Deep into the red

From Scientific American, July 2009 (online May 8, 2009):
Mind control has been traditionally the realm of the hypnotist, but research in the field of fluorescent proteins is opening up the possibility of controlling cellular processes, gene activity and even behavior using nothing more than infrared light.
Fluorescent proteins, which are compounds that can absorb and then emit light, have become a powerful instrument in the cell biologist's toolkit—so powerful, in fact, that the discovery and development of green fluorescent proteins from jellyfish earned the 2008 Nobel Prize in Chemistry. These proteins have limitations, however: They need to be excited with the blue to orange part of the visible spectrum, at wavelengths of 495 to 570 nanometers. These wavelengths of light are too short to penetrate tissue very well, and so green fluorescent proteins are mainly used in test tube studies to watch cell division or to label certain cell types.
But one of the 2008 Nobelists, Roger Y. Tsien of the University of California, San Diego, and his U.C.S.D. colleagues report in today's issue of Science that they have developed a new fluorescent protein that could enable scientists to tag and visualize cellular activity as it happens inside a live animal. The protein, after absorbing light from the far-red part of the spectrum, shines in the near-infrared, at wavelengths of around 700 nanometers. Read more.

Web diagnosis: healthy searching

From the ABC Health and Wellbeing , 18 March 2009:
David's troubles began after a trip to the Middle East. It might have been the hefty dose of food poisoning he copped, or the fact he spent much of the trip lugging someone else's heavy luggage. Either way, it did not come as a huge surprise that he developed a pain in his abdomen when he came home.
He was referred to a couple of gastroenterologists who, after numerous, apparently inconclusive investigations, diagnosed him with irritable bowel syndrome and recommended some dietary interventions.
Unfortunately, the doctors were wrong, and David, a 33-year-old environmental lawyer, suffered two years of often excruciating pain because it didn't cross his mind that his doctors might have missed something.
In the end, an entry in a medical book caught his eye, prompting David to type 'hernia' into a search engine. "The symptoms matched it absolutely perfectly," he says. "I went to local GP in Sydney, described the symptoms and said 'I think I've got a hernia'." The GP agreed, performed a simple on-the-spot test and confirmed the diagnosis within 60 seconds. Why was such a simple diagnosis missed? David thinks it may have been because he was being investigated by gastroenterologists, and "to a guy with a hammer, everything looks like a nail".
David is one of millions of Australians who use the internet to find health information. We use it to try and diagnose ourselves (with varying degrees of success), to learn more about a new diagnosis, to make contact with people who share our conditions, to understand a symptom that may not initially be worth visiting a doctor for, or just to keep ourselves that little bit more informed about the state of our bodies. Read more.

United front tracks silent menace

From The Australian, 4 April 2009:
THEY are called "silent angels", little girls with beautiful faces, touched by a random genetic mutation that has rendered them speechless and robbed them of their chance of a normal life.
Meredith Drakes is one of these silent angels. Now 21, she cannot speak or walk, is wheelchair-bound and dependent on her parents. Her only means of communication is her eyes and hands, which her mother, Astrid Drakes, says she puts to good use.
"She communicates things like her gratitude; she leans across, looks at your eyes, pats your arm," Astrid Drakes says.
At age two, Meredith was diagnosed with a rare and poorly understood condition called Rett syndrome. The diagnosis came only after her worried parents had been bounced from expert to expert, each with their own thoughts on what might be causing Meredith's strange symptoms and behaviours. Read more.

When push comes to scalpel

From The Australian, 7 March 2009:
When a journalist from The New York Times asked British mountaineer George Mallory why he was planning to scale Mt Everest, the reply was simple: "Because it's there." I feel the same way about a drug-free childbirth.
When confronted with the opinion that because modern medicine has developed the pain-free, push-free labour, all women should fall over themselves in gratitude, I can't help but think of Mallory. Why do I aspire to a drug-free and hopefully intervention-free labour? Because I can.
There's more to it than the notion that simply because my female ancestors did it this way, I should too. My female ancestors were far likelier to die in childbirth because of a lack of basic sanitation or bleed to death because physicians of the day had limited surgical skills or knowledge. Their babies also were on the wrong side of the survival odds thanks to pathogens and complications.
I am eternally grateful to be pregnant and facing labour in this era, when I am confident my doctors will be able to fend off almost all the threats that in the not-so-distant past may have put my life, and that of my baby, at risk.
But I am a healthy, fit 33-year-old woman who has been lucky enough to have a pretty normal pregnancy so far.
I'm not quite in the right shape to scale Mt Everest, but I'm approaching labour with the same sense of expectation, excitement, trepidation and motivation. Read more.

Sun, surf and sutures

From Australian Doctor, 3 March 2009:
IT should have been a routine operation: a knee arthroplasty for an elderly man that would have cost about $15,000 and kept the patient off his feet for perhaps a few weeks. There would have been some small risks of complications, but in a high- standard health care environ ment such as Australia, it should have been simple.
But the patient — perhaps frustrated by the prospect of being put on a waiting list or unwilling to face the full cost of undergoing the procedure at a private facility — decided to travel to India for the operation. It was a decision both he, and his doctors, would come to regret.
Instead of enjoying a quick trip up the waiting lists, spending just $8600 on his procedure and getting a holiday in exotic India, the patient developed a post-oper ative infection with Mycobacterium fortuitum. Four operations, countless doses of antibiotics and $140,000 later, the sad story of this otherwise straightforward procedure came to a close.
Toowoomba orthopaedic surgeon Dr Anthony Wilson was one of those charged with the unenviable task of cleaning up the mess — a task made even more frustrating given the patient was originally his.
“People take it upon themselves to go overseas, but the problem is if they have com plications,” Dr Wilson says. “We’re stuck with it and we don’t know what they did, what antibiotics they used; we’re completely in the dark about how to treat this person.”
It’s not the first case of medical tourism gone wrong, and it certainly won’t be the last. As more countries, including Australia, realise the dollar potential of touting their medical services to overseas clients; as more individuals decide they can get their procedure done cheaper, faster or better in another country; and as international travel becomes ever easier and cheaper, medical tourism is on the rise. Read more.

Screening for fragile X sidelined

From The Australian, 21 February 2009:
Emerging into the cold, harsh light of the delivery room can hardly be a pleasant experience for newborns. And to add insult to injury, just as they are adapting to this new world a baby's delicate, soft heel is assaulted with a needle and several drops of blood are drawn.
It's only a brief torment, and one that has the potential to save that baby's life. Those few drops of blood are used to diagnose a range of diseases, where early diagnosis and intervention can make a huge difference to that child's quality of life. Newborn screening has saved countless children from the worst ravages of conditions such as phenylketonuria -- a genetic disorder that can damage brain development but which can be minimised with dietary changes if caught early.
But this screening is far from comprehensive. One disorder not currently on the testing list is fragile X syndrome -- something that researchers from Australia and the US are now working to change.
Fragile X syndrome is the most common cause of inherited intellectual disability, even though it affects only about one in 3600 males and between one in 4000 and one in 6000 females. It's caused by a genetic abnormality on the X chromosome, where a single sequence of three DNA base pairs is repeated far too many times, with devastating consequences. Read more.

A bug for a bug for a bug

From Scientific American, March 2009:
Even in the teeming and varied world of bacteria, Wolbachia is something of a standout. Within its insect host, the bacterium acts as a gender-bending, egg-killing, DNA-hijacking parasite that is passed down from one generation to the next via the female to her eggs. Hosted by at least one fifth of all insect species, it is possibly the most prolific parasite on earth. But now Wolbachia itself is being hijacked, to help humans gain the upper hand in the long-running war against mosquito-borne diseases. Read more.

Gut bacteria reveals human migration

From ABC Science, News in Science, 23 January 2009:
A bacterial parasite known to cause stomach ulcers is shedding new light on ancient patterns of human migration across the Pacific region, according to an international study.
In the latest edition of Science, researchers report that their study of the distribution of Helicobacter pylori genotypes has given further weight to the theory that Australia was first populated around 30,000 years ago.
H. pylori is particularly useful for studying the movement of human populations because it is extremely widespread, and is transmitted from mother to child.
Co-author Professor Barry Marshall, a microbiologist at the University of Western Australia, says H. pylori is a lot like mitochondrial DNA, which is also used to investigate human migration patterns.
"You catch [H. pylori] off your mother," says Marshall. "All of us carry our mothers' mitochondrial DNA and that goes all the way back through the generations."
H. pylori has a further advantage in that it contains thousands of genes, compared to just 37 genes in mDNA, and differs between populations.
"It was found over [the] last few years that each human racial group carried a Helicobacter that was relatively unique in that group," Marshall says. Read more.