Perhaps a method to greatly reduce post wound scarring?

Gina Kolata has an interesting story in the Times – Imagine, Surgery Without a Scar.  The researchers, in an article published in the April 23 Science, found that inhibiting Engrailed-1 activation in fibroblasts remarkably inhibits scarring after wounding in mice.  If similar results are found in humans, this would be a great boon for many patients.

From the paper:

Wounds in adult mammals typically heal by forming fibrotic scars. Mascharak et al. found that a specific population of skin fibroblasts (Engrailed-1 lineage–negative fibroblasts) activate expression of Engrailed-1 and turn on profibrotic cellular programs in response to local tissue mechanics in wounds (see the Perspective by Konieczny and Naik). When mechanical signaling was inhibited in these cells (using either genetic deletion or small-molecule inhibition), skin wounds in mice no longer formed scars but instead healed by regeneration, restoring skin with normal hair follicles and glands, extracellular matrix, and mechanical strength.

2021-04-23T16:03:02-05:00April 23rd, 2021|Home, Musings|

An important verdict

•George Floyd mattered.   Let’s hope the long awaited accountability provided by this verdict is a first of many steps toward restorative justice for all Americans.

2021-06-13T20:00:14-05:00April 20th, 2021|Home, Musings|

What guns mean to Americans

Elizabeth Rosenthal has it right in her Washington Post commentary, I was a teenage gun owner, then an ER doctor. Assault-style weapons make me sick.:

“…the United States has undergone a cultural, definitional, practical shift on guns and what they are for.

Once mostly associated in the public mind with sport, guns in the United States are now widely regarded more as weapons to maim or kill — or to protect from the same. Guns used to be on a continuum with bows and arrows; now they seem better lumped in with grenades, mortars and bombs.”

4/8/21 AMA statement on curbing gun violence

2021-04-12T08:33:33-05:00April 11th, 2021|Home, Musings|

Some Perspective on COVID 19’s Impact

Embedded in out historical mindset was the toll taken by the influenza pandemic of 1918-1919. Estimates of the deaths caused by that pandemic hover around 50 million worldwide, and 675,00 in the US; it’s too early to have really accurate data, but there are currently estimated to be about 3 million confirmed COVID deaths worldwide and some 560,000 in the U.S.  The American population was lower in the 1918 pandemic, and there was a much higher mortality among infants and young adults than that seen with SARS-CoV-2. Fortunately, we have much better medical care today with the widespread availability of supplemental oxygen, therapeutic intubation, ventilators, ECMO, pressors, etc., not to mention the incredibly rapid development and manufacture of highly effective vaccines. One can only speculate what the mortality rate for COVID might be if supportive medical care had remained in its early 20th century state.  Of course, the national approach to public health measures also matters a great deal, and it’s evident that the U.S. could have done better.

Cumulative confirmed COVID-19 deaths

Cumulative COVID deaths per million

2021-04-11T08:39:51-05:00April 11th, 2021|Home, Musings|
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