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Standard sized CT scanners too small for obese
CT scanners customised for horses could accommodate growing problem Dr Dharamshi, said he was told to refer patients to zoo

By Jenny Hope

Last updated at 3:47 PM on 15th January 2012

NHS hospitals have resorted to asking zoos and vets to scan patients who are too obese to fit into hospital scanners.

The bizarre requests to use CT scanners, normally intended for four-legged animals, at the UK’s leading veterinary college in north London were revealed as hospitals face pressure to adapt beds and wards for an increasingly obese population.

The Royal Veterinary College (RVC)yesterday said its CT scanners, customised for horses, could be used to accommodate patients weighing 30 stone or more but they would need to get a special licence to scan humans.

CT scanners usually used by zoos and vet for horses could help scan obese human patients

Riaz Dharamshi, a geriatric registrar at St Mary’s Hospital in Paddington, West London, said he was told to refer obese patients to London Zoo when he was training.

 

The practice of referring patients to zoos is commonplace in America where obesity has reached epidemic levels.

Writing on his blog, he said ‘Imagine the humiliation for the patient. ‘I’m sorry sir but you are too fat to have a CT scan, so we are going to have to send you to the zoo where they are used to dealing with larger specimens.’'

However a spokesperson from the Imperial College Healthcare NHS Trust, which oversees St Mary's Hospital, said: 'We have never referred or been asked to refer a patient to London Zoo or the Royal Veterinary College for scanning.'

London Zoo also denied taking obese patients but a spokeswoman for the Royal Veterinary College confirmed they have been approached.

She said ‘We have been approached on several occasions but have always said we are only licensed to perform scans on animals.’
It is not known whether any veterinary colleges are seeking licenses to perform the procedure.

Hospitals face pressure to adapt equipment for Britain's obese population

Dr Dharamshi added ‘Some bright spark decided it would be a good idea to up the loading capacity of the tables we use in the CT scanners, so the problem of having patients too big to scan is not one we face all that often.

‘Wheelchairs are wider, theatre operating tables are stronger and we have access to reinforced hospital beds when we need them. Being overweight has become the norm.’

The CT scanner at the RVC is housed in the equine hospital and is used with a specially built table to support anaesthetised horses.

CT scans are used by doctors to assess body fat as well as for more general health checks to see if anything is wrong.

Briatin’s fire crews have spent millions on callouts by the NHS in recent years shifting obese patients who have got stuck in the bath or their bedrooms, or who cannot be safely lifted by ambulance staff.

A report last year warned the NHS is ‘poorly prepared’ to deal with obese patients, lacking staff and equipment to care for them safely.

Bigger trolley, beds and wheelchairs are needed – with more than half of women and almost two thirds of  men likely to be obese by 2050, according to official estimates.

The report found incidents involved equipment not being able to take the weight of obese patients, with specially adapted equipment either not being available or normal equipment not working properly when used with obese patients.

 

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'We are going to have to send you to the zoo' says doctor to obese patients too large to fit in scanners

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Hwy. deaths spur police action

/ Friday, 27 January 2012

by Tracker editor Amy McQuire.

The most striking aspect of the Aboriginal Tent Embassy protests, which sprung onto the media’s radar on Survival Day, was the stark difference between the reports of the events, and the reality.

This week, 2000 people made their way to the tent embassy to camp on the land where four Aboriginal men had helped change the course of Aboriginal political history 40 years prior. On January 26, 1972, Michael Anderson, Billie Craigie, Bertie Williams and Tony Coorie staked their claim on the lawns opposite Old Parliament House, in a historic protest for land rights. Yesterday, Aboriginal people and their non-indigenous supporters came together to celebrate that occasion, and protest against the succeeding decades that brought little change.

The day began with a well-attended protest through the heart of Canberra. Starting at the Australian National University, the rally wound its way through the city, to Parliament House, and back to the Tent Embassy. It was peaceful, but lively, and mirrored the concerns of those four men in 1972. Men, women and children marched peacefully alongside the police escorts, calling for “Land Rights Now”.

By the end of the day, that protest would be forgotten, replaced by images of an “angry mob” that had “trapped” the Prime Minister and opposition leader in a Canberra restaurant.

I was at the tent embassy at the time we heard of Tony Abbott’s comments. Abbott had responded to the 40th anniversary by stating it was time the tent embassy move on:

“I think a lot has changed for the better since then … I think the indigenous people of Australia can be very proud of the respect in which they are held by every Australian … I think it probably is time to move on from that.”

Comments such as that from a man who wants to be prime minister were never going to go down well.

The common sentiment from the embassy was that they were insensitive remarks, and wildly untrue. The fact we were still protesting for land rights 40 years on put the lie to those claims.

There has been much discussion in the media about whether Abbott was misinterpreted,  but by saying “moving on” people did interpret that to mean move the tent embassy on, and today many people are still pretty angry at the literal interpretation. For many, it was seen as insensitive because things now are not much better than the 70s (eg. the gap is only getting wider).

When word got around the embassy that Abbott was at a restaurant less than 200 metres away from the camp, people slowly started to trickle over.

The Lobby Restaurant is encased in glass, with the interior easily visible to those outside. While protesters were angry, it’s safe to say the reaction would not have been as emotional had Abbott not made those comments.

But while there was anger, it was far from a “riot”. A riot involves violence and a disturbing of the peace. While it was definitely a loud demonstration, there was no damage. A few smudged fingerprints on the glass of the restaurant was the net result. There were about 1000 protesters around the café when Gillard and Abbott were rushed through their own mob of security guards.

When they did come out, there were few protesters in the firing line. In fact, people such as Michael Anderson, one of the original founding members of the tent embassy, was pushed out of the way and into the stair railing. One of the only Aboriginal protesters near Gillard when she was delivered to her car was a photographer who was unceremoniously pushed away by a policeman.

Similarly, it was the police that made Gillard stumble. There was no protesters around her. People such as  Anderson and Tiga Bayles, a prominent indigenous broadcaster, were involved in soothing the crowd and were negotiating with police who had made a line of blue outside the restaurant. There was a call for people to return to the embassy, as the “point had been made”.

The only violence I saw was on behalf of police, who were pushing protesters away. Nevertheless, that didn’t stop media from portraying an angry mob who were bent on terrorising our first female prime minister. Images of Gillard in the arm of her protector made the front page of newspapers around the country, but would it have been such a source of public outrage if she wasn’t a woman?

There was no attempt to hurt Gillard or Abbott. Protesters simply wanted to make clear their concerns about sovereignty, land rights and Aboriginal rights to the mainstream. On that part, they were effective. Would media even be reporting the protests of the tent embassy if this didn’t happen?

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Tags: aboriginal tent embassy, australia day, Julia Gillard, Tent embassy protests, Tony Abbott

Categories: Federal

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View from the Tent Embassy: reality v news reports

I hope Hamilton is here forever. But if, for any reason (climate change, asteroid collision, the leachate from Adam Sandler movies), humankind must move to a new home in the stars, let there be at least one thing left of our city.

One thing remaining to greet the aliens when they happen upon our ghost planet, many eons hence, from which they can deduce what kind of creatures we were who once inhabited this particular niche of the Earth.

Our Cross of Lorraine.

You may not be aware of it. It doesn’t shine through the night sky from the escarpment anymore. But it did.

To a young Erica Read, who grew up on the Mountain, the lit cross was the beacon that pulled her safely home after car trips with the family. She’d see it from the 403 — “a little girl half asleep in the family station wagon, a woody, no less” — and feel the comforting, protective nearness of the familiar.

She didn’t know then what she knows now, what she shares with the Grade 5/6 class she teaches at Holbrook School. The Cross of Lorraine is a symbol of our once desperate fight against tuberculosis.

Tuberculosis may seem a distant cause. But Hamilton’s record of care, sacrifice and asylum for the very weakest, embodied in the vast Sanatorium lands on the Mountain brow, is one of the noblest chapters in this city’s history. And, perhaps, it prefigures our ongoing evolution from steel city to health care/social services city.

Thousands came to the Sanatorium. Many never left. Tubercular patients from the Far North, places such as Cape Dorset, were brought here for care and gave us their great Inuit tradition of soapstone carvings.

The Cross of Lorraine went up in 1953 at the end of Sanatorium Road. It’s at the edge of the now hotly debated brow condominium development lands.

“The land holds special meaning for my class, as we attend school at Holbrook,” says Erica. “The school is named after (Sanatorium head) Dr. J. Howard Holbrook, a wonderful doctor who ushered in many innovative practices to make the lives of patients more bearable. Two portraits of him grace our building, and the Grade 1 students are convinced his eyes follow them through the halls.”

I visited Erica’s class last week, and we met again at the cross. It’s beautiful in a melancholy way, rising high into the air, its sturdy heraldic double bars still equal to the symbolic weight they carry, but rusted, obscured by foliage and the neon dried in its veins. It’s like a great proud bell but with no tongue to sound its knell.

On this day, Erica’s students were the lights of the cross. They’ve been there several times, thanks to Erica, and it means things to them.

They long to see it shine again.

Several of the students — Kevin Macleod, Michael Ding and Mohan Kennedy — note how it overlooks McMaster Hospital, how patients there would see it through their windows if it were lit. They’re very perceptive.

“They’d look out and know something’s over them. It’s a beacon, from Hamilton to the world,” says Mohan.

“It’s a landmark, something special just to Hamilton,” says Miranda Dalgetty.

“If it was ever torn down, we’d lose part of our history,” says Kyle Mesaglia.

Our cross tells the world that once we cared enough to take in the oft-shunned, at the cost of putting ourselves at risk of infection. Is that a metaphor for what Hamilton is today? Are we still the kind of people who can light up the Cross of Lorraine?

Share your memories of the cross and the Sanatorium. If you know when the light went out, tell me. Should we urge city hall to light it up again? Be heard. Thanks, Holbrook Grade 5/6, for sharing your passion, and our history.

jmahoney@thespec.com

905-526-3306

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Our old, rugged cross

Fat people have less than thin people. Older people have less
than younger people. Men have less than younger women.

It is brown fat, actually brown in color, and its great appeal
is that it burns calories like a furnace. A new study finds
that one form of it, which is turned on when people get cold,
sucks fat out of the rest of the body to fuel itself. Another
new study finds that a second form of brown fat can be created
from ordinary white fat by exercise.

Of course, researchers say, they are not blind to the
implications of their work. If they could turn on brown fat in
people without putting them in cold rooms or making them
exercise night and day, they might have a terrific weight loss
treatment. And companies are getting to work.

But Dr. Andre Carpentier, an endocrinologist at the University
of Sherbrooke in Quebec and lead author of one of the new
papers, notes that much work lies ahead. It is entirely
possible, for example, that people would be hungrier and eat
more to make up for the calories their brown fat burns.

"We have proof that this tissue burns calories - yes, indeed it
does," Carpentier said. "But what happens over the long term is
unknown."

Until about three years ago, researchers thought brown fat was
something found in rodents, which cannot shiver and use
heat-generating brown fat as an alternative way to keep warm.
Human infants also have it, for the same reason. But
researchers expected that adults, who shiver, had no need for
it

and did not have it.

Then three groups, independently, reported that they had found
brown fat in adults. They could see it in scans when subjects
were kept in cold rooms, wearing light clothes like hospital
gowns. The scans detected the fat by showing that it absorbed
glucose.

There was not much brown fat, just a few ounces in the upper
back, on the side of the neck, in the dip between the
collarbone and the shoulder, and along the spine. Although mice
and human babies have a lot more, and in different places, it
seemed to be the same thing. So, generalizing from what they
knew about mice, many researchers assumed the fat was burning
calories.

But, notes Barbara Cannon, a researcher at Stockholm
University, just because the brown fat in adults takes up
glucose does not necessarily mean it burns calories.

"We did not know what the glucose actually did," she said.
"Glucose can be stored in our cells, but that does not mean
that it can be combusted."

A new paper in The Journal of Clinical Investigation by
Carpentier and his colleagues answers that question and more.
By doing a different type of scan, which shows the metabolism
of fat itself, the group reports that brown fat can burn
ordinary fat and that glucose is not a major source of fuel for
these cells. In the study, the subjects - all men - were kept
chilled, but not to the point of shivering, which itself burns
calories. Their metabolic rates increased by 80 percent, all
from the actions of a few ounces of cells. The brown fat also
kept its subjects warm. The more brown fat a man had, the
colder he could get before he started to shiver.

On average, Carpentier said, the brown fat burned about 250
calories over three hours.

But there is another type of brown fat. It has been harder to
study because it often is interspersed in the white fat and
does not occur in large masses. Investigators discovered it in
mice years ago. Now, in a recent article, Bruce Spiegelman,
professor of cell biology and medicine at the Dana-Farber
Cancer Institute, and his colleagues report that, in mice at
least, exercise can make it appear, by turning ordinary white
fat brown.

When mice exercise, their muscle cells release a newly
discovered hormone that the researchers named irisin. Irisin,
in turn, converts white fat cells into brown ones. Those brown
fat cells burn extra calories.

"What I would guess is that this is likely to be the
explanation for some of the effects of exercise," Spiegelman
says. The calories burned during exercise exceed the number
actually used to do the work of exercising. That may be an
effect of some white fat cells turning brown.

Almost everyone of normal weight or below shows this brown fat
if they are chilled, although individuals vary greatly in how
much they have. But this brown fat almost never shows up in
obese people. Is that one reason they are obese, or is their
extra body fat keeping them so warm that there is no reason to
turn on their brown fat?

As for deliberately making yourself cold if you want to lose
weight, Carpentier said, "there is still a lot of research to
do before this strategy can be exploited clinically and
safely."

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Feel a chill? Brown fat's slimming you down

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