What are Hot Dogs Made of? Pathological Analysis...

Ever since the publication of The Jungle by Upton Sinclair in 1906 about the US meat industry, there has been a negative connotation on what hot dogs are actually made of. Urban legend will report anything and everything can potentially be found in a hot dog including rats, human extremities, feces, etc.

So this begs the question of what really is found inside a hot dog when looked under the microscope to bring light of truth upon this murky question.

in 2008, Ohio pathologists took a look at 8 different brands of hot dogs and this is what they found:

• The average meat content in a hot dog was only 5.7% (range 2.9% - 21%). Water actually made up most of a hot dog content consisting of 57% (range 44% - 69%). What meat was seen was recognizable as muscle, but did show evidence of degenerative changes. Also, the higher the meat content, the more expensive the hot dog was.

• No brain tissue was seen in any samples (especially important when considering mad-cow disease is localized in brain tissue and can be transmitted to humans who eat contaminated tissue causing fatal Crutzfeldt-Jakob disease).
• Besides meat, other tissue types were seen including connective tissue, blood vessels, nerves, and fat (all expected in meat/muscle).
• However, cartilage and bone was also found in some samples, perhaps accrued during the butchering and processing of the meat.
• Unexpectedly, skin was found in one hot dog. Plant material was also unexpectedly found which may have been added as a way to add bulk to the meat.

There you have it!

What about hamburger meat? Click here for more info...

Reference:

Applying morphologic techniques to evaluate hotdogs: what is in the hotdogs we eat? Ann Diagn Pathol. 2008 Apr;12(2):98-102. doi: 10.1016/j.anndiagpath.2007.04.012. Epub 2007 Oct 24.

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Exactly What is Fast Food Hamburger Meat Made of? Pathological Analysis...

I freely admit that in my youth, I loved eating burgers from fast food joints like McDonald's. But after getting married and being encouraged to eat healthier by my wife who felt fast food burgers were unhealthy (disgusting) because they weren't actually made of meat, I've always wondered what hamburger meat was truly made of...

Well... a group of pathologists actually performed a pathologic analysis on 8 different fast food hamburger meat. No... they did not identify the fast food chain where they got the meat.

What they found was both reassuring as well as alarming. Here are the key interesting findings:

• Actual meat content in a typical burger is only 12% (range: 2.1%-14.8%). The meat itself did appear normal which is reassuring. Most of the burger is actually made of water comprising 49% of the weight (range: 37%-62%)
• No brain tissue was seen in any samples (especially important when considering mad-cow disease is localized in brain tissue and can be transmitted to humans who eat contaminated tissue causing fatal Crutzfeldt-Jakob disease).
• Besides meat, other tissue types were seen including connective tissue, blood vessels, nerves, and fat (all expected in meat/muscle).
• However, cartilage and bone was also found in some samples, perhaps accrued during the butchering and processing of the meat.
• Plant material was also unexpectedly found which may have been added as a way to add bulk to the meat.
• Intracellular parasites (Sarcocystis) was also seen in a few samples which is why meat should always be cooked prior to eating (whether burger or restaurant grade A meat).

So there you have it... fast food hamburger meat actually does contain meat, though it only makes a small part of it.

What about hot dogs? Click here for more info...

Reference:
Fast food hamburgers: what are we really eating? Annals of Diagnostic Pathology 12 (2008) 406–409

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Surgeons Should be Good at Social Media

Not just surgeons, but also any procedural intensive medical specialties like interventional cardiology and radiology should be reasonably good at social media.

Why?

Because we have built-in time points within our daily routine schedule that enable such activities.

Let me explain... Between every surgical case, there is downtime that lasts anywhere from 15 minutes to as long as 45 minutes.

It is the time during which the operating room is being cleaned, sterilized, and new instruments are brought in and set up.

Before the days of social media, this is the time when many surgeons would read the newspaper/magazine, eat in the cafeteria, surf the internet, chat with staff, etc. Of course, any consults and paperwork that are pending would first be addressed.

But now... this time can be used for social media activities.

This time can now be used to read/write blogs, read/post tweets, and generally think of ideas worthy of sharing.

OR... if you are just sitting there waiting for a surgical case to start, check out my tweets or blog!

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Accurate Hearing Testing Using an iPhone

There is an iPhone app called "EarTrumpet" that apparently can provide accurate hearing testing... almost as good as a professionally administered test (conventional audiometry) and certainly as good (if not better) than medical-quality automated testing machines (ie Otogram).

Created with the assistance of the ENT department at the University of California, Irvine...

According to one study, this iPhone application provided results as good as one administered by an audiologist:

• 96% of the threshold values when obtained in a sound booth
• 94% of the threshold values when testing was done in just a "quiet" room

When accuracy was defined as "within 10 dB of the corresponding threshold value obtained using conventional audiometry."

Given how accurately the iPhone application performs, it may potentially be a very helpful screening tool to evaluate patients with ear/hearing complaints. If the testing comes back normal hearing (between 0-20db at ALL frequencies), than the patient probably hears just fine.

However, if there's any hearing loss detected, it is advised to seek professional opinion because there  are weaknesses to this program and further testing WILL be necessary.

• It ONLY performs air conduction testing. Given the lack of bone conduction testing, pure nerve testing is not possible, especially when hearing loss is detected. For example, the iPhone application will not be able to test hearing loss due to earwax/fluid versus actual nerve hearing loss.
• Speech audiometry is not present. Only pure tone audiometry. Speech audiometry provides information regarding how well spoken words are understood... one can potentially "hear" a beep at a specific frequency just fine, but still mishear a spoken word which is composed of many different sound frequencies.
• As it pertains to this research study, while there was excellent agreement in masked threshold values between the iPhone app and conventional audiometry, the sample size was limited. Masking is especially important when significant asymmetric hearing loss is present.

There may also be potential bias with the research. The developer of the EarTrumpet iPhone app, Allen Foulad, is also the lead researcher of the paper. It would be worthwhile to have other independent labs reproduce and verify the findings.

However, I applaud Dr. Foulad for his work in this area as well as entrepreneurial spirit!

You can download his app here.

As a bonus, this iPhone application can also act as a personal sound amplifier. It can enhance environmental sounds via earphones attached to the iPhone.


Reference:
Automated Audiometry Using Apple iOS-Based Application Technology. Otolaryngol Head Neck Surg. 2013 Aug 20. [Epub ahead of print]

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At Home Allergy Testing

Recently, a new at-home allergy test can be found on store shelves throughout the United States as well as Amazon.com. It is called "MyAllergyTest" produced by ImmuneTech Corporation and it is FDA approved. The way it works is that you place a few drops of blood into the collection kit which is than mailed to a lab in a pre-paid, pre-addressed envelope.

Results are than obtained via internet or by certified mail in about one week.

What's tested? Only ten things (IgE only):

• Timothy Grass
• Bermuda Grass
• Mountain Cedar
• Short Ragweed
• Alternaria Mold
• Cat Dander
• Mite pternoyssinus
• Egg White
• Wheat
• Milk

As such, if testing comes back normal, it does not mean you do not have allergies... It just means that you do not have allergies to these 10 things only... You could be allergic to other non-tested substances.

A report is produced listing what you are allergic to and how badly:

How accurate is the testing? Apparently, it is comparable to Pharmacia CAP system (specific IgE FEIA).

In terms of actual numbers, the test has a sensitivity 88%, specificity 94%, and accuracy 91%.



Source:
FDA.gov

Company Website

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How is Sinusitis Like Diarrhea, Germs and All?

A normal human body is composed of more "bacteria" cells than "human" cells. Indeed, the bacteria collectively living inside a normal healthy person would fill a half-gallon jug; numerically, there are probably 10 times more bacterial cells in the body than human cells.

Though the majority of these bacteria have no known effect on the human body (good or bad), some of these organisms perform tasks that participate in maintaining health and are deemed necessary members of the normal human flora.

When such "good" bacteria is wiped out through medical intervention (most commonly antibiotics), human diseases like clostridium difficile manifested by massive diarrhea occurs. Treatment (gross as it sounds) may include fecal bacteriotherapy which involves transplanting poop from a healthy individual into the patient.

So How is Diarrhea Related to Sinusitis?

Well, it seems when it comes to chronic sinus infections, the same phenomenon may be happening whereby chronic antibiotic usage leads to a situation where all the "good" bacteria has been killed off leading to a situation where "bad" bacteria constantly re-colonizes the sinus cavities causing mayhem.

"Good" bacteria needs to be present to prevent "bad" bacteria from reforming.

It is possible that simply giving more antibiotics may only reinforce the elimination of not only the bad bacteria, but also all the good ones leading to a chronic and repetitive state of sinusitis especially when biofilms develop.

But... is this true???

Apparently... it's possible!

Researchers have determined that there IS a relationship between sinus bacterial composition (microflora) and chronic sinusitis and that it differs from normal healthy sinuses.

The sinus microflora of chronic sinusitis patients exhibited significantly reduced bacterial diversity compared with that of healthy individuals. At least in the sinusitis population investigated, they found relative abundance of a single species, Corynebacterium tuberculostearicum. When mouse sinuses were populated with this bacteria, sinusitis occurred. Having a normal healthy microflora protected AGAINST this bacteria.

In healthy sinuses, Lactobacillus sakei was identified as a potentially protective species and defended against C. tuberculostearicum sinus infections, even when the sinus cavities were wiped of all bacteria.

This study demonstrated that sinus mucosal health may potentially be highly dependent on the sinus microflora and that "good" bacteria presence is necessary in maintaining healthy sinuses.

Now, I'm not advocating that we take poop from healthy people and fill the sinus cavities of chronic sinusitis patients... but it may influence a fundamental change in the way physicians treat patients suffering from sinus infections that just won't go away no matter what treatment has been pursued whether numerous antibiotics, saline flushes, sinus surgery, etc.

In such sinus cripples, perhaps saline flushes containing "healthy" bacteria would be beneficial??? Hopefully, it won't stink like poop, otherwise I think patient compliance may be an issue.

What about a gel containing good bacteria injected into the sinus cavities???

I should mention that taking probiotics would help the gut, but not the sinus cavities as I can't really see how the elements contained within the probiotic pill can get absorbed into the blood and land in the sinus cavities intact.

Pretty cool area of research which I'm looking forward to hopefully seeing more of in the near future!

Source:
Humans Carry More Bacterial Cells than Human Ones. Scientific American 10/30/07

Reference:
Sinus Microbiome Diversity Depletion and Corynebacterium tuberculostearicum Enrichment Mediates Rhinosinusitis. Sci Transl Med. 2012 Sep 12;4(151):151ra124.

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