Medical Tourism

"Medical Tourism" is defined as the practice of journeying outside one's native land for medical treatment.

On Friday 27th, March CNNhealth.com posted an article entitled Lower Costs Lure US patients abroad for treatment. US and Canadian patients are opting to go abroad for medical treatment (the exorbitantly expensive ones like heart surgery or even plastic surgery) simply because it is cheaper. In fact, such procedures can be up to 10% of the cost that one would pay in the US.
Another reason that some go abroad for procedures is the lengthy wait before they can get a date for surgery.

Dispelling the fear of shoddy procedures or lax sanitation, some private hospitals in India market themselves as having upscale accommodations, Western-trained surgeons and state-of-the-art medical equipment.

The article goes on the report that next year alone, an estimated 6 million Americans will travel abroad for surgery, according to a 2008 Deloitte study. "Medical care in countries such as India, Thailand and Singapore can cost as little as 10 percent of the cost of comparable care in the United States," the report found.

Some of the hottest destination for medial tourism include:

1. Brazil
2. Singapore
3. Central America
4. South Africa
5. South Korea
6. Malaysia
7. Hungary
8. India

Soon, more and more people may opt for surgery and site seeing in one reasonably priced trip.

Chill Out

As the temperatures begin to climb it is important to maintain healthy food storage habits.

The USDA Food Safety and Inspection Service website provides useful information and tips for reducing bacterial growth and thus spoilage of food. Freezing and refrigerating food is a method of food preservation based on reducing the rate of bacterial growth in the food. At lower temperatures, bacteria tend to grow at a slower rate. This is because growth is regulated by enzymes, and the work of enzymes is temperature (and pH) dependent.

In BioMI 2911 at Cornell University, we investigated the growth rate of E. coli at different temperatures. It was found that the growth rate (per minute) was 0.0005 at 22C, 0.011 at 30C, 0.048 at 37C, 0.012 at 45C and ~0 at 55C. The most rapid growth occurred near body temperature, and the slowest growth occured at temperatures below (22C) and far above (55C) room/body temperature. This is consistent with some of our practices of food preservation: freezing and cooking.

So, in the warm weather ahead don't forget to refrigerate leftovers!

Diabetes

The American Diabetes Association (ADA) defines Diabetes as a disease in which the body does not properly produce or use insulin. (Insulin is a hormone made in the pancreas that allows cells to use glucose for energy.) 23.6 million people in the United States, or 8% of the population, have diabetes.

The most common diabetes is Type 2 Diabetes according to Pollock of EzineArticles.com. Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). The major complications of diabetes mellitus are both acute and chronic.

In BioAP 311, Prof. Baustian of Cornell University claimed that in the past people could diagnose diabetes by tasting the sweetness in the urine. This is because diabetics are unable to absorb all the glucose into their cells so some of it passes out of their system via the urine.

Diabetes may seem like a disease that just means that one has to regulate weight by cutting down on sugar consumption and resisting the temptation of dessets and carbohydrates. At least, that's what I thought when I was younger. Now I realize that diabetes left uncontrolled is a serious disease that can dramatically affect one's way of life. This disease can lead to blindness and loss of limbs because of poor circulation and thus slower healing.
Diabetes can complicate any complaint, thus making simple things like a wound life threatening. In fact, the ADA reported that diabetes contributed to 224,092 deaths in 2002.

Alzeihmer's Disease and Prions

Scientific American cited a study in the journal Nature which found that prions can team up with amyloid beta, the protein that forms the big plaques in Alzheimer's, to make the condition much worse. Another article in Science news claims "Prions Complicit in Alzheimer's Disease" and calls the findings "sensational" although the research is still in its early stages.

What are prions?

Proteinaceous infectious particles- or PRIONS- are infectious self-reproducing protein structures2. Prions cause a number of degenerative brain diseases: scrapie (a fatal disease in sheep and goats), mad cow disease, Creutzfeldt-Jacob disease, fatal familial insomnia and others1. MedicineNet.com defines a prion as a disease-causing agent that is neither bacterial nor fungal nor viral and contains no genetic material1. A prion is a protein that is harmless in its normally occurring form, but when it folds into an aberrant shape it turns into a rouge agent. It then causes other normal prions to become rouge prions.

How do they replicate?

Prions replicate within the cell by converting other normal cell proteins into other prions3. This method of replication is unique to prions since other agents-like viruses- that cause disease contain genetic material which is necessary for the to spread themselves through the victim5. Since prions do not have genetic material this method is irrelevant. Instead, the prion corrupts a perfectly normal protein, PrP, which usually sits on the external surface of brain cells5.
In general, healthy prion protein that does not cause disease is made of alpha helices. The infectious prion protein is mainly made of beta-pleated sheets4. The infectious prion has a changed structural form dominated by conversion of protein helix structure into flat sheets, even though the amino acid sequence is identical in both strains6. The mechanism for the conversion of the α-helices by infectious ß-pleated sheet prion is not exactly known. Experiments have shown that normal protein interacts with the beta sheet prion form and then changes its structure4.


References:

1. Definition of Prion. 1/22/2004. MedicineNet.com 02/01/2009. http://www.medterms.com/script/main/art.asp?articlekey=5047
2. Prion. Bio-Medicine. http://www.bio-medicine.org/biology-definition/Prion/
3. Pall Medical. http://www.pall.com/pdf/prions-QandA.pdf
4. SFN. How does a prion reproduce? http://www.scienceforums.net/forum/showthread.php?t=18577
5. The prion: simply mad. BBC News. 5/19/1998. http://news.bbc.co.uk/1/hi/health/background_briefings/bse/82972.stm
6. Another hazard: prions and mad cow disease. http://peer.tamu.edu/curriculum_modules/cell_Biology/module_5/hazards3.htm

Women's Health

The Mayo Clinic released this article outlining the 10 top threats to women's health and suggesting preventative methods. According to the web site the top 10 threats are:

1. Heart Disease
2. Cancer
3. Stroke
4. COPD
5. Alzheimer's Disease
6. Injuries
7. Type II diabetes
8. Flu
9. Kidney Disease
10. Blood poisoning (sepsis)

Essentially, it was suggested that avoiding behaviors such as smoking. Maintain a healthy diet and weight, in addition to regulation of consumption of alcoholic beverages. Many of the tips seemed like common sense, such as "do not drive while sleepy."

It seems that the key to leading a healthy life is not a secret.

To go under the knife or not?

This article from the New York Times about the effect of the economy on people's decision to have surgery or hold out puts the financial state of the nation in perspective.
Some choose to have their surgery sooner rather than later for fear of losing their insurance coverage with their job. Others sacrifice having surgery that could relieve pain or prevent further complications because of a tight budget. This leaves hospitals in a quandry, doesn't it?
Are doctors and surgeons really in control of their patients well-being? It seems in this system that the patient has the power to make decisions that can be detrimental to their well-being. When there is such economic strain, it seems that the patient is in the driver's seat.

All that is gold does not glitter...

This post is not about gold, rather it is about glittering and sparkling. (More about gold later)

What glitters and sparkles and catches the eye of many girls and women? DIAMONDS of course!

Ever wonder why diamonds sparkle?

In order to understand this, one must first understand that light bends when it goes from one medium to another providing these media have a different refractive index (n). When light goes from a medium of low refractive index to one of high refractive index, it bends into the normal so that θ, the angle between light and the normal, decreases. The opposite happens when light moves from a medium with high refractive index to one of low refractive index: θ increases.
This relationship is described by Snell's Law. n1sinθ1= n2sinθ2

To understand why diamonds sparkle, we must realize that this occurs when Snell's Law does NOT apply. (This is how fiber optics cables work too)

Say the refractive index of a materials is 2 (and for diamonds it it 2.42):
And n= 1 for air
(2) sinθ1= (1)sinθ2 [Assume that the light is entering the surface at 90 degrees]
sin θ1 = 1/2 sin (90)
sin θ1 = 1/2
=> θ1= 30 degrees

What happens to the light when it strikes the surface at an angle greater than 30 degrees?
It goes back into the substance! This is known as total internal reflection. (This phenomena also occurs when we see a rainbow)

Back to diamonds: the refractive index of diamonds is 2.42, so this means that light that strikes the surface at an angle more than perhaps 25 degrees gets reflected back into the material. As a result, when Snell's law doesn't apply light gets trapped inside the medium. While in the material, the light disperses. This means that white light splits up into the colors of the spectrum: Red, Orange, Green, Yellow, Blue, Indigo and Violet. Each color has a slightly different wavelength. n is inversely proportional to wavelength and as a result the light separates or there is dispersion of light.

If the light stays trapped in the medium long enough, there is a time when there is enough dispersion that the human eye can detect it. Now you know why diamonds sparkle:

1. Light is trapped in the material as there is total internal reflection because of the high refractive index of the diamond
2. Light then disperses in the diamond, and this is what we observe.
   

Acetone Breath

In reading my Organic Chemistry text by Paula Bruice I discovered the condition called ketosis. This is a pathological condition that can occur in people with diabetes.

Acetone breath describes a characteristic “fruity” or acetone breath odor that occurs with a life-threatening condition of diabetic ketoacidosis.

Ketosis can be recognized by the smell of acetone (or ethanone according to IUPAC standards for naming organic compounds) on a person's breath. How does acetone come to be in the body?

In this disease, the body produces more acetoacetate than can be metabolized. This occurs when the body uses fat instead of glucose (sugar) for energy. This can be indicative of the inability of the body to use insulin effectively to burn glucose for energy.
The excess acetoacetate breaks down to acetone (a ketone) and carbon dioxide. Acetone normally passes into the urine, however, only a certian amount can be excreted in this way. Since acetone is highly volatile (think of smelling nail polish remover in a large room) it can be excreted in the breath in person's with a high concentration/excess of acetone in the body.

Got Staph?

Staphylococcus is a genus of 33 species of bacteria. Often, one associates Staph with the species Staphylococcus aureus, which causes disease in humans. While this particular strain causes hassle and can be life threatening as its effects range from mere pimples to pneumonia, other Staphylococci reside normally on our skin and on mucous membranes of other organisms.

Yesterday, the area around the nose was swabbed and placed in a 7% NaCl broth and sealed with mineral oil to prevent the entry of oxygen. This treatment should enrich for Staphylococcus since most of these are salt tolerant bacteria. You may be wondering why the enrichment is under anaerobic conditions when Staphylococcus live on our skin, where there is definitely oxygen. Well, Staphylococcus are facultative anaerobes. This means that they respire both aerobically (in the presence of O2) and anaerobically (without O2). In order to enrich for Staphylococcus it was necessary to remove oxygen from the system to prevent growth of Micrococcus which is a strict aerobe.

Next week we will see what grows. After a isolating the bacteria and then performing tests on the pure culture it will be possible to identify the strain of bacteria isolated. This will be done using a simple dichotomous tree which includes only the most commonly found species. More on this later!

Pickles are evil cucumbers...

My little sister thinks that pickles are terrible. However, many other people, including me, love pickles. I feel that burgers without pickles lack some flavor.

In my microbiology lab, we actually made pickles using lactic acid bacteria (LABs).

We found that LABs inhibit the growth of other microorganisms because they produce acid by-products. The lowered pH of the environment is too harsh for the sustenance of other microbial life. This demonstrates that LABs work by competitive exclusion. In the pickle jar containing LABs, the only colony isolated was a small, white round colony grown on a PCA agar plate.

A few brave souls decided to try the pickles that we made. Funny for us, but not so funny for them. Since we didn't add any agents to maintain freshness, the pickles weren't quite as crunchy as one would like.