Meridian Surgical

Caffeine (C8H10N4O2) is the natural pesticide of coffee beans, paralyzing and killing insects that try to feed on them

rick — Fri, 03 Sep 2010 20:52:28 +0000

Caffeine is a drug of abuse, like alcohol or cocaine, because it meets these two criteria: “reinforcing efforts” and “adverse effects which can cause harm to self or society.” Reinforcing effects is science talk for “addictive”: The more you have, the higher your tolerance levels and the more you need. Take it away, and you experience withdrawal symptoms.

C8H10N4O2 is a chemical compound found in beans, leaves and fruits of some plants. It’s a natural pesticide for them, paralyzing and killing insects that try to feed on them. On humans it acts as a stimulant on the central nervous system and has psychotropic effects. It increases heart rate, blood pressure and respiration, and it is mildly diuretic.

Caffeine is structurally similar to adenosine. Image source: Wikipedia, public domain.

Recovering alcoholics or drug addicts will tell you caffeine is a “gateway drug”–it increases the chances of their falling back into addiction.

Overuse can develop into “caffeinism,” which may cause muscle twitching, insomnia, headaches and heart palpitations. Even with a mild overdose, about 300 mg or so (3 cups of coffee, 7 cups of chai), you can get “caffeine jitters”. You can actually die from an overdose of coffee.

Comments from Google Buzz:

Vamsi Balakrishnan – Voltaire used to drink ~40 cups of coffee a day…:)

Ves Dimov, M.D. – He had developed tolerance. The same phenomenon is commonly observed in drug addicts.

Vamsi Balakrishnan – Still, I think it’s amazing. I wonder what his withdrawal would have been like. Bennie Franklin also had some sort of deal with caffeine.

I think alcohol tolerance would have been better than drug tolerance for analogy…but I’m not really sure. (is the following correct as an analogy?)

Alcohol tolerance = induction of enzymes –> can literally drink more than once could, though still doing damage along the way. –> I’d think caffeine would be like this…

Drug tolerance = like heroin –> more needed for same effects, but once some critical threshold is reached, person will die of OD. (too hungry at the moment to think clearly)

References:

Cheat Sheet: The Dark Side of Caffeine. Forbes.com.

Caffeine Poster Chart http://bit.ly/4yFjbC and Caffeine content for coffee, tea, soda http://bit.ly/4OVo8

The 5 Phases of Caffeine Intake http://bit.ly/3tslld

“Death by Caffeine Test: How much of your favorite energy drink, soda, or caffeinated food would it take to kill you?” http://bit.ly/WtL3f

Michael Douglas on Having Throat Cancer – Late Show with David Letterman (video)

rick — Thu, 02 Sep 2010 20:38:03 +0000

Oropharyngeal cancer is increasing at a “dramatic” rate, particularly in the male population http://goo.gl/JAko

For people with congestive heart failure, a hot dog can trigger a trip to the hospital due to excessive salt

rick — Tue, 31 Aug 2010 20:27:46 +0000

The average daily salt intake in America is one and 1/2 teaspoon a day. This is 3,400 milligrams of sodium a day, or 1,100 milligrams more then the recommended maximum.

For people with congestive heart failure, a salty hot dog can trigger a trip to the hospital.

The experts say the new target for sodium intake should be set at 1,500 milligrams daily.

In a previous study, reducing dietary salt by 3 gm per day (1200 mg of sodium per day) was projected to reduce the annual number of new cases of coronary heart disease by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 and to reduce the annual number of deaths from any cause by 44,000 to 92,000. Such an intervention would be more cost-effective than using medications to lower blood pressure in all persons with hypertension.

77% of the salt in the American diet comes from processed food. Only 6% is shaken out at the table, and only 5% is sprinkled during cooking.

Once people cut back on salt — whether or not they know they are doing it — they begin to prefer less salt in their food. This happens in a matter of weeks.

For example, alarmed by high death rates from strokes, Portugal plans to decrease salt in bread, blamed for high blood pressure. Portugal has one of the highest mortality rates from strokes in Europe – double that in Spain and 3 times that in France. http://is.gd/ndNv

The daily salt intake in Portugal is a staggering 12.3 grams (ranging from 5.2 to 24.8 gm) http://is.gd/ndQq

References:
Americans Need Help Shaking The Salt Habit – Shots – NPR Health News Blog.

“Cutting Salt as Good as Quitting Smoking”

3-gram reduction in daily salt intake would decrease coronary heart disease, stroke, and death

Image source: Wikipedia, GNU Free Documentation License.

Doctors blends cardiology and country music

rick — Mon, 30 Aug 2010 20:26:00 +0000

Listen to the Doctor: Cleve Francis, cardiologist and country singer.

Dr. Francis, who recently turned 65, is a genteel singer of country and pop songs. He favors vintage ballads.

A man inching up the line in a walker can’t believe it. “You want his autograph? I get it on a prescription every three weeks,” he says.

References:

Listen to the Doctor: Cleve Francis, cardiologist and country singer. Washington Post.
Dr. Wes: Working the Backup Plan

When was the earliest journal club?

rick — Fri, 27 Aug 2010 20:17:51 +0000

The earliest references to journal clubs are in the memoirs and letters of Sir James Paget, a British surgeon, who described a group at St. Bartholomew’s Hospital in London in the mid-1800s as “a kind of club … a small room over a baker’s shop near the Hospital-gate where we could sit and read the journals.”

Sir William Osler established the first formal medical journal club at McGill University in Montreal in 1875. The original purpose of Osler’s journal club was “for the purchase and distribution of periodicals to which he could ill afford to subscribe” (see the excerpts from Google Books below).

References:
Journal clubs as a trigger for ’socializing’. The Search Principle blog.

Comments from Google Buzz:

Laika Spoetnik – Besides the point, but I have good memories of St Bartolomews. Here I learned direct sequencing and did part of my experiments. Very old building btw.

Aidan Finley – the father of Stephen Paget of “seed and soil” hypothesis.

Gene test decreases warfarin-related hospitalizations by 28%

rick — Thu, 26 Aug 2010 19:34:02 +0000

Patients who received a test of two genes connected to warfarin sensitivity were 28 percent less likely to be hospitalized for a bleeding episode or blood clot than those whose safe and effective warfarin dosing was determined by traditional trial and error method.

The genetic tests, which are easily done with a cheek swab or blood sample, need only be performed once ever for each patient and cost somewhere between $200 and $400 – far less than even a brief hospital stay.

Warfarin Sensitivity Genotype Test – Mayo Clinic Video.

References:
Gene test can cut warfarin hospitalizations | Reuters.

Women in US academic medicine earn $13,000 less than male peers

rick — Wed, 25 Aug 2010 19:23:02 +0000

A survey of 3,000 faculty members at the top 50 US medical schools has shown that women members earned $13,000 less than their male counterparts with the equivalent career position and professional activity.

There were no obvious reasons for the difference.

According to the study authors, “despite increased national attention to gender inequalities in salary, women in the life sciences at all academic ranks, both PhDs and MDs, continued in 2007 to receive lower annual salaries than did their male counterparts.”

References:

Women in US academic medicine earn less than male peers. BMJ, 2010.

Image source: OpenClipArt.org, public domain.

Lancet: Nephrology is not for normal doctors – it is for exceptionally skilled specialist physicians

rick — Tue, 24 Aug 2010 18:43:04 +0000

From The Lancet:

Many doctors may view nephrology as a remarkable kind of intensive care. A patient presents in an acute crisis, close to death. Immediate transfer to the renal team follows, then the magical effects of dialysis, and finally recovery. Nephrology is not for normal doctors. The kidney is for exceptionally skilled specialist physicians.

Unlike fish, mammals do not seem to have renal regenerative capacity.

The silence of the kidney leads medicine to overlook its importance. This lack of awareness means that immense opportunities to prevent not only renal, but also cardiovascular, diseases are being lost.

References:
Protect the kidney, protect the heart. The Lancet.

Image source: Wikipedia, public domain.

Ed Goljan, M.D., professor of pathology and top notch arm wrestler

rick — Mon, 23 Aug 2010 18:38:12 +0000

Goljan, professor and chairman of pathology, says that as the smallest kid in his class “I got picked on and so I started exercising.” It worked. By age 11, he was able to pin his dad in arm wrestling. Now 61, he’s still a contender.

Goljan likes to say that his arm wrestling is “just a ‘Y’ chromosome thing.” It’s a sport where size doesn’t mean much, he says. “When I weighed 175 pounds, I defeated a 275-pound super heavy weight.” In high school, college and medical school he arm wrestled (with either arm, it didn’t matter) and won.

References:

CenterNet | Rounds. Oklahoma State University Center for Health Sciences.

Clinical Pearls in Men’s Health – Mayo Clinic Proceedings Video

rick — Fri, 20 Aug 2010 17:47:19 +0000

Dr. Thomas Beckman discusses his July 2010 Mayo Clinic Proceedings concise review on 3 cases involving men’s health.