Many people have asked me “What is Twitter?” and “What is it you talk about on Twitter?”. I still have difficulty in answering the first question, but at least I now have a pictorial answer for the second question, thanks to Chad Scira of tumblr.icodeforlove.com . File this under “Nerd Art”. LOL.
The original cloud can be found here. You can create your own TwitterCloud here.
words (ordered by most used)
Many people have asked me “What is Twitter?” and “What is it you talk about on Twitter?”. I still have difficulty in answering the first question, but at least I now have a pictorial answer for the second question, thanks to Chad Scira of tumblr.icodeforlove.com .
File this under Nerd Art. LOL.
Recently, I had the opportunity to listen to a presentation on Preeclampsia presented by Dr. Saul Weinreb of AskMyObGyn.com .
I am sharing a link to the audio from Twithear at the following link:
- Dr. Saul Weinreb on Preeclampsia part 1
- Dr. Saul Weinreb on Preeclampsia part 2
- Dr. Saul Weinreb on Preeclampsia part 3
- Dr. Saul Weinreb on Preeclampsia part 4
Dr. Weinreb’s site is highly informative, and I would recommend AskMyOBGYN.com to anyone with questions regarding pregnancy and gynecologic issues. Regular readers of my blog will also note that some of the articles at AskMyOBGYN.com are written by my friend Angela Davids, from www.KeepEmCookin.com.
I am also going to post a copy of this remix to my posterous blog and to preeclampsiaonline.net.
This blog post was also published on preeclampsiaonline.net by Chukwuma Onyeije, M.D.
At present, the cause of preeclampsia is unknown. However, it is clear that patients who have had preeclampsia are at risk for other cardiovascular conditions in later life. Recently published studies now show that in addition to these concerns; patients who have had preeclampsia are also at risk for hypothyroidism later in life.
This presentation reviews why this is an important consideration for the long term health of these patients.
The CDC recently provided information regarding the rates of obesity and diabetes in the United States by county.
The CDC map and accompanying article can be found here.
My first response was that rather than calling the Southeast the “Bible Belt” it should now be called the “Diabetes / Obesity Belt”
All jokes aside, the maps provided give yet another example of the massive public health problems that face our nation. For the record, at least one third of Americans are currently classified as obese
- Obesity is a major risk factor for type 2 diabetes, and it is estimated that more than 20 million Americans are currently diabetic,
- One out of three people with diabetes do not even realize that they have the disease.
The combination of diabetes and obesity has lead to the term “Diabesity” as a description of what many call an epidemic within the Ameican healthcare crisis. The usual suspects implicated in the diabesity epidemic include sedentary lifestyles, ubiquitous junk food, the supersizing of meal portions, and “emotional eating” are just a few.
From a public health standpoint I like the term diabesity because it makes us focus on not only esthetic aspects of obesity but rather the additional health concerns raised by the epidemic. Such a focus allows us to move from dealing with simply a largely preventable lifestyle related disease, namely obesity, and a huge and expensive health crisis, namely type 2 diabetes.
A few more sobering facts:
- Eighty per cent of type 2 diabetics are obese.
- Glucose metabolism are often seen with other forms of metabolic dysfunction involving lipids, uric acid, urinary albumin, clotting, inflammatory and fertility factors
- Additional mechanical complications such as arthritis, sleep apnea, stress incontinence, are also major health concern in this subset of the population.
Now, take another look at the map above. Why do you think that diabetes and obesity should be connected to geography? The CDC report suggests some answers, however, as clinicians and scientists I feel it is important that we look for underlying causes regarding why these conditions affect certain portions of the population more than others.
FURTHER READING: Diabesity: The Obesity-Diabetes Epidemic That Threatens America–And What We Must Do to Stop It
Originally posted by C. Onyeije, M.D. at PreeclampsiaOnline.net
- A recent study published in BMC Medical Geneticsreviews whether or not the levels of cell-free DNA are related to preeclampsia.
- DNA is nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms. DNA is normally found in an inner portion of the cell known as the nucleus. Recent studies have looked at the importance of so-called “Cell-free” DNA in various disease states. Cell-free DNA is DNA which can be detected in circulating blood. Numerous reports in the literature suggest that levels cell-free DNA in the blood may be a more certain tumors in the detection of early stages of cancer .
- Levels of cell-free DNA are also potentially an important marker for pregnancies at risk for premature birth
The current study looks at whether or not cell-free DNA levels in pregnant patients are related to:
- the clinical characteristics of preeclampsia
- the standard laboratory tests seen in patients with preeclampsia
- markers of inflammation,
- endothelial activation or injury (in other words injury to the inner
- layer of blood vessels often seen in preeclampsia)
- oxidative stress and
- cell-free fetal DNA levels.
How the study was performed?
Blood samples of 67 women with preeclampsia were compared to 70 pregnant women without preeclampsia. The analysis looked at levels of cell- free DNA as well as standard laboratory parameters tests obtained in pregnant patients.
The study concluded that levels of cell-free maternal and fetal DNA were higher in mothers with preeclampsia as shown below:
The quantity of cell-free DNA did not correlate to other lab findings in preeclampsia (with the exception of liver enzyme changes) and did not correlate to the clinical characteristics in the mothers (such as body mass index). The authors conclude that the increased levels of cell free DNA may be triggered by low-level liver damage seen in patients with preeclampsia.
- What does this mean for patients?Currently, there is not enough support for analyzing cell-free DNA in most patients with preeclampsia. However, we appear to be on the cusp of a number of technological breakthroughs involving DNA based diagnostic tests which will allow us to make much earlier diagnoses. In current day medicine, HELLP syndrome is the most severe form of preeclampsia. (HELLP stands for Hemolysis, Elevated Liver enxymes, and Low Platelets). In order for this diagnosis to be made, the patient’s preeclampsia must get to the point where the liver cells are severely damaged and leaking enzymes.
- The results of the current study provide hope that we may be close to a point where an analysis of cell-free DNA can give information about early liver damage in patients with preeclampsia before they get to the point of having HELLP syndrome.
- A full copy of the study can be found here: http://www.biomedcentral.com/content/pdf/1471-2350-10-120.pdf
- For further reading regarding the use of cutting edge diagnostic techniques I would recommend the following blog: http://thedecisiontree.com/blog/
- And the following books.
- The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine
- The Future of Medicine: Megatrends in Health Care That Will Improve Your Quality of Life
- Genomic and Personalized Medicine, Two-Vol Set: V1-2
The following statistics regarding premature birth are sobering, to say the least.
- Currently the number of premature births in the United States is over 540,000 per year.
- The United States’ infant mortality rate exceeds that of China, New Zealand, Canada, Hong Kong, Israel, Japan, Australia, and Singapore.
- It’s estimated that simply by cutting the preterm birth rate in the US in half, to match Sweden’s, would save approximately 8,000 babies.
- Even though preemies in the US are more likely to survive than anywhere else, they are still more likely to die than full-term infants.
- Just under half of premature babies grow up with some form of neurological or developmental disorder.
- Premature infants can develop lifelong health issues such as cerebral palsy, blindness, hearing loss and learning disabilities.
- Despite the increase in medical advances in the US, the amount of premature births has increased 36% in the last 25 years.
- It is the group of “late preterm” births, which occur after 34-37 weeks of pregnancy, that are the fastest growing subgroup of premature births.
The increase in premature birth in the US is attributed to many causes. The smallest, most fragile babies are most common among poor women who lack prenatal health care and social support. As I have noted in other posts, Early inductions and cesareans are also to blame, according to experts. The complications of prematurity can be minimized by avoiding delivery before 39 weeks without a medical reason. Here are what I would consider the 10 most important things a pregnant woman can do to avoid a premature birth:
- Get proper prenatal care throughout your pregnancy.
- Don’t smoke, drink or take drugs while pregnant.
- Avoid violent or abusive situations.
- Lower stress levels. Only take on as much as you are capable of, avoid extremely stressful situations and practice stress-relief exercises as needed.
- Avoid early elective inductions and cesareans. These might be used in emergency situations for the better of mom and baby, but elective cesareans and inductions should not be undertaken before 39 weeks of pregnancy.
- Eat a well-balanced, nutritious diet, including fish or fish oil and folic acid.
- Exercise regularly.
- Avoid exposure to environmental toxins like car exhaust, pesticides and phthalates.
- Avoid working situations where you need to stand for long periods of time.
To learn more about premature labor, click here.
KeepEmCookin.com is another resource that I would strongly recommend for patients at risk for preterm labor
——Original Message——
From: Saxby Chambliss
To: linuxonyeije@onyeije.net
Subject: Responding to your message
Sent: Nov 16, 2009 6:12 PM
Dear Dr. Onyeije:
Thank you for contacting me regarding network neutrality. I appreciate hearing from you.
The Internet is a vital communications tool for millions of Americans. The speed and ease at which information can be retrieved over the Internet is unparalleled. The applications and devices that can be used on the Internet enable families and friends to stay connected, businesses to accomplish their goals, and students to conduct research.
Net neutrality is the concept of allowing Internet service providers to block or discriminate against certain content on high-speed networks. The core disagreement regarding this concept is the question of whether the phone and cable companies that control the nation’s broadband infrastructure will be able to charge for faster access to certain websites.
S. 215, the “Internet Freedom Preservation Act,” was introduced during the 110thCongress and was referred to the Committee on Commerce, Science, and Transportation. This bill would have requiredthat each broadband service provider shall enable any content, application, or service made available via the Internet to be provided on a basis that is reasonable and nondiscriminatory. However, this legislation was not acted upon before the last session adjourned.
As this debate goes forward, I will work with my colleagues to ensure fair market competition and the protection of consumers.
Please contact me if I can be of assistance to you in the future. In the meantime, if you would like to receive timely e-mail alerts regarding the latest congressional actions and my weekly e-newsletter, please sign up via my web site at: www.chambliss.senate.gov.
Very truly yours, Saxby Chambliss
A
SC:md
Sent from Onyeije’s BlackBerry Storm
This may seem like something of a departure from the usual content of this blog; however, in a sense, it fits in perfectly with the ideas I have tried to express on this site and elsewhere. I have always been a strong proponent for using technology to facilitate enhanced communication and to empower individuals, patients and physicians.
It recently became clear to me that the idea of Net Neutrality is an important concept in the attempt to enhance personal freedom and unleash creativity via technology.
This video gives a good summary:
Adapted from Free Press presents, Save the Internet. ( http://www.savetheinternet.com/faq )
WHAT IS NET NEUTRALITY?
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Net Neutrality is the guiding principle that preserves the free and open Internet.
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Net Neutrality simply means no discrimination. Net Neutrality prevents Internet providers from blocking, speeding up or slowing down Web content based on its source, ownership or destination.
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The Internet has driven economic innovation, democratic participation and free speech online in large part due to the fact that it has always featured the idea of Net Neutrality.
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Net Neutrality protects the consumer’s right to use any equipment, content, application or service without interference from the network provider.
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Under Net Neutrality, the network’s only job is to move data — not to choose which data to privilege with higher quality service.
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You can learn more about Net Neutrality: HERE:
SOUNDS GOOD. SO, WHO WOULD BE AGAINST NET NEUTRALITY?
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The nation’s largest telephone and cable companies — including AT&T, Verizon, Comcast and Time Warner Cable are AGAINST Net Neutrality. They want to be Internet gatekeepers, deciding which Web sites go fast or slow and which won’t load at all.
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These large companies want to tax content providers to guarantee speedy delivery of their data. And they want to discriminate in favor of their own search engines, Internet phone services and streaming video — while slowing down or blocking services offered by their competitors.
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Instead of a level playing field, these companies want to reserve express lanes for their own content and services — or those of big corporations that can afford the steep tolls — and leave the rest of us on a winding dirt road.
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The big phone and cable companies are spending hundreds of millions of dollars lobbying Congress and the Federal Communications Commission to gut Net Neutrality, putting the future of the Internet at risk.
WHY IS THIS IMPORTANT TO ME?
As a part time blogger, I have enjoyed the ability to provide content that some people find useful. Anyone who has read my blog for any length of time knows that I have strong opinions and that occasionally these opinions will change and evolve as time goes by. Many times my posts are read by only myself. At other times I can get hundreds of hits and dozens of comments in a single day. I appreciate the fact that my information is only hindered by the creativity of my ideas. I do not want my content to be given second class status at the whim of a telecomunications company. I would like to have equal access to readers around the world without hinderances beyond my control.
HOW YOU CAN HELP:
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Sign the SavetheInternet.com petition and tell Congress to pass Net Neutrality legislation now.
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Show your support for Internet freedom on your Web site or blog.
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Tell your friends about this crucial issue before it’s too late.
