Steve Silberman:

In a major scoop, Silberman, who has become one of the best-informed and best-sourced reporters about neuroscience and medical topics, exposes an epidemic of multiply resistant Acinetobacter baumannii infecting wounded troops in the ‘evacuation chain’ from field hospitals in Iraq through medevac facilities to civilian hospitals in Europe and the US; it has already spread to civilian patients in those hospitals. Although the US government long maintained that the organism originated in Iraqi soil and infected soldiers wounded by IEDs, it is clear that the real culprits are the unsterile conditions and unrestrained use of broad-spectrum state-of-the-art antibiotics in US field hospitals in Iraq. Silberman does a good job of laying out the factors that continue to prevent an effective response to these issues. These include, of course, Rumsfeld’s doctrine of fighting the war on a shoestring and the military’s misuse of medical resources to keep casualties on the front lines as long as possible.

Silberman’s story is one of the Huffington Post’s “most huffed stories.” Huffit is HuffPo’s new Digg-like feature in which readers register which stories they feel are most newsworthy.

Multiply-resistant strains of bacteria are becoming a fact of life. As a physician working in a medical hospital, I am dealing with increasing regularity with patients with MRSA or C. difficile. The situation is only going to become worse as resistant bacteria’s sharing of drug resistance genes (a process which Silberman aptly likens to sharing open source software code) accelerates and we enter a fallow period in antibiotic development. There has always been an ‘arms race’ (another apt metaphor) between infectious disease organisms and medical tactics, and medicine is losing out. Could the Iraq war end up playing a major role in the end of the era of medical ascendancy over infectious disease?

After a patient who had had a stroke that damaged his insula readily and abruptly quit smoking, researchers at the University of Iowa looked at a number of other stroke victims and found that those with insular damage often quit smoking effortlessly and suddenly. (Forbes)

The emerging neurobiology of addictions (both behavioral and substance) emphasizes a two component system, one of which controls cravings and the other the satisfaction or reward associated with the addictive behavior. Separate and complementary interventions target these two components; for example, the concurrent use of the medications acamprosate and naltrexone to assist relapse prevention in recovering severely alcohol-dependent patients. The insula seems to be instrumental to the craving component.

Neuroscientists have long relished studying patients with circumscribed lesions in specific brain areas, to see which functions those areas subsume. Far more precise knowledge can be derived than the newer brain imaging techniques to study regional activation during certain mental tasks.