Medicine Hub

The Fight Against AIDS In Washington D.C.


Today in Washington D.C., 20,000 soldiers in the fight against AIDS -- doctors, writers, social scientists, public policy experts, academicians, and more -- have gathered for the bi-annual meeting of the International AIDS Society. Perhaps because of the gathering, the New York Times has compiled a really excellent profile of the city's recent responses to the AIDS epidemic. It's very worth reading.

Washington D.C. hasn't always reacted well to AIDS, which may be why it's got one of the nation's highest per-capita infection rates. From the Times:

 “D.C. used to be a bureaucratic nightmare,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, which is just three subway stops outside the city, in Bethesda, Md. When Adrian M. Fenty took office as the mayor of Washington in 2007, Dr. Fauci said, “it was a whole new morning in America.”

The change is evident on many fronts ... The city gave away five million male and female condoms last year, 10 times as many as it did in 2007. More than 300,000 clean needles a year are given away, both to heroin users and to an even higher risk group: transgender prostitutes who inject hormones.        

What's more: D.C. now offers testing almost everywhere -- grocery stores, the DMV -- and, in some locations, people are paid seven bucks to get tested. Of the individuals who test positive, 89% see a doctor within three days -- in some cases, driven to the doctor's office by non-profit organizations hired by the government.

Though the city's good at getting newly diagnosed individuals to the doctor, it's struggling to maximize the effectiveness of tests to ensure that the most vulnerabe populations are served. From the Times:

[A] weak point is the inefficiency of random testing. Each test consumes about 20 minutes alone in a room with a counselor — and only about one of every 100 people tested at the Department of Motor Vehicles, for example, is infected. ... Even at AIDS clinics here, only 2 percent of tests are positive. Many family doctors resist testing at all.        

"Contact tracing" -- reaching out to a newly newly diagnosed individual's past sexual contacts -- is more effective, but those who have only just learned they're infected are often unable, or unwilling, to cooperate. Now Washington is experimenting with a less fraught way of reaching high-risk individuals: a ten-dollar cash incentive for those who convince high-risk friends and acquaintances to get tested.

All the effort seems to be having an effect. The Times reports that the number of Washingtonians getting tested each year for HIV has tripled since 2007 -- from 43,000 to 122,000. 


Doctors Testing Nicotine Vaccine That Could One Day Prevent Smoking

NicotinevaccineA team led by Dr. Ronald G. Crystal, chairman and professor of Genetic Medicine at Weill Cornell Medical College in the Big Apple, have tested a vaccine that protects the brain from nicotine.

CBS News reports:

Much like vaccines for diseases that create antibodies to fight infection, the vaccine creates antibodies against nicotine. However, previous attempts at similar vaccines have failed because within a few weeks the antibodies are gone, which won't exactly help people stay smoke-free.

Crystal's team developed a vaccine that contains a virus consisting of a genetic sequence they engineered from a nicotine antibody, and injected it into the liver of mice. The injection genetically modifies the liver to churn out nicotine antibodies, along with other cells it typically makes, thus providing a nicotine antibody "factory" in the body...

The antibodies then work by targeting the nicotine cells within seconds of exposure and preventing them from reaching receptors in the brain that provide the "chill out" feeling, as Crystal called it.

The vaccine, which Crystal says could be tested on humans within a few years, would most likely be a preventative measure. Using it while trying to quit would, in essence, be like quitting cold turkey, and who needs a shot for that?

A Brief Examination Of Homophobia In Medicine

DaVinciHeartThe latest edition of Academic Pediatrics reprints remarks Dr. Mark A. Schuster, head of general pediatrics at Boston Children's Hospital, made in 2010 about experiencing homophobia during medical school.

One story Schuster details in his remarks, delivered at the Children’s Hospital Boston GLBT & Friends Celebration, concerns a woman with symptoms of a herniated disc.

Though the surgeons were ready to operate, and the students ready to learn, a radiologist reversed his diagnosis because the woman appeared to be a lesbian, thus jeopardizing the woman's well-being.

The neurosurgeon abruptly canceled the operation. It turned out that the radiologist had reversed his reading. When pressed as to why he no longer saw what even a third-year medical student could see (that would be me), he confessed that the neurosurgeon had pressured him to change his read.

When our team met with the neurosurgeon, he was direct. He had seen what he assumed to be a lesbian novel at the patient’s bedside, and he wasn’t going to operate. His rationalization was that she might have inserted something into her urethra that caused her incontinence. He had no research or case studies to support his theory. He had no explanation for why a lesbian would do this. He had no explanation for why it wasn’t showing up on x-ray. He made it clear, though, that he wasn’t going to operate on a lesbian.

Dr. Pauline W. Chen at the New York Times says the reprinted Schuster speech "delivers unflinching, evenhanded descriptions of a profession that is committed to helping others, yet is also capable of treating some of its own as aberrant." Still, I would say being the patient in such a situation would be equally horrible, if not worse.

The woman in Schuster's story ended up getting the operation, for those who wondered. You can read more of his experience with this PDF.

NEWS: Dr. Phil, Dr. Plait, And Dr. Paul

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Road Astronomer Phil Plait walks us through the crashing of Phobos-Grunt:

... the third stage on the rocket failed to ignite, stranding the spacecraft in Earth orbit. The air is thin up there, but still exerts a small force, dragging the spacecraft’s orbit lower and lower. In the past few months it’s been dropping, and sometime today it will get low enough that the Earth’s air will consume it.

Road Gay skeptic and magician D.J. Grothe tells Dr. Phil what's up.

Road Thank goodness, somebody's gonna remove that butchered quote from the MLK memorial.

Road Why all the young dudes love Ron Paul.

Picture 35 Road Ben Stein claims he was wrongfully terminated because of his belief that God controls the weather.

Road The rise of the middle school GSA:

While common in high schools across the country, chapters of the Gay Straight Alliance with the younger school set have been slower to gain a foothold, in some cases because of the controversy the clubs stir up.

But there are signs of increasing acceptance.

There are now 500 middle school Gay Straight Alliance chapters nationwide, up from a couple dozen three years ago, according to the national Gay, Lesbian and Straight Education Network.

Many of the clubs formed after publicized suicides of middle school children such as 13-year-old Seth Walsh of Tehachapi (Kern County) in 2010 and 11-year-old Carl Joseph Walker-Hoover of Springfield, Mass., in 2009. Both were bullied because they were believed to be gay.

Road After he spent 2011 burning and shooting children, Syrian president Bashir al-Assad kicks off 2012 by forgiving those who dared complain.

Road Some people say Mitt Romney's the biggest gaylover ever.

Road Sad report on the absence of services available for LGBT victims of domestic violence:

David X spilled his story to the other men seated around him, revealing how his boyfriend -- angry about leaving the heater on too long -- had punched him so hard that his eye socket shattered. Instead of receiving comfort at the counseling session, a man told him: You should have just punched him back. You're a guy.

That was the moment that David, a 56-year-old San Jose gay man whose last name is not being used to protect him, realized he was in the wrong place.

Road A nice young man posted a YouTube video about being gay and Republican. He's pretty stung by the backlash.

Road The best, most rational response to anti-trans Girl Scout cum reluctant YouTube star, Taylor from Ventra.

Road What if Tim Tebow was gay?

Rick Santorum To Mother Of Cancer Survivor: Yes, Your Son Should Pay More For Health Insurance

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Sorry for adding to the shower of Santorum that's inundated the blog -- but before we're hit by the inevitable Santorum tsunami doomed to result from tonight's GOP debate, it's worth taking a look at this appearance by the candidate in Merrimeck this morning, during which Mr. Santorum explained to a mother why it's good and right and holy that her cancer-stricken young son should have to wrestle with prohibitively high health insurance costs his whole life. Watch AFTER THE JUMP ...


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Painless Dental Cavity Filling Could Be Here by 2013: VIDEO


Human clinical trials are underway on the "plasma brush" a device that should revolutionize the dental industry with painless cavity filling:

In less than 30 seconds, the plasma brush uses chemical reactions to disinfect and clean out cavities for fillings. In addition to the bacteria-killing properties, the “cool flame” from the plasma brush forms a better bond for cavity fillings.  The chemical reactions involved with the plasma brush actually change the surface of the tooth, which allows for a strong and robust bonding with the filling material.

“There have been no side effects reported during the lab trials, and we expect the human trials to help us improve the prototype,” said Qingsong Yu, associate professor of mechanical and aerospace engineering of MU, and Meng Chen, chief scientist from Nanova, Inc., which holds a co-patent for the plasma brush with MU.

For those of you who cringe at even the sound of a dentist's drill, this should be good news.


(via gizmodo)

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