Thursday, April 22, 2010

Attiva May Combat Obesity

A new way of treating obesity has been unveiled recently, but it is a pill without a drug in it.  The pill is known as Attiva, and it promises to curb the appetite by fooling the stomach into thinking it is full.  By taking the pill with a glass of water, the ingredients in the pill absorb the water and swell up filling the stomach.  The full stomach signals the patient with the "All Full Sign" thereby reducing hunger cravings.  I wonder if this concoction mixed with water is sonographically visible?  We have used a cellulose solution for years as an oral sonographic contrast agent to visualize the pancreas. 
Gelesis engineered a super-absorbent polymer – is it ironic that it’s derived from an unspecified food source? – that can be reduced to small beads about the size of a grain of sugar. These tiny polymer beads swell up more than 100 times over when introduced to water, kind of like those little sponges you used to play with in the bath. So when you down a pill with a glass of water, the capsule dissolves in your stomach and the hydro-gel beads begin to grow. In a few minutes you’re feeling pretty full, and that second Double Down from KFC is decidedly less attractive. 

Tuesday, April 20, 2010

Intimal Media Thickness: Is The Time Right?

Many health care providers have discussed various ways to screen patients for peripheral vascular disease (PVD) more economically and effectively.  I have been watching the debate concerning a technique that uses high resolution ultrasound now for about 6 years.  Measuring the intimal media thickness (IMT) in the distal common carotid artery is a promising way because the abnormal thickness of this artery correlates with other forms of PVD to include the coronary arteries of the heart.  What I have not seen is a "Gold Standard" criterion on which to accurately classify a patients risk of adverse cardiovascular events to include heart attacks.  Recent articles are encouraging me to watch this area of research with a keen eye.  We may be close to a workable criterion that will be accurate for most people regardless of outside factors (Race, environment, diet, and other risk factors).  Insurance companies are interested in this technique also because it promises to lower the cost of screening for CV disease.  Please note the link below.
"Today, up to 70 percent of people who have heart attacks are in a low or intermediate risk category for a heart attack when their risk is estimated using traditional risk prediction models. That’s not very predictive, and we need to do better," said Dr. Christie Ballantyne, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart & Vascular Center and Baylor College of Medicine in Houston and last author on the study. "Our research shows that a noninvasive ultrasound can give us a more complete snapshot of our patients’ risk, so we can do a better job determining if they’ll have a heart attack."

Friday, April 16, 2010

Doctor aborts wrong fetus

A woman elected to have an ultrasound guided abortion on a fetus that was determined to be genetically damaged.  The woman was pregnant with twins, and the goal was to abort the damaged fetus, but allow the normal fetus to continue to develop.  The physician had little experience performing the procedure, and blamed "poor" ultrasound equipment for aborting the healthy fetus rather than the damaged fetus.  The physician was stripped of his medical license.

"I have never, ever in my entire career ever said 'no' to a patient," he told the Times Monday, noting he told the couple of his inexperience in performing the procedure. "And that was my downfall."
See the story here courtesy UPI

Tuesday, April 13, 2010

Bladder Flukes?

I received a very interesting letter this morning from a student of mine.  I will post part of it here:  "I attended your course in Houston a couple of months ago and have a question. I was in Belize performing ultrasound using a Sonosite portable machine in March. Several of the women had some type of fasciculating / flagellating thing in their bladders. They seemed to be adherent to the bladder wall and be from 1 to 3 cm in length. I also saw a larger bladder tumor and a couple of kidney masses.
Is it possible to see Schistosomal "bladder  flukes" in the bladder on ultrasound? I haven't found a reference for it."
I did a search on this topic, and came up with pretty interesting hits.  Most flukes attack the liver, gall bladder, and gastro-intestinal systems in humans. I found very little on urinary bladder parasites.  Certainly it is possible to have bladder parasites, and schistosomal infections are rampant in third world countries.  I have never seen an image of a urinary bladder parasite on an ultrasound.  If anyone has further information along these lines, including sonograms of parasites, I would be interested in talking with you.  Thanks in advance!