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From a June 2015 post at drgladstone
Recently there was something in the news about roughly half of the information in the shows “the doctors” and the Dr. Oz show was correct (actually it was 63% of the time in “the doctors: and correct about 49% on the Dr. Oz show). See an article reporting on this here. Often times people will have looked things up on the internet when they come into the office.
Now I’m not bringing this up to knock Dr. Oz or the doctors who appear on “The Doctors”, nor looking things up the internet. However it’s important to ask several questions.
1) Does the claim have any scientific basis?
2) Has the study (if a study is being quoted) been replicated with the same or similar results obtained?
2a) who funded the study? was it reported in a reputable journal? If it is a product being touted, did the company making the product fund the study?
3) Does the person ‘reporting’ the results, or pushing the product have a connection with the company? Just because someone is employed or funded doesn’t necessarily mean they’re biased, but it is something to take into account
Read the entire post here
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California, Oregon To Allow Hormonal Contraceptives Without A Doctor’s Prescription
From a July 2015 Kaiser Health News post
California and Oregon will be the first states in the nation to allow women to get birth control pills and other hormonal contraceptives directly from their pharmacists – without a doctor’s prescription.
As California officials were busy finalizing regulations on a state law passed in 2013, Oregon’s governor Kate Brown signed a similar bill into law last week.
The two measures were hailed by women’s health advocates. They noted that men have long had an easier time getting birth control, simply purchasing condoms over the counter.
“We support efforts like these that remove barriers to women gaining access to birth control and other reproductive health care,” said Kathy Kneer, President and CEO of Planned Parenthood Affiliates of California, in a written statement.
Read the entire post here
Why Is the Federal Government Afraid of Fat?
From a July 2015 post at Medication Health News
The New York Times has recently shared an interesting piece with their readers. Since 1980’s Dietary Guidelines and Federal food policies recommended limiting dietary fat in the American diet to less than 30% of a daily caloric intake. This recommendation has remained active since and is still used in the Nutrition Facts panel on all packaged foods. A number of recent studies of low-fat diets revealed no significant benefits in major cardiovascular diseases, diabetes, cancer risk and weight gain. In fact, the only research that suggested a reduction in these conditions related to a Mediterranean-style diet with a higher 40% of total fat intake. Additionally, a harmful increase in the consumption of refined carbohydrates has occurred over the past several decades. For the first time the advisory committee for the 2015 Dietary Guidelines omitted the upper limit on total fat, focusing the recommendation on promoting healthy food consumption and improving the food quality rather than concentrating on the total fat content. In your opinion, is an average American ready to abandon the low-fat trend?
For additional information please read The NewYork times
Image courtesy of [Stuart Miles]/FreeDigitalPhotos.net
From a July 2015 post by Dr. Jekyll
Women who use feminine care products called douches may increase their exposure to harmful chemicals called phthalates–and black women may be at particularly high risk due to frequent use. Public health officials advise against the use of douching products, which can hide vaginal infections and lead to other serious health problems. Despite that, douching products are still a popular item on the drug store shelf, and are disproportionately used by black women.
“This study suggests, for the first time, that vaginal douches may increase a woman’s exposure to phthalates, chemicals that may alter hormone action and are associated with serious health problems,” says senior author of the study Ami Zota, ScD, MS.
“These findings raise questions about the health and safety of vaginal douches and other fragranced products used in and around the vaginal area.”
This study did not directly tie phthalates in douching products to health problems in women–additional research will have to make that direct connection. Still, the research did find that vaginal douching may increase a woman’s exposure to DEP and that’s a troubling finding that needs to be explored further.
The American College of Obstetricians and Gynecologists and other health experts recommend against douching because this practice has been associated with increased risks of vagina infection, pelvic inflammatory disease, problems during pregnancy and sexually transmitted diseases. Now, this study adds the worry that douching may also expose women to chemicals that can lead to health problems later in life or can harm their developing baby–if women are pregnant while using such products.
Read the entire post here
From a July 2015 post at RFF Library blog
[AFP via Yahoo! Health] The unprecedented degradation of Earth’s natural resources coupled with climate change could reverse major gains in human health over the last 150 years, according to a sweeping scientific review published late Wednesday.
“We have been mortgaging the health of future generations to realize economic and development gains in the present,” said the report, written by 15 leading academics and published in the peer-reviewed medical journal The Lancet.
“By unsustainably exploiting nature’s resources, human civilization has flourished but now risks substantial health effects from the degradation of nature’s life support systems in the future.”
Climate change, ocean acidification, depleted water sources, polluted land, over-fishing, biodiversity loss — all unintended by-products of humanity’s drive to develop and prosper — “pose serious challenges to the global health gains of the past several decades,” especially in poorer nations, the 60-page report concludes…
“This is the first time that the global health community has come out in a concerted way to report that we are in real danger of undermining the core ecological systems that support human health,” said Samuel Myers, a scientist at Harvard University and one the authors.
A companion study on the worldwide decline of bees and other pollinators, led by Myers and also published in The Lancet, illustrates one way this might happen.
The dramatic decline of bees has already compromised the quantity and quality of many nutrient-rich crops that depend on the transfer of pollen to bear fruit…
Read the entire post here
E-cigs are at the least annoying. Both my husband and I can tell if there is e-cig smoke in the near vicinity, it is a nasty feeling in one’s lungs. I was walking out of the public library behind someone, and before I could dodge another person exiting, he was vamping. Took about 15 minutes for the vapors to get out of my lungs.
From a July 2015 post at DR B’ VAPING. all.things.vapelife
Petal (Mississippi) resident Jonathan McNeil used to smoke three packs of cigarettes a day. His smoking once caused his two cousins to have asthma attacks, and even forced him to have to use an inhaler. “Now that I vape, I don’t need one,” he said. “I was vaping at the shop and filled the whole place with the vapor. My little cousins walked in, and they were fine. They didn’t have a single attack.” McNeil is one of many who believe electronic cigarettes help people more than they harm them. “This vapor is fine for people to be around,” he said. “It’s the same stuff that comes out of smoke machines on Halloween. A business should be able to do what it wants, so I think a ban like this from the government isn’t needed.” But there are plenty who disagree.
E-cigarettes are being banned in an increasing number of locations, as the debate about their potential harmful side effects rages on. So far, Petal is the lone city inForrest and Lamar counties to specifically address the electronic smoking devices, although the issue is on other cities’ radar. “We’re just trying to keep pace with the technology that is out there,” said Petal Ward 4, Alderman Brad Amacker, who proposed the Friendly City’s ban on using the devices in public locations. “We already have the ban on tobacco cigarettes, so it only seemed prudent to update the ordinance to reflect current smoking devices.”
American Non-smokers Rights Foundation (ANRF) issued a report detailing Local Laws Regulating Use of E-cigarettes. As of July 1, Mississippi had 46 cities and counties where laws restrict e-cigarette use in 100 percent smoke-free venues.
Read the entire article here
From a July 2015 post at Public Health, FYI
You have been colonized by bacteria since the day you were born. Yes, you are the breeding ground for a multitude of tiny organisms. In fact, bacteria outnumber your own cells by 10 to 1!
But before you drench yourself in hand sanitizer to get rid of these little beings, it’s important to note that not all bacteria are bad.
Some good bacteria that live in your gut actually help you digest food. Other good bacteria also live in food like yogurt and milk.
But in a world of good and evil, we do have bacteria that rather complicate our lives and cause us more harm than good.
Meet Staphylococcus aureus, a seemingly innocent-looking bacterium. S aureuslikes to live on your salty skin and in mucosal membranes like your nostrils. This bacterium isn’t always pathogenic, which means it doesn’t always cause disease; however, it can secrete a toxin called that could be the true culprit for causing illness.
These enterotoxins can be found in undercooked or mishandled food, which can cause food poisoning. Beyond causing explosive bowel movement due to a bad burrito, enterotoxins can actually be inhaled, especially if a colony of S aureus lives in your nose.
Herein lies the newest medical mystery – can S aureus enterotoxins cause some kind of respiratory damage like asthma?
Science says… maybe!
From a May 2015 post at The cHealth blog
We made a decision some years ago to build the case for connected health around the management of these illnesses because:
- They are costly. By some estimates these chronic diseases account for 70% of U.S. health care costs.
- They have a significant lifestyle component. This backdrop seems an ideal canvas for connected health interventions because they involve motivational psychology, self-tracking and engagement with health messages. These chronic illnesses pose a unique challenge in that the lifestyle choices that accelerate them are for the most part pleasurable (another piece of cheese cake? spending Sunday afternoon on the couch watching football, smoking more cigarettes and drinking more beer.) In contrast, the reward for healthy behavior is abstract and distant (a few more minutes of life sometime down the road or an avoided heart attack or stroke). This combination of lack of symptoms and the uphill battle around lifestyle improvement makes these illnesses uniquely challenging.
- They are mostly amenable to tracking some objective bit of information about you (e.g. your blood pressure, blood glucose or activity level) in order to make you more aware and, hopefully improve your lifestyle in order to improve your health.
ocused on these illnesses and the attendant challenges, we developed programs for home blood pressure monitoring, home glucose monitoring and various activity challenges (nothing on cholesterol just yet). By iteration, trial and error, we’ve become comfortable with the psychology around these illnesses and how it affects both our ability to manage patients and the patient’s ability to improve these conditions.
Because these conditions are silent and because most people would rather not be reminded that they have an illness, we found that a strong engagement platform is needed to get people’s attention. We also found that we need to create tools that nudge people to adopt and sustain a healthy lifestyle rather than ignore our natural tendencies to ignore these silent conditions and engage in unhealthy behaviors.
Read the entire blog post here
Study finds online hookup sites increase HIV rates in sometimes-surprising ways.
From the 29 May 2015 University of Maryland news release
COLLEGE PARK, Md. – The introduction of Craigslist led to an increase in HIV-infection cases of 13.5 percent in Florida over a four-year period, according to a new study conducted at the University of Maryland’s Robert H. Smith of Business. The estimated medical costs for those patients will amount to $710 million over the course of their lives.
Online hookup sites have made it easier for people to have casual sex—and also easier to transmit sexually transmitted diseases. The new study measured the magnitude of the effect of one platform on HIV-infection rates in one state, and offered a detailed look at the varying effects on subpopulations by race, gender and socio-economic status. Looking at the period 2002 to 2006, it found that Craigslist led to an additional 1,149 Floridians contracting HIV.
The study “underscores the need for broader communication and dissemination of the risks posed by the type of online matching platforms studied here,” noted Ritu Agarwal, a professor at the University of Maryland’s Robert H. Smith School of Business and founding director of the Center for Health Information and Decision Systems (CHIDS), and Brad N. Greenwood, a 2013 Smith Ph.D. and assistant professor at Temple University’s Fox School of Business.
The study also found that the new HIV cases came disproportionately from one racial-ethnic group, African Americans, who accounted for some 63 percent of the new cases. “That is a bit of paradox,” says Agarwal, “because research suggests that the African American community is one which uses the Internet the least, even though the gap is narrowing.”
Greenwood described African Americans as suffering the effects of a “double digital divide.” He said, “Not only have studies shown there is lower utilization of the Internet for welfare-enhancing activities, but now there’s evidence of utilization for negative activities as well.”
There was also an increase in new HIV cases among Latinos and Caucasians—although only intermittently statistically significant and not statistically different from each other. The lack of difference between Latinos and Caucasians was notable, as Latinos have a higher baseline rate of HIV infection. One explanation could be that fewer Latinos may have sought treatment. Or Florida’s Latino community, which is especially large and well-off, may not be reflective of national trends.
Another counterintuitive result was that more cases came from non-Medicaid patients, the wealthier patients, than from the population covered by the government program. That was the case even though the base rate of HIV infection is higher among lower-income citizens. “It could be the case that higher-income people face a higher social penalty for engaging in casual, quasi-anonymous sex, and that the freedom of internet anonymity changes their behavior more than it does for the less wealthy,” Agarwal suggested. “Or it could be a byproduct of substantially better internet access.” (Together with the finding for African Americans, that would suggest that degree of internet access affects different sub-populations in different ways).
HIV-prevention efforts tend to focus on the highest-risk populations, such as the economically disadvantaged, but public-health officials should be aware than online platforms may be “changing the game,” says Agarwal.
Perhaps most surprising of all, given the relatively high rates of infection among bi- and homosexual men, there was not a statistically significant difference in HIV-infection-rate increases across men and women.
It could be the case that homosexual men with HIV who used Craigslist were more likely to practice safe sex than infected heterosexuals, the authors speculated. Or matching platforms may lead to more homosexual activity by men who do not identify publically as homosexuals, who then spread the virus to their female partners. The question demands more research, the authors said.
Agarwal and Greenwood were careful to note that they weren’t making a statement about the overall value of Craigslist. Nevertheless, the study offers a reminder of the downside of connectivity. “While there is a general belief that connectivity is good on average, unfortunately ‘on average’ means that some people are going to benefit more and others are going to lose more,” Agarwal says. “We need to better understand both the beneficial as well as the punitive effects of the Internet on individual and public health.”
Despite guidelines, too many medical tests are performed before low-risk procedures.
From the 1 June 2015 EurkAlert
Despite guideline recommendations to limit medical tests before low-risk surgeries, electrocardiograms (ECGs) and chest x-rays are still performed frequently, found a study inCMAJ (Canadian Medical Association Journal).
Evidence indicates that for patients undergoing low-risk surgery, routine testing does not improve outcomes and can actually lead to surgical delays, patient anxiety and other issues. The Choosing Wisely campaign, which started in the United States and spread to Canada and other countries, aims to raise awareness of unnecessary tests and procedures among physicians and patients to decrease their use.
“Rates of preoperative testing before low-risk procedures were higher than expected, given current guidelines and recommendations, with a significant degree of regional and institutional-level variation across hospitals in a large, diverse jurisdiction with a single-payer health system,” writes Dr. Sacha Bhatia, Department of Cardiology and the Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, with coauthors.
There was a 30-fold difference between institutions with the lowest and highest rates of ordering preoperative tests.
Previous studies have looked at patients over age 65, whereas this study included all patients over age 18.
“Our finding emphasizes the need for re-evaluation of ordering decisions and clinical pathways for patients preparing for low-risk procedures. In particular, preoperative anesthesia and medical consultations have been shown to increase preoperative testing rates.”
The authors suggest more research to understand why these tests continue to be performed, which may be useful for institutions in improving their ordering practices.
Mobile app educates teens on risky sexual behavior.
From the 1 June 2015 Carnegie Mellon news release
By Shilo Rea / 412-268-6094 / email@example.com
Teenagers, parents, educators and clinicians will have a new tool to help adolescents make more informed decisions about their sexual behavior. “Seventeen Days,” a mobile app based on the interactive movie of the same name, will be available at no cost on iPhone, iPad and Android devices beginning June 4.
“Our goal is to create and make readily available a tool that will help teenagers make better decisions for themselves,” said Julie Downs, associate research professor of social and decision sciences at Carnegie Mellon University who studies how social influences affect decision making and how people can make better decisions by understanding these influences. “For the most part, adolescents don’t want to get pregnant. They definitely don’t want to contract a disease. By building on our research about what goes into their decisions, we have crafted an application that will help them avoid these negative outcomes.”
Seventeen Days — in both the video and mobile app form — are results from a five-year, $7.4 million grantfrom the U.S. Department of Health and Human Services to update Downs’ earlier interactive video, “What Could You Do?” which was shown to increase abstinence among teenage girls. Preliminary research indicates that giving young women access to the Seventeen Days film leads to better knowledge about the risks associated with different sexual behaviors and a stronger sense that they can carry out safer behaviors themselves.
In addition to CMU, the mobile app was developed with researchers at West Virginia University, the University of Pittsburgh and Nationwide Children’s Hospital in Columbus, Ohio. The goal of creating the mobile app is to get the interactive tool into as many hands as possible.
“We know that teenagers are having sex, and addressing this is a very important part of their healthcare needs,” said Pamela Murray, M.D., M.P.H., professor of pediatrics at the WVU School of Medicine and section chief for WVU Healthcare’s Adolescent Medicine. “The Centers for Disease Control and Prevention has highlighted teen pregnancy as a winnable public health battle. In the same way that we’ve reduced infectious diseases with immunization, we can reduce teen pregnancy rates and unwanted pregnancies with better communication.”
The mobile app’s release coincides with the American Association of Sexuality Educators, Counselors and Therapists (AASECT) annual conference. Beginning June 4, download the Seventeen Days mobile app.
This project and film were made possible by Grant Number TP1AH00040 from the Office of Adolescent Health, U.S. Department of Health and Human Services.
Watch the 30-second trailer.
Visit the Seventeen Days website.
Follow Seventeen Days on Twitter.
Researchers find fructose contributes to weight gain, physical inactivity, and body fat.
From the 1 June 2015 University of Illinois news release
n the last 40 years, fructose, a simple carbohydrate derived from fruit and vegetables, has been on the increase in American diets. Because of the addition of high-fructose corn syrup to many soft drinks and processed baked goods, fructose currently accounts for 10 percent of caloric intake for U.S. citizens. Male adolescents are the top fructose consumers, deriving between 15 to 23 percent of their calories from fructose–three to four times more than the maximum levels recommended by the American Heart Association.
A recent study found that, matched calorie for calorie with the simple sugar glucose, fructose causes significant weight gain, physical inactivity, and body fat deposition.
“The important thing to note is that animals in both experimental groups had the usual intake of calories for a mouse,” said Rendeiro. “They were not eating more than they should, and both groups had exactly the same amount of calories deriving from sugar, the only difference was the type of sugar, either fructose or glucose.”
The results showed that the fructose-fed mice displayed significantly increased body weight, liver mass, and fat mass in comparison to the glucose-fed mice.
“In previous studies, the increases in fructose consumption were accompanied by increases in overall food intake, so it is difficult to know whether the animals put on weight due to the fructose itself or simply because they were eating more,” Rhodes said.
Remarkably, the researchers also found that not only were the fructose-fed mice gaining weight, they were also less active.
“We don’t know why animals move less when in the fructose diet,” said Rhodes. “However, we estimated that the reduction in physical activity could account for most of the weight gain.”
“Biochemical factors could also come into play in how the mice respond to the high fructose diet,” explained Jonathan Mun, another author on the study. “We know that contrary to glucose, fructose bypasses certain metabolic steps that result in an increase in fat formation, especially in adipose tissue and liver.”
Brain wave study shows how different teaching methods affect reading development.
A study, co-authored by Professor Bruce McCandliss, provides some of the first evidence that a specific teaching strategy for reading has direct neural impact.
From the 28 May 2015 Stanford news release
Stanford Professor Bruce McCandliss found that beginning readers who focus on letter-sound relationships, or phonics, increase activity in the area of their brains best wired for reading.
Words learned through the letter-sound instruction elicited neural activity biased toward the left side of the brain, which encompasses visual and language regions. In contrast, words learned via whole-word association showed activity biased toward right hemisphere processing.
McCandliss noted that this strong left hemisphere engagement during early word recognition is a hallmark of skilled readers, and is characteristically lacking in children and adults who are struggling with reading.
In addition, the study’s participants were subsequently able to read new words they had never seen before, as long as they followed the same letter-sound patterns they were taught to focus on. Within a split second, the process of deciphering a new word triggered the left hemisphere processes.
“Ideally, that is the brain circuitry we are hoping to activate in beginner readers,” McCandliss said.
By comparison, when the same participants memorized whole-word associations, the study found that they learned sufficiently to recognize those particular words on the reading test, but the underlying brain circuitry differed, eliciting electrophysiological responses that were biased toward right hemisphere processes.
Nutrition expert discusses how research changes food policy, politics.
Related Web sites
Marion Nestle thinks the new U.S. dietary guidelines might be on to something
Marion Nestle, a professor at New York University, is very knowledgeable about “food politics” – how thefood industry and powerful lobbying groups have more influence over what Americans eat than science does – and has written a book by the same …
The intersection of food, sustainability and politics
Marion Nestle, a New York University nutrition professor and author of “Food Politics,” said she thinks it’s about time the committee consider the American diet’s impact on the world. Calling the draft guidelines “groundbreaking,” Nestle said they were scientifically sound.
“The committee said the healthiest diet has a lot of plant foods in it,” Nestle says. “And guess what? The most sustainable diet you can possibly eat is exactly the same.”
Dairy is included in the picture to look like a glass of milk. Marion Nestle, author of “Food Politics,” “Eat, Drink, Vote,” and other leading books on the intersection of policy and agriculture, explains that the recommendations shifted from focusing on …
Active substance targeting dreaded hospital germs.
May 29, 2015 / B3C newswire / — In the German Center for Infection Research (DZIF), scientists from the universities of Tübingen, Münster and Munich join forces and prepare together with the company Hyglos clinical studies on an active substance against the dreaded hospital pathogen Staphylococcus aureus: A highly effective protein from bacteria-specific viruses, so-called bacteriophages, shall rapidly kill the bacteria, which frequently occur in the nose. Due to the specific action, the natural microflora is maintained. Such prophylactic treatment of nasal colonization could counteract the spread of especially methicillin-resistant staphylococcus aureus (MRSA) in hospitals and thereby prevent infections in patients.
Pick Your Poison: Intoxicating Pleasures and Medical Prescriptions
It’s not hard to see why our readers loved this thought-provoking expose of America’s long history with mind-altering substances. In fact, the ad for Cocaine Toothache Drops (contemporarily priced at 15 cents) alone is worth a trip to this colorful and well curated site. Lesson plans and online activities help educators illustrate how the United States has handled the thin and shifting line between useful medical prescriptions and harmful, illicit substances.
Over a century ago, it was not uncommon to find cocaine in treatments for asthma, cannabis offered up as a cure for colds, and other contentious substances offered as medical prescriptions. This engaging collection from the U.S. National Library of Medicine brings together sections on tobacco, alcohol, opium, and marijuana. Visitors can learn about how these substances were marketed and also view a selection of digitized items culled from its voluminous holdings, including advertisements, doctor’s prescriptions, and early government documents. In the Education section, educators can look over lesson plans, check out online activities, and explore online resources from the National Institutes of Health, such as, “A Guide to Safe Use of Pain Medicine” and “College Drinking: Changing the Culture.”
Grammar can influence the perception of motion events.
From the 26 May 2015 Max-Planck Institute news release
Different languages can have subtly different effects on the way we think and perceive, a phenomenon known as linguistic relativity. In a new paper in the journal Cognition, researcher Monique Flecken from the Max Planck Institute for Psycholinguistics, together with colleagues, shows that even when we are not speaking, the grammar of our native language may influence the way we perceive motion events.
In the study, Flecken, with colleagues Panos Athanasopoulos (Lancaster University), Jan Rouke Kuipers (University of Stirling) and Guillaume Thierry (Bangor University), measured the extent to which German and English participants allocated attention totrajectory and endpoint of motion events in a task in which they did not have to speak. Participants were presented with short animations of a dot travelling along a trajectory towards a geometrical shape (endpoint), followed by a picture symbolising the event.
…German participants allocated more attention to endpoints than English speakers, in accordance with the grammatical patterns of their language. Prior work has suggested that linguistic relativity effects may only occur when people are (silently) speaking or planning to speak. In a second experiment, Flecken and colleagues were able to show that this was unlikely.
…linguistic relativity extends to the domain of non-verbal motion perception.” So, even in a non-verbal context, the grammatical properties of a language, including the ways in which events are normally encoded in sentences, influence the way people perceive and attend to motion events.
Precision medicine is ‘personalized, problematic, and promising’.
From the 10 July 2015 University of Pennsylvania news release
Since President Barack Obama’s State of the Union Address in January 2015, the nation has been talking about a revolution in patient care, known by many as precision medicine.
Of course, the country is used to hearing the president talk about health care, especially the Affordable Care Act. But when the White House starts launching $215 million initiatives to accelerate research—in this case, the Precision Medicine Initiative, according to a White House Press release—you can be sure it’s not just a passing fad.
First, what is precision medicine?
Precision medicine is about tailoring treatments to the patient’s genome and body function. The promise is that this detailed personal health data can determine what’s most effective for each individual, which can lead to better outcomes.
Most of precision medicine’s application currently focuses on cancer. Launched in 2013, Penn Medicine’s Center for Personalized Diagnostics (CPD) helps oncologists determine the best treatment for their cancer patients by looking at the cancer’s genome.
Here’s how precision medicine is being practiced at Penn:
- A patient is diagnosed with cancer.
- If the cancer involves a solid tumor—like breast, lung, or colon cancer—the tumor is surgically removed during a biopsy, and a chunk of the tissue is sent to Penn Medicine’s CPD. If the cancer involves blood or bone marrow—like leukemia—a sample of the blood or bone marrow is sent.
- The CPD sequences a panel of genes that are known to be involved in cancer. This test examines DNA within the tumor, blood or bone marrow sample. The goal is to find DNA mutations that are driving the cancer.
- A report on the mutations found is sent to the patient’s oncologist.
- The oncologist determines if there are therapies or treatments available that work better than others—or not at all—on the patient’s particular type of cancer.
“We’re using precision medicine to give patients the right drugs, guided by the DNA sequence information from their cancer, so we’re not exposing them to potentially toxic effects,” explains David Roth, MD, PhD, director of the CPD. “This individualized therapy is better than treatment based on the ‘average patient.’”
Precision Medicine is being researched, translated and applied across Penn Medicine. Here,
experts from the Center for Personalized Diagnostics share four predictions on how precision medicine will change how cancer is treated in future generations.
1. Cancer will be diagnosed earlier.
Jennifer Morrissette, PhD, clinical director of the CPD:
“There are different stages of tumors. The earlier you catch the tumor, the more likely you are to survive it. My theory is that this century will be the century of diagnostics. We will be diagnosing people’s cancers earlier and earlier.
“That way, we are not dealing with advanced metastatic tumors that have acquired so many different changes that they’re hard to treat. We’ll be capturing tumors very early, in stage one; have a definitive surgery; follow the patient for a certain number of years to make sure that the cancer hasn’t spread; and then they’ll be cured.
“Some people put off seeing a physician because they don’t want chemo, but the longer they put it off, the more likely they are going to have metastatic disease.”
2. Cancer treatment will be based on each person’s health profile.
David Roth, MD, PhD, director of the CPD:
“[In the past,] doctors had been treating [the average patient] based upon results from a large study.
“The revolution in precision medicine is that now we have better tools to understand what’s going on with you as an individual. Instead of saying, ‘Okay, you have this particular cancer, and you have a 30 percent chance. So, go ahead and get this toxic therapy,’ we can be much more specific.
“If we were able to tell you that you have a five percent chance of responding to a chemotherapy based on the makeup of your tumor, would you still do it?”
3. Gene paneling will be used for diagnosis, not just treatment.
David Lieberman, MS, CGC (certified genetic counselor):
“We tend to see certain genes mutated in certain cancers. For example, there is a certain set of
genes [that are] typically mutated in lung cancer or another set in lymphoma.
“It is not always clear using historical methods what type of cancer a patient has. This makes treatment decisions challenging. Sequencing the tumor’s DNA on a panel of known cancer-related genes may help clarify the cancer’s origin and, in this way, assist the clinician in determining treatment or prognosis.”
$215 million: The amount the White House will invest in the Precision Medicine Initiative in 2016
4. More cancer patients will have a treatment team, rather than just an oncologist.
Jennifer Morrissette PhD, clinical director of the CPD:
“It’s not going to be one physician making all the decisions. Cancer treatment has gotten much more complex. Because of the availability of multi-gene testing, you need a group of people with different types of expertise to make the best decision for a patient.
“In addition to the team directing care for the appropriate approach—whether it’s surgery, radiation, chemotherapy, pain management—now there is also the genetic component.
“[The team’s] able to sit in a room with people from the lab who can talk about what the result means, have the oncologist tell them about the patient and then get the clinical geneticist’s notion that there may be an inherited predisposition. Then, they walk out with a consolidated treatment plan for that patient.”
The future of medicine
For more than 250 years, advancements like “precision medicine” have been the hallmark of Penn Medicine. As the first school of medicine in the United States, it has been and continues to be a place where the future of medicine and the future leaders in medicine are being developed.
The analogy that builds human thought.
From the 27 May 2015 EurkAlert
When Niels Bohr hypothesised his model of atom with the electrons orbiting the nucleus just like satellites orbit a planet, he was engaging in analogical reasoning. Bohr transferred to atoms the concept of “a body orbiting another”, that is, he transferred a relation between objects to other, new objects. Analogical reasoning is an extraordinary ability that is unique to the human mind, is not seen in animals (except very rarely in primates) and that forms the basis of highly sophisticated human thoughts. Scientists have wondered about the origin of this cognitive function: for example, is it necessary to have developed linguistic abilities or are we born already cognitively equipped for this type of abstraction? According to a new study carried out with the collaboration of the International School for Advanced Studies (SISSA) of Trieste and just published in Child Development, the second hypothesis is probably true: analogical abilities precede language and are already present in infants just a few months old.
Data analysis reveals link between age of puberty onsite and health in later life.
From the 18 June 2015 Guardian article
The age that children hit puberty has been found to be a significant predictor of their health in later life, researchers say.
The University of Cambridge study confirms previous findings of a link between early puberty in women and heart disease and type 2 diabetes, and has shown for the first time that early puberty in men is also associated with these conditions.
Those who went through puberty relatively early had around 50% higher relative risks for type 2 diabetes and heart disease. However, women and men who went through puberty relatively late had a higher relative risk of developing asthma.
Researchers from the Medical Research Council (MRC) epidemiology unit at theUniversity of Cambridge found that the age at which both men and women begin puberty is associated with a total of 48 different health conditions including irritable bowel syndrome, arthritis, glaucoma, psoriasis and depression – along with early menopause in women.
Increased anxiety associated with sitting down.
From the 18 June 2015 EurkAlert
Low-energy activities that involve sitting down are associated with an increased risk of anxiety, according to research published in the open-access journal BMC Public Health
Low energy activities that involve sitting down are associated with an increased risk of anxiety, according to research published in the open access journal BMC Public Health. These activities, which include watching TV, working at a computer or playing electronic games, are called sedentary behavior. Further understanding of these behaviors and how they may be linked to anxiety could help in developing strategies to deal with this mental health problem.
Many studies have shown that sedentary behavior is associated with physical health problems like obesity, heart disease, type 2 diabetes and osteoporosis. However, there has been little research into the link between sedentary behavior and mental health. This is the first systematic review to examine the relationship between anxiety and sedentary behavior.
Anxiety is a mental health illness that affects more than 27 million people worldwide. It is a debilitating illness that can result in people worrying excessively and can prevent people carrying out their daily life. It can also result in physical symptoms, which amongst others includes pounding heartbeat, difficulty breathing, tense muscles, and headaches.
Megan Teychenne, lead researcher and lecturer at Deakin University’s Centre for Physical Activity and Nutrition Research (C-PAN) in Australia, said: “Anecdotally – we are seeing an increase in anxiety symptoms in our modern society, which seems to parallel the increase in sedentary behavior. Thus, we were interested to see whether these two factors were in fact linked. Also, since research has shown positive associations between sedentary behavior and depressive symptoms, this was another foundation for further investigating the link between sedentary behavior and anxiety symptoms.”
The C-PAN team suggests the link between sedentary behavior and anxiety could be due to disturbances in sleep patterns, social withdrawal theory and poor metabolic health. Social withdrawal theory proposes that prolonged sedentary behavior, such as television viewing, can lead to withdrawal from social relationships, which has been linked to increased anxiety. As most of the studies included in this systematic-review were cross-sectional the researchers say more follow-up work studies are required to confirm whether or not anxiety is caused by sedentary behavior.
Megan Teychenne said: “It is important that we understand the behavioral factors that may be linked to anxiety – in order to be able to develop evidence-based strategies in preventing/managing this illness. Our research showed that evidence is available to suggest a positive association between sitting time and anxiety symptoms – however, the direction of this relationship still needs to be determined through longitudinal and interventional studies.”
Everything from your risk of a heart attack to the sex of your unborn child may depend on the forecaster’s predictions
From the 17 July 2015 BBC post
In 2013, neuroscientists reported one of the strangest case reports in the history of medicine: a man who claimed to be able to smell the weather. An approaching storm, he said, produced an almost unbearable odour of skunk excrement, mixed with onions. The scientists were at a loss to explain what could be causing these strange symptoms.
Most of us are thankfully lacking this rather unwelcome talent, but even subtle shifts in the atmosphere seem to correlate with changes in our bodies. While scientists have yet to confirm many of these proposed links, the evidence so far is intriguing. If true, it would mean everything from your risk of a heart attack to the sex of your unborn child may, to a greater or lesser extent, depend on the forecaster’s predictions.
Read on to discover the myths and the genuine mysteries.
1) Rain gives you rheumatism… maybe
Recalling happier memories can reverse depression
From the 17 June 2015 MIT news release
MIT neuroscientists have shown that they can cure the symptoms of depression in mice by artificially reactivating happy memories that were formed before the onset of depression.
The findings, described in the June 18 issue of Nature, offer a possible explanation for the success of psychotherapies in which depression patients are encouraged to recall pleasant experiences. They also suggest new ways to treat depression by manipulating the brain cells where memories are stored. The researchers believe this kind of targeted approach could have fewer side effects than most existing antidepressant drugs, which bathe the entire brain.
“Once you identify specific sites in the memory circuit which are not functioning well, or whose boosting will bring a beneficial consequence, there is a possibility of inventing new medical technology where the improvement will be targeted to the specific part of the circuit, rather than administering a drug and letting that drug function everywhere in the brain,” says Susumu Tonegawa, the Picower Professor of Biology and Neuroscience, director of the RIKEN-MIT Center for Neural Circuit Genetics at MIT’s Picower Institute for Learning and Memory, and senior author of the paper.
In 2012, Tonegawa, former MIT postdoc Xu Liu, Ramirez, and colleagues first reported that they could label and reactivate clusters of brain cells that store specific memories, which they called engrams. More recently, they showed that they could plant false memories, and that they couldswitch the emotional associations of a particular memory from positive to negative, and vice versa.
In their new study, the researchers sought to discover if their ability to reactivate existing memories could be exploited to treat depression.
To do this, the researchers first exposed mice to a pleasurable experience. In this case, all of the mice were male and the pleasurable experience consisted of spending time with female mice. During this time, cells in the hippocampus that encode the memory engram were labeled with a light-sensitive protein that activates the neuron in response to blue light.
After the positive memory was formed, the researchers induced depression-like symptoms in the mice by exposing them to chronic stress. These mice show symptoms that mimic those of human sufferers of depression, such as giving up easily when faced with a difficult situation and failing to take pleasure in activities that are normally enjoyable.
However, when the mice were placed in situations designed to test for those symptoms, the researchers found that they could dramatically improve the symptoms by reactivating the neurons that stored the memory of a past enjoyable experience. Those mice began to behave just like mice that had never been depressed — but only for as long as the pleasant memory stayed activated.
Not-so-guilty pleasure: Viewing cat videos boosts energy and positive emotions.
From the 16 June 2015 EurkAlert
BLOOMINGTON, Ind. — If you get a warm, fuzzy feeling after watching cute cat videos online, the effect may be more profound than you think.
The Internet phenomenon of watching cat videos, from Lil Bub to Grumpy Cat, does more than simply entertain; it boosts viewers’ energy and positive emotions and decreases negative feelings, according to a new study by an Indiana University Media School researcher.
The study, by assistant professor Jessica Gall Myrick, surveyed almost 7,000 people about their viewing of cat videos and how it affects their moods. It was published in the latest issue of Computers in Human Behavior. Lil Bub’s owner, Mike Bridavsky, who lives in Bloomington, helped distribute the survey via social media.
“Some people may think watching online cat videos isn’t a serious enough topic for academic research, but the fact is that it’s one of the most popular uses of the Internet today,” Myrick said. “If we want to better understand the effects the Internet may have on us as individuals and on society, then researchers can’t ignore Internet cats anymore.
“We all have watched a cat video online, but there is really little empirical work done on why so many of us do this, or what effects it might have on us,” added Myrick, who owns a pug but no cats. “As a media researcher and online cat video viewer, I felt compelled to gather some data about this pop culture phenomenon.”
Internet data show there were more than 2 million cat videos posted on YouTube in 2014, with almost 26 billion views. Cat videos had more views per video than any other category of YouTube content.
In Myrick’s study, the most popular sites for viewing cat videos were Facebook, YouTube, Buzzfeed and I Can Has Cheezburger.
Among the possible effects Myrick hoped to explore: Does viewing cat videos online have the same kind of positive impact as pet therapy? And do some viewers actually feel worse after watching cat videos because they feel guilty for putting off tasks they need to tackle?
Of the participants in the study, about 36 percent described themselves as a “cat person,” while about 60 percent said they liked both cats and dogs.
Participants in Myrick’s study reported:
- They were more energetic and felt more positive after watching cat-related online media than before.
- They had fewer negative emotions, such as anxiety, annoyance and sadness, after watching cat-related online media than before.
- They often view Internet cats at work or during studying.
- The pleasure they got from watching cat videos outweighed any guilt they felt about procrastinating.
- Cat owners and people with certain personality traits, such as agreeableness and shyness, were more likely to watch cat videos.
- About 25 percent of the cat videos they watched were ones they sought out; the rest were ones they happened upon.
- They were familiar with many so-called “celebrity cats,” such as Nala Cat and Henri, Le Chat Noir.
Overall, the response to watching cat videos was largely positive.
“Even if they are watching cat videos on YouTube to procrastinate or while they should be working, the emotional pay-off may actually help people take on tough tasks afterward,” Myrick said.
The results also suggest that future work could explore how online cat videos might be used as a form of low-cost pet therapy, she said.
Revealed: why GM food is so hard to sell to a wary public.
epa03907292 Belgian activists protest against the US chemical corporation Monsanto and their role in making Genetically Modified Organisms (GMOs) in Brussels, Belgium, 12 October 2013. Belgian anti-GMO activists joined a global protest against Monsanto who make GMOs as well as many toxic chemicals including pesticides, plastics and artificial food additives. EPA/THIERRY ROGE
From the 30 June 2015 article at The Conversation
Whether commanding the attention of rock star Neil Young or apparently being supported by the former head of Greenpeace, genetically modified food is almost always in the news – and often in a negative light.
GM divides opinion, and even individual people can find themselves pulled in two different ways. On the one hand it is a largely new technology and new tech often brings prosperity, solves problems and offers hope for the future. But this also makes it a step into the unknown and people are frightened of what they do not know, or what cannot be known.
In a study recently published in the journal Appetite, colleagues and I examined why some people reject GM technology. We were neither arguing for nor against GM, but rather we wanted to look at the characteristics which determine people’s views.
Specifically, we examined attitudes in the EU to two different types of genetic modifications made to apples. Both involve the introduction of genes to make them resistant to mildew and scab. The first is a gene that exists naturally in wild/crab apples. This is an example of what is called “cisgenesis”. In the second one the gene is from another species such as a bacterium or animal, and is an example of “transgenesis”.
As an idea of the gains available from this process, the production of a new apple cultivar may take 50 years or more. Gene transfer technologies can substantially shorten this. At the same time they may introduce characteristics from totally alien species which is virtually impossible to do naturally. This may then introduce many desirable qualities into the apple – for instance, in the hypothetical case we are analysing, the apples were made more resistant to disease.
We found people’s attitudes tend to be driven by their fears of risk, and their hopes of gain, with hopes being more important for cisgenesis (introduced genes from other apples) and the former for transgenesis (genes from other species).
But quite separate to risk and gain are perceptions that the technologies are “not natural”. Evidently people are disturbed when science takes us away from what they see as the laws of nature. People are also concerned about environmental impact.
People are more united in their disapproval of transgenesis (adding genes from other species). But, again, more educated people tend to be more approving as do men and the more prosperous, while older people tend to be more wary. Finally, for both technologies studying science, or having a father who studied science, impacted favourably on attitude
Anxiety increases the risk of gastrointestinal infection and long-term complications | EurekAlert! Science News.
From the 2 July 2015 news release
A team comprised of scientists at VIB, KU Leuven and UZ Leuven has made significant progress in uncovering the connection between psychological factors and the immune system. Their findings are based on an investigation of a massive drinking water contamination incident in Belgium in 2010, and are now published in the leading international medical journal Gut.
In December 2010, the Belgian communities of Schelle and Hemiksem in the province of Antwerp faced an outbreak of gastroenteritis, with more than 18,000 people exposed to contaminated drinking water. During the outbreak, VIB and KU Leuven set up a scientific task force to study the incident’s long-term effects, led by Guy Boeckxstaens (UZ Leuven / KU Leuven) and Adrian Liston (VIB / KU Leuven).
Seizing an unexpected opportunity
Adrian Liston (VIB/KU Leuven): “The water contamination in Schelle and Hemiksem was an ‘accidental experiment’ on a scale rarely possible in medical research. By following the patients from the initial contamination to a year after the outbreak we were able to find out what factors altered the risk of long-term complications.”
Anxiety and depression affect immune system
The scientists found that individual with higher levels of anxiety or depression prior to the water contamination developed gastrointestinal infections of increased severity. The same individuals also had an increased risk of developing the long-term complication of irritable bowel syndrome, with intermittent abdominal cramps, diarrhea or constipation a year after the initial contamination.
Guy Boeckxstaens (UZ Leuven / KU Leuven): “Irritable Bowel Syndrome is a condition of chronic abdominal pain and altered bowel movements. This is a common condition with large socio-economic costs, yet there is so much that still remains to be discovered about the causes. Our investigation found that that anxiety or depression alters the immune response towards a gastrointestinal infection, which can result in more severe symptoms and the development of chronic irritable bowel syndrome.”
Psychological factors key in preventing long-term complications
The study’s results provide valuable new insight into the cause of irritable bowel syndrome, and underscoring the connection between psychological factors and the immune system.
Adrian Liston (VIB/KU Leuven): “These results once again emphasize the importance of mental health care and social support services. We need to understand that health, society and economics are not independent, and ignoring depression and anxiety results in higher long-term medical costs.”
Profiling the Adventurous Eater – From the Cornell University Food and Brand Lab***.
Think you’re a foodie? Adventurous eaters, known as “foodies,” are often associated with indulgence and excess. However, a new Cornell Food and Brand Lab study shows just the opposite –adventurous eaters weigh less and may be healthier than their less-adventurous counterparts.
The nationwide U.S. survey of 502 women showed that those who had eaten the widest variety of uncommon foods — including seitan, beef tongue, Kimchi, rabbit, and polenta— also rated themselves as healthier eaters, more physically active, and more concerned with the healthfulness of their food when compared with non-adventurous eaters. “They also reported being much more likely to have friends over for dinner,” said lead author Lara Latimer, PhD, formerly at the Cornell Food and Brand Lab and now at the University of Texas.
“These findings are important to dieters because they show that promoting adventurous eating may provide a way for people –especially women – to lose or maintain weight without feeling restricted by a strict diet,” said coauthor Brian Wansink, (author of Slim by Design: Mindless Eating Solutions for Everyday Life). He advises, “Instead of sticking with the same boring salad, start by adding something new. It could kick start a more novel, fun and healthy life of food adventure.” The article is published in the journal Obesity. It is authored by former Cornell researchers, Lara Latimer, PhD, (currently a Lecturer at the University of Texas at Austin) and Lizzy Pope, PhD, RD (currently Assistant Professor at the University of Vermont), and Brian Wansink, (Professor and Director of the Food and Brand Lab at Cornell University.
Summary by Brian Wansink
***The Food and Brand Lab is an interdisciplinary group of graduate and undergraduate students from psychology, food science, marketing, agricultural economics, human nutrition, education, history, library science, and journalism along with a number of affiliated faculty.
and other research areas with summaries of findings for us nonscientists!
Consumers understand supplements help fill nutrient gaps, new survey shows | EurekAlert! Science News.
From the 1 July 2015 news release
Washington, D.C., July 1, 2015–The vast majority of consumers recognize that multivitamins, calcium and/or vitamin D supplements can help fill nutrient gaps but should not be viewed as replacements for a healthy diet, according to a new survey conducted on behalf of the Council for Responsible Nutrition (CRN). Conclusions from the survey of more than 2,000 U.S. adults were published in Nutrition Journal in a peer-reviewed article titled, “Consumer attitudes about the role of multivitamins and other dietary supplements: report of a survey,” authored by CRN consultant Annette Dickinson, Ph.D.; Douglas (Duffy) MacKay, N.D., senior vice president, scientific & regulatory affairs, CRN; and Andrea Wong, Ph.D., vice president, scientific & regulatory affairs, CRN.
“Our data suggest that policy makers and health professionals can recommend dietary supplements to help improve nutrient intakes without being concerned that this will cause consumers to discount the importance of eating a healthy diet,” Dr. Dickinson noted.
In the Nutrition Journal article, the authors cited U.S. government statistics indicating that a considerable percentage of U.S. adults fall short of recommended intakes for several nutrients, such as vitamins C, D and E. At the same time, Dr. Dickinson noted, “Surveys find that dietary supplement users tend to have better diets and adopt other healthy habits–suggesting that they view supplements as just one strategy in an array of health habits to help ensure wellness.” Further, CRN noted in the report that evidence demonstrates that incidence of over-nutrification with micronutrients is low.
Co-author Dr. MacKay advises the importance of CRN conducting this type of consumer research, noting, “As Americans continue to seek ways to stay healthy, dietary supplements play an important role, therefore, it’s important for our industry, as well as those in scientific, academic, health care practitioner and policy circles, to understand how consumers view that role.”
Learn about your prescription drugs and over-the-counter medicines. Includes side effects, dosage, special precautions, and more.
Browse dietary supplements and herbal remedies to learn about their effectiveness, usual dosage, and drug interactions.
Information about label ingredients in more than 17,000 (most of 55,000 by 2016). selected brands of dietary supplements. It enables users to compare label ingredients in different brands. Information is also provided on the “structure/function” claims made by manufacturers.
Features include historic information on supplements, calculators to compare nutrients and Dietary Reference Intakes (DRIs).
These claims by manufacturers have not been evaluated by the Food and Drug Administration. Companies may not market as dietary supplements any products that are intended to diagnose, treat, cure or prevent any disease.
Longwood Herbal Task Force
This site has in-depth monographs about herbal products and supplements written by health professionals and students. It provides clinical information summaries, patient fact sheets, and information about toxicity and interactions as well as relevant links. The task force is a cooperative effort of the staff and students from Children’s Hospital, the Massachusetts College of Pharmacy and Health Sciences, and the Dana Farber Cancer Institute.
European Americans embrace positive feelings, while Chinese prefer a balance.
From the 6 July 2015 article at San Diego Newscape
“Culture teaches us which emotional states to value, which can in turn shape the emotions we experience,” said Stanford psychology Professor Jeanne Tsai, director of the Culture and Emotion Lab on campus. Stanford psychology postdoctoral fellow Tamara Sims was the lead author on the research paper, which was published in the Journal of Personality and Social Psychology.
Sims noted that a number of studies by other researchers have shown that people from Chinese and other East Asian cultures are more likely to feel both negative and positive – or “mixed emotions” – during good events, such as doing well on an exam.
On the other hand, Americans of European descent are more likely to just feel positive during good events. Tsai said this is explained by cultural differences in models of the “self.” Americans tend to be more individualistic and focus on standing out, whereas Chinese tend to be more collectivistic, focusing on fitting in.
“In multicultural societies like ours, this can lead to deep misunderstandings,” Tsai said.
For instance, Americans might view Chinese who feel bad during good events as being depressed, when in fact they are feeling how their culture expects them to feel.
In an interview, Sims said, “Although Americans know what it’s like to look for the good in the bad – the silver lining – they are less likely to see the bad in the good, compared to Chinese.”
FDA cracks down on unapproved ear drops.
Agency Also to Examine Children’s Use of Cough, Cold Medications With Codeine
From the 7 July 2015 AAFP news release
On July 1, FDA officials moved to shut down the manufacture and sale of 16 unapproved prescription otic products used to relieve ear pain, inflammation and infection. Specifically, the agency notified(www.fda.gov) companies that produce and/or distribute these products that it will take enforcement action against them if they continue to make and market the ear drops.
In separate action, the agency said it also plans to scrutinize safety data pertaining to the use of codeine-containing products used to treat cough or colds in children younger than 18 years.
Prescription Ear Drops
Otic drops are frequently given to young children suffering from ear infections and other ailments that cause ear pain and swelling. A number of FDA-approved prescription otic products are available to manage these symptoms, as are legally marketed OTC ear drops. Those products are not affected by the agency’s action.
Products that have not been evaluated by the FDA for safety, quality and efficacy, on the other hand, increase patients’ risk for adverse effects, such as those due to contamination or varying dosage levels that stem from improper manufacturing practices. The unapproved products covered by this action contain the following ingredients:
- benzocaine and antipyrine;
- benzocaine, antipyrine and zinc acetate;
- benzocaine, chloroxylenol and hydrocortisone;
- chloroxylenol and pramoxine; and
- chloroxylenol, pramoxine and hydrocortisone.
Patients who are using these unapproved products (or their parents) are advised to consult with their physician regarding other treatment options.
Codeine-containing Cough-and-Cold Products
In a Drug Safety Communication(www.fda.gov) issued July 1, FDA officials announced that the agency is investigating the safety of using cough-and-cold medications that contain codeine in children younger than 18 years. The agency cited concerns about the potential for severe side effects associated with use of these products, including slowed or difficult breathing.
Children with existing respiratory problems, such as asthma or other breathing disorders, may be particularly susceptible to these adverse effects.
The FDA’s action comes on the heels of an April announcement(www.ema.europa.eu) from the European Medicines Agency (EMA), which declared that the use of codeine-containing cough-and-cold medications was contraindicated in children younger than 12 years because of the risk of side effects. The agency also noted at the time that use of these products was not recommended in children ages 12-18 who have breathing problems.
Furthermore, EMA officials warned, patients of any age who are considered “ultra-rapid metabolizers” of the drug, which is converted into morphine in the body, must not use codeine to treat cough or colds.
The FDA announcement states that the agency will continue to evaluate the safety of using codeine products to treat cough or colds in children and young teens — including reviewing the EMA’s action and the evidence on which it was based — and will release final conclusions when that investigation is completed.
In the meantime, agency officials recommend caution when prescribing these medications for young patients, and they urge both physicians and patients to report adverse effects(www.accessdata.fda.gov) linked to use of the drugs via MedWatch, the FDA’s Safety Information and Adverse Event reporting Program.
Age-related cognitive decline tied to immune-system molecule.
From the 6 July 2015 University of San Francisco news release
Deleterious Effects of ‘Pro-Aging Factor’ Can Be Reversed in Mice
A blood-borne molecule that increases in abundance as we age blocks regeneration of brain cells and promotes cognitive decline, suggests a new study by researchers at UC San Francisco and Stanford School of Medicine.
The molecule in question, known as beta-2 microglobulin, or B2M, is a component of a larger molecule called MHC I (major histocompatibility complex class I), which plays a major role in the adaptive immune system. A growing body of research indicates that the B2M-MHC I complex, which is present in all cells in the body except red blood cells and plasma cells, can act in the brain in ways not obviously related to immunity—guiding brain development, shaping nerve cell communication, and even affecting behavior.
“We are in the process of elucidating the exact mechanism by which B2M works,” said Saul A. Villeda, PhD, a UCSF Faculty Fellow and co-senior author of the new study. “Since B2M increases with age, both in the blood and in the brain, we want to know what is the ‘traditional’ immune contribution to effects on cognition, and what is the non-traditional neural contribution.”
In 2014, highly publicized work in the laboratories of Villeda and Tony Wyss-Coray, PhD, professor of neurology at Stanford, showed that connecting the circulatory system of a young mouse to that of an old mouse could reverse the declines in learning ability that typically emerge as mice age.
Over the course of their long-term research on so-called young blood, however, the researchers had noted an opposite effect: blood from older animals appears to contain “pro-aging factors” that suppress neurogenesis—the sprouting of new brain cells in regions important for memory—which in turn can contribute to cognitive decline.
In the new research, published online on July 6, 2015 in Nature Medicine, Villeda and co-senior author Wyss-Coray again joined forces to follow up on these findings, as well as a range of studies correlating high B2M blood levels with cognitive dysfunction in Alzheimer’s disease, HIV-associated dementia, and as a consequence of chronic dialysis for kidney disease.
Members of the Villeda and Wyss-Coray labs first showed that B2M levels steadily rise with age in mice, and are also higher in young mice in which the circulatory system is joined to that of an older mouse. These findings were confirmed in humans, in whom B2M levels rose with age in both blood and in the cerebrospinal fluid (CSF) that bathes the brain.
When B2M was administered to young mice, either via the circulatory system or directly into the brain, the mice performed poorly on tests of learning and memory compared to untreated mice, and neurogenesis was also suppressed in these mice.
These experiments were complemented by genetic manipulations in which some mice were engineered to lack a gene known as Tap1, which is crucial for the MHC I complex to make its way to the cell surface. In these mice, administration of B2M in young mice had no significant effect, either in tests of learning or in assessments of neurogenesis.
The group also bred mice missing the gene for B2M itself. These mice performed better than their normal counterparts on learning tests well into old age, and their brains did not exhibit the decline in neurogenesis typically seen in aged mice.
Villeda emphasized that the effects on learning observed in the B2M-administration experiments were reversible: 30 days after the B2M injections, the treated mice performed as well on tests as untreated mice, indicating that B2M-induced cognitive decline in humans could potentially be treated with targeted drugs.
“From a translational perspective, we are interested in developing antibodies or small molecules to target this protein late in life,” said Villeda. “Since B2M goes up with age in blood, CSF, and also in the brain itself, this allows us multiple avenues in which to target this protein therapeutically.”
Public expectations about screening still don’t match what screening programs can deliver.
A guide to weighing up the benefits and harms of health screening programmes
Public expectations about screening don’t match what screening programmes can deliver. By addressing misconceptions about how screening works, its limitations and the calculation of benefits and harms, scientists and clinicians hope to bridge the gap between the active debates of the scientific community and the concerns raised by the public.
Download the guide (PDF) below.
Author: Sense About Science
Document type: Making Sense Of
Published: 3 July 2015
– See more at: http://www.senseaboutscience.org/resources.php/7/making-sense-of-screening#sthash.bv0cknq7.dpuf
Extra DNA acts as a ‘spare tire’ for our genomes.
From the 6 July 2015 American Chemical news release
Carrying around a spare tire is a good thing — you never know when you’ll get a flat. Turns out we’re all carrying around “spare tires” in our genomes, too. Today, in ACS Central Science, researchers report that an extra set of guanines (or “G”s) in our DNA may function just like a “spare” to help prevent many cancers from developing.
Various kinds of damage can happen to DNA, making it unstable, which is a hallmark of cancer. One common way that our genetic material can be harmed is from a phenomenon called oxidative stress. When our bodies process certain chemicals or even by simply breathing, one of the products is a form of oxygen that can acutely damage DNA bases, predominantly the Gs. In order to stay cancer-free, our bodies must repair this DNA. Interestingly, where it counts — in a regulatory DNA structure called a G-quadruplex — the damaged G is not repaired via the typical repair mechanisms. However, people somehow do not develop cancers at the high rate that these insults occur. Cynthia Burrows, Susan Wallace and colleagues sought to unravel this conundrum.
The researchers scanned the sequences of known human oncogenes associated with cancer, and found that many contain the four G-stretches necessary for quadruplex formation and a fifth G-stretch one or more bases downstream. The team showed that these extra Gs could act like a “spare tire,” getting swapped in as needed to allow damage removal by the typical repair machinery. When they exposed these quadruplex-forming sequences to oxidative stress in vitro, a series of different tests indicated that the extra Gs allowed the damages to fold out from the quadruplex structure, and become accessible to the repair enzymes. They further point out that G-quadruplexes are highly conserved in many genomes, indicating that this could be a factory-installed safety feature across many forms of life.
Due to a premature posting of this paper online, the embargo is now lifted as of July 6.
The authors acknowledge funding from the National Institutes of Health.
The paper will be available July 8, 2015, at this link: http://pubs.acs.org/doi/full/10.1021/acscentsci.5b00202.
Babys first stool can alert doctors to future cognitive issues, new study finds.
Credit: Anna Langova/public domain
From the 15 July 2015 Case Western news release
A newborn’s first stool can signal the child may struggle with persistent cognitive problems, according to Case Western Reserve University Project Newborn researchers.
In particular, high levels of fatty acid ethyl esters (FAEE) found in the meconium (a newborn’s first stool) from a mother’s alcohol use during pregnancy can alert doctors that a child is at risk for problems with intelligence and reasoning.
Left untreated, such problems persist into the teen years, the research team from the Jack, Joseph and Morton Mandel School of Applied Social Sciences found.
“We wanted to see if there was a connection between FAEE level and their cognitive development during childhood and adolescence—and there was,” said Meeyoung O. Min, PhD, research assistant professor at the Mandel School and the study’s lead researcher. “FAEE can serve as a marker for fetal alcohol exposure and developmental issues ahead.”
Detecting prenatal exposure to alcohol at birth could lead to early interventions that help reduce the effects later, Min said.
Opinion: Will The Joint Commission’s New Standards Keep You Safe from Unnecessary Medical Imaging? | mHealthWatch.
Mature doctor talking to his patient who is about to receive an MRI Scan.url=http://www.istockphoto.com/search/lightbox/9786662][img]http://dl.dropbox.com/u/40117171/medicine.jpg[/img][/url]
From the 14 July 2015 mHealth post
The following is a guest contributed post by Karen Holzberger, Vice President and General Manager for Diagnostics at Nuance.
The Joint Commission standards for diagnostic imaging, which recently went into effect, are designed to help prevent duplicate and unnecessary medical imaging of patients, and reduce potentially harmful exposure to radiation when patients need CT scans, MRI or a combination of these and other diagnostic tests. Beginning July 1, 2015, these standards require protocols, documentation and data collection, staff education and other criteria that raise the bar for quality and safety at ambulatory imaging sites, critical access hospitals and accredited hospitals. What do these standards really mean to the patient?
The new imaging standards focus primarily on the radiation dose index. There are a number of uncertainties tied to the long-term impact of imaging on patients, but researchers agree it impact patients differently depending upon sensitivities to radiation, age, body parts being tested, absorption rates and other factors and these are still being studied. In the meantime, to prevent undue risk, The Joint Commission has put a stake in the ground with these specific standards to help improve patient safety. The Joint Commission joins other accredited healthcare organizations, such as the American College of Radiology (ACR) and other clinical associations that are releasing new quality-focused recommendations,enhanced education tools and technologies to make it easier for healthcare teams to keep you safe from unintended risks while you receive diagnostic imaging that could shed light on serious health conditions.
Smart capsule is potential new drug-delivery vehicle
From 14 July 2015 Purdue University new item
WEST LAFAYETTE, Ind. — A new “smart capsule” under development could deliver medications directly to the large intestines to target certain medical conditions.
“Usually, when you take medication it is absorbed in the stomach and small intestine before making it to the large intestine,” said Babak Ziaie, a professor of electrical and computer engineering at Purdue University. “However, there are many medications that you would like to deliver specifically to the large intestine, and a smart capsule is an ideal targeted-delivery vehicle for this.”
Such an innovation might be used to treat of irritable bowel syndrome, Crohn’s disease and a potentially life-threatening bacterial infection called Clostridium difficile in which the body loses natural microorganisms needed to fight infection.
Findings are detailed in a research paper that appeared online and will be published in a future print issue of the Institute of Electrical and Electronics Engineers (IEEE) Transactions on Biomedical Engineering. The paper was authored by graduate students Wuyang Yu, Rahim Rahimi and Manuel Ochoa; Rodolfo Pinal, an associate professor of industrial and physical pharmacy; and Ziaie.
Finding and using health statistics has become requisite for a number of careers in the past several decades. It’s also a worthwhile skill for anyone navigating the increasingly complex world of health care and medicine. This free online course from the U.S. National Library of Medicine is divided into three related parts: About Health Statistics, Finding Health Statistics, and Supporting Material. Selecting any of these tabs opens to a table of contents. From there, readers can follow the course page by page. For instance, About Health Statistics begins by reviewing the importance of health stats, moves on to their uses, and then speaks about sources for the gathering of statistics, such as population surveys and registers of diseases.
Copyright © 2013 Internet Scout Research Group – http://scout.wisc.edu
I remember studying the parasympathetic system in high school back in the 70’s. Basically we were taught that it exists and it balances the sympathetic system. Also recall we were taught that the nervous system and immune systems were separate, one did not “talk” to the other.
From the 26 May 2015 article at Discover – Science for the Curious
Kevin Tracey, a neurosurgeon based in New York, is a man haunted by personal events – a man with a mission. “My mother died from a brain tumor when I was five years old. It was very sudden and unexpected,” he says. “And I learned from that experience that the brain – nerves – are responsible for health.”
This background made him a neurosurgeon who thinks a lot about inflammation. He believes it was this perspective that enabled him to interpret the results of an accidental experiment in a new way.
In the late 1990s, Tracey was experimenting with a rat’s brain. “We’d injected an anti-inflammatory drug into the brain because we were studying the beneficial effect of blocking inflammation during a stroke,” he recalls. “We were surprised to find that when the drug was present in the brain, it also blocked inflammation in the spleen and in other organs in the rest of the body. Yet the amount of drug we’d injected was far too small to have got into the bloodstream and traveled to the rest of the body.”
After months puzzling over this, he finally hit upon the idea that the brain might be using the nervous system – specifically the vagus nerve – to tell the spleen to switch off inflammation everywhere.
It was an extraordinary idea – if Tracey was right, inflammation in body tissues was being directly regulated by the brain. Communication between the immune system’s specialist cells in our organs and bloodstream and the electrical connections of the nervous system had been considered impossible. Now Tracey was apparently discovering that the two systems were intricately linked.
From the 27 May 2015 American Chemical Society news release
With summer nearly here, U.S. consumers might think they have an abundance of sunscreen products to choose from. But across the Atlantic, Europeans will be slathering on formulations that manufacturers say provide better protection against the sun’s damaging rays — and skin cancer — than what’s available stateside, according to an article in Chemical & Engineering News (C&EN), the weekly newsmagazine of the American Chemical Society.
Marc S. Reisch, a senior correspondent at C&EN, reports that sunscreens on the U.S. market do protect users from some ultraviolet-A and -B rays. But there are eight sunscreen molecules approved for use in Europe that could boost the effectiveness of products in the U.S. and also give manufacturers more flexibility in making their lotions. Some have been in line for FDA approval since 2002.
Why the hold-up? In Europe, sunscreen molecules are considered cosmetic ingredients. In the U.S., they are subject to the same scrutiny as over-the-counter drugs, which go through a more rigorous review process than cosmetics. More than 10 years ago, the FDA introduced a streamlined process to speed up the review of sunscreens from overseas to bring them to the U.S. market. But the products’ makers are still waiting for approval, and some have given up.
The American Chemical Society is a nonprofit organization chartered by the U.S. Congress. With more than 158,000 members, ACS is the world’s largest scientific society and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.
From the 28 May 2015 Stanford Medicine news release
A new study is the first to directly implicate the cerebellum in the creative process. As for the brain’s higher-level executive-control centers? Not so much.
Investigators at Stanford University have found a surprising link between creative problem-solving and heightened activity in the cerebellum, a structure located in the back of the brain and more typically thought of as the body’s movement-coordination center.
In designing the study, the researchers drew inspiration from the game Pictionary.
The cerebellum, traditionally viewed as the brain’s practice-makes-perfect, movement-control center, hasn’t been previously recognized as critical to creativity. The new study, a collaboration between the School of Medicine and Stanford’s Hasso Plattner Institute of Design, commonly known as the d.school, is the first to find direct evidence that this brain region is involved in the creative process.
From the 28 May 2015 MIT news item
Neuroscientists identify a brain circuit that controls decisions that induce high anxiety.
Some decisions arouse far more anxiety than others. Among the most anxiety-provoking are those that involve options with both positive and negative elements, such choosing to take a higher-paying job in a city far from family and friends, versus choosing to stay put with less pay.
MIT researchers have now identified a neural circuit that appears to underlie decision-making in this type of situation, which is known as approach-avoidance conflict. The findings could help researchers to discover new ways to treat psychiatric disorders that feature impaired decision-making, such as depression, schizophrenia, and borderline personality disorder.
The new study grew out of an effort to figure out the role of striosomes — clusters of cells distributed through the the striatum, a large brain region involved in coordinating movement and emotion and implicated in some human disorders. Graybiel discovered striosomes many years ago, but their function had remained mysterious, in part because they are so small and deep within the brain that it is difficult to image them with functional magnetic resonance imaging (fMRI).
From the 27 May 2015 post at You Think You Know
The CDC recently released an interesting map depicting the most “distinctive” cause of death in each state from 2001 through 2010. These causes of death are not the most common – that would be cancer or heart disease in every state – but rather unusual causes of death that are disproportionately common in each state.
Because these aren’t the most common cause of death, in some states just a few dozen people are dying of each condition. For example, the number of deaths range “from 15,000 deaths from HIV in Florida to 679 deaths from tuberculosis in Texas to 22 deaths from syphilis in Louisiana.”
Maps like this one can be helpful in elucidating unique health conditions or social issues in each state. We all know that as a country we are overweight; pointing out the number one killer (heart disease) on a map on seeks to reinforce what is already known. The “distinctive cause” of death points to other issues – like people in coal-mining states being disproportionately likely to die from pneumoconiosis (black lung).
For the physicians out there – the authors of the study noted the importance of categorizing causes of death accurately on death certificates. “It would not take many systematic miscodes involving an unusual cause of death for it to appear on this type of map,” they write.
You can also visit this article on Slate about fun with maps that go viral, which clearly shows how manipulating data can give you some interesting results.
Still believe physicians and other health care professionals should legally be able to ask if there are guns in the household. The presence of guns in a household does factor into increased accidents and injuries. Also, patients can refuse to answer the question if they so desire.
Originally posted on mikethegunguy:
Down in Brazos, Texas, two ER doctors made local headlines by donating a pair of Mossberg shotguns to the local County Constable office. The guns were donated in memory of Constable Brian Bachmann, a 20-year law enforcement veteran, who was killed while attempting to serve an eviction notice onan enraged individual, the latter after shooting Bachmann then shot and killed a civilian, and wounded two other police officers before being killed himself.
What caught my eye about this story was the fact that it highlighted the relationship between law enforcement and medicine when we think about violence perpetrated with guns. After all, if we use a phrase like ‘gun violence’ to cover every incident in which someone suffers an injury from a gun, then three-quarters of all violence involving guns also happen to be crimes. In 2013, hospitals treated roughly 60,000 people who were victims of shootings and treated 135,000…
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From the 28 May 2015 ScienceLife news release
ancer, all by itself, is bad enough. Although cancer treatment, especially chemotherapy, has become much gentler than it was a decade ago, most interventions still carry significant risks and side effects.
Recently, many physicians have focused on a different sort of hazard that they call “financial toxicity.” Along with the distress of a cancer diagnosis and the discomforts of treatment, patients increasingly have to deal with the cost, anxiety and loss of confidence inspired by large, unpredictable expenses, often compounded by decreased ability to work.
A team led by Jonas de Souza, MD, a head-and-neck cancer specialist at the University of Chicago Medicine, has developed the first patient-oriented website devoted to helping cancer patients understand and cope with financial toxicity (FT). Their goal is to increase awareness of this side effect prior to and during medical treatment so patients know what to expect and can better understand how costs impact them and their families.
First patient-led research registry for arthritis patients launched.
From the 20 May 2015 University of Alabama news release
CreakyJoints, an online, nonprofit, patient support community with more than 80,000 members, has launched Arthritis Power, the first patient-led, patient-generated, patient-centered research registry for arthritis, bone, and inflammatory skin conditions. Focusing on rheumatoid arthritis, psoriasis, psoriatic arthritis as well as numerous other musculoskeletal conditions, the goal of Arthritis Power is to securely collect health data from tens of thousands of arthritis patients to support future research.
Arthritis Power includes a steering committee of patients called the Patient Governor Group that identifies research needs for study development and prioritizes research requests from the CreakyJoints patient community around the world. The new initiative is launched in partnership with the University of Alabama at Birmingham. Arthritis Power is supported in part by the Patient Centered Outcomes Research Institute (PCORI), a nonprofit, nongovernmental organization created by Congress as part of the Patient Protection and Affordable Care Act of 2010. Its overall goal is to enhance informed health-care decision-making and to improve health-care delivery.
Usually patients with rheumatoid, psoriatic arthritis or other chronic conditions learn about opportunities to participate in research from their health-care providers. Arthritis Power will offer a variety of clinical trial and other research opportunities, allowing patients to proactively decide when and how to participate. Securely donated data will be used by patients, universities, research facilities, and physicians to better understand how to fight these diseases and perhaps, contribute to finding elusive cures. Arthritis Power data will be collected using a smart phone, laptop, desktop or tablet where there is an Internet connection.
“Patient-centered research means that we can more effectively use big data to answer questions that are important to those living with these illnesses. This opportunity will produce results that help patients weigh the value of health-care options according to their personal circumstances, conditions, and preferences,” says Jeffrey Curtis, M.D., M.S., MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology in the UAB Division of Clinical Immunology and Rheumatology.
Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th Edition “The Pink Book”.
This illustration depicts the influenza virus. Graphic created by Dan J. Higgins, Division of Communication Services, CDC
The 13th Edition Epidemiology and Prevention of Vaccine-Preventable Diseases, a.k.a. the “Pink Book,” provides physicians, nurses, nurse practitioners, physician assistants, pharmacists, and others with the most comprehensive information on routinely used vaccines and the diseases they prevent.
Typical chapters include a description of the disease, pathogenesis, clinical features, laboratory diagnosis, medical management, epidemiology, vaccination schedule and use, contraindications and precautions, adverse reactions following vaccination, vaccine storage and handling, and references.
Six appendices contain a wealth of reference materials including: vaccine minimum ages and intervals, current and discontinued vaccines, vaccine contents, foreign vaccine terms, and more.
To view online or download to print specific sections, see links below.
Order a bound copy from the Public Health Foundation Learning Resource Center.