Tomorrow’s Nurse

Nurses will be expected to adopt technology in their practices and further their education in order to successfully manage the increasing number of patients

This infographic by The University of San Francisco discusses the trends in medicine and the need for nurses to broaden their knowledge and use of new technology to help facilitate medical advances.

Ovary Removal tied to Colon Cancer Risk

Hysterectomy and health risks: if given a choice, keep your ovaries

Ovary Removal Tied to Colon Cancer Risk, NY Times, MAY 4, 2016

Removal of the ovaries — a procedure known as oophorectomy — may increase the risk for colorectal cancer, a new study concludes.

Abstract

Population‐based analysis of colorectal cancer risk after oophorectomy, bjs, Apr 26, 2016.

Background
The development of colorectal cancer is influenced by hormonal factors. Oophorectomy alters endogenous levels of sex hormones, but the effect on colorectal cancer risk is unclear. The aim of this cohort study was to examine colorectal cancer risk after oophorectomy for benign indications.

Methods
Women who had undergone oophorectomy between 1965 and 2011 were identified from the Swedish Patient Registry. Standard incidence ratios (SIRs) and 95 per cent confidence intervals for colorectal cancer risk were calculated compared with those in the general population. Stratification was carried out for unilateral and bilateral oophorectomy, and hysterectomy without specification of whether the ovaries were removed or not. Associations between the three oophorectomy options and colorectal cancer risk in different locations were assessed by means of hazard ratios (HRs) and 95 per cent confidence intervals calculated by Cox proportional hazards regression modelling.

Results
Of 195 973 women who had undergone oophorectomy, 3150 (1·6 per cent) were diagnosed with colorectal cancer at a later date (median follow‐up 18 years). Colorectal cancer risk was increased after oophorectomy compared with that in the general population (SIR 1·30, 95 per cent c.i. 1·26 to 1·35). The risk was lower for younger age at oophorectomy (15–39 years: SIR 1·10, 0·97 to 1·23; 40–49 years: SIR 1·26, 1·19 to 1·33; P for trend < 0·001). The risk was highest 1–4 years after oophorectomy (SIR 1·66, 1·51 to 1·81; P < 0·001). In the multivariable analysis, women who underwent bilateral oophorectomy had a higher risk of rectal cancer than those who had only unilateral oophorectomy (HR 2·28, 95 per cent c.i. 1·33 to 3·91).

Conclusion
Colorectal cancer risk is increased after oophorectomy for benign indications.

Visible Effects of Estrogen Pills

I am afraid some of the side effects are hidden and/or not even published…

Well it’s not just “off the internet“…
and some effects are not immediately visible…
talk about DES estrogen for example…

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The Most Polluted Generation

Penelope Jagessar Chaffer at TEDxBrussels, 2014

Video published on 15 Dec 2014 by TED channel.

Chemicals can be toxic at very low levels.

  • If chemicals behave like drugs, why are they not regulated and tested like drugs?
  • There is so much debate about the fetus right to life…. what about the morality of millions of polluted fetuses?

Penelope Jagessar Chaffer is a multi award winning filmmaker and artist, writer, feminist, children’s environmental health advocate and global environmentalist.

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The Toxic Baby

Onstage together at TEDWomen, Jagessar Chaffer and Tyrone Hayes tell their story

Filmed Dec 2010, video uploaded on 13 Feb 2012 by TED channel.

We know so much about global warming and climate change and yet we have no concept of internal environmentalism.

Filmmaker Penelope Jagessar Chaffer was curious about the chemicals she was exposed to while pregnant: could they affect her unborn child? So she asked scientist Tyrone Hayes to brief her on one he studied closely: atrazine, a herbicide used on corn.

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Can’t see how any man can afford to feed without Stilbosol

Stilbosol patenting turned the cattle feed industry upside down in the mid fifties with its phenomenal use by the farmers and feeders

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Colorado State has declared that fostering oil and gas development is in its interest

Colorado Supreme Court upholds State power, says cities can’t impose fracking bans

Colorado’s high court today struck down the rights of Coloradans to enact local fracking bans. The justice denied residents their “right of enjoying and defending their lives and liberties; and of seeking and obtaining their safety and happiness” as outlined in the Colorado Constitution, by determining that oil and gas development is pre-empted by the state.

This decision overturns the democratically enacted measure to ban fracking passed overwhelmingly by Longmont residents in 2012 and strips all Coloradans of their Constitutional right to say “no” to fracking in their communities in order to prevent problems inherent in fracking, including air pollution, health complications, water contamination and reduced property values. ” …

… Continue reading Colorado Supreme Court Upholds State Power, Says Cities Can’t Impose Fracking Bans, ecowatch, May 2, 2016.

Genes associated with Breast Cancer and mutational signatures that influence tumour development

Personalized Breast Cancer Treatment Gets Closer to Reality

Five new breast cancer genes and range of mutations pave way for personalized treatment, eurekalert, 2 MAY-2016.

The largest-ever study to sequence the whole genomes of breast cancers has uncovered five new genes associated with the disease and 13 new mutational signatures that influence tumour development. The results of two papers published in Nature and Nature Communications also reveal what genetic variations exist in breast cancers and where they occur in the genome.

Abstract

Landscape of somatic mutations in 560 breast cancer whole-genome sequences, nature, 02 May 2016.

We analysed whole-genome sequences of 560 breast cancers to advance understanding of the driver mutations conferring clonal advantage and the mutational processes generating somatic mutations. We found that 93 protein-coding cancer genes carried probable driver mutations. Some non-coding regions exhibited high mutation frequencies, but most have distinctive structural features probably causing elevated mutation rates and do not contain driver mutations. Mutational signature analysis was extended to genome rearrangements and revealed twelve base substitution and six rearrangement signatures. Three rearrangement signatures, characterized by tandem duplications or deletions, appear associated with defective homologous-recombination-based DNA repair: one with deficient BRCA1 function, another with deficient BRCA1 or BRCA2 function, the cause of the third is unknown. This analysis of all classes of somatic mutation across exons, introns and intergenic regions highlights the repertoire of cancer genes and mutational processes operating, and progresses towards a comprehensive account of the somatic genetic basis of breast cancer.

Persistence of DDT and PCB contamination in European lakes and waters

Lake Como contaminated with chemicals banned in the 1970s

DDT, a pesticide, and PCBs, once used in electronic devices, are considered toxic chemicals. They can persist in the environment for long periods and accumulate in food chains. The use of DDT and PCBs in the EU was banned in 1978 (Directive 79/117/EEC) and 1983 (Directive 76/769/EEC), respectively.

Lake Como contaminated with chemicals banned in the 1970s, Science for Environment Policy News Alert, 17 March 2016.

The bans have been largely effective, and their presence in the environment has been steadily decreasing. However, recent concentrations of DDT and PCBs have been surprisingly high in some southern Alpine lakes. The presence of these banned chemicals presents a renewed risk to the flora and fauna in such lakes, as well as to the humans who exploit these lakes for food.

Recent DDT and PCB contamination in the sediment and biota of the Como Bay (Lake Como, Italy), ScienceDirect, doi:10.1016/j.scitotenv.2015.10.099.
Como lake image by Jim.

New research has examined levels of PCBs and DDT in one such lake, Lake Como, in northern Italy. The researchers took sediment samples and ‘cores’ (collected from the bottom of the lake using a drill, capturing the layers of sediment laid down year after year) in 2009. The cores were used to construct a timeline of PCB and DDT contamination in Lake Como, spanning the last 20–25 years.

The concentrations of six PCBs and three forms of DDT were analysed in all samples. Core samples showed a reasonably steady decline in PCBs between 1970 to 2009, dropping from a combined total close to 200 nanograms per gram of dry sediment (ng/g dry weight (d.w.)) in the earliest (1970–75) sediments to around 90 ng/g d.w. in the 2009 sediments.

There was a noticeable increase, close to 300 ng/g d.w., around 2000–2002, which the authors attribute to three flood events in the lake, which overflowed in the city of Como, likely the source of this PCB ‘peak’. Levels of DDT, however, never declined, instead remaining relatively constant over time.

The persistence of DDT in the lake is best explained, the authors say, by glacial release. DDT, previously used for fruit tree pest control in the valleys below glaciers, was carried upmountain in the air and fell on glaciers trapped in snow. As a warming climate causes glaciers to retreat, the trapped contaminants are released back into the environment in melt water, flowing through rivers and streams and accumulating in lakes.

Samples of zooplankton (small aquatic organisms) were also collected in 2009 and samples of the Agone fish (Alosa agone) — which preys on zooplankton and is commonly eaten in the area — were taken between 2006 and 2009.

The human consumption limit for PCBs and DDT in Italy (according to the Italian Ministry of Health) is 125 and 100 ng/g wet weight (w.w.), respectively.

Agone in all years were contaminated with both PCBs and DDT. DDT remained below safe limits for human consumption in all years. However, while PCB levels were typically well below the safe limit in most years, in 2009 levels were nearly double the safe limit. Levels of both PCBs and DDT in zooplankton were both lower than those in Agone, indicating that these chemicals are being ‘bioaccumulated’.

The results show how historically banned chemicals can persist in, and be released into other parts of, the environment by unexpected mechanisms, posing a risk to both human health and the environment. While the findings are specific for Lake Como, they may represent processes occurring in other southern alpine lakes and water systems, and demonstrate the need for continued monitoring of persistent organic compounds in European waters.

Clinical Practice Guidelines must change!

End of Guidelines, parody of “End of the Line” by James McCormack feat. ZDoggMD + friends)

End of Guidelines by James McCormack, published on 28 Apr 2016.

Chronic disease state guidelines (blood pressure/lipids/glucose/bone density) do not provide clinicians with complete enough information that they can use to do shared decision-making. This is a problem that needs to be fixed ASAP.

We need patient centred care, including discussion of the values of the patient, the harms of intervention, and alternative options. Right now we have a bunch of arbitrary target numbers for treatment that medicalize normal people.
These guidelines are mired in conflict of interest as the majority of guideline-authors having egregious conflicts of interest with industry.

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