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+ A sniff test may soon be available to help identify if someone is at high risk for Parkinson’s disease! The  2004 Nobel Prize in Physiology went to scientists (Richard Axel and Linda B. Buck) who ID’ed 4-10,000 odors we can recognize. The nerve for human smell – olfactory nerve (cranial nerve-1 -CN1) contains 6–10 million receptor cells. Impressive! Parkinson’s is a neurodegenerative disease, the study* followed people for 9.8 years with poor ability to smell indicating in the short and intermediate term likelihood of developing the disease.

+ A new online therapy program** was developed to remedy insomnia but it incidentally helped to improve hallucinations and paranoia conditions.

**Source Reference: Lallukka T and Sivertsen B “Sleep improvement by internet-based cognitive behaviouraltherapy might help prevent mental health disorders” Lancet Psych 2017; DOI: 10.1016/S2215-0366(17)30360-7.

A breakthrough! A DNA test looking for EBV (Epstein Barr virus) in the blood can detect with 100% sensitivity and specificity a diagnosis of nasopharyngeal cancer. EBV is also known as herpesvirus 4 – the culprit in infectious ‘mono’. In China where 35 of 100,000 people develop this cancer a recent investigational study of 20,000 people identified individuals before they developed a visual painless neck mass. A simple blood test – liquid biopsy can make all the difference as by the time a mass can be seen the disease is already at Stage II (spread to right or left sides of throat and lymph node(s) or III (spread further to sinus and bones nearby).

FYI: In US incidence is 1/100,000

Do you want to be resuscitated? Who will decide your medical care when you are unconscious? If you can’t speak on your own behalf who is going to assist in all medical decisions? Medical staff look for a living will and or a medical power of attorney (MPA).

In the USA, 2 of 3 adults have completed advanced directives. Many older and seriously ill individuals have them but not all. Please read and consider completing for your self and your circle.

Living Will (think of as end of life care) specifies what exactly you want to be done should you become unresponsive ex. resuscitation (CPR), intubation (a tube placed) so machine can breathe for you, tube feeding. Such terms as ‘comfort only’, ‘limitations of treatment’, ‘direction to prolong life’ are found. In a living will you predetermine, if not medical staff will look for direction from family, even ex-wifes’, relatives. Will they just be guessing think you might want done. In addition, organ donation is an option to address.

In health care a MPA document names an individual to act, as your medical decision maker should you become incapacitated. This should be a person who knows you well, the person that you put in your contact list as your I.C.E. contact -In Case of Emergency. A person who knows your health conditions, medications, allergies, and your end of life wishes.

Pragmatically many states have combined both documents. In Arizona ‘The advanced directive registry’ is free to electronically file and store your medical directives. Please check in your state what resources are available to download and complete. Notarization is usually necessary.

Please explore this sample “Living Will’

Please let us doctors know what you want!

Some technology can lower medical costs and increasing the access to care. AI thru deep learning programing and building information paths algorithms so neural networks in computer can arrive at decisions. Inputed data is passed thru many transformations (linear and non linear) before an ‘output’ is generated. Popular with the media is ‘Watson’, IBM’s supercomputer working on best cancer treatment  based on inputed condition/details of the patient. AI is at forefront, I have blogged  in the past regarding this. Every medical speciality is exploring its use with Dermatologists and ophthalmologist at forefront.

Computers using artificial intelligence (AI) have equaled dermatologists in diagnosing skin cancer! AI has nearly matched retina specialists in recognizing diabetic retinopathy from fundus images. In a recent paper, researchers at Google used 9,963 images from 4,997 patients to train a computer to recognize diabetic retinopathy. The computer achieved 97.5% sensitivity and 93.4% specificity.

Impressive will Dr. AI  come before self-driving cars?

Something everyone knows, it is intuitive, drinking sodas and fruit drinks results in excess weight gain, obesity and type 2 diabetes. But how about when one is pregnant could the child by age 7 suffer from obesity from the sodas mom took while pregnant?

Soda consumed during pregnancy had an effect resulting in higher waist size and BMI for kids years later. A research study* out of Harvard Medical School revealed this reality, another thing to blame your parent for!

This is an impressive study to me; there were face to face meetings with each at the end of the first and second trimesters, and during the first few months after the baby was born. Then kids were followed including measurements, thru out in early childhood, around age 3, and in mid–childhood, around age 8 and up to age 11. Questionnaires on each of kid’s birthdays were filled by moms.

Results- moms who drank more sugary drinks (at least two servings of sugary drinks per day) during had 25% of their children obese by mid–childhood.

The surprise was not the child’s intake of soda but was the mother’s intake during pregnancy having the greater impact on kid’s obesity.

Flu illness can cause death especially in children and elderly. Naturally quick recognition of what is the cause of an illness is critical to stopping any spread. Flu pandemic is a real possibility that has prompted development of a point of care device to rapidly diagnosis an Influenza illness.

Reported in the Journal Analytical Chemistry, this simple hopefully low cost device could allow for office testing with a simple color change determining positive or negative. No needle stick, just a swab from the nose, put swab in device twirl for 10 seconds to release any virus present and then wait. At present 35 minutes later a 70% accurate result for Influenza A is noted by your naked eye. Not costly @$6. for this disposable device.

There is antiviral treatment for Influenza A illness but it must be given early in the illness. This antiviral drug does not work for other viral illnesses.

At present multiple tests are available for ‘rapid’ testing: Prodesse ProFlu+/ProFAST+ (PFlu/PFAST), FilmArray Respiratory Panel (RP), cobas Influenza A/B test (cIAB), and Xpert Flu (Xpt). However these require specialty labs and time. an example, Xpt takes 70 min.- FilmArray Respiratory Panel tests for 17 viruses and 3 bacteria takes about an hour on special device.

Watch what your healthcare provider offers you next.