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Photo: Ron Lute

Up on the roof of a government research building in Swift Current, Saskatchewan, the Canadian province that straddles Montana and North Dakota, Barbara Cade-Menun has a tarp filled with poo. Little brown pucks of cow manure that bake in the sun and freeze in the winter, where temperatures regularly drop below 5 degrees.

Cade-Menun and students are tracking how bacteria such as E. coli survive the harsh prairie winters. “[I]f E. coli can survive here, they’ll survive anywhere,” says the CBC. The research has important implications for people living in or downstream of agricultural regions as E. coli in your water can be a very bad thing.

Thirteen years ago this month tragedy struck a small Ontario, Canada, town when E. coli bacteria got into the water system. In Walkerton, Ontario, a town of 5,000 people, 2,300 fell ill suffering from “bloody diarrhea, vomiting, cramps and fever.” Seven people died. Over time, the tragedy was traced to manure spread on a nearby farm that had managed to carry the E. coli bacteria through the ground and into the town’s water system. That, alongside regulatory missteps, caused the preventable disaster—the “most serious case of water contamination in Canadian history.”

Though steps have been taken in the region to prevent similar disasters in the future, there is still much that is unknown about how E. coli moves through a watershed. From her rooftop investigation Cade-Menun found that E. coli are sneaky little bacteria.

Cade-Menun and her colleagues found that when the temperature plummets the frozen manure pucks seem to be bacteria-free. But the bacteria aren’t dead, and when the spring warmth returns so too do the bacteria.

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Parasitic hookworms in a person’s intestinal lining. Photo: CDC Public Health Image Library

Of the neglected tropical diseases, parasitic worms, or helminths, are one of the most common maladies. Diseases like this, caused by parasite or bacteria, kill around 534,000 a year, according to the CDC.  These have been largely wiped out in developed countries, but they still persist in the poorest parts of the world. People pick up infections by walking or consuming bits of contaminated soil in areas where sanitation is poor. After a person becomes infected, he perpetuates the infection in others through feces teeming with worm eggs.

Treating the worms is usually straight forward, but doctors must first determine whether or not a person is infected. Microscopes are not always available in poor communities, however, since they are difficult to transport and break easily. To get around this, an international team of doctors have developed an impromptu microscope by sticking a cheap lens onto his iPhone using double-sided tape. The New York Times describes the contraption:

The invention, described recently in The American Journal of Tropical Medicine and Hygiene, was tested in Tanzania on 200 stool samples from children who had a mix of hookworms, roundworms and giant roundworms.

A three-millimeter ball lens was taped over the camera lens of an iPhone 4. The zoom was increased to maximum, and slides, with tape atop the samples, were pressed right up to the lens. A pen flashlight shone light through the slide.

The improvised microscope detected giant roundworm eggs 81 percent of the time, roundworm eggs 54 percent of the time and hookworm eggs 14 percent of the time. The latter parasite may evade detection because it produces fewer eggs which also tend to degrade quickly outside of the body, the Times writes.

In order for doctors to determine whether or not to treat a person or village with anti-helminth medication, they need to have a microscope that performs with at least 80 percent accuracy. Unfortunately, the iPhone scope delivered results at just 70 percent accuracy compared to a conventional microscope. But with increasingly high tech smartphone cameras frequently introduced, the Times points out, the iPhone may soon find its place as a diagnostic tool after all.

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Image: Phillip von Ostau

Today, Angelina Jolie announced that she has decided to have a preventive double mastectomy, after testing positive for the BRCA1 gene implicated in increasing the risk of breast cancer in women. Her decision is a drastic one, but she’s not the only woman to have both breasts removed before any sign of cancer. While the procedure is still rare, rates of preventive double mastectomies are on the rise. But no one is quite sure what’s driving these increasing rates, and doctors disagree about the benefits of the procedure.

Jolie joins a few celebrities who have had the procedure. Sharon Osbourne had her breasts removed last year. Miss America contestant Allyn Rose said in January that she would have hers removed once the contest was over. In 2006, the then 23-year-old Lindsay Avner became one of the first women to undergo the procedure to avoid breast cancer. A study from last year reported that the rate of these surgeries—which remove breasts before cancer is found—is on the rise. In 2002, 94 women in Pennsylvania had preventative surgery. In 2012 that number was 455. (These number include both women who had two seemingly healthy breasts removed and women who had one healthy breast removed after a diagnosis of cancer in the other.) The Journal of Clinical Oncology found that bilateral mastectomies—in which a woman with cancer in one breast has both removed—increased from 1.8 percent in 1998 to 4.8 percent in 2003.

It’s hard to track these sorts of things, though. There is no good nationwide data on exactly how many are done each year and how that number has changed from year to year. But doctors generally agree that the rate is increasing.

The reasons for that increase are also slippery. Easier and cheaper genetic testing is providing more women with the information that often spurs the procedure. And surgeries to remove the breasts are getting safer and less expensive, as are plastic surgeries to replace tissue or minimize scarring.

The women who opt for the surgery cite a few reasons. The first is the real risk of breast cancer. Angelina Jolie, in her opinion piece for the New York Times, says that “doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer.”

The second is peace of mind. Women living with the gene say they feel as though cancer is looming over them at all times. “There wasn’t a minute where it didn’t cross my mind in some way,” Sara Tenenbein wrote in XO Jane. “BRCA was taking over my entire life.” Tenenbein opted for the preventive double mastectomy. She knows her choice was unusual, but she doesn’t regret it. “I know that I chose something extreme in order to live without fear. I chosejoie de vivre over vanity, and I am proud of it,” she writes.

“A lot of women really feel that it’s liberating,” Jocelyn Dunn, a breast surgeon in Palo Alto, California, told the Daily Beast. “Regrets are rare.” But peace of mind has a dark side, too. The Daily Beast also talked to Stephen Sener,  a doctor and former president of the American Cancer Society. “The main motivation is fear. Some women say, ‘I can’t live with the anxiety of having this happen again’.” The opening of a 2007 story about another woman who chose the surgery reads: “Her latest mammogram was clean. But Deborah Lindner, 33, was tired of constantly looking for the lump.”

But doctors say that there’s also a problem in risk perception. Only 5-10 percent of the women who get breast cancer are positive for the “breast cancer genes.” Women with the genes have a 60 percent chance of getting breast cancer. But having the double mastectomy doesn’t guarantee that you’ll be cancer free, either. One study found that the procedure doesn’t work for all women. The study looked at women who have preventive mastectomies after being diagnosed with cancer in one breast and found that the procedure only seemed to help women under 50 whose cancer was in very early stages. Another study that looked at preventive mastectomies says that, while the procedure does reduce the risk of developing breast cancer, “there is conflicting evidence on whether or not it reduces breast cancer mortality or overall death.”

While the research is still out on how effective it is, women who have the BRCA1 gene or a family history of breast cancer might see people like Jolie and Osbourne as examples. Removing both breasts might seem drastic, but it can feel worth it to those who have watched a loved one die of cancer. But that fear and dread could be pushing women to make decisions that aren’t medically sound. Allyn Rose, the Miss America contestant, says her father suggested the procedure, and when she pushed back he told her that, if she didn’t do it, “you’re going to end up dead like your mom.”

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Image: Aurora Michele

Having a baby can mean thinking a lot about pee. You pee on a stick to see if you’re ovulating. You pee on a stick to check if you’re pregnant. And soon, you might be able to pee to check your baby’s health. Using urine samples collected from pregnant women, researchers have developed a test that found signs of serious medical issues in the still unborn baby, including Down syndrome, premature birth, brain damage and pre-eclampsia (a disorder that can cause a mother to have seizures).

The new research, conducted by a team of Portuguese researchers lead by Sílvia Diaz, is still in the early stages. But, if the technique bears out it could mean that checking for serious complications will be as easy as peeing in a cup—an alternative to the invasive techniques, like biopsies or umbilical cord blood tests, used today.

The researchers collected urine samples from 300 women who were in the second trimester of their pregnancies. They froze the samples and waited until the baby was born. Then, they combed through the urine with a sensitive analytical technique called nuclear magnetic resonance spectroscopy looking for chemicals that were related with the conditions of the babies. According to the researchers, they found chemicals that could be related to “central nervous system malformations, trisomy 21, preterm delivery, gestational diabetes, intrauterine growth restriction and preeclampsia.”

According to Chemical and Engineering News, the next step is to do bigger and better tests, looking at more mothers from a larger geographic area.

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Photo: Thomas Marthinsen

Drug addiction is a complicated and messy thing, and fighting a history of heroin use is especially so. In the San Diego Union-Tribune, Bradley Fikes reports on a new tool that may soon be added to the regime of psychological and behavioral counseling and pharmaceutical treatments: a compound he describes as a “heroin vaccine.” So far only tested in rats, the researchers behind the study tell Fikes that the drug is ready for human testing.

Unlike methadone or other synthetic opiates that mimic the behavior of heroin, the new drug actually trains the body to pull heroin from the bloodstream:

Senior study author Kim Janda says the vaccine causes the body to produce antibodies against heroin and its psychoactive products. These antibodies circulate in the bloodstream, and neutralize any of these substances they encounter before they reach the brain.

“It’s like the old ’80s game Pac-Man,” Janda said. “They immediately seek out the target and sequester it.”

People looking to quit heroin use, or those trying to help them, would be able to use the vaccine to nullify the effects of any future heroin use. Substance abuse is way more than just a physical addiction: this vaccine could help protect users whose bodies are off heroin but who decide it’d be a good idea to start using again. Combined with existing treatments to get a person used to a drug-free life, the new pharmaceutical would help make sure the treatment sticks.

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