iJournals

or...Britney Spears sings the classic: "Degradation of Sperm Mitochondria"


As the world has changed so dramatically with the internet, I find it unfortunate that modern scientific journals have lagged behind. Still, in this day of instant real-time blogs and transoceanic e-conferences, why do journals still insist on publishing articles 6 to 12 months after submission, using the old journal format with limited academic access?

In my experience researching subjects for WebMD's Men's Health and Male Fertility message boards, I often find an article that I would like to read. Time and again, when I click on the journal, I find that to read this one article for educational purposes, I must pay 10 to 12 dollars or more.

And this for a journal that only costs $100 for an entire year of monthly publications! I can understand paying for the cost of printing and distribution of entire journals, but to buy a single article? It's not that online instant access academic journals don’t exist. They do, with a rapid peer review and publication. But they are few and far between.

Isn't it time that the leading academic and scientific societies insist that their journals be made available online to all that seek the knowledge? Or do the journals exist primarily to generate a profit for publishing houses, with the spread of scientific knowledge a secondary purpose?

If the goal truly is timely and accurate dissemination of cutting-edge academic knowledge, then the ancient concept of a written published journal should be phased out as soon as possible.

Let me see if I understand this. I can pay 99 cents to download a song, yet it costs about $12 for an article. Perhaps the answer is to arrange for someone to sing each journal article. Then I can save $11, paying only the 99 cents for the article with, I hope, a catchy tune.

Related Topics: Medscape: Journals & Reference, Health Week in Review

Technorati Tags: medical journals, e-medicine

Floyd Landis: By Intention or Accident?

Testosterone seems to be the hot topic today, with all the excitement in the Tour de France and Floyd Landis -- he was found to have abnormally elevated levels of a synthetic testosterone AND his normal pituitary hormone levels were abnormally suppressed.

This does not look good for Floyd.

Okay, a quick endocrinology lesson. The pituitary gland in the brain constantly monitors testosterone levels in the body. When the levels are too low, then the pituitary secretes hormones to raise testosterone levels. When the levels are too high, then the pituitary drops these stimulating hormones to reduce testosterone levels.

If a person takes testosterone therapy, then the body detects too much testosterone and so drops the levels of these pituitary hormones. So Floyd having low pituitary levels suggests a more long term, deliberate problem.

Moving back to the controversy at hand: Could it be that somehow testosterone worked its way from Floyd's masseuse's massage cream or that mysteriously he absorbed testosterone from his bicycle seat? Could someone have unscrupulously snuck a testosterone lozenge, if one existed, into his sport drink while he was signing autographs? Maybe he was framed, though I think I will never be one of those chosen few who really gets the true facts.

Since you did so well with the endocrinology class, it is now time to move into advanced endocrinology for men.

There are two types of testosterone treatments. One is to restore a man's testosterone levels back to normal when they are abnormally low. This is called testosterone replacement. This is used when a man has seriously low energy, excess fatigue, weak bones from osteoporosis, and low testosterone caused depression to name a few. The goal of replacement therapy is to bring back the man's testosterone levels to normal "physiologic" levels.

This is not what we are talking about when we are discussing Mr. Landis. When an athlete needs an extra burst of energy or endurance beyond what humans are normally capable of, then some choose to unethically use performance enhancing testosterone therapy, both illegal and easily available. The goal is to get the already normal levels of testosterone to abnormally high "supraphysiologic" levels. With Floyd's situation, this is where all the excitement has been, as well as in most modern sports.

Believe it or not, there are labs that can tell an athlete how long it takes for the illegal testosterone to clear from his or her system, so he or she can gauge when they can use it and when they have to stop it prior to an event.

Could this be a single dose somehow snuck into his system or without his knowledge? Very unlikely. I am told that to get such high levels of testosterone AND to have measured byproducts of synthetic testosterone in his system AND to have suppression of his normal pituitary hormones requires intentional, repeated injections of testosterone or a testosterone-like substance over time.

Can we check and see if he is telling the truth? Easy enough. Just continue, over the next several months, to monitor his blood to measure his normal testosterone levels, levels of synthetic testosterone and the byproducts as well as his pituitary hormones. If they return to normal levels, then he did indeed somehow end up with performance enhancing testosterone in his system.

No way to explain away these results. Not a good thing for Mr. Landis. If they stay at his current levels, then really smart endocrinologists will have to get involved to explain what is happening with the hormones in his body and he may get to keep the yellow jersey.

Related Topics: Innocent Reasons for Landis Dope Test?, High-Tech Cheating: Gene Therapy to Boost Athletic Performance

Technorati Tags: Floyd Landis, Tour de France, doping, testosterone

Welcome back, Bill

"Dr. Marks," my assistant started. "I have some bad news. One of your long-time favorite patients, Bill, just passed away. Here is his chart." Wow, I thought. I have known Bill for so long.

After I removed his prostate 15 years ago, we became friends. We even played golf together (though it was at that point that I think I decided that golf didn't like me as much as I liked it.). So Bill was dead. So sad. And so bad for his wife, Martha. What a nice lady. It must be tough for her right now. Okay, time to make one of those dreaded calls.

Ringing, ringing, ringing then a familiar male voice. "Bill?" I asked. "Yes, this is Bill," he responded. "This is Sheldon. I thought you were dead."

"Hmmm, I don't think so. Let me check. Martha, it's Sheldon on the phone. Am I dead?" "No, I don't think so. Yet." she called from far away. "No, Sheldon, I guess I am not dead. How are you?" "Well pretty good, now." So went my first conversation with the dead-but-not-yet.

Perhaps this is what it is like for psychics and mediums who routinely talk to people on the other side. But for Bill and I, it was just the other side of town. I guess a sort of trial run.

Today Bill came in for his annual check-up, and I must say, he looks pretty darn good for a guy who came back from the dead, even if only for a few moments in my office records. Once again, just another reason to enjoy every day as if it may be your last. Especially if you are one of my favorite patients.

Related Topics: 8 Summer Steps for Healthy Living, WebMD Video: Why Men Don't Go to the Doctor

Technorati Tags: men's health, prostate