a malignant tumor, then re-implanted the repaired organ in his body… It’s always been easier to do repairs at a work bench.

Dentistry may be one of the oldest professions as reported in Scientific American. Eric Crubezy of Toulouse University in France and his colleagues recently found a wrought-iron dental implant in a Gallo-Roman necropolis dating to the first or second century AD. Because the implant and socket match perfectly and the iron and bone meshed, they concluded the implant maker used the original tooth as a model and hammered in the replacement… And that was before anesthesia.

Cystic fibrosis trait prevents typhoid fever: Although sickle cell anemia is a killer disease, it has been well known that the single faulty gene produces enough hemoglobin to carry adequate oxygen, but the presence of the faulty hemoglobin somehow inhibits the growth of the parasites that cause malaria, one of West Africa’s top killers. This protection outweighs the fatalities imposed by the anemia, so the faulty gene is preserved in the population. Last month, Nature, reported that Harvard Researcher Gerald Peir similarly found that a single dose of cystic-fibrosis gene protects against Salmonella typhi. It may not be of much comfort for the parents of a CF child to know that their carrier status confers protection against typhoid fever, but it is another neat example, according to The Economist, of how modern life has rendered a genetic adaption from the past irrelevant.

Jerome Groopman, MD, (The Measure of Our Days–New Beginnings to Life’s End) an immuno-oncologist at Harvard, discusses in the New Yorker why the Surgeon General wants to send letters to hundreds of thousands of people informing them that they might be dying of Hepatitis-C even though they are currently feeling healthy. Hepatitis-C has been silently spreading so that it now affects four times more people than HIV in the United States or four million Americans, (175 million worldwide). Three million Americans do not know that they are infected with the virus or that they may be passing it on. Dr Groopman refers to a patient who had, while in college, shared straws to snort cocaine and also engaged in coitus with several men she didn’t know very well. She was found to have Hepatitis-C in evaluating a minimal ALT elevations on a routine chemistry panel. Dr Groopman feels that either of these which occurred over a decade earlier could be the source of her infection. In 1997, the NIH budget for HIV research totalled a billion and a half dollars or about $1600 per infected person in the country. In contrast, the NIH spent twenty-five million on hepatitis-C research the same year or about $6 per infected person.

States vs.. Washington in the fight over organs: UNOS, the United Network for Organ Sharing, is the organization contracted by the federal department of Health and Human Services (HHS) to run the transplant network. UNOS thinks a policy of local organs for local people is the fairest way to allocate them. HHS thinks otherwise, and has given UNOS just four months to come up with a new method to share the 4,000 livers available for the 10,000 Americans who need liver transplants on a national priority basis. UNOS thinks this is impractical. Computer modeling has shown such a scheme would lead to longer waits, with fewer people receiving more transplants since, with the sickest patients, the first operation often fails, thus wasting organs and requiring a second one. This may also decrease the supply since donations are related to local campaigns and neighborly goodwill and this could dry up. While organ donations have increased by one-third over a decade, patients awaiting transplants have trebled. Rationing is never easy.

Fatal Distraction: Over the last 20 years, according to Psychology Today, the rate of suicide among people over 45 has been falling, thanks in part to doctors’ aggressive treatment of depression in adults. But that gain has been almost entirely offset by a rising number of suicides among the young which have tripled in the last 45 years. Of the 30,000 Americans who kill themselves annually, more than 5,000 are between the ages of 15 and 24. Psychiatrist John Mann, MD of Columbia University says, “What we’re seeing is a shift in the demographics of suicide.” Commenting on the effectiveness of antidepressants, Mann says, “We’re doing better at identifying treatments that work. We’re not doing so well at actually delivering them to those who need them.”