Maggots

From Medical Maggots To Stench Soup, ‘Grunt’ Explores The Science Of Warfare
May 31, 2016
http://www.npr.org/sections/health-shots/2016/05/31/480146514/from-medical-maggots-to-stench-soup-grunt-explores-the-science-of-warfare

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DBS for OCD affects language

Deep brain stimulation for obsessive-compulsive disorder affects language: a case report.
Neurosurgery. 2013 Nov;73(5):E907-10
Polak AR, et al.
http://www.ncbi.nlm.nih.gov/pubmed/23756741

BACKGROUND AND IMPORTANCE:
Deep brain stimulation (DBS) is an effective treatment for patients with refractory neuropsychiatric disorders. Along with symptom improvement, DBS may have concurrent behavioral effects that help to unravel the role of specific brain circuitries in complex human behavior.

CLINICAL PRESENTATION:
This article reports on 2 patients with obsessive-compulsive disorder who received DBS targeted at the nucleus accumbens that resulted in a temporary change of accent and use of vocabulary.

CONCLUSION:
Changes in accent and speaking manners are most likely related to direct DBS stimulation effects of the electrode targeted at the nucleus accumbens.
The shift in accent, resembling foreign accent syndrome after injuries in brain language centers, has not been reported before in the course of DBS.
Induction of aggressive vocabulary may be related to transient hypomanic behavior after DBS.

see also:
https://franzcalvo.wordpress.com/2013/12/22/foreign-accent-syndrome

Inadequacy of BMI as an Indicator for Bariatric Surgery

BMI doesn’t distinguish between body fat and muscle mass, which weighs more than fat. Many NFL players have been labeled “obese” because of their high BMI, when they actually have a low percentage of body fat.

Inadequacy of BMI as an Indicator for Bariatric Surgery 
JAMA. 2012;307(1):88-89
Edward H. Livingston, MD
http://jama.jamanetwork.com/article.aspx?articleid=1103978

In response to overnutrition, some patients preferentially accumulate peripheral rather than central fat, preventing development of the metabolic syndrome.
When the ability to accumulate subcutaneous fat is limited, overeating results in central obesity and ectopic fat deposition that causes insulin resistance, diabetes, and ultimately life-limiting cardiovascular disease.
Thus, fat distribution, not overall fatness, is a critical determinate of the health risks of obesity.

Bariatric Surgery

For Many, Affordable Care Act Won’t Cover Bariatric Surgery
May 27, 2013
http://www.npr.org/blogs/health/2013/05/27/186310916/for-many-affordable-care-act-wont-cover-bariatric-surgery

What makes bad food so good? NPR and Oxford American, team up to explore issues of appetite and health in Holmes County, the most obese county in Mississippi. It’s the first of an ongoing spotlight on the South called Southword.

Transoral outlet reduction
January 19, 2015
http://www.npr.org/blogs/health/2015/01/19/377731653/when-bariatric-surgerys-benefits-wane-this-procedure-can-help

 

Proposed Changes In Organ Donation Stir Debate

Proposed Changes In Organ Donation Stir Debate
June 24, 2013
http://www.npr.org/blogs/health/2013/06/24/194275901/proposed-changes-in-organ-donation-stir-debate

The board of directors of the United Network for Organ Sharing will open a two-day meeting at the organization’s headquarters in Richmond, Va., to consider new guidelines for donation after cardiac death.

Donation after cardiac death involves removing organs minutes after life-support has been stopped for patients who still have at least some brain activity.

“From the beginning the organ transplantation establishment has recognized that you must keep them separate,” Youngner says. “You must keep the people who are taking care of and making decisions about the potential donor separate from those who are trying to get an organ to put it into the recipient.”

But the UNOS committee proposing the new guidelines says exactly how to handle that process is best decided on a case-by-case basis because local values vary, as do the circumstances of individual cases.

In addition, when it comes to donations after cardiac death, decisions have to be made quickly. “The organs have a very short time period — measured in minutes — after the pronouncement of death for those organs to be removed to where they can still be transplanted,” Hughes says.

“The problem is that it could well be that your child will, you know, regain some consciousness,” he says. “There’s just no telling at that point.”

For his part, Hughes says the proposal includes other changes aimed at protecting potential donors. Organ bank workers, for example, would be prohibited from getting directly involved in giving patients drugs to preserve their organs.

exploitation of a possible donor

 

 

Another person’s heart: magical and rational thinking in the psychological adaptation to heart transplantation.

Another person’s heart: magical and rational thinking in the psychological adaptation to heart transplantation.
Isr J Psychiatry Relat Sci. 2004;41(3):161-73.
http://www.ncbi.nlm.nih.gov/pubmed/15754519

produces an amplified sense of the precariousness of existence.
Simultaneously, it gives rise to rejoicing at having been granted a new lease on life and a clear sense of new priorities, especially with regard to relationships.

see also:
https://franzcalvo.wordpress.com/2013/03/10/catherine-mohr-surgerys-past-present-and-robotic-future-video

? http://www.ted.com/playlists/65/personal_tales_from_the_edge_o.html

‘Not Fighting For Just Sarah’: Rating Transplant Priorities

‘Not Fighting For Just Sarah’: Rating Transplant Priorities
June 08, 2013
http://www.npr.org/2013/06/08/189861416/not-fighting-for-just-sarah-rating-transplant-priorities

the fairness of organ transplant

a Pennsylvania girl who is dying from cystic fibrosis

The first thing to note is that there just aren’t enough organs available.
More than 100,000 people are on the list for a new organ, according to the Organ Procurement and Transplantation Network, a nonprofit contracted by the federal government to regulate transplants in the U.S.
And 18 die each day while still waiting.

“What isn’t a good situation is admission to the transplant centers. One of the first tests that everybody does is a very thorough wallet biopsy,” he says. “So the ability to pay counts. … It’s a major driver in access to transplants.”

He says Medicaid will cover transplantation for low-income patients, but not in every state.
Transplants easily run hundreds of thousands of dollars, some even hitting seven figures.

Roberts says it’s the post-surgery costs that can create the biggest financial hurdle for patients.
“The medications are lifelong, and they are expensive,” he says.

*her gain is someone else’s loss

*rationing

related:
http://www.npr.org/2015/05/01/403303311/for-man-with-cystic-fibrosis-death-is-like-a-deadline