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December 05, 2017

This surgery, which is called limb lengthening or precice tibia lengthening, allows short people to become about a foot taller.
The procedure has been performed successfully for about 50 years in Kurgan, Russia. The concept was developed Gavriil A. Ilizarov back in 1951 after seeing many WWII veterans who had leg fractures that had not healed. Watch the video below to see how the surgery is done.

“Limb lengthening and reconstruction techniques can be used to replace missing bone and lengthen and/ or straighten deformed bone segments. The procedures may be performed on both children and adults who have limb length discrepancies due to birth defects, diseases or injuries. The limb lengthening and deformity correction process works on the principle of distraction osteogenesis. This is a revolutionary concept that reverses the long-held belief that bone cannot be regenerated. In this process, a bone that has been cut during surgery can be gradually distracted (pulled apart), leading to new bone formation (osteogenesis) at the site of the lengthening. In this way, bone segments can be lengthened by 15 to 100 percent of their original length. We use a variety of techniques, including the use of monolateral (one-sided) and circular external fixation devices, to correct angular deformities as well as limb length discrepancies.” ~ Hospital for Special Surgery
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December 05, 2017
IS IT REALLY DOWN TO RADIATION SICKNESS, OR SOMETHING ELSE? ATTILA JANDI/SHUTTERSTOCK
There’s no doubt that parts of North Korea feature hellish humanitarian disasters. The Punggye-ri Nuclear Test Site near Mount Mantap has made headlines several times in this regard in the last few months, with reports of deformed babies, corpses floating down rivers, and more being linked to the subterranean detonations.
Now, as reported by NBC News, North Korean defectors fleeing the area have spoken of something they’re colloquially referring to as a “ghost disease”. According to their accounts, leaking radiation is having a dreadful effect on their health, causing weakness, sores, and worse.
One middle-aged escapee explained that people were dying all around her back in Kilju County, which features the underground test site.
“We thought we were dying because we were poor and we ate badly. Now we know it was the radiation,” defector Lee Jeong Hwa told the human rights activists based in Seoul.
Reports of sick and dying North Koreans have steadily emerged from those that used to live near Punggye-ri over the last few months. Although the nuclear tests occur deep below the surface, the increasingly weak geology there makes it a distinct possibility that some of the radiation is effusing up toward the surface.
Some have suspected that the site suffers from Tired Mountain Syndrome, wherein repeated massive explosions cause the surrounding rock to become increasingly permeable. This has been corroborated with the accounts of other defectors who have spoken of disappearing water within wells, a phenomenon that could be down to a lowering of the water table as the underlying geology collapses after each test.
However, at this stage, you can’t conclusively blame the awful health of the North Korean defectors on radiation. Without any researchers being allowed onto the site, it’s difficult to tell how much radioactive contamination at the surface there actually is.


 Malnutrition – something that is rife in North Korea – poor sanitation, and hygiene, as well as waterborne diseases, could also be to blame. Unlike radioactive contamination, these are known to be prevalent throughout the country.
Incidentally, South Korean officials have tested Lee and 29 other defectors hailing from Kilju County for signs of radioactive contamination. So far, they’ve not found any.
This doesn’t mean that the defectors are fabricating these stories, though. It’s more likely that being aware of the underground nuclear tests, they associate the accompanying radiation with their poor health. Even with other factors taken into account, these colossal blasts are so frightening that they find it difficult to not make the association.
There’s no doubt that the living conditions in Kilju are unfathomably awful. Still, at this stage, the degree to which any radioactive contamination at the surface is occurring – if at all – remains uncertain.
[H/T: NBC News]
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December 04, 2017
A MAN WITH A 'DO NOT RESUSCITATE' TATTOO. THE SIGNATURE BELOW THE WORD 'RESUSCITATE' HAS BEEN BLURRED OUT FOR ANONYMITY REASON. THE NEW ENGLAND JOURNAL OF MEDICINE ©2017

Imagine the dilemma: You’re about to resuscitate a dying man, but when you peel back his shirt, you see a bold black tattoo saying ”DO NOT RESUSCITATE”. The word “not” is underlined and his signature is below the final word. Do you consider the tattoo a real medical warning? Or just a dark-humored joke?
That’s what happened to Dr Gregory Holt at Miami’s Jackson Memorial Hospital. In a case report for The New England Journal of Medicine, he explained how they handled the experience, along with the profusion of ethical dilemmas and confusion caused by the man’s choice of body art.
The 70-year-old man was brought to the hospital unconscious, heavily intoxicated with alcohol, and with dropping blood pressure. They quickly discovered the man’s tattoo, but initially decided to ignore it. A "Do Not Resuscitate" (DNR) tattoo is not a legally-binding document after all. In Florida, you can only request to not be resuscitated if you have signed a Do Not Resuscitate Order – Form 1896 on a piece of yellow paper (they are very particular about the yellow paper bit).
Stuck with this predicament, they requested an ethics consultation with some experts on the matter. The consultants argued it was “reasonable to infer that the tattoo expressed an authentic preference.” Fortunately, the situation was quickly settled when they obtained an official copy of his Florida Department of Health DNR order.
The man died later that evening, as per his wishes.
The doctors behind the case say the story highlights how DNR tattoos can put medical professionals in a very sticky situation, although they note that their report "neither supports nor opposes the use of tattoos to express end-of-life wishes." However, they do say that it is much more effective to simply sign the appropriate forms if this really is a patient’s true request.
“This patient’s tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated,” Dr Holt explains.
Their decision to not follow the tattoo's orders without further investigation was well-founded. In 2012, the Journal of General Internal Medicine reported that a team of doctors were placed in a similar position when a physical examination revealed a “D.N.R.” tattoo on the man's chest. In this case, they decided to ignore the tattoo and resuscitate him. That was a pretty good call considering this guy had only received the tattoo because he had lost a bet in a poker game with friends.
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December 04, 2017
NICK LUNDGREN/SHUTTERSTOCK

Whether it's popping pills like Kim and Kourtney or consuming it raw in a smoothie like actor Gaby Hoffman, eating placenta has been the latest alternative maternity trend to hit the mainstream. But in case you were wondering whether or not it's a good idea to follow suit, the latest research suggests it's best to sit this one out.
Not only does it put your child at risk (the CDC issued a health warning this summer), it appears the health benefits have been over-exaggerated. According to a study recently published in Women and Birth, new mothers who take placenta capsules show no significant improvement in maternal mood, mother-infant bonding, or fatigue.
The placenta develops during pregnancy to supply the fetus with nutrition and discard its waste. The theory goes that post-labor, the nutrients that have been passed from mother to fetus during pregnancy persist in the placenta and eating it raw helps the mother recover from childbirth. The practice has been gaining increasing popularity in recent years with proponents claiming that placenta pills can ease fatigue, prevent post-natal depression, and improve milk production.
Advocates also point out that humans are one of the relatively few species of mammal that don't partake in placentophagy (the scientific name for eating the placenta). While this might be true, it doesn’t necessarily mean that we should do the same. As Rebecca Baergen, a professor and Chief of Perinatal and Obstetric Pathology at Weill Cornell Medicine, pointed out in an interview with Scientific American, “there are a lot of other things that animals do that we don't do.”
Still, until now, there has been relatively little science that has looked into the effects – beneficial or not – of eating your placenta.
Researchers from the University of Nevada, Las Vegas, monitored maternal mood, mother-infant bonding, and fatigue levels in 27 new mothers. Twelve volunteers were given placenta pills to take. The remaining 15 were given placebo pills.
Ultimately, there was no significant improvement in any of the categories measured, though the researchers did note very slight decreases in depressive symptoms in the placenta pill group, which could be investigated further. There were also small but noticeable changes in hormone concentrations.
“What we have uncovered are interesting areas for future exploration, such as small impacts on hormone levels for women taking placenta capsules, and small improvements in mood and fatigue in the placenta group,” Sharon Young, lead author of the study, explained in a statement.
It was a small study so it would be interesting to see whether these findings can be replicated on a larger scale, but while experts advise against the practice, and with pills costing upwards of $200, for now, it might be a trend to skip.
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December 03, 2017
CHOLERA IS SPREAD BY DRINKING WATER CONTAMINATED WITH FECES, MAKING SANITATION A KEY PRIORITY. RICCARDO MAYER/SHUTTERSTOCK

Cholera is still very much a modern disease, infecting millions and causing the deaths of close to 100,000 people around the globe each year. Caused by a bacteria, it now seems that nearly all of the explosive epidemics seen within the last 50 years have originated from one region: Asia.  
This astonishing and potentially groundbreaking discovery has been reported in two papers published this week in Science, one of which focused on the cholera epidemics that have struck the Americas, and another that looked at those which have burned through Africa. From sequencing and then comparing the genomes of over a thousand samples of the disease, it seems the road leads all the way back to the Far East.
This is a fascinating finding for a number of reasons. Since the 1800s there have been seven cholera pandemics, with the current pandemic having started in the 1960s. It is caused by a single lineage of the bacterium Vibrio cholerae known as 7PET. This pandemic has led to various epidemics, with particularly large ones occurring in South America and Africa.
The first epidemic from this most recent spread in Africa sprung up in the 1970s, while in South America there were two; one started in Peru in 1991, while another was identified in Haiti in 2010. There has been a long-running, and often vitriolic debate over where these epidemics originated, with some arguing that in certain regions of Africa, the V. cholerae is endemic, surviving in reservoirs in the environment for years before rearing its head and starting a new epidemic.
But this research shows that this theory is unlikely to be completely accurate. While it is true that some strains of cholera are indeed endemic, the studies found that those which cause the massive epidemics that spread quickly and kill thousands are all members of the 7PET lineage, and so all originated in Asia.
“Our results show that multiple new versions of 7PET bacteria have entered Africa since the 1970s,” explained François-Xavier Weill, who led the African research. “Once introduced, cholera outbreaks follow similar paths when spreading across that continent. The results give us a sense of where we can target specific regions of Africa for improved surveillance and control.”
But not only that, it means that when a cholera outbreak occurs, researchers can first test to see if it is 7PET, and if it is, measures can be stepped up to contain the potential new epidemic. It also means that the complete eradication of cholera in places like Africa is absolutely achievable, which is no doubt going to be welcome news to the World Health Organization, which plans on cutting cholera deaths by 90 percent by 2030.
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December 03, 2017
HISTOPLASMA CAPSULATUM. METHENAMINE SILVER STAIN SHOWING HISTOPATHOLOGIC CHANGES IN HISTOPLASMOSIS. CENTERS FOR DISEASE CONTROL AND PREVENTION'S PUBLIC HEALTH IMAGE LIBRARY

A new medical case study in BMJ Case Reports tells a very unusual story involving a heart transplant, a vacation in North Carolina, bat poop, and a very sneaky fungal infection.
Doctors from the University of Arizona Health Sciences Center explain how a 70-year-old man visited the hospital in Tucson after suffering from an “altered mental status” and confusion for a number of days. A CT-scan highlighted a number of unusual blotches on the man’s brain, strongly suggesting there was some kind of growth.
Further tests indicated that the man might be suffering from a histoplasmosis fungal infection, better known as “cave disease" or "Ohio valley disease”. This fungus often thrives in decaying bird poop, bat guano, and soil found around the humid caves of the Ohio and Mississippi River valleys, as well as select parts of the Americas, Africa, Asia, and Australia.
However, there was just one problem: the man had remained in Arizona for many years, where there are next to no reported cases of the fungus. Furthermore, symptoms typically appear within just two weeks of inhaling the spores.
The fungal spores usually enter a person’s lungs and trigger a fever, cough, tiredness, and various other nasty flu-like symptoms. However, most people can fight off an infection relatively easily unless they have a suppressed immune system. Johnny Cash even sang about a nasty run-in with the fungus in the song Beans for Breakfast.
Some hard detective work by the doctors revealed what might be behind this odd set of circumstances. The man had a vacation in North Carolina, an area known to harbor the fungus, during the mid-1980s. In 1986, he had also undergone a heart transplant and was given long-term immunosuppressant drugs to make sure his body didn’t reject the transplanted organ. These drugs allowed the fungal spores to lay hidden in his body undetected by the immune system. It appears that the fungus had only just presented itself in his brain, 30 years after the initial infection.
The man was discharged from the hospital, given an antifungal medication to treat the infection, and later made a recovery. The doctors on the case say it's a reminder of how histoplasmosis can often play a fickle game by not always presenting itself where and when you think it should.
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December 01, 2017
THE TAKE AWAY FROM THIS STORY: HUGS ARE GOOD. TANIA KOLINKO/SHUTTERSTOCK
Every hug gives your body a small dose of oxytocin, the neurotransmitter associated with love, intimacy, and lots of other good stuff. Just in case you needed another excuse to snuggle up, a new study has shown how cuddling infants during their early years could have a deeply profound effect on their biology later in life.
Recent research from the University of British Columbia (UBC) shows that the amount of hugging a child receives as an infant can influence epigenetic changes in at least five areas of their DNA, including areas related to the immune system and metabolism. Infants who had experienced less close physical contact in their first weeks of life were also shown to have a molecular profile in their cells that was underdeveloped for their age.
Previous work has found a similar phenomenon in rodents, but this is the first study to investigate how humans could also be affected by close contact and affection in early life.
“In children, we think slower epigenetic aging could reflect less favorable developmental progress,” Michael Kobor, a professor at UBC's Department of Medical Genetics, said in a statement.
The study, recently published in the journal Development and Psychopathology, asked the parents of 94 babies to keep a diary of their infants’ behavior, as well as their touching and cuddling habits, for the first 5 weeks of postnatal care. Four to five years later, they then sampled the DNA of these same children.
They then looked out for the epigenetic process of DNA methylation. This process works a bit like a dimmer switch to control how active a gene is. Epigenetics – literally meaning "on top of" genetics – explains how the extent of methylation can be affected by environmental influences, especially in childhood.
According to their findings, there were consistent differences in the extent of methylation at five specific DNA sites between the kids who had experienced a high level of contact and those who had not. In particular, one of these sites is known to play a role in the immune system and another influences metabolism.
It’s still early days for this research, however, the scientists on the project hope to follow these subjects to further learn about how our early experience, particularly snuggling and cuddling, can deeply affect our biology and our lives.
“We plan to follow up on whether the ‘biological immaturity’ we saw in these children carries broad implications for their health, especially their psychological development,” said lead author Sarah Moore, a postdoctoral fellow. “If further research confirms this initial finding, it will underscore the importance of providing physical contact, especially for distressed infants.”
So, the take away from this story: hug more.

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