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Carol Bernstein Part II
Wasp-stung lung bugs, fat clay, Botoxed Vulcans, and ‘GOT’ mortality risk
The wonderful world of wasps
Never thought you’d be thankful for wasps, did you? Neither did we. Using mice as test subjects, scientists at MIT found that a tiny peptide in the venom was able to completely eliminate Pseudomonas aeruginosa, which causes respiratory infections and is often resistant to antibiotics. Now if you’re sick, all you have to do is go outside and get stung by a bunch of wasps!
Wait, no, that’s not right. The researchers at MIT engineered a molecule that can be used to create an antibiotic that’s safe for humans. While most insect venom is chock full of compounds that are toxic to humans, the scientists were able to transform their tiny peptide into a bacteria-defeating machine. This is a big victory in the war against antibiotic-resistant bacteria. Go, wasps!
Live long and Botox
Talk about highly illogical! Botox patients sometimes return for follow-up visits with dermatologist Kelly Stankiewicz, MD, and haven’t noticed they’ve “Spocked,” even though it may be obvious to just about everyone else.
But other Botox patients are most certainly aware that their eyebrows have arched up on the right and left sides – just like those of a certain Vulcan character on “Star Trek.” And they want to be beamed out of that uncomfortable situation pronto.
Dr. Stankiewicz, who works in Park City, Utah, explained the “Spocking” phenomenon in a presentation about facial treatments at the recent Las Vegas Dermatology Symposium. Spocking can occur in patents who get Botox treatment to eliminate the “11 line” – two vertical wrinkles – between the eyebrows, Dr. Stankiewicz said. It occurs “when the middle of the forehead doesn’t move but the outside does,” she said, causing an unsightly outwardly arched eyebrow look.
The solution to Spocking is easy, she said: “Put a tiny bit of Botox in the forehead muscle right where the eyebrow is peaking the most.”
Leonard Nimoy, the original Mr. Spock, is not available for comment, given that he died in 2015. But Dr. Stankiewicz does have a perspective on Mr. Spock’s trademark look: “It’s like the people who drew his brow knew that Botox was on the horizon.”
Add the dirt, lose the fat
Lots of things are supposed to be stronger than dirt, but it looks like obesity might not be one of them. Investigators who were trying to improve drug delivery using a type of clay – spray-dried smectite clay particles, to be exact – discovered that it has “a unique ability to ‘soak up’ fat droplets in the gut,” according to a statement from the University of South Australia, Adelaide.
“Not only were the clay materials trapping the fats within their particle structure, but they were also preventing them from being absorbed by the body, ensuring that fat simply passed through the digestive system,” researcher Tahnee J. Dening said.
In the study, the smectite outperformed the weight-loss drug orlistat in rats fed a high-fat diet for 2 weeks (Pharm Res. 2019;36:21 doi: 10.1007/s11095-018-2552-9). Even better, smectite is already widely used in foods and nutraceuticals and is considered to be safe. Even even better, smectite is a really fun word to say. And with the prevalence of obesity such as it is, we’re sure that physicians will prescribe smectite just so they can say “smectite” to their patients. Smectite.
When you play the game of thrones …
… You conduct an evidence-based analysis of mortality across the Seven Kingdoms. In celebration of the approaching final season, two researchers published a study of mortality and survival in HBO’s “Game of Thrones” series. They examined data on sociodemographic factors and circumstances of death to identify predictors of mortality.
After looking at 330 characters from the show (186 who suffered death), the authors determined that being male, lowborn, and loyal had the highest correlation with mortality. Poor men who never switched their allegiance from one side to the other had the lowest chance of survival. In addition, the probability of dying in the first hour after appearing on screen was 14%. Not a good statistic if you’re trying to become famous in Westeros. And a mortality risk rivaling even that of Mr. Spock’s red-shirted shipmates down in engineering.
Nurse, sand wedge, STAT!
There really is no sport like golf. The wide green spaces, the fresh air, the thrill of launching a 300-yard drive down the fairway, the fun of double-bogeying the last three holes to shoot yet another 93; golf is a noble pursuit, indeed. And a sport everyone knows doctors love. Right?
In research published in the Christmas edition of the BMJ, a group of doctors from Massachusetts sought to find out just how accurate the stereotype was. Their answer? Doctors really do enjoy teeing it up.
Well, male doctors.
Well, old male doctors.
Using a database of about a million physicians, the researchers found that 5.5% of male physicians and 1.3% of female physicians – or 4.1% overall – maintained an official United States Golf Association handicap. Male physicians aged 61-70 years were most likely to play, and female physicians aged 31-35 years were least likely.
However, while golf is certainly a common pastime among doctors, they aren’t exactly very good at it, as the average doctor is actually slightly worse than the average nondoctor. Surgeons presented a notable exception, possessing significantly lower handicaps than their colleagues while, perhaps not coincidentally, also playing more often. We’re sure there’s a joke about overpaid surgeons in narrow specialties having too much time on their hands, and we’ll get right back to you with it after our 12 o’clock tee time.
The wonderful world of wasps
Never thought you’d be thankful for wasps, did you? Neither did we. Using mice as test subjects, scientists at MIT found that a tiny peptide in the venom was able to completely eliminate Pseudomonas aeruginosa, which causes respiratory infections and is often resistant to antibiotics. Now if you’re sick, all you have to do is go outside and get stung by a bunch of wasps!
Wait, no, that’s not right. The researchers at MIT engineered a molecule that can be used to create an antibiotic that’s safe for humans. While most insect venom is chock full of compounds that are toxic to humans, the scientists were able to transform their tiny peptide into a bacteria-defeating machine. This is a big victory in the war against antibiotic-resistant bacteria. Go, wasps!
Live long and Botox
Talk about highly illogical! Botox patients sometimes return for follow-up visits with dermatologist Kelly Stankiewicz, MD, and haven’t noticed they’ve “Spocked,” even though it may be obvious to just about everyone else.
But other Botox patients are most certainly aware that their eyebrows have arched up on the right and left sides – just like those of a certain Vulcan character on “Star Trek.” And they want to be beamed out of that uncomfortable situation pronto.
Dr. Stankiewicz, who works in Park City, Utah, explained the “Spocking” phenomenon in a presentation about facial treatments at the recent Las Vegas Dermatology Symposium. Spocking can occur in patents who get Botox treatment to eliminate the “11 line” – two vertical wrinkles – between the eyebrows, Dr. Stankiewicz said. It occurs “when the middle of the forehead doesn’t move but the outside does,” she said, causing an unsightly outwardly arched eyebrow look.
The solution to Spocking is easy, she said: “Put a tiny bit of Botox in the forehead muscle right where the eyebrow is peaking the most.”
Leonard Nimoy, the original Mr. Spock, is not available for comment, given that he died in 2015. But Dr. Stankiewicz does have a perspective on Mr. Spock’s trademark look: “It’s like the people who drew his brow knew that Botox was on the horizon.”
Add the dirt, lose the fat
Lots of things are supposed to be stronger than dirt, but it looks like obesity might not be one of them. Investigators who were trying to improve drug delivery using a type of clay – spray-dried smectite clay particles, to be exact – discovered that it has “a unique ability to ‘soak up’ fat droplets in the gut,” according to a statement from the University of South Australia, Adelaide.
“Not only were the clay materials trapping the fats within their particle structure, but they were also preventing them from being absorbed by the body, ensuring that fat simply passed through the digestive system,” researcher Tahnee J. Dening said.
In the study, the smectite outperformed the weight-loss drug orlistat in rats fed a high-fat diet for 2 weeks (Pharm Res. 2019;36:21 doi: 10.1007/s11095-018-2552-9). Even better, smectite is already widely used in foods and nutraceuticals and is considered to be safe. Even even better, smectite is a really fun word to say. And with the prevalence of obesity such as it is, we’re sure that physicians will prescribe smectite just so they can say “smectite” to their patients. Smectite.
When you play the game of thrones …
… You conduct an evidence-based analysis of mortality across the Seven Kingdoms. In celebration of the approaching final season, two researchers published a study of mortality and survival in HBO’s “Game of Thrones” series. They examined data on sociodemographic factors and circumstances of death to identify predictors of mortality.
After looking at 330 characters from the show (186 who suffered death), the authors determined that being male, lowborn, and loyal had the highest correlation with mortality. Poor men who never switched their allegiance from one side to the other had the lowest chance of survival. In addition, the probability of dying in the first hour after appearing on screen was 14%. Not a good statistic if you’re trying to become famous in Westeros. And a mortality risk rivaling even that of Mr. Spock’s red-shirted shipmates down in engineering.
Nurse, sand wedge, STAT!
There really is no sport like golf. The wide green spaces, the fresh air, the thrill of launching a 300-yard drive down the fairway, the fun of double-bogeying the last three holes to shoot yet another 93; golf is a noble pursuit, indeed. And a sport everyone knows doctors love. Right?
In research published in the Christmas edition of the BMJ, a group of doctors from Massachusetts sought to find out just how accurate the stereotype was. Their answer? Doctors really do enjoy teeing it up.
Well, male doctors.
Well, old male doctors.
Using a database of about a million physicians, the researchers found that 5.5% of male physicians and 1.3% of female physicians – or 4.1% overall – maintained an official United States Golf Association handicap. Male physicians aged 61-70 years were most likely to play, and female physicians aged 31-35 years were least likely.
However, while golf is certainly a common pastime among doctors, they aren’t exactly very good at it, as the average doctor is actually slightly worse than the average nondoctor. Surgeons presented a notable exception, possessing significantly lower handicaps than their colleagues while, perhaps not coincidentally, also playing more often. We’re sure there’s a joke about overpaid surgeons in narrow specialties having too much time on their hands, and we’ll get right back to you with it after our 12 o’clock tee time.
The wonderful world of wasps
Never thought you’d be thankful for wasps, did you? Neither did we. Using mice as test subjects, scientists at MIT found that a tiny peptide in the venom was able to completely eliminate Pseudomonas aeruginosa, which causes respiratory infections and is often resistant to antibiotics. Now if you’re sick, all you have to do is go outside and get stung by a bunch of wasps!
Wait, no, that’s not right. The researchers at MIT engineered a molecule that can be used to create an antibiotic that’s safe for humans. While most insect venom is chock full of compounds that are toxic to humans, the scientists were able to transform their tiny peptide into a bacteria-defeating machine. This is a big victory in the war against antibiotic-resistant bacteria. Go, wasps!
Live long and Botox
Talk about highly illogical! Botox patients sometimes return for follow-up visits with dermatologist Kelly Stankiewicz, MD, and haven’t noticed they’ve “Spocked,” even though it may be obvious to just about everyone else.
But other Botox patients are most certainly aware that their eyebrows have arched up on the right and left sides – just like those of a certain Vulcan character on “Star Trek.” And they want to be beamed out of that uncomfortable situation pronto.
Dr. Stankiewicz, who works in Park City, Utah, explained the “Spocking” phenomenon in a presentation about facial treatments at the recent Las Vegas Dermatology Symposium. Spocking can occur in patents who get Botox treatment to eliminate the “11 line” – two vertical wrinkles – between the eyebrows, Dr. Stankiewicz said. It occurs “when the middle of the forehead doesn’t move but the outside does,” she said, causing an unsightly outwardly arched eyebrow look.
The solution to Spocking is easy, she said: “Put a tiny bit of Botox in the forehead muscle right where the eyebrow is peaking the most.”
Leonard Nimoy, the original Mr. Spock, is not available for comment, given that he died in 2015. But Dr. Stankiewicz does have a perspective on Mr. Spock’s trademark look: “It’s like the people who drew his brow knew that Botox was on the horizon.”
Add the dirt, lose the fat
Lots of things are supposed to be stronger than dirt, but it looks like obesity might not be one of them. Investigators who were trying to improve drug delivery using a type of clay – spray-dried smectite clay particles, to be exact – discovered that it has “a unique ability to ‘soak up’ fat droplets in the gut,” according to a statement from the University of South Australia, Adelaide.
“Not only were the clay materials trapping the fats within their particle structure, but they were also preventing them from being absorbed by the body, ensuring that fat simply passed through the digestive system,” researcher Tahnee J. Dening said.
In the study, the smectite outperformed the weight-loss drug orlistat in rats fed a high-fat diet for 2 weeks (Pharm Res. 2019;36:21 doi: 10.1007/s11095-018-2552-9). Even better, smectite is already widely used in foods and nutraceuticals and is considered to be safe. Even even better, smectite is a really fun word to say. And with the prevalence of obesity such as it is, we’re sure that physicians will prescribe smectite just so they can say “smectite” to their patients. Smectite.
When you play the game of thrones …
… You conduct an evidence-based analysis of mortality across the Seven Kingdoms. In celebration of the approaching final season, two researchers published a study of mortality and survival in HBO’s “Game of Thrones” series. They examined data on sociodemographic factors and circumstances of death to identify predictors of mortality.
After looking at 330 characters from the show (186 who suffered death), the authors determined that being male, lowborn, and loyal had the highest correlation with mortality. Poor men who never switched their allegiance from one side to the other had the lowest chance of survival. In addition, the probability of dying in the first hour after appearing on screen was 14%. Not a good statistic if you’re trying to become famous in Westeros. And a mortality risk rivaling even that of Mr. Spock’s red-shirted shipmates down in engineering.
Nurse, sand wedge, STAT!
There really is no sport like golf. The wide green spaces, the fresh air, the thrill of launching a 300-yard drive down the fairway, the fun of double-bogeying the last three holes to shoot yet another 93; golf is a noble pursuit, indeed. And a sport everyone knows doctors love. Right?
In research published in the Christmas edition of the BMJ, a group of doctors from Massachusetts sought to find out just how accurate the stereotype was. Their answer? Doctors really do enjoy teeing it up.
Well, male doctors.
Well, old male doctors.
Using a database of about a million physicians, the researchers found that 5.5% of male physicians and 1.3% of female physicians – or 4.1% overall – maintained an official United States Golf Association handicap. Male physicians aged 61-70 years were most likely to play, and female physicians aged 31-35 years were least likely.
However, while golf is certainly a common pastime among doctors, they aren’t exactly very good at it, as the average doctor is actually slightly worse than the average nondoctor. Surgeons presented a notable exception, possessing significantly lower handicaps than their colleagues while, perhaps not coincidentally, also playing more often. We’re sure there’s a joke about overpaid surgeons in narrow specialties having too much time on their hands, and we’ll get right back to you with it after our 12 o’clock tee time.
Parental leave for residents
Also today, exercise is important for patients with sickle cell, COPD patients are experiencing a risk in non-TB mycobacteria infections, and how to be an influencer on social media.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Also today, exercise is important for patients with sickle cell, COPD patients are experiencing a risk in non-TB mycobacteria infections, and how to be an influencer on social media.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Also today, exercise is important for patients with sickle cell, COPD patients are experiencing a risk in non-TB mycobacteria infections, and how to be an influencer on social media.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify
Carol Bernstein: Burnout or depression?
Dr. Bernstein is a professor at NYU Langone in New York City and has been a guest on the MDedge Psychcast.
Apple Podcasts
Google Podcasts
Dr. Bernstein is a professor at NYU Langone in New York City and has been a guest on the MDedge Psychcast.
Apple Podcasts
Google Podcasts
Dr. Bernstein is a professor at NYU Langone in New York City and has been a guest on the MDedge Psychcast.
Apple Podcasts
Google Podcasts
Potty pathogens in space, fundus photos, and ethnic microbiomes
The earth is not enough
Earthly competitors have proved to be unworthy, so this week, Bacteria vs. the World visits the International Space Station, which – and we double-checked this – is in space. It’s a pretty exclusive location, and admission is by invitation only. Unless, of, course, you happen to be the ultimate hitchhiker. Four samples taken from the toilet of the ISS (and one from a piece of exercise equipment) were found to contain unknown strains of antibiotic-resistant Enterobacter bugandensis, investigators reported (BMC Microbiol. 2018 Nov 23;18[1]:175).
These bacterial stowaways were not virulent, lead author Nitin Singh, PhD, of the Jet Propulsion Laboratory said in a separate statement. But an analysis conducted by the team “reveals that the ISS isolates have a 79% probability of being a human pathogen.”
So, what does this mean for future space exploration? Cue the “Star Trek” music: “Space … the final frontier. These are the voyages of the bacterial transport ship Enterprise.”
Putting the FUN in fundus photos
You just got even more dependent on your phone: The American Academy of Opthalmology has published guidelines on how to use smartphones to take fundus photography, a.k.a. photographs of the back of the eye.
Advancement in smartphone optical quality has turned them into an important clinical tool, especially for specialists in low-funded or rural areas who don’t have access to imaging systems. Doctors can purchase special lenses and phone software to take these photos and then can easily upload the images to their Instagram accounts. (Even doctors need likes.)
An eye hospital in India has taken fundus accessibility a step further and posted a video on YouTube showing how to make a functional fundus camera that costs only 100 rupees. All you need in some cardboard, a water bottle, and a lens. “MacGyver: Chennai Edition.”
I feel it in my gut
Whoever said “inside, we’re all the same” clearly wasn’t considering the gut. A study from Vanderbilt University comprising 1,700 American subjects found that differences in gut microbiomes are most consistently linked with ethnicity. Vanderbilt biologist Seth Bordenstein emphasized how changing the gut microbiome can lead to curing illness but that it’s imperative that medical professionals understand how the gut differs across ethnicities.
Researchers found 12 types of bacteria that vary in abundancy by ethnicity. No comment on whether this was linked to differences in cuisine, but this writer fervently hopes new research arrives proving that tacos produce the healthiest gut microbiome.
F-bombing blood cancer
Call it a tale of two Toms.
TV newsman Tom Brokaw, who has multiple myeloma, says he’s become the “poster boy” for blood cancer. At first, though, he kept his diagnosis secret from just about everyone. But occasionally he let his emotions get the best of him. Especially when he’d see a Manhattan bus stop ad spotlighting the chiseled body of another Tom: the quarterback named Brady.
As he explained in a presentation at the annual meeting of the American Society of Hematology, he found it harder to get around because of back problems, which are common in multiple myeloma. As a result, he couldn’t manage to get to the office.
Still, “every day I’d force myself to leave the walker at home,” he recalled. “In that cold and sleety fall, I’d walk half a block to the coffee shop to get a bagel. There was this enormous new bus stop, with an animated advertisement board. Looking right at me was Tom Brady, advertising Ugg boots. I’d look down 79th Street at every inch of Tom Brady, and all the little old ladies were mooning over him as they were getting on the bus.”
Brokaw knew just what to do to make himself feel better. “I’d hobble over and look at him and drop the F-bomb on him every morning. Frankly, it was therapeutic for me.”
Later, he met the New England Patriots quarterback and told him the story, replacing “F-bomb” with the real word. “He had this little posse with him, and they roared. They said nobody talks to Tom like that.”
Brokaw still resists pleas to slow down from concerned loved ones, such as his emergency physician daughter. “My birth certificate says I’m 78 years old,” he said, “but I still think I’m 38 anchoring the news.” And still tossing tight-spiral F-bombs at cancer and gridiron G.O.A.T.s alike.
The earth is not enough
Earthly competitors have proved to be unworthy, so this week, Bacteria vs. the World visits the International Space Station, which – and we double-checked this – is in space. It’s a pretty exclusive location, and admission is by invitation only. Unless, of, course, you happen to be the ultimate hitchhiker. Four samples taken from the toilet of the ISS (and one from a piece of exercise equipment) were found to contain unknown strains of antibiotic-resistant Enterobacter bugandensis, investigators reported (BMC Microbiol. 2018 Nov 23;18[1]:175).
These bacterial stowaways were not virulent, lead author Nitin Singh, PhD, of the Jet Propulsion Laboratory said in a separate statement. But an analysis conducted by the team “reveals that the ISS isolates have a 79% probability of being a human pathogen.”
So, what does this mean for future space exploration? Cue the “Star Trek” music: “Space … the final frontier. These are the voyages of the bacterial transport ship Enterprise.”
Putting the FUN in fundus photos
You just got even more dependent on your phone: The American Academy of Opthalmology has published guidelines on how to use smartphones to take fundus photography, a.k.a. photographs of the back of the eye.
Advancement in smartphone optical quality has turned them into an important clinical tool, especially for specialists in low-funded or rural areas who don’t have access to imaging systems. Doctors can purchase special lenses and phone software to take these photos and then can easily upload the images to their Instagram accounts. (Even doctors need likes.)
An eye hospital in India has taken fundus accessibility a step further and posted a video on YouTube showing how to make a functional fundus camera that costs only 100 rupees. All you need in some cardboard, a water bottle, and a lens. “MacGyver: Chennai Edition.”
I feel it in my gut
Whoever said “inside, we’re all the same” clearly wasn’t considering the gut. A study from Vanderbilt University comprising 1,700 American subjects found that differences in gut microbiomes are most consistently linked with ethnicity. Vanderbilt biologist Seth Bordenstein emphasized how changing the gut microbiome can lead to curing illness but that it’s imperative that medical professionals understand how the gut differs across ethnicities.
Researchers found 12 types of bacteria that vary in abundancy by ethnicity. No comment on whether this was linked to differences in cuisine, but this writer fervently hopes new research arrives proving that tacos produce the healthiest gut microbiome.
F-bombing blood cancer
Call it a tale of two Toms.
TV newsman Tom Brokaw, who has multiple myeloma, says he’s become the “poster boy” for blood cancer. At first, though, he kept his diagnosis secret from just about everyone. But occasionally he let his emotions get the best of him. Especially when he’d see a Manhattan bus stop ad spotlighting the chiseled body of another Tom: the quarterback named Brady.
As he explained in a presentation at the annual meeting of the American Society of Hematology, he found it harder to get around because of back problems, which are common in multiple myeloma. As a result, he couldn’t manage to get to the office.
Still, “every day I’d force myself to leave the walker at home,” he recalled. “In that cold and sleety fall, I’d walk half a block to the coffee shop to get a bagel. There was this enormous new bus stop, with an animated advertisement board. Looking right at me was Tom Brady, advertising Ugg boots. I’d look down 79th Street at every inch of Tom Brady, and all the little old ladies were mooning over him as they were getting on the bus.”
Brokaw knew just what to do to make himself feel better. “I’d hobble over and look at him and drop the F-bomb on him every morning. Frankly, it was therapeutic for me.”
Later, he met the New England Patriots quarterback and told him the story, replacing “F-bomb” with the real word. “He had this little posse with him, and they roared. They said nobody talks to Tom like that.”
Brokaw still resists pleas to slow down from concerned loved ones, such as his emergency physician daughter. “My birth certificate says I’m 78 years old,” he said, “but I still think I’m 38 anchoring the news.” And still tossing tight-spiral F-bombs at cancer and gridiron G.O.A.T.s alike.
The earth is not enough
Earthly competitors have proved to be unworthy, so this week, Bacteria vs. the World visits the International Space Station, which – and we double-checked this – is in space. It’s a pretty exclusive location, and admission is by invitation only. Unless, of, course, you happen to be the ultimate hitchhiker. Four samples taken from the toilet of the ISS (and one from a piece of exercise equipment) were found to contain unknown strains of antibiotic-resistant Enterobacter bugandensis, investigators reported (BMC Microbiol. 2018 Nov 23;18[1]:175).
These bacterial stowaways were not virulent, lead author Nitin Singh, PhD, of the Jet Propulsion Laboratory said in a separate statement. But an analysis conducted by the team “reveals that the ISS isolates have a 79% probability of being a human pathogen.”
So, what does this mean for future space exploration? Cue the “Star Trek” music: “Space … the final frontier. These are the voyages of the bacterial transport ship Enterprise.”
Putting the FUN in fundus photos
You just got even more dependent on your phone: The American Academy of Opthalmology has published guidelines on how to use smartphones to take fundus photography, a.k.a. photographs of the back of the eye.
Advancement in smartphone optical quality has turned them into an important clinical tool, especially for specialists in low-funded or rural areas who don’t have access to imaging systems. Doctors can purchase special lenses and phone software to take these photos and then can easily upload the images to their Instagram accounts. (Even doctors need likes.)
An eye hospital in India has taken fundus accessibility a step further and posted a video on YouTube showing how to make a functional fundus camera that costs only 100 rupees. All you need in some cardboard, a water bottle, and a lens. “MacGyver: Chennai Edition.”
I feel it in my gut
Whoever said “inside, we’re all the same” clearly wasn’t considering the gut. A study from Vanderbilt University comprising 1,700 American subjects found that differences in gut microbiomes are most consistently linked with ethnicity. Vanderbilt biologist Seth Bordenstein emphasized how changing the gut microbiome can lead to curing illness but that it’s imperative that medical professionals understand how the gut differs across ethnicities.
Researchers found 12 types of bacteria that vary in abundancy by ethnicity. No comment on whether this was linked to differences in cuisine, but this writer fervently hopes new research arrives proving that tacos produce the healthiest gut microbiome.
F-bombing blood cancer
Call it a tale of two Toms.
TV newsman Tom Brokaw, who has multiple myeloma, says he’s become the “poster boy” for blood cancer. At first, though, he kept his diagnosis secret from just about everyone. But occasionally he let his emotions get the best of him. Especially when he’d see a Manhattan bus stop ad spotlighting the chiseled body of another Tom: the quarterback named Brady.
As he explained in a presentation at the annual meeting of the American Society of Hematology, he found it harder to get around because of back problems, which are common in multiple myeloma. As a result, he couldn’t manage to get to the office.
Still, “every day I’d force myself to leave the walker at home,” he recalled. “In that cold and sleety fall, I’d walk half a block to the coffee shop to get a bagel. There was this enormous new bus stop, with an animated advertisement board. Looking right at me was Tom Brady, advertising Ugg boots. I’d look down 79th Street at every inch of Tom Brady, and all the little old ladies were mooning over him as they were getting on the bus.”
Brokaw knew just what to do to make himself feel better. “I’d hobble over and look at him and drop the F-bomb on him every morning. Frankly, it was therapeutic for me.”
Later, he met the New England Patriots quarterback and told him the story, replacing “F-bomb” with the real word. “He had this little posse with him, and they roared. They said nobody talks to Tom like that.”
Brokaw still resists pleas to slow down from concerned loved ones, such as his emergency physician daughter. “My birth certificate says I’m 78 years old,” he said, “but I still think I’m 38 anchoring the news.” And still tossing tight-spiral F-bombs at cancer and gridiron G.O.A.T.s alike.
Life is beautiful
A crimson November San Diego sunset over the Pacific Ocean. Seeing your parents dance on their 50th wedding anniversary. A stein of cold Oktoberfest beer. Your car, freshly detailed. Your name written in black ink on a Starbucks Pumpkin Latte. A nicely everted surgical wound.
The smile on your daughter’s face when descending the stairs after a huge trick-or-treat score. A perfectly arranged Mayo stand, oh, exactly as you like it. An empty EMR in basket. A flap close on the nose that closes just so.
A Red Sox World series win (again). Lollipop lamb chops sizzling on the grill on a chilly Saturday tailgating morning. The answer to 14 down that leads to all the other answers you’ve desperately been trying to solve. The “ting” sound that Mimosa glasses make toasting Sunday brunch with friends. The next episode of Black Mirror launching automatically. A brilliant orange maple tree against a brilliant blue sky. The fissures on the crust of a still-warm loaf of Italian bread.
An elderly woman, her husband, daughter, and son-in-law who waited weeks and traveled miles to see you because they know you care. And they insist on seeing only you. A man who comes to see you without his wife this time just because he wanted to tell you in person how much they appreciated your care for her in the end. Opening your mailbox to see the September issue of Vogue, waiting for you to tear off the plastic. An as-yet-untouched Sunday New York Times. The sound of wood popping in the fireplace. The string of melted marshmallow down your son’s arm still attached to a s’more at the other end. 7-7-7 on your dollar slot at the casino. Eight-year-old girls at the center of the field celebrating a Sunday morning soccer victory. Departures showing your flight, gate 8, on time.
The smell of incense. The smell of lightly roasting garlic and olive oil. The smell of your wife’s perfume. The smell of wet leaves. The smell of your favorite scented candle. The smell of burning firewood on an early-morning walk in the Rockies. Snow falling. Snow crunching under your feet. Snow melting.
Remembering the uproarious laughter after your belly flop into the pool back in July. Steph Curry shooting a 3 in slow motion. Snoopy floating over 5th Avenue on Thanksgiving morning. The sound of wrapping paper being stuffed into garbage bags when the opening is done. A prior auth letter of approval. The feeling when you turn that first page of a brand-new Stephen King book. The feel of the grip on your fairway wood. Seeing your favorite movie pop up on Amazon Prime. The head massage your stylist gives you when washing your hair. The near pain of a really good massage.
The warmth of a child on your lap. The bark your dog gives when he sees you for the first time today as if it has been a million years. The crack of your favorite beer can opening. The ding when your microwave popcorn is ready. That warm feeling when you realize that, no, you don’t need any filter for that picture, it is ready to post exactly the way it is. The smile on your medical assistant’s face when you hand her a gratitude card. The ping that an email makes when you’re dying to hear back. The pride you feel when you execute a downward-facing dog and the instructor tells everyone to do it just like you. The smell of balsam fir. A podcast episode so good, you sit in your driveway to finish listening. A patient with a delightful British accent. The feel of pasta dough in your hands after adding just the right amount of flour and water so it’s now ready to go. Watching the Red Sox win the World Series (Wait, did I say that already?). The sound of your laptop keyboard clicking away while you write this piece. The feeling that 2019 is going to be your best year ever.
I promise it will be a more beautiful place where you are when you’re done.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
A crimson November San Diego sunset over the Pacific Ocean. Seeing your parents dance on their 50th wedding anniversary. A stein of cold Oktoberfest beer. Your car, freshly detailed. Your name written in black ink on a Starbucks Pumpkin Latte. A nicely everted surgical wound.
The smile on your daughter’s face when descending the stairs after a huge trick-or-treat score. A perfectly arranged Mayo stand, oh, exactly as you like it. An empty EMR in basket. A flap close on the nose that closes just so.
A Red Sox World series win (again). Lollipop lamb chops sizzling on the grill on a chilly Saturday tailgating morning. The answer to 14 down that leads to all the other answers you’ve desperately been trying to solve. The “ting” sound that Mimosa glasses make toasting Sunday brunch with friends. The next episode of Black Mirror launching automatically. A brilliant orange maple tree against a brilliant blue sky. The fissures on the crust of a still-warm loaf of Italian bread.
An elderly woman, her husband, daughter, and son-in-law who waited weeks and traveled miles to see you because they know you care. And they insist on seeing only you. A man who comes to see you without his wife this time just because he wanted to tell you in person how much they appreciated your care for her in the end. Opening your mailbox to see the September issue of Vogue, waiting for you to tear off the plastic. An as-yet-untouched Sunday New York Times. The sound of wood popping in the fireplace. The string of melted marshmallow down your son’s arm still attached to a s’more at the other end. 7-7-7 on your dollar slot at the casino. Eight-year-old girls at the center of the field celebrating a Sunday morning soccer victory. Departures showing your flight, gate 8, on time.
The smell of incense. The smell of lightly roasting garlic and olive oil. The smell of your wife’s perfume. The smell of wet leaves. The smell of your favorite scented candle. The smell of burning firewood on an early-morning walk in the Rockies. Snow falling. Snow crunching under your feet. Snow melting.
Remembering the uproarious laughter after your belly flop into the pool back in July. Steph Curry shooting a 3 in slow motion. Snoopy floating over 5th Avenue on Thanksgiving morning. The sound of wrapping paper being stuffed into garbage bags when the opening is done. A prior auth letter of approval. The feeling when you turn that first page of a brand-new Stephen King book. The feel of the grip on your fairway wood. Seeing your favorite movie pop up on Amazon Prime. The head massage your stylist gives you when washing your hair. The near pain of a really good massage.
The warmth of a child on your lap. The bark your dog gives when he sees you for the first time today as if it has been a million years. The crack of your favorite beer can opening. The ding when your microwave popcorn is ready. That warm feeling when you realize that, no, you don’t need any filter for that picture, it is ready to post exactly the way it is. The smile on your medical assistant’s face when you hand her a gratitude card. The ping that an email makes when you’re dying to hear back. The pride you feel when you execute a downward-facing dog and the instructor tells everyone to do it just like you. The smell of balsam fir. A podcast episode so good, you sit in your driveway to finish listening. A patient with a delightful British accent. The feel of pasta dough in your hands after adding just the right amount of flour and water so it’s now ready to go. Watching the Red Sox win the World Series (Wait, did I say that already?). The sound of your laptop keyboard clicking away while you write this piece. The feeling that 2019 is going to be your best year ever.
I promise it will be a more beautiful place where you are when you’re done.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
A crimson November San Diego sunset over the Pacific Ocean. Seeing your parents dance on their 50th wedding anniversary. A stein of cold Oktoberfest beer. Your car, freshly detailed. Your name written in black ink on a Starbucks Pumpkin Latte. A nicely everted surgical wound.
The smile on your daughter’s face when descending the stairs after a huge trick-or-treat score. A perfectly arranged Mayo stand, oh, exactly as you like it. An empty EMR in basket. A flap close on the nose that closes just so.
A Red Sox World series win (again). Lollipop lamb chops sizzling on the grill on a chilly Saturday tailgating morning. The answer to 14 down that leads to all the other answers you’ve desperately been trying to solve. The “ting” sound that Mimosa glasses make toasting Sunday brunch with friends. The next episode of Black Mirror launching automatically. A brilliant orange maple tree against a brilliant blue sky. The fissures on the crust of a still-warm loaf of Italian bread.
An elderly woman, her husband, daughter, and son-in-law who waited weeks and traveled miles to see you because they know you care. And they insist on seeing only you. A man who comes to see you without his wife this time just because he wanted to tell you in person how much they appreciated your care for her in the end. Opening your mailbox to see the September issue of Vogue, waiting for you to tear off the plastic. An as-yet-untouched Sunday New York Times. The sound of wood popping in the fireplace. The string of melted marshmallow down your son’s arm still attached to a s’more at the other end. 7-7-7 on your dollar slot at the casino. Eight-year-old girls at the center of the field celebrating a Sunday morning soccer victory. Departures showing your flight, gate 8, on time.
The smell of incense. The smell of lightly roasting garlic and olive oil. The smell of your wife’s perfume. The smell of wet leaves. The smell of your favorite scented candle. The smell of burning firewood on an early-morning walk in the Rockies. Snow falling. Snow crunching under your feet. Snow melting.
Remembering the uproarious laughter after your belly flop into the pool back in July. Steph Curry shooting a 3 in slow motion. Snoopy floating over 5th Avenue on Thanksgiving morning. The sound of wrapping paper being stuffed into garbage bags when the opening is done. A prior auth letter of approval. The feeling when you turn that first page of a brand-new Stephen King book. The feel of the grip on your fairway wood. Seeing your favorite movie pop up on Amazon Prime. The head massage your stylist gives you when washing your hair. The near pain of a really good massage.
The warmth of a child on your lap. The bark your dog gives when he sees you for the first time today as if it has been a million years. The crack of your favorite beer can opening. The ding when your microwave popcorn is ready. That warm feeling when you realize that, no, you don’t need any filter for that picture, it is ready to post exactly the way it is. The smile on your medical assistant’s face when you hand her a gratitude card. The ping that an email makes when you’re dying to hear back. The pride you feel when you execute a downward-facing dog and the instructor tells everyone to do it just like you. The smell of balsam fir. A podcast episode so good, you sit in your driveway to finish listening. A patient with a delightful British accent. The feel of pasta dough in your hands after adding just the right amount of flour and water so it’s now ready to go. Watching the Red Sox win the World Series (Wait, did I say that already?). The sound of your laptop keyboard clicking away while you write this piece. The feeling that 2019 is going to be your best year ever.
I promise it will be a more beautiful place where you are when you’re done.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
Legos for lunch, saliva-sterilized pacifiers, and a healthy personality
Legos for lunch
As any parent, teacher, or teenage babysitter knows, children try to eat everything. Six intrepid researchers from Australia and the United Kingdom decided to put their lives – or, at least, their intestines – on the line by swallowing Lego pieces to determine “typical transit times” for the commonly ingested toy. The things people do in the name of science.
The study participants first measured their bowel habits by the Stool Hardness and Transit (SHAT) score, and then measured the Found and Retrieved Time (FART) score once the Lego was ... expelled. The researchers found that the average FART score was 1.71 days.
At this point, all involved stopped to have a hearty laugh and a round of high-fives. Parents can rest assured that their little progeny who swallow Legos are safe. Everything is awesome.
Don’t wash that pacifier!
If you want to clean your child’s pacifier, you should consider passing on the sink and pop it into your own mouth instead. That’s the story from research presented at the annual scientific meeting of the American College of Allergy, Asthma, and Immunology.
In a survey of 128 mothers over an 18-month period, 41% of those whose child was currently using a pacifier reported cleaning by sterilization, and 72% reported hand washing their child’s pacifier. (We will henceforth refer to these mothers as “normal people.”) Just over 10% of mothers reported cleaning through parental pacifier sucking.
Before you cringe too much, the children of these mothers had significantly lower IgE levels than the children of normal people, indicating they were at a lower risk of developing allergies or asthma.
The study authors hypothesized that exposure to adult saliva may transfer healthy microorganisms to their children, and they advocated for further study into the subject. We suggest getting the pediatricians from the Lego study involved – they’ll eat anything for science.
One camel latte, please
An unlikely partnership between a Saudi entrepreneur and Amish farmers might lead to a brand-new dairy market in the United States. Walid Abdul-Wahub is on a mission to put camel milk on the shelves of every grocery store in America.
Middle Eastern residents have been drinking camel milk for centuries, so it’s only a matter of time until some hipster coffee shop co-opts it and starts selling camel milk lattes for $9. On the plus side, camel milk has a different protein than cow milk, making it more similar to human milk than bovine milk. This could be a godsend for people with milk allergies and need alternatives to that god-awful almond milk. One camel milkshake, coming right up.
How healthy is your personality?
It’s a question bipedal hominins have pondered since our days scrounging for snacks in the Olduvai Gorge: Is my personality why no one wants to hunt and gather with me?
Homo sapiens researchers from the University of California, Davis, and elsewhere believe they have the answer. In fact, it is your personality that leaves you scavenging for baobab alone.
What’s a healthy personality? The Scientia sapiens split personality into five factors: agreeableness, conscientiousness, extroversion, neuroticism, and openness to experience. They then surveyed scientists and college students to construct the consensus Dream Date – er, healthy personality: low levels of neuroticism, sprinkled with lots of agreeable straightforwardness, openness to feelings, positive emotions, and warmth. It wouldn’t hurt to ease up on the Old Spice, either.
The taste of deprivation
At one time or another, you’ve probably seen someone who was pretty much physically attached to his or her phone and wondered about the owner’s personal priorities and where the phone fit into them.
Wonder no more.
In a study conducted at the University at Buffalo (N.Y.), 76 students were deprived of food for 3 hours and their smartphones for 2 hours, and then given a computer task that would earn them a serving of their favorite snack or use of their phone. To make things more interesting, the amount of work needed to earn food or phone time increased as the subjects completed their tasks.
“We knew that students would be motivated to gain access to their phones, but we were surprised that, despite modest food deprivation, smartphone reinforcement far exceeded food reinforcement,” lead investigator Sara O’Donnell said in a written statement.
Recruiting subjects for the next step in this line of research – choosing between phones and breathing – could get a little tricky. But we have to admire the creative solution that got one participant disqualified from the current study: He tried to eat his phone.
Legos for lunch
As any parent, teacher, or teenage babysitter knows, children try to eat everything. Six intrepid researchers from Australia and the United Kingdom decided to put their lives – or, at least, their intestines – on the line by swallowing Lego pieces to determine “typical transit times” for the commonly ingested toy. The things people do in the name of science.
The study participants first measured their bowel habits by the Stool Hardness and Transit (SHAT) score, and then measured the Found and Retrieved Time (FART) score once the Lego was ... expelled. The researchers found that the average FART score was 1.71 days.
At this point, all involved stopped to have a hearty laugh and a round of high-fives. Parents can rest assured that their little progeny who swallow Legos are safe. Everything is awesome.
Don’t wash that pacifier!
If you want to clean your child’s pacifier, you should consider passing on the sink and pop it into your own mouth instead. That’s the story from research presented at the annual scientific meeting of the American College of Allergy, Asthma, and Immunology.
In a survey of 128 mothers over an 18-month period, 41% of those whose child was currently using a pacifier reported cleaning by sterilization, and 72% reported hand washing their child’s pacifier. (We will henceforth refer to these mothers as “normal people.”) Just over 10% of mothers reported cleaning through parental pacifier sucking.
Before you cringe too much, the children of these mothers had significantly lower IgE levels than the children of normal people, indicating they were at a lower risk of developing allergies or asthma.
The study authors hypothesized that exposure to adult saliva may transfer healthy microorganisms to their children, and they advocated for further study into the subject. We suggest getting the pediatricians from the Lego study involved – they’ll eat anything for science.
One camel latte, please
An unlikely partnership between a Saudi entrepreneur and Amish farmers might lead to a brand-new dairy market in the United States. Walid Abdul-Wahub is on a mission to put camel milk on the shelves of every grocery store in America.
Middle Eastern residents have been drinking camel milk for centuries, so it’s only a matter of time until some hipster coffee shop co-opts it and starts selling camel milk lattes for $9. On the plus side, camel milk has a different protein than cow milk, making it more similar to human milk than bovine milk. This could be a godsend for people with milk allergies and need alternatives to that god-awful almond milk. One camel milkshake, coming right up.
How healthy is your personality?
It’s a question bipedal hominins have pondered since our days scrounging for snacks in the Olduvai Gorge: Is my personality why no one wants to hunt and gather with me?
Homo sapiens researchers from the University of California, Davis, and elsewhere believe they have the answer. In fact, it is your personality that leaves you scavenging for baobab alone.
What’s a healthy personality? The Scientia sapiens split personality into five factors: agreeableness, conscientiousness, extroversion, neuroticism, and openness to experience. They then surveyed scientists and college students to construct the consensus Dream Date – er, healthy personality: low levels of neuroticism, sprinkled with lots of agreeable straightforwardness, openness to feelings, positive emotions, and warmth. It wouldn’t hurt to ease up on the Old Spice, either.
The taste of deprivation
At one time or another, you’ve probably seen someone who was pretty much physically attached to his or her phone and wondered about the owner’s personal priorities and where the phone fit into them.
Wonder no more.
In a study conducted at the University at Buffalo (N.Y.), 76 students were deprived of food for 3 hours and their smartphones for 2 hours, and then given a computer task that would earn them a serving of their favorite snack or use of their phone. To make things more interesting, the amount of work needed to earn food or phone time increased as the subjects completed their tasks.
“We knew that students would be motivated to gain access to their phones, but we were surprised that, despite modest food deprivation, smartphone reinforcement far exceeded food reinforcement,” lead investigator Sara O’Donnell said in a written statement.
Recruiting subjects for the next step in this line of research – choosing between phones and breathing – could get a little tricky. But we have to admire the creative solution that got one participant disqualified from the current study: He tried to eat his phone.
Legos for lunch
As any parent, teacher, or teenage babysitter knows, children try to eat everything. Six intrepid researchers from Australia and the United Kingdom decided to put their lives – or, at least, their intestines – on the line by swallowing Lego pieces to determine “typical transit times” for the commonly ingested toy. The things people do in the name of science.
The study participants first measured their bowel habits by the Stool Hardness and Transit (SHAT) score, and then measured the Found and Retrieved Time (FART) score once the Lego was ... expelled. The researchers found that the average FART score was 1.71 days.
At this point, all involved stopped to have a hearty laugh and a round of high-fives. Parents can rest assured that their little progeny who swallow Legos are safe. Everything is awesome.
Don’t wash that pacifier!
If you want to clean your child’s pacifier, you should consider passing on the sink and pop it into your own mouth instead. That’s the story from research presented at the annual scientific meeting of the American College of Allergy, Asthma, and Immunology.
In a survey of 128 mothers over an 18-month period, 41% of those whose child was currently using a pacifier reported cleaning by sterilization, and 72% reported hand washing their child’s pacifier. (We will henceforth refer to these mothers as “normal people.”) Just over 10% of mothers reported cleaning through parental pacifier sucking.
Before you cringe too much, the children of these mothers had significantly lower IgE levels than the children of normal people, indicating they were at a lower risk of developing allergies or asthma.
The study authors hypothesized that exposure to adult saliva may transfer healthy microorganisms to their children, and they advocated for further study into the subject. We suggest getting the pediatricians from the Lego study involved – they’ll eat anything for science.
One camel latte, please
An unlikely partnership between a Saudi entrepreneur and Amish farmers might lead to a brand-new dairy market in the United States. Walid Abdul-Wahub is on a mission to put camel milk on the shelves of every grocery store in America.
Middle Eastern residents have been drinking camel milk for centuries, so it’s only a matter of time until some hipster coffee shop co-opts it and starts selling camel milk lattes for $9. On the plus side, camel milk has a different protein than cow milk, making it more similar to human milk than bovine milk. This could be a godsend for people with milk allergies and need alternatives to that god-awful almond milk. One camel milkshake, coming right up.
How healthy is your personality?
It’s a question bipedal hominins have pondered since our days scrounging for snacks in the Olduvai Gorge: Is my personality why no one wants to hunt and gather with me?
Homo sapiens researchers from the University of California, Davis, and elsewhere believe they have the answer. In fact, it is your personality that leaves you scavenging for baobab alone.
What’s a healthy personality? The Scientia sapiens split personality into five factors: agreeableness, conscientiousness, extroversion, neuroticism, and openness to experience. They then surveyed scientists and college students to construct the consensus Dream Date – er, healthy personality: low levels of neuroticism, sprinkled with lots of agreeable straightforwardness, openness to feelings, positive emotions, and warmth. It wouldn’t hurt to ease up on the Old Spice, either.
The taste of deprivation
At one time or another, you’ve probably seen someone who was pretty much physically attached to his or her phone and wondered about the owner’s personal priorities and where the phone fit into them.
Wonder no more.
In a study conducted at the University at Buffalo (N.Y.), 76 students were deprived of food for 3 hours and their smartphones for 2 hours, and then given a computer task that would earn them a serving of their favorite snack or use of their phone. To make things more interesting, the amount of work needed to earn food or phone time increased as the subjects completed their tasks.
“We knew that students would be motivated to gain access to their phones, but we were surprised that, despite modest food deprivation, smartphone reinforcement far exceeded food reinforcement,” lead investigator Sara O’Donnell said in a written statement.
Recruiting subjects for the next step in this line of research – choosing between phones and breathing – could get a little tricky. But we have to admire the creative solution that got one participant disqualified from the current study: He tried to eat his phone.
Probative pee, Pilgrim obesity, and med school baked bribes
He tweets, he (doesn’t) score!
We all know that less sleep equals poor job performance. Up way too late on a Sunday night means you might fall face first into your keyboard the next morning and accidentally send an email that ends with “hhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh.” So, yeah, sleep is important.
It’s especially important when you are a professional athlete and your entire livelihood depends on you being in tip-top shape. Researchers from the State University of New York at Stony Brook studied the performance of NBA players in relation to their late-night Twitter binges. Unsurprisingly, tweeting in the wee hours correlated with fewer points and fewer rebounds in the next day’s game. We’re sure coaches are just thrilled to hear about their players spending precious night hours @-ing random trolls on Twitter. Does this mean less tweeting and more sleep means anyone can be the next LeBron? Or, um, the next @KingJames? Probably not … but give it a try.
Poppy seeds and probative pee
As you tuck into your Thanksgiving leftovers, give a thought to a valiant physician who ate and drank – and peed – for science. Not just once, but twice.
At the recent Pain Care for Primary Care symposium in San Diego, Mount Sinai Beth Israel addiction specialist Edwin Salsitz, MD, gave a presentation about drug screening and mentioned his own homegrown investigation into two reputed sources of false positives.
A few years ago, a patient tested positive for opiates and, like many before him, blamed his fondness for poppy-seed bagels. Dr. Salsitz asked the patient to buy him a poppy bagel from his usual source, then the doctor went home and ate it on a Sunday prior to collecting his own pee. The doctor’s subsequent urine test was positive for opiates, and the patient was off the hook. (For more about the poppy-seed menace to accurate opiate testing, check this clinical update from the Aegis testing company.)
Later, it was time to check another possible urban legend. Dr. Salsitz got some mate de coca tea from a friend who’d returned from South America. Again, he took time out of a Sunday, this time to enjoy a hot beverage, mate de coca style, and collect his own pee. The urine test was positive this time, too – for cocaine.
The moral of the story? If you have a drug test looming, be safe and just stick to a croissant and coffee.
Psst … want a cookie?
In medical school, the best and brightest sacrifice their bodies and social lives to absorb knowledge like human sponges. Or maybe it’s where they absorb cookies in exchange for positive end-of-course evaluations.
Investigators from the University of Münster (Germany) decided to give 118 of the school’s third-year medical students a little test. During a course on emergency medicine, some groups were given access to free chocolate cookies (Discus deliciosum spp.) in their sessions, and some groups were not. When it came time to fill out their “student evaluations of teaching” at the end of the semester, the “cookie group” was more generous in its ratings of the course material and gave significantly higher scores to the teachers and to the course overall, compared with the control group (Med Educ. 2018 Oct;52[10]:1064-72).
This all seemed a little suspicious, so we did a little digging. Turns out that the cookie group – the one that provided all that warm, chocolatey positive reinforcement – was chock full of the usual suspects: Ernie the elf, Mrs. Fields, Famous Amos, and Mr. Big himself, Cookie Monster.
Why Myles Standish wasn’t fat
In the autumn of 1621, obesity didn’t dine with the 53 Pilgrims who gave culinary thanks for surviving their first disappointing Boston Bruins season. Er, for their first harvest after a brutal New England winter. Why was that first Thanksgiving such a svelte affair, free of the high-BMI epidemic that afflicts so many Bruins faithful nearly 4 centuries later? Was it the free-range turkey? The lean venison? The Wampanoag guests’ demands for a DASH-diet dinner?
A modern study may help reveal the historical truth: 17th century Plymouth Plantation wasn’t yet bisected by the 21st century Cape Cod traffic snarling the Pilgrims Highway, a.k.a. Massachusetts Route 3.
It was Spanish researchers, not English Puritans, who unbuckled the portly puzzle’s Pilgrim hat. Investigators with the Barcelona Institute for Global Health examined the link between traffic noise exposure and obesity markers among a group of Swiss adults. The verdict? Those exposed to the highest levels of traffic noise ran the greatest risk of becoming obese. Specifically, every 10-decibel rise in road noise packed on another 17% increase in obesity. Seems tractor-trailer downshifts and honking horns may disturb sleep, gridlocking glucose metabolism and diverting everyone to the nearest drive-thru.
Next on the Spaniards’ research to-do list: Can your New England uncle’s annual Turkey Day tales of Red Sox triumphs trigger psychosis among familial Yankees fans?
He tweets, he (doesn’t) score!
We all know that less sleep equals poor job performance. Up way too late on a Sunday night means you might fall face first into your keyboard the next morning and accidentally send an email that ends with “hhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh.” So, yeah, sleep is important.
It’s especially important when you are a professional athlete and your entire livelihood depends on you being in tip-top shape. Researchers from the State University of New York at Stony Brook studied the performance of NBA players in relation to their late-night Twitter binges. Unsurprisingly, tweeting in the wee hours correlated with fewer points and fewer rebounds in the next day’s game. We’re sure coaches are just thrilled to hear about their players spending precious night hours @-ing random trolls on Twitter. Does this mean less tweeting and more sleep means anyone can be the next LeBron? Or, um, the next @KingJames? Probably not … but give it a try.
Poppy seeds and probative pee
As you tuck into your Thanksgiving leftovers, give a thought to a valiant physician who ate and drank – and peed – for science. Not just once, but twice.
At the recent Pain Care for Primary Care symposium in San Diego, Mount Sinai Beth Israel addiction specialist Edwin Salsitz, MD, gave a presentation about drug screening and mentioned his own homegrown investigation into two reputed sources of false positives.
A few years ago, a patient tested positive for opiates and, like many before him, blamed his fondness for poppy-seed bagels. Dr. Salsitz asked the patient to buy him a poppy bagel from his usual source, then the doctor went home and ate it on a Sunday prior to collecting his own pee. The doctor’s subsequent urine test was positive for opiates, and the patient was off the hook. (For more about the poppy-seed menace to accurate opiate testing, check this clinical update from the Aegis testing company.)
Later, it was time to check another possible urban legend. Dr. Salsitz got some mate de coca tea from a friend who’d returned from South America. Again, he took time out of a Sunday, this time to enjoy a hot beverage, mate de coca style, and collect his own pee. The urine test was positive this time, too – for cocaine.
The moral of the story? If you have a drug test looming, be safe and just stick to a croissant and coffee.
Psst … want a cookie?
In medical school, the best and brightest sacrifice their bodies and social lives to absorb knowledge like human sponges. Or maybe it’s where they absorb cookies in exchange for positive end-of-course evaluations.
Investigators from the University of Münster (Germany) decided to give 118 of the school’s third-year medical students a little test. During a course on emergency medicine, some groups were given access to free chocolate cookies (Discus deliciosum spp.) in their sessions, and some groups were not. When it came time to fill out their “student evaluations of teaching” at the end of the semester, the “cookie group” was more generous in its ratings of the course material and gave significantly higher scores to the teachers and to the course overall, compared with the control group (Med Educ. 2018 Oct;52[10]:1064-72).
This all seemed a little suspicious, so we did a little digging. Turns out that the cookie group – the one that provided all that warm, chocolatey positive reinforcement – was chock full of the usual suspects: Ernie the elf, Mrs. Fields, Famous Amos, and Mr. Big himself, Cookie Monster.
Why Myles Standish wasn’t fat
In the autumn of 1621, obesity didn’t dine with the 53 Pilgrims who gave culinary thanks for surviving their first disappointing Boston Bruins season. Er, for their first harvest after a brutal New England winter. Why was that first Thanksgiving such a svelte affair, free of the high-BMI epidemic that afflicts so many Bruins faithful nearly 4 centuries later? Was it the free-range turkey? The lean venison? The Wampanoag guests’ demands for a DASH-diet dinner?
A modern study may help reveal the historical truth: 17th century Plymouth Plantation wasn’t yet bisected by the 21st century Cape Cod traffic snarling the Pilgrims Highway, a.k.a. Massachusetts Route 3.
It was Spanish researchers, not English Puritans, who unbuckled the portly puzzle’s Pilgrim hat. Investigators with the Barcelona Institute for Global Health examined the link between traffic noise exposure and obesity markers among a group of Swiss adults. The verdict? Those exposed to the highest levels of traffic noise ran the greatest risk of becoming obese. Specifically, every 10-decibel rise in road noise packed on another 17% increase in obesity. Seems tractor-trailer downshifts and honking horns may disturb sleep, gridlocking glucose metabolism and diverting everyone to the nearest drive-thru.
Next on the Spaniards’ research to-do list: Can your New England uncle’s annual Turkey Day tales of Red Sox triumphs trigger psychosis among familial Yankees fans?
He tweets, he (doesn’t) score!
We all know that less sleep equals poor job performance. Up way too late on a Sunday night means you might fall face first into your keyboard the next morning and accidentally send an email that ends with “hhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh.” So, yeah, sleep is important.
It’s especially important when you are a professional athlete and your entire livelihood depends on you being in tip-top shape. Researchers from the State University of New York at Stony Brook studied the performance of NBA players in relation to their late-night Twitter binges. Unsurprisingly, tweeting in the wee hours correlated with fewer points and fewer rebounds in the next day’s game. We’re sure coaches are just thrilled to hear about their players spending precious night hours @-ing random trolls on Twitter. Does this mean less tweeting and more sleep means anyone can be the next LeBron? Or, um, the next @KingJames? Probably not … but give it a try.
Poppy seeds and probative pee
As you tuck into your Thanksgiving leftovers, give a thought to a valiant physician who ate and drank – and peed – for science. Not just once, but twice.
At the recent Pain Care for Primary Care symposium in San Diego, Mount Sinai Beth Israel addiction specialist Edwin Salsitz, MD, gave a presentation about drug screening and mentioned his own homegrown investigation into two reputed sources of false positives.
A few years ago, a patient tested positive for opiates and, like many before him, blamed his fondness for poppy-seed bagels. Dr. Salsitz asked the patient to buy him a poppy bagel from his usual source, then the doctor went home and ate it on a Sunday prior to collecting his own pee. The doctor’s subsequent urine test was positive for opiates, and the patient was off the hook. (For more about the poppy-seed menace to accurate opiate testing, check this clinical update from the Aegis testing company.)
Later, it was time to check another possible urban legend. Dr. Salsitz got some mate de coca tea from a friend who’d returned from South America. Again, he took time out of a Sunday, this time to enjoy a hot beverage, mate de coca style, and collect his own pee. The urine test was positive this time, too – for cocaine.
The moral of the story? If you have a drug test looming, be safe and just stick to a croissant and coffee.
Psst … want a cookie?
In medical school, the best and brightest sacrifice their bodies and social lives to absorb knowledge like human sponges. Or maybe it’s where they absorb cookies in exchange for positive end-of-course evaluations.
Investigators from the University of Münster (Germany) decided to give 118 of the school’s third-year medical students a little test. During a course on emergency medicine, some groups were given access to free chocolate cookies (Discus deliciosum spp.) in their sessions, and some groups were not. When it came time to fill out their “student evaluations of teaching” at the end of the semester, the “cookie group” was more generous in its ratings of the course material and gave significantly higher scores to the teachers and to the course overall, compared with the control group (Med Educ. 2018 Oct;52[10]:1064-72).
This all seemed a little suspicious, so we did a little digging. Turns out that the cookie group – the one that provided all that warm, chocolatey positive reinforcement – was chock full of the usual suspects: Ernie the elf, Mrs. Fields, Famous Amos, and Mr. Big himself, Cookie Monster.
Why Myles Standish wasn’t fat
In the autumn of 1621, obesity didn’t dine with the 53 Pilgrims who gave culinary thanks for surviving their first disappointing Boston Bruins season. Er, for their first harvest after a brutal New England winter. Why was that first Thanksgiving such a svelte affair, free of the high-BMI epidemic that afflicts so many Bruins faithful nearly 4 centuries later? Was it the free-range turkey? The lean venison? The Wampanoag guests’ demands for a DASH-diet dinner?
A modern study may help reveal the historical truth: 17th century Plymouth Plantation wasn’t yet bisected by the 21st century Cape Cod traffic snarling the Pilgrims Highway, a.k.a. Massachusetts Route 3.
It was Spanish researchers, not English Puritans, who unbuckled the portly puzzle’s Pilgrim hat. Investigators with the Barcelona Institute for Global Health examined the link between traffic noise exposure and obesity markers among a group of Swiss adults. The verdict? Those exposed to the highest levels of traffic noise ran the greatest risk of becoming obese. Specifically, every 10-decibel rise in road noise packed on another 17% increase in obesity. Seems tractor-trailer downshifts and honking horns may disturb sleep, gridlocking glucose metabolism and diverting everyone to the nearest drive-thru.
Next on the Spaniards’ research to-do list: Can your New England uncle’s annual Turkey Day tales of Red Sox triumphs trigger psychosis among familial Yankees fans?
Craig Getting, Luis Aguilar-Montalva: Part I
Thomas Jefferson University in Philadelphia partnered with the Lantern Theater Company to offer a class that teaches staging, acting, and playwriting. The class is designed specifically for med students, current residents, attending physicians, and any other medical professionals. The class eliminates hierarchy, encourages artistic exploration, and can lead to increased empathy when dealing with patients and their families. Nick, Luis, and Craig recognize the similarities between medicine and art but also highlight what we can learn from different passions.
Apple Podcasts
Google Podcasts
Thomas Jefferson University in Philadelphia partnered with the Lantern Theater Company to offer a class that teaches staging, acting, and playwriting. The class is designed specifically for med students, current residents, attending physicians, and any other medical professionals. The class eliminates hierarchy, encourages artistic exploration, and can lead to increased empathy when dealing with patients and their families. Nick, Luis, and Craig recognize the similarities between medicine and art but also highlight what we can learn from different passions.
Apple Podcasts
Google Podcasts
Thomas Jefferson University in Philadelphia partnered with the Lantern Theater Company to offer a class that teaches staging, acting, and playwriting. The class is designed specifically for med students, current residents, attending physicians, and any other medical professionals. The class eliminates hierarchy, encourages artistic exploration, and can lead to increased empathy when dealing with patients and their families. Nick, Luis, and Craig recognize the similarities between medicine and art but also highlight what we can learn from different passions.
Apple Podcasts
Google Podcasts
Necrotizing lunchitis, pneumonia throwdown, global gamete warming
Global gamete warming
Apparently, increasing deadly wildfires, hurricanes, and global famine aren’t enough. Turns out, climate change has found yet another way to harm its arch nemeses, a.k.a. every single species on the planet. A study originally published in Nature Communications found that rising temperatures also have a significant effect on male (but not female) fertility. Men: so fragile.
Testing fertility in flour beetles, researchers concluded that successive heat waves of 5-7° C above normal for 5 days reduced sperm competitiveness and practically sterilized the males. Inseminated sperm inside females were also not spared the devastating effects of the heat-wave conditions. And, as the icing on the cake, reduced fertility persisted amongst later generations.
Unless we can figure out how robot sperm can deliver DNA, we’re in trouble.
Pneumonia throwdown
Previously, we pitted Clostridium difficile against cockroaches in a battle of toughness. In this week’s edition of Bacteria vs. the World, bacterial pneumonia goes up against another worthy adversary, viral pneumonia.
“We’ve always known pneumonia was a risk factor for a major adverse cardiac event,” said J. Brent Muhlestein, MD, of Intermountain Medical Center in Salt Lake City. “What we didn’t know was which type of pneumonia was more dangerous.”
To find out, he and his associates followed almost 4,800 patients hospitalized with pneumonia and tracked nonfatal heart attacks, stroke, heart failure, or death. Data they presented at the American Heart Association scientific sessions in Chicago show that 34% of patients with bacterial pneumonia had a major cardiovascular event within 90 days, compared with 26% of those diagnosed with viral pneumonia. It is likely “that bacterial pneumonia causes greater inflammation of the arteries compared to viral pneumonia,” Dr. Muhlestein said.
So the bacteria stay undefeated, and somewhere Chuck Norris, who will never have a heart attack – even a heart isn’t foolish enough to attack Chuck Norris – is smiling.
Ch-ch-check it out
Drop the beat! Researchers at the University of California were interested in examining beatboxing processes to explore how the human mind works.
These crazy scientists threw some beatboxers into an MRI for an exclusive performance and studied the movements of their mouth and tongue. Researchers hypothesized that beatboxers base their sounds on already-known speech. But they discovered that these talented virtuosos are creating a whole new language.
“They’re coming up with ways to create these really complex acrobatic sounds by taking approaches drawn from different parts of the mouth that they don’t use in any language, and nobody uses for any language,” according to the lead researcher.
Does that mean beatboxing will be taught in schools as a foreign language? Perhaps. It might be more useful than learning Latin.
Keloid castration
Keloids – those pesky overgrowths of scar tissue – can be mighty hard to treat.
“Virtually every patient says, ‘I want this cut off – I want it gone,’ ” dermatologist Hilary E. Baldwin, MD, said in a presentation at the recent Las Vegas Dermatology Seminar. She responds to patients with reality checks about what’s actually possible in keloid treatment.
But sometimes, they just want to adjust the appearance of their keloids. Like the man who complained that “my keloid looks like my junk.” Dr. Baldwin took a look and had to agree – the keloid on his deltoid was the spitting image of male genitalia. She treated the keloid with the equivalent of castration (removing its “testicles” via surgery) and circumcision of sorts (flattening its “glans penis” via corticosteroids).
“It didn’t look pretty,” she said, as at least one male member of the audience squirmed, “but it no longer looked offensive to him.”
‘Necrotizing lunchitis’
Here at the Bureau of Livin’ on the MDedge, we pride ourselves on having the best words. And being University of Michigan graduates. So, the pain is Likert-scale 10 when Big Ten rivals have better words – and worse office fridges.
Exhibit A: the operative report surgical-taped to a Penn State University call room refrigerator, which general surgery resident and American hero Dr. Cassie Sonntag shared on Twitter. The 18-cubic-foot communal Kenmore’s diagnosis? “Necrotizing lunchitis.”
The grave condition called for immediate intervention by surgeon “Whitt,” with assistance from circulating nurse “Liu.” The surgical team performed “debridement of the upper, middle, and lower compartments of the call room refrigerator with extension into the fridge door, disarticulation and washout of the lower chamber, explantation of necrotic lunches of varying ages.” Complications? “Multiple never-before-seen species of mold casually exterminated.” The patient’s postprocedure condition is “guarded.” The complete report is well worth your review. Even if the Sears appliance’s specimens were “refused by path.”
Global gamete warming
Apparently, increasing deadly wildfires, hurricanes, and global famine aren’t enough. Turns out, climate change has found yet another way to harm its arch nemeses, a.k.a. every single species on the planet. A study originally published in Nature Communications found that rising temperatures also have a significant effect on male (but not female) fertility. Men: so fragile.
Testing fertility in flour beetles, researchers concluded that successive heat waves of 5-7° C above normal for 5 days reduced sperm competitiveness and practically sterilized the males. Inseminated sperm inside females were also not spared the devastating effects of the heat-wave conditions. And, as the icing on the cake, reduced fertility persisted amongst later generations.
Unless we can figure out how robot sperm can deliver DNA, we’re in trouble.
Pneumonia throwdown
Previously, we pitted Clostridium difficile against cockroaches in a battle of toughness. In this week’s edition of Bacteria vs. the World, bacterial pneumonia goes up against another worthy adversary, viral pneumonia.
“We’ve always known pneumonia was a risk factor for a major adverse cardiac event,” said J. Brent Muhlestein, MD, of Intermountain Medical Center in Salt Lake City. “What we didn’t know was which type of pneumonia was more dangerous.”
To find out, he and his associates followed almost 4,800 patients hospitalized with pneumonia and tracked nonfatal heart attacks, stroke, heart failure, or death. Data they presented at the American Heart Association scientific sessions in Chicago show that 34% of patients with bacterial pneumonia had a major cardiovascular event within 90 days, compared with 26% of those diagnosed with viral pneumonia. It is likely “that bacterial pneumonia causes greater inflammation of the arteries compared to viral pneumonia,” Dr. Muhlestein said.
So the bacteria stay undefeated, and somewhere Chuck Norris, who will never have a heart attack – even a heart isn’t foolish enough to attack Chuck Norris – is smiling.
Ch-ch-check it out
Drop the beat! Researchers at the University of California were interested in examining beatboxing processes to explore how the human mind works.
These crazy scientists threw some beatboxers into an MRI for an exclusive performance and studied the movements of their mouth and tongue. Researchers hypothesized that beatboxers base their sounds on already-known speech. But they discovered that these talented virtuosos are creating a whole new language.
“They’re coming up with ways to create these really complex acrobatic sounds by taking approaches drawn from different parts of the mouth that they don’t use in any language, and nobody uses for any language,” according to the lead researcher.
Does that mean beatboxing will be taught in schools as a foreign language? Perhaps. It might be more useful than learning Latin.
Keloid castration
Keloids – those pesky overgrowths of scar tissue – can be mighty hard to treat.
“Virtually every patient says, ‘I want this cut off – I want it gone,’ ” dermatologist Hilary E. Baldwin, MD, said in a presentation at the recent Las Vegas Dermatology Seminar. She responds to patients with reality checks about what’s actually possible in keloid treatment.
But sometimes, they just want to adjust the appearance of their keloids. Like the man who complained that “my keloid looks like my junk.” Dr. Baldwin took a look and had to agree – the keloid on his deltoid was the spitting image of male genitalia. She treated the keloid with the equivalent of castration (removing its “testicles” via surgery) and circumcision of sorts (flattening its “glans penis” via corticosteroids).
“It didn’t look pretty,” she said, as at least one male member of the audience squirmed, “but it no longer looked offensive to him.”
‘Necrotizing lunchitis’
Here at the Bureau of Livin’ on the MDedge, we pride ourselves on having the best words. And being University of Michigan graduates. So, the pain is Likert-scale 10 when Big Ten rivals have better words – and worse office fridges.
Exhibit A: the operative report surgical-taped to a Penn State University call room refrigerator, which general surgery resident and American hero Dr. Cassie Sonntag shared on Twitter. The 18-cubic-foot communal Kenmore’s diagnosis? “Necrotizing lunchitis.”
The grave condition called for immediate intervention by surgeon “Whitt,” with assistance from circulating nurse “Liu.” The surgical team performed “debridement of the upper, middle, and lower compartments of the call room refrigerator with extension into the fridge door, disarticulation and washout of the lower chamber, explantation of necrotic lunches of varying ages.” Complications? “Multiple never-before-seen species of mold casually exterminated.” The patient’s postprocedure condition is “guarded.” The complete report is well worth your review. Even if the Sears appliance’s specimens were “refused by path.”
Global gamete warming
Apparently, increasing deadly wildfires, hurricanes, and global famine aren’t enough. Turns out, climate change has found yet another way to harm its arch nemeses, a.k.a. every single species on the planet. A study originally published in Nature Communications found that rising temperatures also have a significant effect on male (but not female) fertility. Men: so fragile.
Testing fertility in flour beetles, researchers concluded that successive heat waves of 5-7° C above normal for 5 days reduced sperm competitiveness and practically sterilized the males. Inseminated sperm inside females were also not spared the devastating effects of the heat-wave conditions. And, as the icing on the cake, reduced fertility persisted amongst later generations.
Unless we can figure out how robot sperm can deliver DNA, we’re in trouble.
Pneumonia throwdown
Previously, we pitted Clostridium difficile against cockroaches in a battle of toughness. In this week’s edition of Bacteria vs. the World, bacterial pneumonia goes up against another worthy adversary, viral pneumonia.
“We’ve always known pneumonia was a risk factor for a major adverse cardiac event,” said J. Brent Muhlestein, MD, of Intermountain Medical Center in Salt Lake City. “What we didn’t know was which type of pneumonia was more dangerous.”
To find out, he and his associates followed almost 4,800 patients hospitalized with pneumonia and tracked nonfatal heart attacks, stroke, heart failure, or death. Data they presented at the American Heart Association scientific sessions in Chicago show that 34% of patients with bacterial pneumonia had a major cardiovascular event within 90 days, compared with 26% of those diagnosed with viral pneumonia. It is likely “that bacterial pneumonia causes greater inflammation of the arteries compared to viral pneumonia,” Dr. Muhlestein said.
So the bacteria stay undefeated, and somewhere Chuck Norris, who will never have a heart attack – even a heart isn’t foolish enough to attack Chuck Norris – is smiling.
Ch-ch-check it out
Drop the beat! Researchers at the University of California were interested in examining beatboxing processes to explore how the human mind works.
These crazy scientists threw some beatboxers into an MRI for an exclusive performance and studied the movements of their mouth and tongue. Researchers hypothesized that beatboxers base their sounds on already-known speech. But they discovered that these talented virtuosos are creating a whole new language.
“They’re coming up with ways to create these really complex acrobatic sounds by taking approaches drawn from different parts of the mouth that they don’t use in any language, and nobody uses for any language,” according to the lead researcher.
Does that mean beatboxing will be taught in schools as a foreign language? Perhaps. It might be more useful than learning Latin.
Keloid castration
Keloids – those pesky overgrowths of scar tissue – can be mighty hard to treat.
“Virtually every patient says, ‘I want this cut off – I want it gone,’ ” dermatologist Hilary E. Baldwin, MD, said in a presentation at the recent Las Vegas Dermatology Seminar. She responds to patients with reality checks about what’s actually possible in keloid treatment.
But sometimes, they just want to adjust the appearance of their keloids. Like the man who complained that “my keloid looks like my junk.” Dr. Baldwin took a look and had to agree – the keloid on his deltoid was the spitting image of male genitalia. She treated the keloid with the equivalent of castration (removing its “testicles” via surgery) and circumcision of sorts (flattening its “glans penis” via corticosteroids).
“It didn’t look pretty,” she said, as at least one male member of the audience squirmed, “but it no longer looked offensive to him.”
‘Necrotizing lunchitis’
Here at the Bureau of Livin’ on the MDedge, we pride ourselves on having the best words. And being University of Michigan graduates. So, the pain is Likert-scale 10 when Big Ten rivals have better words – and worse office fridges.
Exhibit A: the operative report surgical-taped to a Penn State University call room refrigerator, which general surgery resident and American hero Dr. Cassie Sonntag shared on Twitter. The 18-cubic-foot communal Kenmore’s diagnosis? “Necrotizing lunchitis.”
The grave condition called for immediate intervention by surgeon “Whitt,” with assistance from circulating nurse “Liu.” The surgical team performed “debridement of the upper, middle, and lower compartments of the call room refrigerator with extension into the fridge door, disarticulation and washout of the lower chamber, explantation of necrotic lunches of varying ages.” Complications? “Multiple never-before-seen species of mold casually exterminated.” The patient’s postprocedure condition is “guarded.” The complete report is well worth your review. Even if the Sears appliance’s specimens were “refused by path.”