Congenital heart disease is one of several ailments, including pneumonia and sepsis, that kill eight babies every minute, every day. But a decades-old technology, combined with a smartphone app, can tell doctors in less than 60 seconds if a baby is at risk for any of these asymptomatic, hard-to-detect killers. And in developing nations like China, it costs less than a diaper change.
There’s some controversy in pediatrics about the utility of the oxygen saturation screening for congenital heart disease. There are a lot of false positives and a lot of the most common types of congenital heart defects don’t result in oxygen saturation problems. There are a lot of issues with doing this in places in the U.S. without easy access to pediatric cardiologists and echocardiography, where the false positives make it harder for kids with real issues to get seen and treated.
Expanding this into resource poor nations is a waste. What good is a positive screen if you don’t have available echo techs, cardiologists, and cardiothoracic surgeons? It’s only a chance at a long life if you can do something about a positive screen. For example hypoplastic left heart syndrome, one of the conditions we’re screening for, requires three complex surgeries over the first 3 years of life, months of cardiac ICU time, a really good multidisciplinary team, and is ultimately just palliative and usually ends up with a heart transplant in the teens or early twenties. So what’s the utility of screening for this in a country that is struggling to provide basic clean water and manage diseases that cost pennies to prevent or treat?
If you’re serious about fitness, you know the importance of training your muscles and your brain. Without the right prep, you won’t have the physical or mental endurance to finish, whether it’s a five-k or an Ironman. But it turns out that it may be just as important to train your gut—or suffer inflammatory consequences.
I’d heard similar things about endurance events, like Ironman. That the exertion can deplete the body such that these competitors are trimming years off their life.
One competitor told me about how they went swimming with friends after an event. The person decided they couldn’t participate because it was too soon after an event. They were conscious of how little body fat/etc they had to draw on if they wanted to participate.
When penicillin was first used medically, in 1940, it was a time of austerity. While Alexander Fleming first discovered penicillin in 1928, his world-changing observations had garnered hardly any notice, and it wasn’t until 1938 that another team of researchers finally began to isolate and test the active chemical ingredients in the world’s first antibiotic. By that time, World War II was raging, and medical manufacturing capacity that could be devoted to experimental treatments was in short supply.
Producing usable penicillin from Penicillium notatum mold was no easy feat, says PBS: “In spite of efforts to increase the yield from the mold cultures, it took 2,000 liters of mold culture fluid to obtain enough pure penicillin to treat a single case of sepsis in a person.”
Pencilin production couldn’t happen nearly fast enough to match rising demand. To make up the shortfall, writes Rebecca Kreston for her Body Horrors blog at Discover Magazine, researchers came up with a novel way to get the penicillin they needed: extracting and isolating it from patients’ urine.
40 – 99 % of the penicillin antibiotic is excreted in urine in its fully functional form about 4 hours after administration thanks to our kidneys! But doesn’t that mean that the dose was too high?
…But even today, some portion of the active ingredient from many drugs passes through our bodies unchanged. Instead of isolating and recycling them, though, we send them down the toilet and out into the world.
That part is why I sourced the Smithsonian article rather than the Discover one. While our ability to synthesize antibiotics has greatly improved, the impact to our water supply is rather scary.