You ain’t from here

Dr. Victor Sierpina

Dr. Victor Sierpina

Today, I finally met and had a nice conversation with ole John Dundee, whose father’s family has been in Galveston since long before the Storm. Not Ike, the 1900 one. Oh, that big one. It is fascinating what draws people to a place and how some just settle in for generations while others move on to happier hunting grounds.

Galveston seems to be a magnet for both the lifers and the gypsies and we are all richer for it. My talk with John and his mom, who is a relative newbie to the Island, only having lived here since 1942, reminded me of Cecil, a 93-year-old patient I took care of in Colorado.Sometime in the 1930s, during the Great Depression, Cecil and his family were traversing the U.S. looking for a better life. Their Model T pickup broke down in the high country San Luis Valley of Colorado. Their only possessions were a bag of potatoes and a bag of beans, so they decided to light there and became contributing members of the community, teachers, farmers, small business owners, and so on. Continue reading

Ebola — you won’t get it from shaking hands

Dr. Victor Sierpina

Dr. Victor Sierpina

A strange thing happened to me last Monday when I went to the clinic.

With the report of a man in Texas with Ebola who had been discharged from a Dallas hospital, then readmitted very sick a couple days later, I realized that any patient I came in contact with that day, or any day, might have this deadly virus.

Now we don’t usually think of work in health care as inherently a hazardous profession — say like being a soldier, firefighter or policeman. Yet it has actually always been so. From doctors and nurses who cared for patients with leprosy and bubonic plague in medieval times to those caring for the Ebola epidemic in Africa today, our colleagues in white coats put their lives on the line caring for those who have no other recourse for help.

Emergency workers, ambulance crews, and paramedics are often called into dangerous settings after shootings, bombings, and other catastrophes where the sites are not always secure or safe. They transport people with unknown diseases and unknown risk.

Of course, we have developed methods of reducing risk. Part of annual training at UTMB for all clinical staff includes reviewing universal precautions, which include several levels of infectious disease control. These range from basic hand washing and use of rubber globes to advanced personal protective equipment, including specialized gowns, masks, and in some cases like the Galveston National Laboratory, even hazmat type suits and respirators. Continue reading

Single change in one letter makes you a natural blond

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Out of the 3 billion letters contained in the human genetic code, all it takes to be born a blond is a single change in a certain place from an A to a G.

With the sheer complexity of the human genome, this new discovery shows how remarkably simple it is to be a natural blond. Especially when you consider the lengths people go to become one artificially.

This discovery actually came from research on the evolution of Sticklebacks, small fish that emerged from the oceans and colonized streams, rivers and lakes at the end of the last Ice Age.

Scientists at Stanford University have been studying how Sticklebacks have adapted to different habitats around the world, and particularly how different populations acquired their skin colors.

They discovered that changes in a single gene determined the pigmentation of fish throughout the world. The gene responsible, the Kit ligand gene, is also in the human genome. Different versions of it have evolved around the world and are associated with differences in skin color. Continue reading

The real skinny on holistic bariatric surgery

Dr. Victor Sierpina

Dr. Victor Sierpina

I recently read a really well-done book by a highly successful bariatric surgeon in Dallas and former UTMB medical student.

Dr. Nick Nicholson’s book, “Weight Loss Surgery: The Real Skinny,” is an essential read for those of you who might be contemplating surgery for your weight problem, as well as for your family and friends. Such surgery has become the second most common general surgery procedure after gallbladder removal. So if you haven’t met someone who has had this surgery, you surely will.

Bariatric means relating to weight loss, thus bariatric surgery involves one of several types of procedures to help people lose weight. This is not a minor event. If your six-pack has turned into a 12-pack, you are 10-30 pounds overweight, don’t fit into your favorite dress or jeans, bariatric surgery is likely not for you. It is not a cosmetic treatment like getting a face-lift or getting a boob job.

Your BMI needs to be over 40, or over 35 if you have certain obesity related medical conditions to even qualify for this kind of surgery. Additionally, most insurances, if they cover this treatment, require psychological evaluation, documentation of failed attempts at diet, exercise, and the usual approaches to losing weight. Continue reading

Low-power laser treatment works on molecular level for cavities

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

For all those who cringe at the thought of going to the dentist or hearing the word cavity, there is hope.

Apparently, when low-power laser light is focused onto damaged teeth, it stimulates the regrowth of dentin to correct the damage.

The laser light stimulates the stem cells that already are in teeth to differentiate and repair damage from within, so that someday dentists can repair or even regrow teeth without fillings.

Teeth consist of four different tissues; three of these — enamel, dentin and cement — are harder than bone, while one — dental pulp — is soft. Enamel, the hardest material in the body, is the outer surface of the crown of a tooth.

Once enamel has completely formed it cannot be repaired, but it can remineralize. It allows teeth to withstand large amounts of stress, pressure and temperature differences.

Dentin lies beneath enamel and forms the main portion of a tooth through numerous microscopic channels called dentin tubules. Continue reading

Recommendations on bicycle safety for kids

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The following are recommendations from the American Academy of Pediatrics on bicycle safety:

Do not push your child to ride a 2-wheeled bike without training wheels until he or she is ready.

Consider the child’s coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes. Consider a balance bike with no pedals for young children to learn riding skills.

Take your child with you when you shop for the bike so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new one. Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.

Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many injuries happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Set the example: Whenever you ride, put on your helmet.


When purchasing a helmet, look for a label or sticker that says the helmet meets the CPSC safety standard.

A helmet protects your child from serious injury and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.

A helmet should be worn so that it is level on the head and covers the forehead, not tipped forward or backward. The strap should be securely fastened with about two fingers able to fit between the chin and strap.

The helmet should be snug on the head but not overly tight. Skin should move with the helmet when moved side to side. If needed, the helmet sizing pads can help improve the fit.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

New evidence suggests long-term relationships with bacteria begins before we’re born

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While we know for sure that the microbiome of bacteria living in and on us are key to our own well-being, more evidence suggests that we acquire our microbiomes before we’re even born.

While a baby does acquire bacterial flora from its mother as it moves through the birth canal, scientists now think that our symbiotic, lifelong relationships with bacteria begin in utero long before birth.

They found bacteria living in the placenta, an organ previously thought to be sterile.

They also discovered a baby’s bacteria to be similar to the bacterial flora of the mother’s mouth, making oral hygiene during pregnancy extra important.

An experiment in 2008 by Spanish scientists indicated that bacteria are acquired in some way before birth.

They inoculated pregnant mice with labeled bacteria, which were then found in the meconium, the first bowel movement after birth.


 

This was true even when the babies had been delivered by C-section. So scientists knew then that bacteria are acquired before birth and even without the birth canal, changing what we thought we knew about the womb.

Since then, scientists at Baylor College of Medicine have been studying the inside of the womb and birth canal in both humans and animals.

They discovered that the vaginal microbiome changed during pregnancy, but it did not resemble that of newborns. So where did they get their bacteria from?

Baylor scientists then examined placentas from 320 women immediately after birth. Using DNA sequencing, they identified the individual types of bacteria each placenta contained.

Comparing them to bacteria growing in and on the mothers, they found that the types of bacteria living in the mothers’ mouths most closely resembled those in their own placentas.

Interestingly, the bacteria in the placenta consisted of high proportions of bacteria responsible for synthesizing vitamins and other nutrients, which probably benefits a developing fetus and newborn.

So a fetus is first exposed to bacteria from the placenta, then at birth additional bacteria are introduced, and then again when babies are exposed bacteria on their parent’s skin, in breast milk and in their environment.

Other studies have shown the influence of the microbiome on a mother and her baby. In one experiment, monkeys who ate a high-fat diet while pregnant and lactating produced babies with different proportions of bacteria in their guts than those of monkeys fed a normal diet.

The short- and long-term consequences of abnormal maternal and infant microbiomes are not yet known, but it’s speculated that these changes could influence the metabolism of the infant and the development of metabolic disorders.

Science is increasingly aware of the role and importance the microbiome has in various parts of the body and the part it plays in human health and disease.

Professors Norbert Herzog and David Niesel are biomedical scientists at the University of Texas Medical Branch. Learn more at medicaldiscoverynews.com.

There are various treatment options for childhood cancers

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

September is Childhood Cancer Awareness month.

During the last two weeks, we’ve discussed what cancer is and some of the common types of childhood cancers.

This week, we discuss the various treatment options, how they work and some of the side effects.

Doctors have three main treatment strategies to treat cancer: surgery, radiation, and chemotherapy.

Depending on the type of cancer and how much it has spread, the overall treatment may combine several of the different kinds of therapy.

We’ve found it useful to explain cancer treatment with an analogy many people can easily relate to — fighting weeds in your yard.

When you discover a small cluster of weeds in the middle of your yard, you can probably successfully get rid of them by digging around the offending patch and pulling them out by the roots. Continue reading

New DEA rules on pain killers are coming soon

Dr. Victor Sierpina

Dr. Victor Sierpina

The US Drug Enforcement Agency, after lengthy debate and public input, has implemented a rescheduling of the most widely prescribed group of drugs in the U.S., the hydrocodone-acetaminophen combinations. These are drugs with brand names of Vicodin, Norco and Lortabs.

There are 135 million prescriptions annually for these hydrocodone combination products (HCPs), much more than for the next most common prescriptions for thyroid, blood pressure, and cholesterol lowering drugs.

Some time ago, government rules reduced the total acetaminophen (trade name Tylenol) content to 325 mg a day per pill as greater than 4,000 mg daily in combination with hydrocodone was placing patients at risk for liver damage.

Those addicted to these meds might have been taking 10, 20 or 30 pills a day, way exceeding the safe amount of acetaminophen the liver can handle.

Now, this HCP group of drugs is moving from a Schedule 3 to a Schedule 2 class, entering the same category as morphine, Dilaudid, oxycodone, Percocet, Demerol, Fentanyl and other powerful and highly addictive pain medicines. Continue reading

3 main types of childhood cancer

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

According to the American Cancer Society, more than 10,000 children younger than 15 years old in the United States are diagnosed with various kinds of cancer each year.

Last week, we discussed what cancer is and how it begins when microscopic cells that make up a normal body part start growing out of control.

This week, we discuss some of the different types of childhood cancer.

Leukemias are the most common, accounting for about one-third of all childhood cancers.

Leukemia is a type of cancer that originates from white blood cells, which normally help fight infection.

Leukemia generally begins in the bone marrow where blood cells are formed, but eventually the cancerous cells are released out into the bloodstream, so there is no distinct tumor. Continue reading