Tea and Mars Bars

In one part of the hospital that I am based at, one obscure little cafe, based in the researchy ara of the hospital, provides a cup of tea for 40p and a mars bar for 35p. At the front entrance to this hospital, where all the patients walk in and out (its also next to the main reception), another cafe owned by a big company provides a cup of tea for £1 and a mars bar for 55p.

Bit unfair dont you think?

Diet and the Big Brother State

This graph shows how much money is spent by the government telling us what to eat when compared to the food industry.

Not that we're influenced in anyway by advertisement when it comes to deciding what to eat. As responsible people we just use it all to come to an informed decision

Anyway I am pleased to annouce that afert a week of 2010 I have still stuck to my resolution of eating five (or more) portions of fruit and veg and a day. And have ignored the chip shop that is a five minute walk from my house

Nothing to get your hopes up about

Medical students are taught to be rather sceptical when evaluating new treatments (or anything else for that matter). This has served me well, especially when I am "Home, Home" and I glance the Daily Mail as read so by my parents. Apparently Alzheimers disease can be prevented and reversed by using mobile phones.



This was based on just one study on 96 mice, to me this signifies nothing, except maybe as an indicator as to where future research should be directed.



A quick google search will find this article, that didn't seem to worry or affect us then

Cricket

England have got to get 466 to win and clinch the test series in South Africa, with 140 odd overs to do it in, so all we have to do is rattle along at 3.5 an over and its in the bag. What could possibly go wrong?

She/He fought the cancer bravely and thats what helped her through it. I remember my mum said something like this when discussing a family friend who had a brush with cancer. I was reminded of this when I saw this article

http://www.guardian.co.uk/lifeandstyle/2010/jan/02/cancer-positive-thinking-barbara-ehrenreich

Although my mums comment was a harmless one, she was grateful the person in question was ok, the sentiments mentioned in the above article are actually quite insidious.

"She fought the cancer bravely." is a common phrase. What does this mean? Its horrible, because it implies that those people who died because of cancer did not fight hard enough. That they didn't really want to live, its there own fault it took there lives. It ignores the fact that cancer is still a deadly disease, the mechanisms of which we barely understand

Keeping a positive attitude can be helpful, not because it will help you fight the disease but it can help people deal the disease and come to terms with it

Is there a Journal of Negative Results?

One of the best forms of evidence that can be used in determining treatment is a meta analysis. Without going into to much detail this is basically where you sum up with statistics the results of all the Randomised Controlled Trials that has been performed. Unfortunately Scientific Journals are more likely to publicise RCTs that show a treatment is succesful as opposed to ones that aren,t. This means that meta analysis may show that a treatment is more useful then what it actually is

Journals are less likely to publice any research that gives a negative result, so a scientist may look at the literature and see that no work has been published on a particular gene. They then may spend a considerable time scanning it for mutations etc. However there is a good chance that this work has already been done a few years earlier by someone else who could not get there work published due to journals not being interested

A Journal of negative results would solve all of this

Evolution and Medicine

http://news.bbc.co.uk/1/hi/health/8435320.stm

This is an interesting story about prions and how natural selection can act to select the more aggressive ones. I apologise for another geeky type science post but I thought I would share a few more examples of how evolution can help doctors understand a disease

I have an interest in cancer pathology and applying Darwinian evolution to cancer cells is a neat way of understanding it. It can explain why cancers can become resistant to chemotherapy. Say chemotherapy is used to kill 99% of cancer cells, the remainding 1% is resistant - it then exapands (pathologists use the term clonal expansion) giving a tumour that no longer responds to treatment.

The best known example of evolution in medicine is the selection of bacteria that are resistant to antibiotics. This is why GPs are constantly being told not to prescirbe antibiotics unless its necessary and why patients are told to make sure they finish the course - to minimse the chance of further resistance to anitbiotics developing. In one lecture we were shown a picture of rows of children suffering from TB; this was before antibiotics. Nothing really could be done for them. Hopefully we will design a bunch of brand spanking new antibiotics quickly so this situation does not arise again.

Huntingtons disease is a gentic disorder that laregly escapes natural selection, as the disease generally presents after a person has reproduced, this can explain why early-onset Huntingtons is very rare.

I love the theory of evolution, i think it is an elegant explanation of how life came about and how it became as diverse as it is today. Evolution underpins biology and biology underpins medicine. All the examples above make more sense when explained by the theory of evolution, which is why I think its important that medical students have at least an appreciation of its power