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Archive for March, 2008

News to Watch: Bacteria and Kidney Stones

Mar14

Bad news for clean freaks: No matter how many floors swept, bathtubs scrubbed, countertops sprayed and windows washed, you will always miss a spot. No matter how sparkly the outside, there are trillions upon trillions of bacteria living comfortably inside your gut. It may sound like a germaphobe’s nightmare, but scientists say these intestinal tenants pay their rent by protecting us from disease.

Kidney stones, the sometimes-painful, crystal-like accumulations of waste in the kidney, were linked with great confidence last week to at least one gut bacterium. Researchers from Boston University’s Slone Epidemiology Center found that being colonized by Oxalobacter formigenes can reduce the risk of kidney stones by 70%. The link was first considered in 1986, when scientists learned the bacteria removes oxalate from the intestines. Oxalate is a key component of the most common type of kidney stone, so without it, the stones cannot form.

According to Dr. David Kaufman, lead author of the study published in this month’s Journal of the American Society of Nephrology, his group’s research is the most carefully conducted and largest-scale examination to date of the O. formigenes-kidney stone relationship. They analyzed the stool of participants with and without kidney stones for signs of the bacteria. The data revealed 17% of the 247 participants with kidney stones were colonized with O. formigenes compared to 38% of the 259 participants without stones.

If not having the bacteria increases your risk for kidney stones, then to prevent them, maybe you could just take a dose of O. formigenes? Enter the emerging field of probiotics, medicine that gives life to bacteria rather than taking it away. Scientists have already begun to experiment with bacteria-coated capsules, although the trials are still too small to be sure of their success. Years may pass before a probiotic kidney stone solution exists due to the pace of long-term clinical trials as well as unanswered questions as to how and when the bacteria colonize the gut, and whether its population remains constant or changes over time.

“That a bacterium can be potentially relevant for protection against a medical problem – that is not trivial,” says Dr. Kaufman. “Many other relationships need to be looked at between bacteria and disease, good and bad. The results will give further impetus to do these studies.”

Just something to think about next time you reach for the Purell.

The study: Kaufman, D.W., Kelly, J.P., Curhan, G.C., Anderson, T.E., Dretler, S.P., Preminger, G.M., and D.R. Vave. (2008). Oxalobacter formigenes may reduce the risk of calcium oxalate kidney stones. J. Am. Soc. Nephrol. (doi: 10.1681/ASN.200710101058)

Photo of kidney stone on X-ray from iStockPhoto.

Posted by Joseph, under health, news | Date: March 14, 2008
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Lecture Notes: Scalpel and the Soul

Mar13

Where do you shelve a book written by a surgeon? This morning, I wouldn’t have thought this to be a trick question. When Dr. Atul Gawande, a surgeon at the Brigham and Women’s Hospital in Boston and best-selling author writes a book, copies fly off the science and medicine stacks. Then I listened to Dr. Allan J. Hamilton, a professor of surgery at the University of Arizona Health Science Center, and learned the real answer — it depends on the surgeon.

Dr. Hamilton came to the Harvard Coop in Cambridge this evening to sign copies of his first book, “The Scalpel and the Soul: Encounters with Surgery, the Supernatural, and the Healing Power of Hope.” As the title reveals, the book fuses medicine and faith. Here is a surgeon who writes about “the soul,” “the creator,” and “miracles,” alongside his experiences removing brain tumors and immunizing children in developing nations. So, where in the bookstore can we find Dr. Hamilton?

According to Amazon.com, “The Scalpel,” is in the top 25 bestsellers in the Spiritual Healing category. At The Coop, it can be found within the New Age section. Even the location of the book signing, held on the third floor between rows Bibles and Marxist texts, seemed to remove Dr. Hamilton’s medical authority. Leading medical writer, Dr. Gawande, also writes about ethical and philosophical issues – especially the imperfections and humanity of medicine – but doesn’t come to conclusions based on faith. What separates Dr. Gawande from Dr. Hamilton, then, doesn’t seem to be medical experience, but interpretation.

Dr. Hamilton told a story from his days as an intern at Massachusetts General Hospital about a boy who suffered severe burns and fell into a coma. As he continued to reject several skin-graft surgeries, the boy’s father, perhaps from the stress of the whole thing, had a heart attack and died. The boy’s mother asked if the father’s skin could be grafted, in the chance there might be a genetic match. The doctors tried and after the surgery, Dr. Hamilton was called into the boy’s room. “What happened to my father?” the boy asked. Dr. Hamilton, not wanting to upset him after his sudden recovery, told the boy his father was fine. “If that’s so, why is he standing at the edge of my bed?” the boy responded. “What a miraculous thing to happen,” concluded Dr. Hamilton. Would Dr. Gawande have called this a miracle or peppered his words with a bit of skepticism?

At the end of his talk, Dr. Hamilton discussed some ways spirituality can help in recovery, although, what he called spirituality could be interpreted as a self-generated placebo. One of his rules is to not let statistics, which doctors rely on to gauge the course of a disease, predict the outcome. Although controversial, his advice is a tool for potential patients, and that’s who Dr. Hamilton’s audience is. He did not write a collection of essays recounting the peculiar world of the OR, he wrote a book of stories to help patients and medical professionals incorporate their spiritual selves into the often-cold environment of the hospital.

While this book may just be a work of pseudoscience written by a surgeon, it does no harm. Since many patients identify as religious or spiritual, the positive thinking one can take away from “The Scalpel” may be just as good a medicine as anything Dr. Gawande orders.

Posted by Joseph, under lecture notes | Date: March 13, 2008
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New Beginnings

Mar10

Science Metropolis is being reborn. By the end of the week expect new content, a better blog, and more ways to learn what’s going on in the world of Boston science. Email Joseph if you’re interested in being a writer or want to get involved.

Posted by Joseph, under uncategorized | Date: March 10, 2008
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Writing for the Web

Mar05

Dear Readers,

Thank you so much for joining me in my exploration of blogging these past two months. It’s been a learning experience and I thought I’d take advantage of my recent “technical difficulties,” to share with you some of my observations from running a Website. Perhaps this will help some of you who are thinking about embarking on this journey yourselves.

- Recently, I’ve recommended that my friends, most of whom are writers, develop an online presence. It’s essential nowadays to show up on that first page of Google, especially after an evening of networking. Having a Website is the best way to do that. Develop a brand and plaster your name all over it. Learn how to add your pages to Google and Yahoo. Use Facebook, YouTube, e-mail signatures and your friends to get the word out. You many not have 100 hits a days, but at least when someone is looking for the quality of your work, it’s an instant portfolio.

- A professor of mine once said, the difference between print and video, is that video is timeless. I would argue that is no longer the case. Treat each post like it is an entity of its own. With the way Google and tagging works, you never know which of your essays, articles, podcasts or videos will be searched for weeks, months or years later. A review I did criticizing PBS for airing “The Brain Fitness Program” is my most popular page, and has received more visitors than any other post.

- A Web story is not a print or broadcast story. If there is some way to make it visual, try to find that perfect photograph or illustration. Plus it just looks nicer and gives the post a more professional feel. Don’t just steal an image from the Web either, put that digital camera to work. Size also matters. Your 900-word essay on ethanol may not be as readable on the Web as it would in print. Unless it’s a thoroughly researched story, I aim for 500-600 words per post with short paragraphs. Any supporting evidence is where hyperlinks come in handy.

- Make it useful. This is Rule #1. Give readers a reason to come back. If you plan on using your Web space to talk about how much fun you had over the weekend, stop now. Many online writers are finding specific niches to report on and are able to grow and retain a loyal following that way. This allows you to generate authority, (very important on a blogosphere site like technorati), and find richer subjects to write about.

- Don’t be a techno-addict! It’s very easy to become consumed by your blog. If everything in life turns into a potential post, call a friend and ask for help.

- Look ahead. My dream for Science Metropolis is for a digital and physical Boston science community, one in which visitors go together to local events, and talk to each other on and off line about something they are passionate about. Blogging is very isolating, but it doesn’t have to be. Use it to make new friends. Invite people you know to contribute. That’s the true power of the Internet.

If you have any questions or want someone to bounce ideas off of, there’s a human behind these words and I’m willing to help.

Thank you again for your continued support.

Joseph Caputo

Posted by Joseph, under science writing | Date: March 5, 2008
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Technorati Round-up: Boston and Science

Mar03

Curious to know what else is going on in the world of Boston science? You don’t have to wait for Stephen Smith at the Boston Globe for a relevant science article anymore, just hit the technorati search engines and cross your fingers. Here’s what I found:

- ParallelNormal – Mark Baard, a technology columnist for the Globe, links readers to his recent piece, MD to Fight Stress in Second Life, about a Massachusetts General Hospital doctor who will lead relaxation lessons on the virtual community Second Life. He even uses “the lingo” in his piece like in-world, referring to activities that occur in Second Life. I guess this is opposed to the out-world, where bills, family and responsibilities exist.

- Betterhumans - Although the purpose of this Website is unclear, they posted a YouTube video by NewScientist (done by BU alum Ivan Semeniuk) on the Obama-Clinton science debate from the American Association for the Advancement of Science meeting a few weeks ago.

- Boston Phoenix Phlog – While this entry, a 1998 report on animal experimentation at Boston University, isn’t a blog post, it’s still interesting 10 years later. The controversy was whether using and killing rabbits for educational dissections is ethical. Hopefully, the Phoenix will do a follow-up.

- Walking the Berkshires – This is a thoughtful compilation of sources about the recent outbreak of white-nose syndrome, which has been causing massive die-0ff of some bat species in the Northeast. Greenman Tim emphasizes that scientists do not yet know what’s causing the epidemic, could it be a fungus, climate change or something new?

- TheEnvironmentSite - Another report from the AAAS meeting about Dr. Karen Kidd, an ecotoxicologist at the University of New Brunswick, who “poisoned” a lake in Canada with oestrogen, a common hormone found in sewage, to see its effects. While smaller organisms like bacteria weren’t affected, some of the fish species saw drastic changes to their ability to reproduce.

- Nature Network Boston – Corie Lok, (another BU science journalism alum), is the editor of this Website as well as a Boston science blogger. In this post she asks readers for their favorite science videos. Her title is particularly good – Would you Kiss Your PCR machine?

So that’s it for now. If you have any keyword suggestions for the next Technorati round-up, do let me know.

Posted by Joseph, under science writing | Date: March 3, 2008
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Lecture Notes: Trans-Friendly Healthcare

Mar01

Doctors declaring themselves “trans-friendly” may be guilty of false advertising, said panelists discussing “Trans Issues in Healthcare” today. No, not a fondness for trans fats, a subject close to the hearts of many science news connoisseurs, but sensitivity to people, who are transitioning, or have transitioned from one gender to another.

Of the healthcare issues unique to transpeople, as laid out by panelist Gunner Scott, director of the Massachusetts Transgender Political Coalition, knowing what to expect from a “trans-friendly” doctor is the easiest to fix. Other problems – like counselors who hold clients in therapy, charging them for months before writing the letter legally required for sex reassignment surgery, as well as insurance companies not covering these kinds of operations – would require fierce policy battles. (The ongoing fight for equal rights was a sub-theme of this weekend’s conference on “TransLaw,” sponsored by Harvard Law School, where the healthcare panel took place.)

Some of the mistakes doctors make when treating transgender patients involve basic communication. Diego M. Sanchez, AIDS Action Committee PR Director and recently elected superdelegate, explained that if in the initial phone call to a new clinic, the receptionist uses gender-specific phrases like sir or madam to address a transgender caller, this is automatically disengaging. Other trans-insensitive policies include identifying patients by name rather than a number in the waiting room and using anatomical terms during a medical examination when, “I’m going to use this speculum below your waist,” works just fine. Another experience, which arises especially with mental-health providers, is for the patient to be told their situation is just homosexuality, a phase or a fetish, said Thomas, a conference attendee who asked that his last name not be used.

Some of this insensitivity may stem from doctors’ inexperience with transgender patients, but this soon may change. While the numbers of transpeople in the United States has never been counted, it wouldn’t be farfetched to assume that with the increase in civil rights laws, the population is growing. Monica Roberts, the blogger behind TransGriot, estimates the ratio of males who undergo sex reassignment surgery to become female is 1 in 2500.

Those who already advertise as “trans-friendly” are usually doctors who identify as gay, lesbian, or bisexual. Being gay, however, doesn’t mean you are automatically sympathetic and knowledgeable of issues specific to transpeople. “There are providers in our community who claim they are ‘trans-friendly,’ when the stories that result are horrendous,” said Sanchez. While there may be some overlap among the experiences, one of the only ways to educate all providers, gay or straight, is through training.

At the moment, no funded training or certificate programs exist to familiarize doctors and therapists with trans issues. According to Sanchez, an organization called TransHealth used to exist through the Justice Resource Institute, but was defunded.

What should a patient expect from a “trans-friendly” provider? According to Thomas: A provider who listens, has a clinical space welcoming to difference, is able to ask the right questions to experts, not hold things off and believes what you say is true. “Transpeople should expect what any client should expect, no more or no less,” he said. “Trans-friendly doesn’t have to mean trans-perfect. It means that if there is a breach of sensitivity, I can speak up.”

For those looking for care in the Boston area, Fenway Community Health is a good place to visit, although according to Sanchez, there is “opportunity for improvement.” For people under 29, there is the Sydney Borum Jr. Health Center. Other more mainstream providers include Boston Medical Center, Massachusetts General Hospital and, depending on the relationship, your general-care provider.

Resources for doctors and patients on this topic:

- The World Professional Association for Transgender Health

– Gay and Lesbian Medical Association

Posted by Joseph, under LGBT, lecture notes | Date: March 1, 2008
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