Redefining age 66 - when your job description is "rockstar"

Deep Purple and Orchestra - Maybe I'm a Leo, Mainz, Germany, July 2011:



Ian Gillan, 65, is best known as the lead singer and lyricist for Deep Purple. Roger Glover, 65, is the bassist and songwriter for the group. Ian Paice, 63, is the drummer. He is the only founding member of the band who never stopped performing with the group, and the only member to appear on every album the band has released during the last 43 years (Deep Purple was founded in 1968).

This is the same group almost 40 years ago, in 1972:



I have attended two concerts of Deep Purple, the last one was in June 2011 and it was quite impressive. The audience age ranged from 5 to 75 and everyone rose to their feet to the sound of Smoke on the Water.

From Time-Colonist, Vancouver, Canada:

Welsh-born Roger Glover, now a 66-year-old grandfather, says "when you're on stage, you're still the 19-year-old boy you once were, in thrall with the music. I probably enjoy it more than I did before."

Back in the early 1970s, Deep Purple toured relentlessly. In 1972 alone, the band undertook six tours of North America and a tour of Japan — and wrote an album. Overwork sapped their joy, with the band folding (albeit temporarily) in 1976.

"Now, every night I step on stage I value it immensely. [Performing] is something very few people get to experience, therefore I can't take it for granted," Glover said.

"That's the only time when there's no distractions. There's no phone calls, there's no computers, there's no family, there's no children. There's nothing except for your music and the audience. . . . It's a lovely moment in time, and you're so in the moment. You brain is whizzing along at light speed, because you react to what the others are playing. It's a moving, liquid thing. You keep it together as possible, and also as expressive as possible."

Older and greyer, Glover nonetheless remains slim and trim. Asked whether he maintains a fitness regime, he laughed. He is, after all, still a rock 'n' roll star.

"I'm not really an exercise person. I should be," he said. "I work out on stage. Two hours every night is like two hours in a gym. It is physical."

How long can the group go on? According to Ian Gillan: “People like to do stuff that they’re good at, that they enjoy, that they get something out of. So while it’s fun and we’re all getting older and bits are dropping off here and there, it’s still great. I think there probably will be another album.”

References:

Videos from Deep Purple at Ravinia Festival 2011, 3 part series.
Deep Purple – review, The Guardian, 2011.
"During the monster-rocking ““Smoke on the Water” the middle-aged man in front of me inserted a pair of earplugs and started singing as if for all his life" http://goo.gl/OaWCa
Jon Lord says thank you for Classic Rock Innovator Award, 2011, http://goo.gl/aAFRG
Deep Purple live: 66-year-old vocalist, a plastic cast on his foot, seems to build up steam as the night goes on http://goo.gl/roZzH
Legendary UK Deep Purple band soldiers on: "We haven’t eaten for 2 days, we look at each other, and "it’s the glamour that keeps us going" http://goo.gl/N4SGV
Deep Purple not for the faint of heart. Time-Colonist, Vancouver, Canada, 02, 2012.

Comments from Facebook:

Deep Purple shows shades of youth - British hard rock group are still on the road after 40 years, a feat in itself - Toronto, 2012

I've seen Deep Purple in concert twice (2000 and 2012), Ian Gillan once, in the 1990s. Amazing energy.

They're the basis of my "How to be a Twitter rockstar" talk for physicians... :)

100-year-old doctor still practicing at UCSF, shares unconventional longevity secrets

Even though he recently turned 100, Dr. Ephraim Engleman still sees arthritis patients regularly at the University of California San Francisco (UCSF). He has some rather unconventional longevity secrets to share:

"I think exercise is mostly overrated. And the use of vitamins, forget it. And I don't encourage a lot of doctors.

Fall in love and get married. Sex is to be encouraged. Children are a priority."

His two sons are physicians. His daugher, a lawyer, is a married to a doctor, and their son is a physician.

From NBC’s Nightly News:

Visit msnbc.com for breaking news, world news, and news about the economy

The extended 17-minute version of the report is embedded below:

Visit msnbc.com for breaking news, world news, and news about the economy

Comments from Twitter:

@theRealAnubis: Hum...If he was right, 1/2 of the world population would reach 100 yrs.... For what I see about his case, money is the biggest ally..

Mayo Clinic on procedure competency: "140 colonoscopies isn't cool. You know what's cool, 275 colonoscopies"

Mayo Clinic: GI professional organizations have traditionally recommended that gastroenterology (GI) fellows perform 140 colonoscopies before assessing competency. Robert E. Sedlack, M.D., of the Department of Gastroenterology and Hepatology at Mayo Clinic, discusses findings that suggest it takes an average of 275 procedures to acquire the skills needed to perform safe and effective exams.

The quote is from here:

"The Social Network" tells the story of how Facebook went from a college startup to essentially the only way that old friends keep in touch. Napster founder-turned-Facebook president Sean Parker gives site creator Mark Zuckerberg, some shrewd financial advice. "A million dollars isn't cool. You know what's cool? A billion dollars," he says.

How much heat you can take? 232 years ago, three British gentlemen found out

Have you ever wondered how much heat you can take? 232 years ago, three British gentlemen decided to find out: 260 degrees Fahrenheit (126.6 degrees Celsius).

From NPR:



Be sure to check the cartoon slideshow too.

What happens when you ask for medical advice on Twitter - CNN's Anderson Cooper knows from experience

What happens when you ask for medical advice on Twitter and you are CNN's host Anderson Cooper with 1.5 million followers:

andersoncooper Anderson Cooper

Ok, thanks for all the great info! I'm pretty sure I have it. Uh oh.

14 minutes ago

andersoncooper Anderson Cooper

How do you know if you have bronchitis? Anyone know?

21 minutes ago

Replies:

@thehighsign I generally just go with the opinion of a million and a half strangers.

@SashaTalebi Crazy times we're living in when @andersoncooper can crowdsource his bronchitis diagnosis via Twitter. Get well soon.

@JPLondon72 When a doctor says "You have bronchitis". Usually. Not always.

@emokidsloveme I feel like @andersoncooper has health insurance. Call me crazy, but I think he could afford to pay out of pocket too. #TwitterER

@Technikohler But why don't you just hit up good ole Gupta and ask him ?

@SadaoTurner hey @sanjayguptaCNN, do u know this guy @andersoncooper

@sherrybutlerpr Tight breathing, Burning in chest, fever. B careful, walking pneumonia

@LizaLizzieHalim i knew when i had troubled breathing&it makes sounds.Then i get the doctor checked&was diagnosed with it. Still have it now.

@lynngosselin I've had bronchitis many times so yes I know...but maybe a Dr. will pick up your post

@feathersong Two words - doctor, antibiotics. Make that three words - stat. Feel better soon, you've got a show to do!

@EldinaV And use a mist vaporizer in your dream and lots of OJ

@teresac8 fever, cough, wheezing and irritated breathing but to be sure see a doctor.

@cheeki3 well you want to the homeopathic route. Oregano oil (diluted in juice) will knock it right out.#justsaying

@sherrybutlerpr Also coughing up phlegm. Get on meds. U don't slow down, so will need that or will really go down. Take good care.

Acute bronchitis: Many patients expect to be treated with antibiotics and cough meds but this differs from guidelines

Mind map of differential diagnosis of cough. See more Allergy and Immunology mind maps here.

Cough is the most common symptom bringing patients to the primary care physician's office. The most common diagnosis in these patients is acute bronchitis, according to a recent review in the official journal of AFP, American Family Physician.

Acute bronchitis should be differentiated from other common causes of cough such as pneumonia and asthma - because the therapies are clearly different.

Symptoms of acute bronchitis typically last 3 weeks. As we already know, the presence of colored (e.g., yellow or green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. This statement was contradicted by a recent study: Green or yellow phlegm likely to be bacterial - confirming beliefs by doctors and patients alike (http://goo.gl/zff8X and http://goo.gl/cwKGs).

Viruses cause more than 90% of acute bronchitis, and therefore, antibiotics are generally not indicated. They should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older).

The typical therapies that have been traditionally used for managing acute bronchitis symptoms have been shown to be ineffective. The U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than 6 years.

The supplement pelargonium may help reduce symptom severity in adults.

Many patients expect to be treated with antibiotics and cough medications but this differs from evidence-based recommendations.

References:

Diagnosis and treatment of acute bronchitis. Albert RH. Am Fam Physician. 2010 Dec 1;82(11):1345-50.

Medicine's first Nobel laureate

Medicine's first Nobel laureate was Emil von Behring (1854-1917). He was the discoverer of diphtheria antitoxin in 1890 and attained a great reputation in his lifetime but also was a subject of controversy:

Behring’s unabashed pursuit of financial rewards for his efforts — unusual in that era—drew much criticism. One of the first modern medical entrepreneurs, he aggressively sought to patent his discoveries, and profited handsomely from their applications. This conflicted with the more genteel notions that prevailed at the time, which venerated physicians as selfless servants of mankind.

For all his accomplishments, Behring was a deeply troubled man. He suffered from frequent bouts of profound depression, and was institutionalised several times.

The great discoverer of serum therapy died of pneumonia in Marburg on March 31, 1917.

References:
Emil von Behring (1854-1917): Medicine's first Nobel laureate. Singapore Med J. 2011 Jan;52(1):1-2 (free full text PDF).

Image source: Emil Adolf von Behring, Wikipedia, public domain.

How to apply sunscreen

NHSChoices: An expert explains why it is important to protect your skin from sunburn to help avoid skin cancer. She also gives advice on how to apply sunscreen correctly and what to look out for when buying sunscreen.

You get exposed to both UVA and UVB light:

- UVB light is the light that Burns (causes sunburn)

- UVA light as the light that Ages the skin (wrinkles, etc.)

There is 8-10% increase in sun exposure for every 1,000 feet of elevation. In the summertime, you can get anywhere from 40-50% greater sun intensity than at sea level

Related reading:

Only 25% of Children Wear Sunscreen Regularly. WebMD, 2012.

How much vitamin D do you need? Distilling strong advice from weak evidence

Vitamin D is a steroid hormone and a component of a complex endocrine pathway sometimes called 'vitamin D endocrine system' (Medscape, 2012).

From Nature News:

Vitamin D has been lauded in the media for preventing or treating multiple disease but most evidence is circumstantial or weak.

Despite this, some physicians recommend supplementation of up to 6,000 international units (IU) to compensate for the time that people spend indoors. This is less than what a fair-skinned person make in 30 minutes of exposure to the summer sun (without sunscreen).

The amount spent on vitamin-D supplements in the United States had risen 10-fold in 10 years.

Poor data is one reason that the IOM panel did not recommend higher doses for vitamin D supplementation in 2010. The IOM 1,000-page report recommended that people should aim for blood levels of 50 nanomoles per litre (nmol/L).

However, according to the Endocrine Society's guidelines:

- people with levels under 50 nmol/L are "vitamin-D deficient"
- those with levels between 50 nmol/L and 72.5 nmol/L are "insufficient"

The society's guidelines also offer an 'ideal' level of 100–150 nmol/L which would require 1,500–2,000 IU daily. It advises physicians to monitor vitamin-D levels in healthy people.

Quest Lab already began to implement these deficiency and insufficiency standards over the IOM's. Many physicians are expected to follow suit.

A vitamin D3 dosage of 800 IU/d increased serum 25-(OH)D levels to greater than 50 nmol/L in 97.5% of women http://bit.ly/GzBCcA

References:

The vitamin D-lemma. 6 July 2011 | Nature 475, 23-25 (2011) | doi:10.1038/475023a

Image source: Wikipedia, public domain.

Comments from Google+:

Neil Mehta - This sounds like deja vu' all over again. How many times have we been down this path? vitamin C, Vitamin E, Carotenes....

Common themes:

The myth of natural products: "it is a natural product so it can't cause harm can it?" Thus if a little bit of it is good, more must be better.
The research problem: "It is over the counter and present in foods so very difficult to determine how much someone is actually taking"
Huge confounder of observational studies: "People who take supplements, other "health products" are different from those who don't.

Exercise is good for you, Mr Bean, even judo class

Mr Bean attends a judo class but doesn't want to be thrown by the teacher. From Back to School Mr Bean.

Mr. Bean now has an Official YouTube Channel.

Related reading:

Minimum amount of physical activity for reduced mortality and extended life expectancy: 15 min a day or 90 min a week. Lancet, 2011.

Neighborhood Determinants of Quality of Life - street lighting, sidewalks, trees, absence of air or noise pollution

This paper analyzed quality of life in Uruguay. Differences in overall happiness can be explained by access to public goods.

Neighborhood Determinants of Quality of Life included:

- access to electricity, running water, sewage system, drainage, waste disposal system
- street lighting
- sidewalks in good condition
- trees in the street - "forest bathing" (exposure to parks and forests) may increase immunity

- absence of air or noise pollution

Don't forget that happy people are 22% less likely to develop heart disease.

Based on research, Mike Cadogan summarized happiness in just 4 ideas - repeat every morning: "I'm happy, I'm hopeful about the future, I enjoy life, and I feel I'm just as good as other people."

References:

Neighborhood Determinants of Quality of Life. Néstor Gandelman, Giorgina Piani and Zuleika Ferre. Journal of Happiness Studies, 2011.

Image source: OpenClipArt.org, public domain.

Secure web messaging between patients and doctors: Not well received

Although e-mail may be an efficient clinician-patient communication tool, standard e-mail is not adequately secure to meet Health Insurance Portability and Accountability Act (HIPAA) guidelines. For this reason, firewall-secured electronic messaging systems have been developed for use in health care.

The Kryptiq messaging system was implemented at an academic center and messages were monitored continuously and tracked.

In the 8 months after implementation, only 5 messages were initiated by patients in contrast to 2,363 phone calls.

Patients/families expressed strong interest in e-mailing but secure Web messaging was:

- less convenient than using the phone

- too technically cumbersome

- lacked a personal touch

- only by a handful of patients

One pediatrician on Twitter wants a simpler solution:

@Doctor_V (Bryan Vartabedian): Gimme an integrated, secure Tw like tool for doc to doc/pt comm - part of record.

Comments from Twitter:

@davisliumd: No, Kaiser's data different: Use of Health Information Technology Leads to Improved Care Quality

@yejnes: My patients like it!

References:

Secure Web Messaging in a Pediatric Chronic Care Clinic: A Slow Takeoff of "Kids' Airmail". PEDIATRICS Vol. 127 No. 2 February 2011, pp. e406-e413 (doi:10.1542/peds.2010-1086)

Medical practices using email with patients see their voicemail volume drop - email replaces inefficient phone tag. "We in health care can no longer sit back and say, "I don't do email with patients" - a doctor in WSJ, 2012.

Image source: Wikipedia, public domain.

Cirrhosis: Phil's story

From NHSChoices: Many people enjoy a drink in the pub after work without realising how social drinking can damage health. Phil didn't realise the harm his alcohol intake was doing until he was diagnosed with cirrhosis of the liver. He talks about his experience and the shock he felt at being diagnosed.

Related reading:

Cirrhosis - JAMA Patient Page, 2012.

Twitter epidemics - BMJ video

BMJ medical innovations: During the swine flu pandemic, Google showed that it was able to track the spread using the searches that its users were making. In this video Dr Patty Kostkova shows her work using twitter - and how the data from that could be used to track future epidemics.

Related blog post from ScienceRoll:

"Do you remember when Google Flu Trends was announced to be able to track and predict flu outbreaks in US states based on the search queries focusing on flu symptoms? Do you remember when a study pointed out although it was interactive and neat but was not as useful as CDC national surveillance programs? Well, now Twitter is meant to fill this gap. If you ask me, it won’t."

What young doctors read

From the former BMJ Editor-in-Chief:

"I meet with young doctors all over the world, and I usually ask them what they read. I ask for a show of hands and find fairly consistently that half read the NEJM, the Lancet, a local journal, and a specialist journal, a third the BMJ, and most a local newspaper.

About half are reading a novel, and about a third have read a poem in the past week.

Almost all are on Facebook but very few on Twitter."

A lot of them also use Wikipedia as textbook replacement but they will not admit it unless asked directly.

Here, in the U.S., the majority of young doctors use UpToDate as a primary source, if the subscription is purchased by their hospital.

References:

Richard Smith: Review of “bring back browsing”. BMJ Blogs.

Image source: OpenClipArt.org, public domain.

Comments from Google+:

jennifer gunter - I read textbooks and journals! A lot of them.

Ves Dimov - Good for you. I read most of my journals in Google Reader, then post the most relevant info from them on the blogs, thus creating a searchable archive.

Arin Basu - Ves, I remember some years ago you put up a graphic about your workflow. I'd like to revisit that workflow where you showed how you integrated your RSS reading, blogging, and other readings were coordinated. If you have the link to the resource, would you mind sharing it? Or may be put up the graphic here with some notes as a picture?

Ves Dimov - Sure. That's easy to find. I'm glad you found it useful at the time. It's from 2009:
http://casesblog.blogspot.com/2009/03/how-to-deal-with-information-overload.html

Nancy Onyett, FNP-C - I am not a physician, I am a family nurse practitioner owner in private practice. I read all the articles that are updated on my feed burner, and the medical journals that come in monthly and bimonthly JAMA, NEJM, American Family Physician, Pain Medicine News, Lancet, JCEM (Journal of Clinical Endocrinology & Metabolism), Maturitas.

Cholesterol numbers - Mayo Clinic video

Mayo Clinic: You've heard the warnings before — high cholesterol increases your risk of heart disease. So how often should you get your cholesterol checked, what should your numbers be, and how do you get them there?

Heart numbers to know, from Cleveland Clinic

Knowing your risk for heart disease depends on knowing and understanding some important numbers:

- Blood pressure should be less than 120/80 mm Hg

- Fasting blood sugar should be less than 100 mg/dL

- Total cholesterol less than 200 mg/dL

- LDL (bad cholesterol) less than 100 mg/dL, HDL (good) greater than 40 mg/dL

- Waist circumference should be less than 40 inches for men and less then 35 inches for women

- Body Mass Index (BMI) should be between 18.5 and 25. Calculate your BMI here: http://bit.ly/glMJE5

First Gunshot Victim in the New World - National Geographic Video

Archaeologists in Peru have discovered the 500-year-old skeleton of a man who died from a gunshot wound. Experts believe he's the first shooting victim in the New World.

Celiprolol as treatment of choice to prevent complications in vascular Ehlers-Danlos syndrome

Vascular Ehlers-Danlos syndrome is a rare hereditary connective tissue disorder caused by mutations in the collagen type III gene ( COL3A1 ), which leads to a loss of tissue integrity in many organ systems.

Patients with vascular Ehlers-Danlos syndrome have weakened blood vessels and an increased risk of arterial dissection or rupture that can lead to early death.

The researchers assessed the ability of celiprolol, a β1-adrenoceptor antagonist with a β2-adrenoceptor agonist action, to prevent arterial dissections and ruptures in vascular Ehlers-Danlos syndrome.

Patients with clinical vascular Ehlers-Danlos syndrome were randomly assigned to 5 years of treatment with celiprolol or to no treatment.

33 patients were positive for mutation of collagen 3A1 (COL3A1). Celiprolol was uptitrated every 6 months by steps of 100 mg to a maximum of 400 mg twice daily. The primary endpoints were arterial events (rupture or dissection, fatal or not).

Mean duration of follow-up was 47 months, with the trial stopped early for treatment benefit.

The primary endpoints were reached by 20% in the celiprolol group and by 50% controls (hazard ratio [HR] 0·36).

Celiprolol might be the treatment of choice for physicians aiming to prevent major complications in patients with vascular Ehlers-Danlos syndrome.

References:

Effect of celiprolol on prevention of cardiovascular events in vascular Ehlers-Danlos syndrome: a prospective randomised, open, blinded-endpoints trial. The Lancet, Volume 376, Issue 9751, Pages 1476 - 1484, 30 October 2010.

Celiprolol therapy for vascular Ehlers-Danlos syndrome. The Lancet, Volume 376, Issue 9751, Pages 1443 - 1444, 30 October 2010.

Cyclist who survived: Use your head. Use your helmet

James Cracknell, OBE (born 5 May 1972) is a British rowing champion and double Olympic gold medalist.

From Official JCracknell: On 20th July it's exactly one year since James Cracknell was seriously injured in a cycling accident in America. His helmet saved him. James has made a short film to encourage others to wear cycle helmets. To show your support, pass the film to your friends and most importantly, when you're out cycling, use your head. Use your helmet.

More about the cycling Accident from Wikipedia:

On 20 July 2010, Cracknell was hit from behind by a truck whilst attempting to cycle, row, run and swim from Los Angeles to New York within 16 days. The accident happened at around 5.30 am on a quiet stretch of road outside Winslow, Arizona. It has been reported that his bicycle helmet saved his life but he suffered a contre-coup injury to the frontal lobes of his brain. He is now back at home with his family, although recovery is expected to be still some time away.

Related reading:

How Dangerous is Cycling? Cycling Accidents Facts and Figures - INFOGRAPHIC

Medical educators around the world - Healthcare / HCSM / HIT Social Media List

Medical education around the world, a map by Anne Marie Cunningham: Add yourself so we can find people interested in medical education from all around the world.

Look at this short video for guidance on how to edit the map: http://www.screenr.com/vU2s



Here is a list of Healthcare / HCSM / HIT Social Media-related accounts around the world.

This is a list of the Top Twitter Doctors arranged by specialty in alphabetical order - feel free to add your own suggestions. The list is open to anybody to edit:



Related:
For doctors: How to be a Twitter superstar in two easy steps

The Singing Doctor

From Cleveland Clinic YouTube chanel: Who knew doctors can sign? Hear the ENT doctor Paul Bryson sing the National Anthem sing at an Indians Game (Cleveland baseball team).

Comments from Twitter:

@scanman Wow!! Great voice!!

@DrSnit this was a lovely singing voice.

@faisal_q Working talent @ClevelandClinic

@gastromom Ruled out GERD ;)

Weight lifters turning to human growth hormone - and that's just the tip of the iceberg

From WebMD and the American Journal on Addictions:

In the study of 230 male weight lifters aged 18 to 40:

- 12% reported use of human growth hormone (HGH) or a similar supplement known as insulin-like growth factor-1

- all weight lifters reported use of anabolic steroids

- 56% percent had a current or past dependence on opioids, cocaine, and/or Ecstasy

HGH was prohibitively expensive in the 1990s, but now pills, powders, and injections can be purchased at low cost on the Internet.

Weight lifters who already take steroids add HGH as a "turbo boost". “You can always tell which elite athletes are on HGH because their bones are growing at a faster rate and their faces look distorted.”

References:
Weight Lifters Turning to Human Growth Hormone. WebMD.

Image source: OpenClipart, public domain

Drug companies trying to "create" parasites for treating ulcerative colitis

Ulcerative colitis, a type of inflammatory bowel disease (IBD), is less common in countries endemic for helminth infections, suggesting that helminth colonization may have the potential to regulate intestinal inflammation in IBD. Therapeutic effects of experimental helminth infection have been reported.

According to a researcher: "What we found was that after worm infection, the regions of the colon that were previously not making mucus, were now making mucus again."

"That's a key factor in healing, and it looked like the mucus came back because the worms were causing the body to produce IL-22. This is a molecule that promotes epithelial growth and healing."

Studies suggest parasites can regulate the immune system in ways that prevent it from "going wild" and attacking healthy tissue, and possibly human evolution took that into account.

A case report in the journal Science Translational Medicine provides a cellular and molecular portrait of dynamic changes in the intestinal mucosa of an individual who infected himself with Trichuris trichiura to treat his symptoms of ulcerative colitis.

Tissue with active colitis had a prominent population of mucosal T helper (TH) cells that produced the inflammatory cytokine interleukin-17 (IL-17) but not IL-22, a cytokine involved in mucosal healing.

After helminth exposure, the disease went into remission, and IL-22–producing TH cells accumulated in the mucosa. Genes involved in carbohydrate and lipid metabolism were up-regulated in helminth-colonized tissue, whereas tissues with active colitis showed up-regulation of proinflammatory genes such as IL-17, IL-13RA2, and CHI3L1.

T. trichiura colonization of the intestine may reduce symptomatic colitis by promoting goblet cell hyperplasia and mucus production through TH2 cytokines and IL-22. Controlled helminth infections may lead to new therapies for inflammatory bowel diseases.

References:

Eat Your Worms: The Upside Of Parasites. NPR.

M. J. Broadhurst, J. M. Leung, V. Kashyap, J. M. McCune, U. Mahadevan, J. H. McKerrow, P. Loke, IL-22+ CD4+ T Cells Are Associated with Therapeutic Trichuris trichiura Infection in an Ulcerative Colitis Patient. Sci. Transl. Med. 2, 60ra88 (2010).

Helminth Trichuris suis (pig whipworm) had no effect as therapy for allergic rhinitis

Ulcerative Colitis - NEJM update, 2011.

Image source: Trichuris egg in stool sample (40x). Wikipedia, GNU Free Documentation License, Version 1.2.