There’s hope for sickle cell

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While sickle cell disease has long been studied, a recent discovery revealed that the disease significantly increases the levels of a molecule called sphingosine-1-phosphate, or S1P, which is generated by an enzyme called sphingosine kinase 1.

Inhibiting this SphK1 enzyme was found to reduce the severity of sickle cell disease in mice, which will hopefully lead to new drugs that target SphK1 in order to treat sickle cell disease in humans.

Sickle cell disease is caused by a change in the gene that is responsible for a type of hemoglobin, the protein molecule in red blood cells that carries oxygen. This tiny change results in hemoglobin clumping together, changing the shape of red blood cells.

The name for sickle cell disease actually comes from misshapen red blood cells. Rather than being shaped like a disk, or a doughnut without a whole, sickle cells are shaped like a crescent, sort of bending over on themselves in a process called sickling. Continue reading

7 steps to improving empathy

Dr. Victor Sierpina

Dr. Victor Sierpina

Last week, we discussed the topic of empathy, how it is different from compassion and how essential empathy is to human relationships.

This matters not only in health care but in families, in business, in friendships.

Based on research from Harvard’s teaching hospital by Dr. Helen Riess and her research coordinator, Gordon Draft-Todd, the following is a an acronym published in the journal Academic Medicine, August 2014. I hope you find it helpful.

The E.M.P.A.T.H.Y. approach to better communication and connection:

E. Eye Contact. This is so essential to connection and engagement, and even the neurobiology of relation, that we need to attend to it. Be aware that some cultures find prolonged eye contact intrusive, seductive or even rude. As a physician, it seems harder to maintain good eye contact throughout an encounter because of the ever-present electronic record which requires us to document, review results, write orders, refills, write work or jury excuses, etc. Early, late, and as often as possible, eye contact is what I recommend to my students and colleagues despite the intrusion of the electronic environment and a busy clinic schedule with short office visits. Also, I recommend patients shut off their phones during visits as the precious time we have can be interrupted by frequent calls and texts. Continue reading

Domestic violence is not just an NFL problem

Dr. Jeff Temple

Dr. Jeff Temple

After an initially weak response by the NFL and victim-blaming by the Baltimore Ravens, pro football player Ray Rice was finally dropped from his team for knocking his wife (then fiancée) unconscious. It has been more than 100 days since the incident, and he was cut loose by his team only after a video clearly showed him knocking her out.

The video of Rice dragging his victim’s body out of the elevator wasn’t enough to warrant this punishment. Apparently, NFL officials needed to see the punch. Some, including Rice, argued that he acted in defense. The Ravens tweeted, “Janay Rice says she deeply regrets the role that she played the night of the incident.”

Sound familiar? That’s because women in abusive relationships have heard this all before

“Why did you marry him?”; “Why do you stay?”; “What did you do to make him so angry?”

And rarely do women in violent relationships have a video to document what happened to them.

While violence perpetrated by pro athletes may demand disproportionate attention, we must be careful not to forget that domestic violence is a very real problem that affects our sisters, daughters, mothers, colleagues and neighbors. Continue reading

Agavin offers more choices to those watching caloric, sugar intake

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Next time you have a bitter pill to swallow, think about reaching for a spoonful of agavin instead of sugar to help the medicine go down.

You might not know what agavin is yet, but you’ve probably noticed that a number of alternative natural sweeteners like Stevia have been added to grocery store shelves next to traditional sugar.

These products sweeten foods but often do not add calories or raise blood sugar levels. Recent research suggests that a sweetener made from agave, the same plant used to make tequila, may lower blood sugar levels and help people maintain a healthy weight.

Agavin is a natural form of sugar, fructose, called fructan. With fructan, individual sugar molecules are linked together in long chains.

The human body cannot use this form of fructose so it is a non-digestible dietary fiber that does not contribute to blood sugar levels. But it can still add sweetness to foods and drinks. Continue reading

Empathy is a vital skill for health industry

Dr. Victor Sierpina

Dr. Victor Sierpina

Editor’s note: This the first in a series.
Empathy is the ability to detect, understand, and relate to another’s emotions. It is the basis of deep interpersonal relationships, including therapeutic relationships such as between a healer and a client or patient. Much of empathy is a nonverbal process.

Empathy is different from compassion. Compassion is a positive trait embraced by all major faith traditions. Compassion literally means “to suffer together.” It is defined as the feeling that arises when you are confronted with another’s suffering and the feeling you have motivating you to relieve that suffering. Continue reading

Reading an easy way to shape a better life

Dr. Victor Sierpina

Dr. Victor Sierpina

I have always been an incessant reader. Throughout my life, the world has entered my mind and experience through words.

New places and persons, extraordinary ideas, philosophies, faiths, art and all the panoply of what is available through literature has been instantly available to me though books and magazines.

It is even more so now through electronic sources. As a kid, summer vacations occasioned biweekly trips to the Phoenix Public Library where I would check out the maximum allowable 10 books.

Biographies of famous people like Thomas Edison, outdoorsmen like Kit Carson and Teddy Roosevelt served to inspire and keep me busy during hot summer days. Novels, nonfiction and hobby themes abounded as well in my reading lists. Continue reading

Thirdhand smoke is dangerous, too

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Science has long proved that smoking is bad for you and those around you, with 90 percent of lung cancer cases caused by smoking.

Even secondhand smoke is dangerous enough to warrant banning smoking in public places. The idea of thirdhand smoke premiered in 2009, and scientific evidence shows that it, too, can harm human health.

Thirdhand smoke is the many toxic compounds from tobacco smoke that settle onto surfaces (particularly fabrics) such as carpet, furniture and the inside of a car. Researchers have identified chemicals in thirdhand cigarette smoke called NNA and NNK that can bind to DNA, a person’s genetic information, and cause damage and mutations that could lead to cancer. Continue reading

I Spy for Heart Disease

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While a shrink ray like the kind used in science fiction is still stuck in the future, miniature devices are not. Tiny devices have been created to perform a variety of tasks, from an implantable telescope to improve vision in those with macular degeneration to the new pacemaker in clinical trials that is about the size of a large vitamin pill. Now, researchers have developed a catheter-based device smaller than the head of a pin that can provide real-time 3-D images of the heart, coronary arteries and other blood vessels. This is an important invention as the casualties of heart disease continue to rise. Statistically, 1 in 4 people will have a heart attack.

Many Americans are at risk for developing coronary artery disease due to the buildup of cholesterol and plaque. If there is a rupture or breakage of the plaque, creating a blood clot, that can result in a heart attack with little to no warning. Traditional diagnostic tests such as stress tests and echocardiograms show how much blood is flowing to the heart. If there are regions of the heart that are not getting as much blood as others, it might be a sign of clogged coronary arteries. However, blood flow can also appear to be normal even with plaque buildup. Continue reading

Toenails play role in your health – take care of them

Dr. Victor Sierpina

Dr. Victor Sierpina

This week, please allow me to address a topic that seldom makes the top ten of health care problems: toenails. Take a moment now, and look at your toenails. Can you say with all honesty that you love and appreciate them? Or do you prefer they remain hidden under glitzy toe polish or buried in a boot or shoe? Are they the nice, symmetrical, pink-white shiny nails of youth or the horny, crusty, yellowed hooves of old age? Are they all the same color, or are some darker, green, yellow, or even black?

My inspiration to write about this came Saturday night when I had to do my bimonthly toenail trimming. Reaching them is harder every year and requires more exotic and garage-worthy equipment. For some older folks, the best bet is to let a family member, doctor, or foot specialist trim your nails. This is especially important for those with diabetes or peripheral vascular disease as a bad nail or nail infection in these folks can result in an amputation or worse.

A patient of mine with diabetes came in very concerned about a black toenail. She was sure it was diabetic gangrene. After an exam, we concluded that the blood flow was good and likely it was a bruise under the nail. Three months later when the “bruise” had not resolved, I sent her to Dermatology for a biopsy. We found that it was a melanoma, a potentially deadly kind of skin cancer growing under the nail. Off with the toe and 12 years later, she is alive and well. Continue reading

Sponges save a soldier

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Since the wars in Afghanistan and Iraq began in 2001 and 2004, respectively, more than 1 million people have died in the combat.

By the end of 2013, 5,829 of those casualties were American soldiers. In 76 percent of potentially survivable battlefield wounds, the leading cause of death was hemorrhage. But more soldiers may make it home thanks to a new invention called XStat.

It uses a light, pocket-size injector to send 92 sponges into a wound, stopping arterial bleeding in 15 seconds.

Currently, caring for a wounded soldier on the battlefield is limited to what combat medics carry with them.

Controlling hemorrhage is the first priority when treating a wounded soldier and can involve tourniquets or field dressings, Hemcon, Quickclot, and Fibrin bandages. Hemcon dressings are treated with chitosan, a naturally occurring biocompatible compound from shrimp shells that strongly adheres to blood and reduces blood clotting times. Quickclot gauze and pads are coated with a naturally occurring mineral, kaolin, which initiates the body’s natural coagulation to reduce clotting times. Continue reading