Longer looks: Providing dental care in rural Alaska; the after-effects of the ICU; cure for allergies

Nov 28 2013

Health Affairs: In Alaska, Reaching Into Remote Corners To Provide Dental Care
Aniak, Alaska, is a Yu'pik village of 500 people on the Yukon-Kuskokwim delta, about 400 miles northwest of Anchorage. It is in this special and isolated community where I practice as a dental therapist, trained and certified to deliver some, but not all, types of dental care. Dental therapists have been practicing in Alaska for nine years and now provide routine dental care to 40,000 Native Alaskans. In the United States about forty-seven million people live in areas where there is a shortage of dentists, and millions more can't afford to see them. For so many Americans, even the most basic dental care is out of reach. Yet right here in Alaska, I think we've found part of the solution (Conan Murat, November, 2013).

The New York Times: Bringing Back My Real Self With Hormones
In my early 30s, for a few months, I altered my body chemistry and hormones so that I was closer to a man in his early 20s. I was blown away by how dramatically my thoughts changed. I was angry almost all the time, thought about sex constantly, and assumed I was the smartest person in the entire world. Over the years I had met guys rather like this. I was not experimenting with hormone levels out of idle curiosity or in some kind of quirky science experiment. I was on hormone treatments because I'd had a tumor removed along with part of my pituitary gland (Mary Lou Jepsen, 11/23).

The Atlantic: After The ICU: What Does It Mean To Be 'Okay'?
As more adults survive intensive care, we've inadvertently created a new world populated by the walking wounded. Some return to work, bodies healed, but find their minds are different, slower than before. Others are depressed, anxious, tortured by flashbacks to horrific events that never occurred. As a critical care doctor, it's entirely possible for me never to see any of these outcomes. But I've come to fear that our best interventions are less meaningful, and our counsel to families shallow, if we don't fully understand what happens to our patients after they leave our units' doors. ... About one in three ICU survivors who are sick enough to require intubation might develop post-traumatic stress disorder. Recent studies have also described that those who leave the ICU also suffer high rates of impaired brain functioning, on the level of mild or moderate dementia (Daniela J. Lamas, 11/21).

The Weekly Standard: Doing Harm
My mother, who admired Linus Pauling, kept three rows of bottles filled with vitamins and herbs in her kitchen, as well as stacks of newsletters with advice about "natural" remedies. ... Despite my mother's wide reading, I doubt that she knew about the many studies concluding that high doses of vitamins increase the risk of cancer. More than half of all Americans take vitamins-;a $28 billion industry in 2010-;and even unbelievers tend to think they are harmless. Do You Believe in Magic?-;the charming title of which comes, of course, from the 1965 Lovin' Spoonful song-;is a fun read, a fast tour through stories about villains and crackpots. Linus Pauling is among them (Temma Ehrenfeld, 11/26).

The New York Times: A Cure For The Allergy Epidemic
Will the cure for allergies come from the cowshed? ... comparative studies highlight the importance of environment, beginning, it seems, in the womb. Microbes are one intriguing protective factor. Certain ones seem to stimulate a mother's immune system during pregnancy, preventing allergic disease in children. By emulating this naturally occurring phenomenon, scientists may one day devise a way to prevent allergies. 
... This task, though still in its infancy, has some urgency. Depending on the study and population, the prevalence of allergic disease and asthma increased between two- and threefold in the late 20th century, a mysterious trend often called the "allergy epidemic." These days, one in five American children have a respiratory allergy like hay fever, and nearly one in 10 have asthma (Moises Velasquez-Manoff, 11/9).