I matched!

5 04 2016

This will be the last time that I post from this blog. To end this chapter, I created a new blog which will start posting beginning June 2016 called https://ruraldoctorblog.wordpress.com/





Trypophobia

5 04 2016

There’s a term going around the Internet called “Trypophobia”, which means fear of holes. I had to post my share of trypophobia induced by my husband’s pancakes. My husband just said “I can’t believe we ate that today.”

Must say this is one of the best trypophobia pancakes picture online.

image





Can soy sauce cause cancer?

10 03 2016

I tried searching the net and did not find a lot of article talking about this matter, which had articles online in 2001. So wanted to repost the information I found so next time it would be easier to search when someone types in “can soy sauce cause cancer” or “soy sauce cancer”.


“3-MCPD is present in a wide range of foods that includes cereals (biscuits, including malted and toasted products), bread, breakfast cereals, corn snacks, savoury crackers. Dairy creams (aerosols and dessert toppings); low fat cheeses, Parmesan cheeses, processed cheeses and cheese alternatives, meats (chargrilled burgers, cooked meat, salami, smoked bacon, breaded products, cakes and pastries). In light of these findings, there is a call to reduce the levels of chloropropanols as low as technologically possible and the public is advised to maintain a balanced diet in order to avoid excessive intake of 3-MCPD and 1,3-DCP. The European Union has adopted a lower standard that allows 0.02 mg/kg of 3-MCPD in soy sauce, which came into force in 2002.”

Reference:

http://www.philstar.com/opinion/756897/does-your-soy-sauce-cause-cancer?nomobile=1

Article reposted below, highlighting what I find important. Be aware that this article was written to address Filipino concers but it applies to consuming soy sauce.

——————

“Does your soy sauce cause cancer?

Last week, Miss Pinky Webb of ABS-CBN presented a report that many of the popular soy sauce brands in the market could be cancer causing.Considering how much soy sauce is part of the Filipino diet  the news report should have caused a mega stir but surprisingly it did not.

It could be that folks just took the soy sauce report with a grain of salt after the airing of so many questionable news reports by the broadcast media, which are slanted towards perpetuating the Filipino over-entertained and under informed syndrome. It could also be that Filipinos  besieged by high prices, lawlessness in our communities, terrorist threats, an alarming Metro Manila pollution, rampant infections  simply considered the cancer risk in some soy sauce brands as less likely to kill them.

 

Whatever it is, your Chair Wrecker felt that the matter needed a deeper probe. The ABS-CBN report avoided specifying the soy sauce brands that contain the risk of cancer. Luckily, we have the right friend to call on for this clarification – Dr. Suzette Lazo, the Director of the FDA (Food and Drug Administration).

During our phone discussion, Dr. Suzette narrated how this had already been raised as an issue several years ago and that they had already looked into it and had taken the necessary steps to ensure consumer protection. Dr. Suzette was surprised why this issue was resurrected since the warning did not come from the FDA. Further investigation by your Chair Wrecker pointed to a market player as the source of the scare campaign.

Per Dr. Suzette, the substance in question is called 3-MCPD  a by-product of acid hydrolysis of a vegetable protein called HVP. Dr. Suzette also shared with us a primer, transmitted via email, she had made about this issue, as follows:

Primer on 3-MCPD

1. 3 chloro-1,2-propanediol (3-MCPD) is a by-product of acid hydrolysis process of vegetable protein (HVP) shown by animal studies to be carcinogenic at high doses (greater than 20 ppm) when given at prolonged periods in animals (Sunahara 1993, Cho 2008 – Appendix 1).in October 2000 the Committee on Mutagenicity of Chemicals in Food, Consumer Products and the Environment considered two new toxicity studies and has advised that 3-MCPD need no longer be considered as mutagenic in vivo, but still carcinogenic in animals.

2. Given the demonstrated carcinogenic effect, there has been no such effect actually documented in human subjects. JECFA states: “At any level of intake that can reasonably be expected to be encountered, 3-chloro-1,2-propanediol would not show acute toxic effects…” (page 21 , WHO Food Additives Series 48).

3. Initial levels surveyed in Asian soya sauces (soy sauce, oyster sauce) showed excessively high levels of 3-MCPD (about 300 ppm) but over the years, improvement in production have decreased these levels and previously non-compliant products have met the standards.

4. Around 2001, countries set standards for allowable limits of 3-MCPD based on results of toxicity studies. Health Canada for example used the LOEFL value of 1.1 mg/kg body weight per day demonstrated by long-term toxicity and carcinogenicity effects from the Sunahara study in 1993 and applying an UNCERTAINTY FACTOR of 1000 as follows: 1.1 mg divided by a factor of 1000 = 1.1 ug/kg as the Tolerable Daily Intake (TDI).

5. In 2002, the Bureau of Food and Drug issued Memorandum Circular No. 4 (Appendix 3) adopting 1 ppm as the allowable limits of 3-MCPD contaminant in soy sauce products following the standards used by the US FDA, Health Canada and Thailand.

6. Over the years, further studies have been carried out in Asian populations to ascertain the risk from consumption of 3-MCPD. Studies have been conducted in Asia in Hong Kong and in Thailand that showed that based on actual consumption, subjects in the study were unlikely to experience major toxicological effects from 3- MCPD (Appendix 4).

7. Downstream of the 3-MCPD metabolic pathway is another chloropropanol, 1,3 DCP which has also been shown to be carcinogenic.

8. Later surveys in Europe have ascertained that aside from soy sauce products, 3-MCPD is present in a wide range of foods that includes cereals (biscuits, including malted and toasted products), bread, breakfast cereals, corn snacks, savoury crackers. Dairy creams (aerosols and dessert toppings); low fat cheeses, Parmesan cheeses, processed cheeses and cheese alternatives, meats (chargrilled burgers, cooked meat, salami, smoked bacon, breaded products, cakes and pastries). In light of these findings, there is a call to reduce the levels of chloropropanols as low as technologically possible and the public is advised to maintain a balanced diet in order to avoid excessive intake of 3-MCPD and 1,3-DCP. The European Union has adopted a lower standard that allows 0.02 mg/kg of 3-MCPD in soy sauce, which came into force in 2002. The Codex Alimentarius adopted a higher standard of 0.4 mg/kg, which the FDA will also be adopting next year.

9. FDA has made a general review of all soy sauce products in the Philippines and to date 16 products have been compliant with the 1-ppm maximum allowable limit (DOH-FDA Advisory 2011-015 in Appendix 5). Products that failed to comply were subjected to voluntary recall until they can demonstrate that 3-MCPD levels comply with standards through improvement of the manufacturing process.

10. FDA assures the public that soy sauce products compliant with the 1-ppm maximum allowable standard are safe for consumption. Acute toxicity studies (LD50) as determined by JECFA of 150 mg/kg will require continuous intake of about 8,000 liters for prolonged periods to cause harm; a volume which is impossible far too much (Appendix 6). Estimations also show that even with daily intake of 30 ml based on consumption data of heavy users like the Japanese would show that users of Philippine soy sauce products would consume amounts of 3-MCPD which is several-fold (23 times) lower that the Tolerable Daily Intake of 3-MCPD (Appendix 7).

Prepared by:

Suzette H. Lazo, MD

Director

Food and Drug Administration

Due to space limitations, the mentioned appendices could not be included.

Filipinos should make it a habit to check the FDA content analysis of each of the food and drink brands that they’re consuming. We should do this as if our lives depended on it. In a globalized world, the risks that many food and drink products could be harmful have increased concomitantly.

*      *      *

Chair Wrecker e-mail and website: macesposo@yahoo.com and www.chairwrecker.com

Read the rest of this entry »





An epiphany about residency training

2 03 2016

I was watching a TVB episode about the young girl who came back from her studies abroad and her company did not keep their promise to promote her to LE (Legal Assistant) status and tried to put it off for as long as possible. They then gave her a promotion, but held off and couldn’t give her any salary increase until 6 months later. It could be another empty promise.

This just cause me to have a epiphany about residency training. Is it like this where you cannot get promoted, your salary will stay lower than anyone elses’, and you cannot speak for yourself ever… ?





Ultrasound training

12 02 2016

Professors





Zika virus and microcephaly

3 02 2016

https://www.washingtonpost.com/news/morning-mix/wp/2016/02/02/what-its-like-to-live-with-microcephaly-the-birth-defect-linked-to-zika-emergency/?tid=hybrid_experimentrandom_1_na





Ben Carson

3 02 2016

I had no idea that the first surgery went well, but the children did not have a normal life.

https://www.washingtonpost.com/lifestyle/style/the-story-of-the-surgery-that-made-ben-carson-famous–and-its-complicated-aftermath/2015/11/13/15b5f900-88c1-11e5-be39-0034bb576eee_story.html





Binge Drinking is a form of alcoholism

8 01 2016

Had a heavy lecture today about Alcoholic Anonymous and it really got me to think that I haven’t done my best to convey the proper message to people I care about. I really believe there are a lot of people who are suffering in ways I will never understand, but I want them to get better and feel better about themselves. And more importantly stop the things that are hurting them lethally. But this cannot be done without themselves putting in the hard work. If you get through this: just know that I love you and am thinking about you.

Nothing else will help if we continue to promote what harms us.

I’m laying here thinking about people: of my father whose heart stopped… then of those with the liver issues, heart failure, kidney failure, pancreatitis; of the Russian woman in her late forties who literally turned yellow from hepatorenal syndrome and died from chronic alcohol. Thinking of the Hispanic male in his 40s who kept having a visual hallucination that his brother was bringing him a case of beer and how he tried to throw a chair at the window on the THIRD FLOOR to break the window in attempt to get down from where he’s at (in-patient Psychiatry hospitalization) and how he went into Delirium Tremens after that. Thinking of the skinny African American male in his 60s with alcoholic cirrhosis of the liver who kept having to come into the hospital with delirium and how his bilirubin levels could not be kept under control causing even further brain damage. The telephone cord now looks like a snake. Thinking of the African American male in his 60s who suffered three strokes from high blood pressure all his life ending up with paralysis in all four limbs from the stroke and he can’t even talk anymore and died with his fourth stroke. Thinking of the 30 years old female who was morbidly obese and how her body could not handle the fight against swine flu because her body was technically immune suppressed by the obesity causing her lungs and kidneys to fail from the swine flu virus… and death.

Thinking of others with who deny that there are eating disorders, mouth ulcers and sores even head and neck and mouth cancers, eye issues, and ….. finally myself and family.

This field of work isn’t cut out for us all. It is hard and depressing with deaths left and right and more so when you haven’t made a single dent to send the message. I get it: people die everyday. We can’t stop that, but we can help the ones we love feel better and get better.

So here it is: the fight against binge drinking. Let’s do smoking on another day: which is the leading cause of preventable health issues.

___________________________________

“Binge drinking causes brain damage faster and more severely than chronic drinking (alcoholism). The neurotoxic insults are due to very large amounts of glutamate which are released and over-stimulate the brain as a binge finishes. This results in excitotoxicity, a process which damages or kills neurons (brain cells).[8] Each binge drinking episode immediately insults the brain; repeat episodes result in accumulating harm. The developing adolescent brain is thought to be particularly susceptible to the neurotoxic effects of binge drinking, with some evidence of brain damage occurring from drinking more than 10 or 11 drinks once or twice per month.[9]”

I would still check-in with a health professional for Thiamine (Vitamin B1) deficiency to prevent neurological and brain damage in the long term. Visual impairment can be caused by alcohol. In Wernicke-Korsakoff in the later stages you get: confusion, ataxia, opthalmoplegia which is confusion, tipsy and imbalanced, and nystagmus or eye problems.

 

https://en.m.wikipedia.org/wiki/Binge_drinking

Binge drinking varies from state to state, and estimates of adults who binge drink range from 10.9% in Utah to 25.6% in Wisconsin. Binge drinking is most common in the Midwest, New England, the District of Columbia, Alaska, and Hawaii.

Map:

SOURCE: 2010 Behavioral Risk Factor Surveillance System Combined Landline and Cell Phone Developmental Dataset, Adults Aged 18 and Older, US

 

The average largest number of drinks within a short period of time among binge drinkers ranged from 6 drinks in the District of Columbia to 9 drinks in Wisconsin. The largest number of drinks consumed by binge drinkers is highest in the Midwest and southern Mountain states (Arizona, Nevada, New Mexico, and Utah), and some states such as Louisiana, Mississippi, and South Carolina where binge drinking is less common.

The average largest number of drinks consumed by binge drinkers on an occasion

Map:

SOURCE: 2010 Behavioral Risk Factor Surveillance System Combined Landline and Cell Phone Developmental Dataset, Adults Aged 18 and Older, US

 

 





Surgery work in Vietnam

29 11 2015

Missing surgical supplies and maybe more training. Definitely forwarding to that one organization that’s going out to train other countries crating sustainable residency programs there.

https://www.facebook.com/tri.thanhtri.7/posts/796721783773698

Definitely should be forwarded to organizations like the HEAL Initiative at UCSF.





Where we donate vs diseases that kill us

20 11 2015

CDC report graph in 2011 shows that we’re not donating to the causes that kills the most.

2011 CDC report