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Insulin has a dark side

A recent study by Kalimouttou et al. used machine learning to conclude that insulin is one of the most effective interventions to promote survival in sepsis. The reaction on Twitter included this from Josh Farkas: Why the laugh emoji? Isn’t machine learning the best way to wade through big data? […]

Diabetic neuropathy caused by gut microbes?

For a decade or more, evidence has implicated the gut microbiota in the pathogenesis of type 2 diabetes. Transfer of fecal bacteria from an obese, insulin resistance mouse causes the rapid induction of insulin resistance in recipient mice, for instance. More recent work by Thaiss et al. published in Science demonstrates a […]

Just so

I read an early review of Zoobiquity, the excellent and popular book written by cardiologist and evolutionary medicine colleague Barbara Natterson-Horowitz and Kathy Bowers. I was surprised to see the reviewer dismiss the entire book as a just so story. Where did this criticism come from, and what is a just so […]

Catecholamines helpful or harmful in critical illness?

Catecholamines are amine molecules important in the autonomic nervous system and cardiovascular system. Catecholamines are produced in abundance when the body is under a severe stress. Epinephrine and norepinephrine (adrenaline and noradrenaline) are catecholamines that prepare the body for a fight or flight response. These stress hormones affect the entire […]

The function of fat

If we view fat purely through the lens of pathology, we are blind to the adaptive function of fat. It is popular to pathologize fatness, and to emphasize the burden of disease that accompanies excessive body weight. Especially when individuals are blamed for being fat, the notion that fat is […]

Saved by AI in sepsis?

Does machine learning improve outcomes in sepsis? This possibility was tested by Adams and colleagues in a recent Nature Medicine paper with the title: “Prospective, multi-site study of patient outcomes after implementation of the TREWS machine learning-based early warning system for sepsis.” Background: Sepsis remains a major killer of patients […]

Conflict and proton pump inhibitors

The other day I went to my local Costco. As I entered the queue of over-laden carts, emblematic of the excesses of globalized consumerism, I passed an enormous display of over-the-counter Kirkland-brand Omeprazole stacked high in eye-catching purple and pink packaging. Omeprazole was made over the counter in 2003 but […]

Conflict in the colon?

There is conflict brewing in your guts. This conflict plays out between your genome and the multiplicity of microbial genomes in the microbiota. As Herald Brüssow and others have pointed out, the conflict zone is mostly in your upper gut, above your colon. The large intestine, or colon, is relatively […]