Wednesday, August 22, 2007

Shrimp Cocktail

I am in Iceland (yes, Iceland) for a couple of days to give a talk at a conference -- more on that in a moment -- and I was reading an article about Icelandic shrimp in Atlantica, the Icelandic Air airplane magazine. I ripped it out at the time because I thought it was interesting but didn´t think about it again until tonight when I was eating some of those exact shrimp at a reception.

It appears that there is a carbohydrate -- chitosan -- derived from the exoskeletons of Icelandic shrimp that is applied to bandages that have a high success rate in external hemorrhage control in combat operations. According to this article, the company that makes them is based in Oregon and is called HemCon and has apparently sold more than 400,000 bandages to the US Army.

The good news is that the bandages help. The bad news, of course, is that they are needed by our armed forces and by civilians in war zones. (Before anyone asks, I do not know if BIDMC or any of our faculty ever have had any financial relationship with this company -- and I have not had a chance to check with our folks in Boston, so I can´t find out right now -- but I doubt it. There is a very large trauma service in Seattle, and I would bet that clinical trials would have taken place there.)

By the way, the local shrimp are delicious and are served peeled (maybe to send the exoskeletons to work as bandages.)

The conference I am attending is called the Nordic Conference for University Hospitals and Faculty Deans, with attendees from Iceland, Denmark, Sweden, Norway, and Finland, and three of us guest speakers from Calgary, Manchester (UK) and Boston. I always worry a bit when I am invited to speak at these things because I have so little knowledge of the field compared to others, but I liked the topic I was assigned. It is "Never let the practice of medicine be replaced by the business of medicine." Of course I agree with that, but I also think part of the topic has to be "Never forget that the business of medicine can affect the practice of medicine."

What´s really interesting is that these countries, which have national health insurance systems, are feeling the pinch more and more from their legislative bodies. Members of parliament are upset with the rising costs of health care and want to see more efficiency and higher quality. The underlying system is not likely to change, but hospital CEOs are expected to deliver more for less, and they look towards our US experience for ideas and suggestions.

I can´t wait to see what I am going to say during my talk tomorrow. If I come back wearing lots of shrimp-laced bandages, you will know that it didn´t go very well.

P.S. I took this picture of a waterfall east of Reykjavik at a World Heritage Site called ├×ingvellir National Park.

14 comments:

Anonymous said...

Whoa! You mean you are just winging the talk??!! I've always envied people who could do that. I have to prepare every word and basically read it. Send us your notes if you have any!

This should be a fascinating experience with all those people from the health care systems touted by everyone here. It will be interesting to see what they have to say; looking forward to followup posts!

Anonymous said...

There are good ideas in Massachusetts, too. Marine Polymer Technologies of Danvers, Mass. also makes a chitin dressing used by DoD.

Anonymous said...

Can you ask around about nursing in Iceland and the challenges with the profession there? shortage, staffing, etc..

Paul Levy said...

Dear Anons:

Notes!? You mean I should have a record of what I said? Way too dangerous. Then, I could be held accountable.

Thanks for the MA connection.

Will do on the stafing question. Iceland currently has an unemployment rate below 1%!

SS said...

Did you fly first class or executive class to Iceland? Hmmmm....lucky :)

Paul Levy said...

They paid, and it was business class...

Anonymous said...

Medicine is a business. In the not too distant past, most new physicians used to set up solo practices. The first steps in setting up a practice are: obtaining licenses, leasing or buying space, finding an accountant, hiring staff, purchasing equipment and supplies, and setting up systems for scheduling and billing. Medicine is also a calling. Charles Lauer of Modern Healthcare in a July 2002 publisher's letter said the following about the healthcare industry "It's about saving lives, mending broken bones and making people whole again." I'm glad I was called to this business.

Maxine said...

all well and good, but what about those of us allergic to shellfish. do we have to worry about bandages now too.

Paul Levy said...

Great question. I doubt it because the manufacturing process probably breaks down the proteins that would be allergenic. But I am just guessing. Anyone out there know?

The Imp ;-) said...

Google is your friend.

Regards,

Mark

http://www.allergicchild.com/shellfish_allergy.htm

"There have been no known allergic reactions as a result of using the HemCon Bandage since distribution began in 2003 and there have been no adverse effects reported in over 500,000 bandages shipped. HemCon Medical Technologies, Inc. has results from a shellfish allergy study conducted by its chitosan supplier which demonstrates that, out of 221 individuals with suspected hypersensitivity, including 8 individuals with known shellfish allergies, none demonstrated any dermal sensitivity when pricked with a chitosan test solution. However, since chitosan is extracted from the shells of shrimp, other shellfish and fungi, individuals with known shellfish allergies should exercise caution in the use of products containing chitosan."

Paul Levy said...

That took you an awfully long time . . .

:))

Thanks.

Maxine said...

thanks Mark. I'll just add that to my bracelet anyway.

Anonymous said...

What about those wonderful pineapple slices with choclate....? Perhaps the pineapple peel can be useful for something?

Thanks for a very fruitful talk!

/Irja

Paul Levy said...

Very good!

(Note to others: The food on this island with just 300,000 people is very good, including remarkably fresh fruit -- virtually all imported, of course -- and with some tasty combinations. Noted here, pinapple slices dipped in some very nice dark chocolate.)