What's in that expresso?

A study of 20 commercial expresso coffees in Scotland reveals a 6-fold differences in caffeine levels, a 17-fold range of caffeoylquinic acid contents, and 4-fold differences in the caffeoylquinic acid : caffeine ratio.

Yikes! I had no idea that stuff was in there.

These variations reflect differences in batch-to-batch bean composition, possible blending of arabica with robusta beans, as well as roasting and grinding procedures, but the predominant factor is likely to be the amount of beans used in the coffee-making/barista processes. The most caffeine in a single espresso was 322 mg and a further three contained >200 mg, exceeding the 200 mg day upper limit recommended during pregnancy by the UK Food Standards Agency.

This snap-shot of high-street expresso coffees suggests the published assumption that a cup of strong coffee contains 50 mg caffeine may be misleading. Consumers at risk of toxicity, including pregnant women, children and those with liver disease, may unknowingly ingest excessive caffeine from a single cup of espresso coffee. As many coffee houses prepare larger volume coffees, such as Latte and Cappuccino, by dilution of a single or double shot of expresso, further study on these products is warranted.

Starbucks had the lowest amount of caffeine.

One way we'll control the cost of healthcare

More than 3,000 people in England with diabetes, heart failure or COPD (a serious lung disease called chronic obstructive pulmonary disease) took part in a recent two-year trial of telehealth technology for monitoring people who are chronically ill.

According to the results of the trial, published by the Department of Health, telehealth can reduce mortality, reduce the need for admissions to hospital, lower the number of days spent in a hospital bed and cut the time spent in A&E.

Here's how it works.

First thing in the morning, Terry Munro always puts the kettle on. "Then I take my blood sugar, take my blood pressure and my weight and in that time the kettle's boiled.
"And I've got a record of it on my TV. It's marvellous, it really is." 

Terry, who is 67 years old and has diabetes, has been keeping tabs on his own health using nothing more than his television. The testing equipment uses Bluetooth so when Terry has taken his daily measurements they are automatically uploaded to the TV. 

A trained nurse can access and monitor the readings from a central location and make decisions about potential changes in treatments. "I like walking, but I used to go out and go hypo. Now I know I can't go out if my blood sugar is too low, so I am more aware now. 

"It's like having a doctor there all the time."

Patients like Terry are constantly being watched by nurses, albeit at a distance. Any unusual readings entered onto the TV are picked up straight away and will prompt a visit by a nurse or an alert to the patient's doctor.

Your amazing brain

Your brain know a lot more than you realize, neuroscientist David Eagleman writes, He explores the processes and skills of the subconscious mind, which our conscious selves rarely consider.

Are there transvestite chicks?

Let's start with chickens.

When chicken hatchlings are born, large commercial hatcheries usually set about dividing them into males and females, and the practice of distinguishing gender is known as chick sexing. Sexing is necessary because the two genders receive different feeding programs: one for the females, which will eventually produce eggs, and another for the males, which are typically destined to be disposed of because of their uselessness in the commerce of producing eggs; only a few males are kept and fattened for meat. So the job of the chick sexer is to pick up each hatchling and quickly determine its sex in order to choose the correct bin to put it in. The problem is that the task is famously difficult: male and female chicks look exactly alike. 

Well, almost exactly. The Japanese invented a method of sexing chicks known as vent sexing, by which experts could rapidly ascertain the sex of one-day-old hatchlings. Beginning in the 1930s, poultry breeders from around the world traveled to the Zen-Nippon Chick Sexing School in Japan to learn the technique. 

The mystery was that no one could explain exactly how it was done. It was somehow based on very subtle visual cues, but the professional sexers could not say what those cues were. They would look at the chick’s rear (where the vent is) and simply seem to know the correct bin to throw it in. 

And this is how the professionals taught the student sexers. The master would stand over the apprentice and watch. The student would pick up a chick, examine its rear, and toss it into one bin or the other. The master would give feedback: yes or no. After weeks on end of this activity, the student’s brain was trained to a masterful—albeit unconscious—level.

And let's conclude with baseball.

On August 20, 1974, in a game between the California Angels and the Detroit Tigers, The Guinness Book of Records clocked Nolan Ryan’s fastball at 100.9 miles per hour. If you work the numbers, you’ll see that Ryan’s pitch departs the mound and crosses home plate—60 feet, 6 inches away—in four-tenths of a second. This gives just enough time for light signals from the baseball to hit the batter’s eye, work through the circuitry of the retina, activate successions of cells along the loopy superhighways of the visual system at the back of the head, cross vast territories to the motor areas, and modify the contraction of the muscles swinging the bat. Amazingly, this entire sequence is possible in less than four-tenths of a second; otherwise no one would ever hit a fastball. But even more surprising is that conscious awareness takes longer than that: about half a second. So the ball travels too rapidly for batters to be consciously aware of it.

Think I'd rather be a baseball player than a chicken.

Go to the dentist, live forever

Modern dentistry: nothing to fear.

Among more than 100,000 people, those who had their teeth scraped and cleaned (tooth scaling) by a dentist or dental hygienist had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke compared to those who had never had a dental cleaning. The participants were followed for an average of seven years.

Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke.

Peridontal disease is also a no-no:

-- Fewer than 21 teeth had a 69 percent increased risk of heart attack compared to those with the most teeth.
-- A higher number of deepened periodontal pockets (infection of the gum around the base of the tooth) had a 53 percent increased risk of heart attack compared to those with the fewest pockets.
-- The least amount of teeth had a 2.5 increased risk of congestive heart failure compared to those with the most teeth.
-- The highest incidence of gum bleeding had a 2.1 increased risk of strokecompared to those with the lowest incidence.

I'm going tomorrow, so I'll probably be around another 100 years.

Listening to other people chew

Misophonia terrorist.

For people with a condition that some scientists call misophonia, mealtime can be torture. The sounds of other people eating — chewing, chomping, slurping, gurgling — can send them into an instantaneous, blood-boiling rage, Joyce Cohen writes.

Many people can be driven to distraction by certain small sounds that do not seem to bother others — gum chewing, footsteps, humming. But sufferers of misophonia, a newly recognized condition that remains little studied and poorly understood, take the problem to a higher level.

They also follow a strikingly consistent pattern, experts say. The condition almost always begins in late childhood or early adolescence and worsens over time, often expanding to include more trigger sounds, usually those of eating and breathing.

Aage R. Moller, a neuroscientist at the University of Texas at Dallas who specializes in the auditory nervous system, believes the condition is hard-wired, like right- or left-handedness, and is probably not an auditory disorder but a “physiological abnormality” that resides in brain structures activated by processed sound. 

Misophonia (“dislike of sound”) is sometimes confused with hyperacusis, in which sound is perceived as abnormally loud or physically painful. But Dr. Johnson says they are not the same. “These people like sound, the louder the better,” she said of misophonia patients. “The sounds they object to are soft, hardly audible sounds.” One patient is driven crazy by her beloved dog licking its paws. Another can’t bear the pop of the plosive “p” in ordinary conversation.

Yeah, that one gets me, too.

How to think about cancer screening tests

I wrote the other day of a new recommendation that men not undergo the PSA test for prostate cancer. It's still a choice, and some men, and doctors, might want the test. National statistics are not the same as your particular body.

The decision to screen for breast cancer is somewhat similar -- there are questions about whether it actually saves lives.

Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, has written an excellent article for The New York Times explaining the difficulty of deciding, and I recommend that you read all of it.

I'll just grab a few of the highlights.

Both breast and prostate cancer screening are really difficult calls, and the statistical differences between them are only of degrees. Reasonable individuals, in the same situation, could make different decisions based on their valuation of the benefits and harms of screening.

Screening is like gambling: there are winners and there are losers. And while the few winners win big, there are a lot more losers.

False positives are really common in both breast and prostate cancer screening. Approximately 15 to 20 percent of women and men who are screened annually over a 10-year period will have to undergo at least one biopsy because of a false-positive mammogram or PSA — prostate-specific antigen — test.

Patients who are overdiagnosed are the big losers here. They undergo surgery, radiation and chemotherapy unnecessarily. And then there are the associated complications: chemotherapy can cause nausea and radiation can burn normal tissue; breast surgery can be disfiguring, and prostate surgery can lead to bladder and sexual dysfunction.

Now let’s consider the winners — those who have avoided dying from breast or prostate cancer by getting screened. While there is some debate about whether they really exist, my reading of the data is that they do, but they are few and far between — on the order of less than 1 breast or prostate cancer death averted per 1,000 people screened over 10 years. That’s less than 0.1 percent.

"The truth is that neither test works that well," he concludes. "Even with screening, most people destined to develop deadly, untreatable cancers will still do so. When it comes to breast and prostate cancer screening, there are no right answers, just trade-offs."

It's worth your time to read the whole thing.

If you're a man, read this

Healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided.

This issue is not new. I have played the PSA game for more than a decade, and I no longer care to play. My number goes up, I'm off to the urologist. Then it goes down. Then it goes up again, and I'm off to the urologist, who now wants to biopsy. Over and over.

The recommendation:

is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a PSA test — sometimes without their knowledge — during routine physicals.

“Unfortunately, the evidence now shows that this test does not save men’s lives,” said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Moreover, there is no evidence that a digital rectal exam or ultrasound are effective, either. “There are no reliable signs or symptoms of prostate cancer,” said Dr. Timothy J. Wilt, a member of the task force and a professor of medicine at the University of Minnesota. Frequency and urgency of urinating are poor indicators of disease, since the cause is often benign.

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”

Plenty of reputable people are opposed to this new recommendation. What should you do? Talk to your doctor, and ask a lot of questions about everything you hear. Remember, there's a difference between public health statistics and your own body. Read everything you can. Get a second opinion, and a third. Ultimately, the decision is yours.

You can read a lot more about this here.