Healthcare, medicine & pharmaceuticals

A Spoonful of Robots Make the Medicine Go Down

Science fiction often pre-empts science and the concept of “swallowing the surgeon” was part of the 1966 film, Fantastic Voyage. Today, we are developing small medical robots that, when swallowed, can sense disease, deliver drugs, or carry out surgery, in the gastro-intestinal tract (GIT). In 2001, an Israeli company created a Pillcam, or camera-equipped capsule, which is widely used for diagnosis, but is not a robot because it moves via the body’s own contractions. But Italian scientists are now designing prototypes of capsule robots with hooked feet that can move around the GIT taking images, giving drugs or performing biopsies.

Another European project is designing a modular GIT robot that can be swallowed in pieces and then configure itself inside the stomach. A doctor can then control this “operating room” from outside. Like electric cars (see Air Batteries), there is the question of how to power the batteries sufficiently – one way is to apply external magnetic fields. In Canada, scientists are using fields generated by magnetic resonance imaging (MRI) to lead small beads through the blood to deal with tumours. This is exciting and risky, because the beads must not be allowed to run off-course.

As always, much of the inspiration for this work comes from nature, for example, the way microbes navigate through bodily fluids. They use flagella – tiny rotary motors that look like corkscrews – that can potentially be used to move a mini-robot through an artery or vein. The current version is 250 micrometers in diameter but, once again, it needs a power supply. American researchers are using bacteria as biological motors to push small beads through fluids. They were able to start and stop the flagella by exposing them to two different substances.

The theme behind each of these methods is the ability to treat illness without making any wound or scar on the outside. In this sense, the methods are non-invasive. In another sense, they are deeply invasive because they attempt to strike at the very heart of the problem. Swallow that one.

Ill-Conceived Ideas?

The first “test-tube baby” turned 30 this year. Yet, when parents (or hapless teachers) tell children about the birds and the bees, they probably won’t mention a test tube, even though already more than 1% of babies in the UK, and 4% in Denmark were made in a lab. It is a chilling thought, perhaps, but like many technologies, all couples can potentially use it, not just those with genetic diseases or those who can’t have children any other way.

One good reason why it will become more common is that IVF is no longer as irksome a process as it once was, and the chances of conception are now about 25%. Second, while men have long been able to freeze their sperm, it has only just become safe for women to freeze (or vitrify) their eggs because eggs are full of water than can form ice crystals. Doctors can now replace the water in these eggs with a type of anti-freeze. This process has always been offered to cancer patients but now healthy women can choose to freeze their eggs until the “right” man comes along.

A chain of fertility clinics in the UK offers social egg-freezing and egg-sharing, where a woman can bank half her eggs for herself and donate the rest to a woman who wants to pay for them. This may appear as unethical as IVF did 30 years ago. On the other hand, young eggs are in better shape than older eggs so, if a woman wants to wait until she is older before she has children, she can benefit from her more youthful ova. The next step could be freezing ovarian tissue, which can be used to grow eggs later.

If this technology makes it easier to delay having a child, it could mean that many more women don’t have a child at all. The question is whether there is ever a good time to have a child. Most mothers will tell you that once they have children, they could not possibly imagine life without them. Certainly IVF makes it possible to choose, but the choice never gets any easier if you continue to reduce reproduction to a mere lifestyle choice.

Live Longer – Eat Breakfast!

The oldest human being, as listed in the Guinness Book of Records, smoked until her 120th birthday. Unfortunately, smoking is not considered to be a life-extending habit. On the other hand, eating breakfast and exercising daily, eating plenty of carotenoids (reddish vegetables) and vitamin A, and drinking alcohol in moderation, are implicated in living long. It also helps to be a woman, because their bodies seem to endure better, but also because they tend to talk on the phone more often and sustain their relationships.

If your father lived long, this is an indicator of how long you might live, but your mother is no indication. It also helps to have less body fat and a higher waist-to-hip ratio (which co-incidentally is also a universal indicator for sexual attractiveness). Finally, keep your brain moving because higher cognitive ability leads to a longer life. Perhaps the well-established habit of men reading the newspaper over breakfast is one way they have of competing with women’s unfair advantage for long life!

Fat Chance in the Suburbs

It seems geography has a big part to play in your health and how long you live. If you live in the Shetland Islands, you are more likely to be obese than if you live in Camden, London, and if you are a boy born in a deprived part of Glasgow, you will live eleven years fewer than a boy in Hampstead, London. The recently published “fat map” appears to contradict common beliefs that Glaswegians live on alcohol and deep fried Mars bars (6.6% are obese) or that Shetlanders live on a diet rich in local fish (15.5% are obese). There is also a trend for the obesity of the north, as measured in 2006, to spread south to London’s outer suburbs and Kent.

Meanwhile, the WHO three-year study of life expectancy found boys born in a deprived part of Glasgow had a life expectancy (of 54 years) shorter than people in India (62) or the Philippines (64). Life expectancy overall in Britain is 79, lower than Australia, Canada or Japan, where it is 83. The Department of Health is understandably keen to reduce these “health inequalities” by 10% by 2010.

While eating breakfast may contribute to longevity (see Live longer – eat breakfast!), it may be better to avoid the great English breakfast because of its links to bowel cancer. Eating 150g of processed meat a day (say, two sausages and three bacon rashers) increases the risk of bowel cancer by 63%. For most people, it will be cheaper (and healthier) to give up eating sausages than to move to a more prosperous region.

Why Brain Scans are Flawed

The brain has been compared with many things, including a hydraulic machine, a calculator, a computer, and even a Swiss Army knife. Metaphors are useful but, in this case, they are misleading. This is why it is dangerous to pay too much attention to experiments that use brain scans because they rely heavily on perceiving the brain as something that can be scanned, analysed, and understood.

First, a scanner is not a natural environment for any kind of cognition, as many people placed in the claustrophobic tube will attest. Second, they appear to measure brain activity but they actually measure what happens when protons are excited by the radiowaves. Third, the use of colours to highlight activity in certain areas of the brain makes the brain activity seem more pronounced and localised than it is and fails to consider that most brain activity is spontaneous, not stimulus-driven.

Fourth, pictures of the brain are statistical compilations and do not match any particular brain. Fifth, you cannot relate one area of the brain to one activity. The brain works through a series of neural networks, not modules, which is better described as “distributed intelligence” and certainly better than seeing the brain as a Swiss Army knife. Brain scans may tell us more about how researchers think than they do about how the brain thinks.