Category: Health

Not the fountain of youth, but the river of age

11/02/2011

from utmb.edu

What if you could take a drug that would slow down the aging process?

A study reported in today’s issue of the journal Nature explains how researchers at the Mayo Clinic kept mice from aging by purging their bodies of senescent cells, which set off low levels of inflammation that spurs the aging process.

Here is an overview:
“Advanced age is the main risk factor for most chronic diseases and functional deficits in humans, but the fundamental mechanisms that drive ageing remain largely unknown, impeding the development of interventions that might delay or prevent age-related disorders and maximize healthy lifespan. Cellular senescence, which halts the proliferation of damaged or dysfunctional cells, is an important mechanism to constrain the malignant progression of tumour cells1, 2. Senescent cells accumulate in various tissues and organs with ageing3 and have been hypothesized to disrupt tissue structure and function because of the components they secrete4, 5. However, whether senescent cells are causally implicated in age-related dysfunction and whether their removal is beneficial has remained unknown. “

According to Purging Cells in Mice Is Found to Combat Aging Ills by Nicholas Wade,
“The experiment raises the prospect that drugs could be developed that would keep human tissues healthier longer, but it is unclear until further testing is done whether such drugs could eventually help people live longer. The finding indicates that any therapy that rids the body of senescent cells would delay age-related changes.

Senescent cells accumulate in aging tissues, like arthritic knees, cataracts and the plaque that may line elderly arteries. The cells secrete agents that stimulate the immune system and cause low-level inflammation. Until now, there has been no way to tell if the presence of the cells is good, bad or indifferent.”

Stay tuned.

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Great news on the malaria front

10/24/2011

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I hope the New York Times does not mind me reprinting one of today's editorials, in toto. It can be found at http://nyti.ms/nxbDus. Thank you, GlaxoSmithKline. Thank you, Bill and Melinda Gates.

October 23, 2011
Two Cheers for the Malaria Vaccine

A vaccine to protect children against malaria has been shown moderately effective in a large clinical trial — an achievement that could save millions of lives. The vaccine, known as RTS,S and made by GlaxoSmithKline, is the first ever to be shown effective against a human disease caused by parasites. When tested in 6,000 infants ages 5 to 17 months in seven sub-Saharan nations, it reduced the risk of infection with severe malaria by 47 percent during the year after the shots, far less than the 90 percent efficacy rate typically sought for other vaccines. And there are other big hurdles still to surmount. There are hints that the protection may wane over time and results from administering a booster shot won’t be known until 2014. Side effects could pose a problem; seizures and fevers were higher among children given the vaccine.

If final results of this ongoing study, which involves more than 15,000 children in all, show that the vaccine is safe and effective, the goal is to deploy it in 2015.

Glaxo has pledged to sell the vaccine at its manufacturing cost plus 5 percent that will be spent on research on malaria and neglected diseases. The company has not set a price, and, once it does, international donors and African health systems will have to find the resources to buy and administer it at a time of global recession.

The Bill & Melinda Gates Foundation deserves major credit. Glaxo spent $300 million over 25 years to develop the vaccine for military personnel and travelers but was unwilling to pay for pediatric trials for impoverished nations without a partner. The Gates Foundation donated $200 million to drive the research to completion, and Glaxo expects to add another $100 million of its own.

The fight against malaria has made gains thanks to effective drug treatments, insecticide-treated bed nets and programs to spray the interior walls of houses. With the vaccine, health experts are talking with renewed optimism about eradicating malaria entirely (some countries already have). But it will take vigilance and money to stay ahead of resistant mosquitoes and parasites.

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Everyone can make it to the healthy wealthy corner

01/06/2011

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Click below for a quick look at how the nations of the world have changed in terms of annual income and life expectancy over the past 200 years, as per Hans Rosling on the BBC. This animated graphic certainly underscores how competitive the world has become , expecially since the middle of the 20th century, with all countries vying for the limited resources this planet has to offer.

I’d like to see how Rosling's numbers compare with Ted Fishman’s research on the aging of the world’s population. What will this all mean to our children and grandchildren?

Any thoughts?

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For your daughters, stepdaughters, daughters-in-law

10/23/2009

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Why Pregnant Women Should Get the H1N1 Vaccine
By Amy Tuteur M.D.

http://www.kevinmd.com/blog/2009/10/pregnant-women-h1n1-flu-vaccine.html

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Looking for Mr./Ms. Right, in sickness and in health

10/16/2009

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WANTED: A partner for richer or poorer

and for better or worse and absolutely,

positively in sickness and in health.

I love this column from the Boston Globe, and you’ll see why:

Will he hold your purse?
By Robin Schoenthaler
October 4, 2009

As a breast cancer doctor, I’ve learned how to spot a devoted husband -- a skill I try to share with my single and searching girlfriends. “Everything I know about marriage I learned in my cancer clinic.”

I’ve been known to say this to my friends, maybe more than once, maybe even causing some of them to grind their teeth and grumble about Robin and Her Infernal Life Lessons.

I can’t help myself. I’ve worked as a breast cancer doctor for 20 years, I’ve watched thousands of couples cope with every conceivable (and sometimes unimaginable) kind of crisis, and I’ve seen all kinds of marriages, including those that rise like a beacon out of the scorched-earth terror that is a cancer clinic.

It’s a privilege to witness these couples, but the downside is I find myself muttering under my breath when my single female friends show me their ads for online dating. “Must like long walks on beach at sunset, cats,” they write, or “French food, kayaking, travel.” Or a perennial favorite: “Looking for fishing buddy; must be good with bait.” These ads make me want to climb onto my cancer doctor soapbox and proclaim, “Finding friends with fine fishing poles may be great in the short term. But what you really want to look for is somebody who will hold your purse in the cancer clinic.”

It’s one of the biggest take-home lessons from my years as an oncologist: When you’re a single woman picturing the guy of your dreams, what matters a heck of lot more than how he handles a kayak is how he handles things when you’re sick. And one shining example of this is how a guy deals with your purse.

I became acquainted with what I’ve come to call great “purse partners” at a cancer clinic in Waltham. Every day these husbands drove their wives in for their radiation treatments, and every day these couples sat side by side in the waiting room, without much fuss and without much chitchat. Each wife, when her name was called, would stand, take a breath, and hand her purse over to her husband. Then she’d disappear into the recesses of the radiation room, leaving behind a stony-faced man holding what was typically a white vinyl pocketbook. On his lap. The guy -- usually retired from the trades, a grandfather a dozen times over, a Sox fan since date of conception -- sat there silently with that purse. He didn’t read, he didn’t talk, he just sat there with the knowledge that 20 feet away technologists were preparing to program an unimaginably complicated X-ray machine and aim it at the mother of his kids.

I’d walk by and catch him staring into space, holding hard onto the pocketbook, his big gnarled knuckles clamped around the clasp, and think, “What a prince.”

I’ve worked at cancer clinics all around Boston since then, and I’ve seen purse partners from every walk of life, every age and stage. Of course, not every great guy accompanies his wife to her oncology appointment every day -- some husbands are home holding down the fort, or out earning a paycheck and paying the health insurance premiums -- but I continue to have a soft spot for the pocketbook guy. Men like him make me want to rewrite dating ads from scratch.

WANTED: A partner for richer or poorer and for better or worse and absolutely, positively in sickness and in health. A partner for fishing and French food and beach walks and kayak trips, but also for phone calls from physicians with biopsy results. A guy who knows that while much of marriage is a 50-50 give-and-take, sometimes it’s more like 80-20, and that’s OK, even when the 80-20 phase goes on and on. A man who truly doesn’t care what somebody’s breast looks like after cancer surgery, or at least will never reveal that he’s given it a moment’s thought. A guy who’s got some comfort level with secretions and knows the value of a cool, damp washcloth. A partner who knows to remove the computer mouse from a woman’s hand when she types phrases like “breast cancer death sentence” in a Google search. And, most of all, a partner who will sit in a cancer clinic waiting room and hold hard onto the purse on his lap.

Robin Schoenthaler is a radiation oncologist at the MGH Department of Radiation Oncology at Emerson Hospital in Concord.
http://www.boston.com/bostonglobe/magazine/articles/2009/10/04/will_he_hold_your_purse/

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Guest Post: An important reminder from Karen in California

10/14/2009

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Dear Wonderful Women!

Just a reminder to you that October is Breast Cancer Awareness Month,
and if you haven't done it lately, it's time to schedule your yearly mammogram!! Yeah, yeah, it's not fun, but I can tell you from personal experience, breast cancer is a pretty scary experience.

And don't think you're safe just because your mother, grandmother, or sisters never had it. No one in my family had had breast cancer, but there I was, with a diagnosis that knocked the wind out of my sails.

But I was lucky: It was discovered early - through a routine mammogram - and a radical mastectomy was all the treatment I needed. No radiation, no chemo.

It's been 12 ½ years since the diagnosis/surgery, and I'm in great shape. Tomorrow is my mammogram appointment. I hope to see you there!

Love and life!!
Karen

PS: Don't forget regular self exams, too!

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Guest Post: Are we being taken for a ride by drug and insurance companies?

10/14/2009

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Joanie in New Jersey shares her experience buying prescription drugs directly from a pharmacy in Canada:

Here is the update on my daughter’s meds. Feel free to pass this on so that others will know what a rip off the pharmaceutical companies are pulling on Americans.

The company that manufactured her drug changed the formula, and the old one was no longer available. The new one was not effective for her. Consequently, her symptoms returned and she became quite ill again.

Well, since the Internet is the door to the world, I went online. I put in the name of the old drug and there it was (!), available from an international pharmacy in Canada.

Now, here is the rip off: When she bought it here, through her insurance, she was charged a $65 copay for about 200 capsules.

When we ordered it directly from the Canadian company, the total cost for 100 was $29US.

If you can get 100 for $29 and the copay was $65 for 200, it appears that the copay actually pays for the drug.

So, what the insurance paid to the manufacturer was pure profit!

Oh, by the way the drug is sold over the counter in Canada. Here they treat it like it is some big-time cancer drug!

When you buy just one bottle from the Canadian pharmacy, there is a shipping charge. But if you buy more than a certain amount, shipping is free!

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Rationing vs. Change

08/18/2009

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Kevin Pho, M.D.

New Hampshire-based Kevin Pho, M.D., believes most physicians – especially family docs, like himself – will welcome comparative effectiveness research, but drug and device companies “will be resistant.” Specialists, too, might balk because, he believes, some testing and procedures they do might not be “deemed necessary.”

In an interview for Progress Magazine, Pho told me he currently pays for a service providing online, peer-reviewed, evidence-based data to help him make everyday decisions on patient care. He, for one, will be quite pleased when he can access a larger, free service.

“Physicians need an authoritative source of unbiased data, untainted by the influence of drug companies and device manufacturers,” Pho wrote in a recent post on his blog, www.kevinmd.com/blog/.

Will the publication of data collected through CER result in the rationing of care? Maybe, Pho says, but that might not be such a bad thing.

There's no reason to assume changing care will be equal to reducing care. If we know what works and what doesn’t, for whom and under what conditions, he says, change will benefit the patient, not hurt him or her.

Pho believes advertising agencies and other media have sold patients the myth that, when it comes to health care, #1/ more is better, and #2/ the newest care is always best.

Not so fast, says Pho. A number of important, large-scale recent studies (see Dartmouth Atlas 2008) have shown that sometimes more care can be harmful.

As for new drugs, don’t forget that, just because they’re on the market, there’s no guarantee they will work for you.

“We need to break that myth,” he says. “Older, more established treatments may actually be better. It’s a difficult concept for some patients to grasp.”

Think Eastern medicine and herbal remedies. Maybe your grandmother was right about the benefits of cod liver oil. And, and OTC drug is a whole lot cheaper than some of the fancy drugs you see advertised on television. If it works, why not use it?

Think of all the drugs that have been taken off the market in recent years because they were either ineffective or potentially harmful.

“There’s no point paying for treatments you know won’t work,” he said, in the interview.

“Realistically, to control health care costs, the medical community will have to make some big decisions, and the best way is to make unbiased decisions with unbiased data and recommendations,” he wrote on his blog.

Is that rationing? Or, just making good use of experience?

To read more of Kevin Pho’s comments on health care, go to his blog, www.kevinmd.com/blog/.

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Read this before you take that next pill...

08/18/2009

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If you’re like me, you thought when a drug or medical procedure is approved by the FDA, it works, right?

Wrong!

The FDA certifies the drug won’t hurt you, not that it will help you.

To discover which drugs, diagnostic tests as well as surgical and therapeutic procedures work, and under what circumstances, we must rely on the people that sell them, and on the experience of the docs who use them.

Obviously, that information could be incomplete or biased. And, even if it isn’t, it might take a long time to gather, sort and distribute.

So, at the advice of all kinds of high-level medical think tanks in place for many years, the Obama administration added a provision to the American Recovery and Reinvestment Act of 2009, to set up a mechanism to fund research examining all kinds of public records, clinical trials, legal records and other information. Eventually, we should have evidence that will lead to lists of what works and what doesn’t, under a variety of circumstances.

A daunting task, to be sure.

Nobody believes such information will be available soon. But, the government will take it one step at a time. From my own research on the subject, most doctors welcome the program.

Obviously this will be a long-term research project but it’s built on a program begun in 1989 by President George H.W. Bush, to give you an idea of how long this concept has been kicked around. It’s not new, nor is it unique to the US. Other countries have had similar programs in place for years.

Although in its infancy, the very concept of comparative effectiveness research has added fuel to the fire on talk radio, giving the likes of Rush Limbaugh et al, “proof” health care reform will limit care!

When you think about it, doesn’t the word reform mean re + form, implying change?

The hundreds of health care experts (including representatives from many related industries) who wrote the legislation, as well as the Congress that passed it, must believe this particular change will be for the better.

For an explainer on the pros and cons of comparative effectiveness research (CER), click here to read a fairly short story I wrote recently for Progress Magazine, an ezine published by Sigma Xi, the science research society. This piece looks specifically at the concerns of minorities, who, to be sure, do not want to be left out of any studies. To make sure they’re included, Congress included a special provision into the final draft of the bill that was enacted into law on February 17, 2009. Stay tuned.

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A Sideways Glance at the Least-Likely-to-Be-Insured Crowd

08/17/2009

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Young adult cancer patients have a new weapon against the insidious disease waging war on their bodies: Humor!

For a look at what they call "cancertainment," see this week's Newsweek Magazine.

Here's an excerpt from A Malignant Melanoma Walks into a Bar...:

About 70,000 people between the ages of 18 and 40 are diagnosed with cancer every year, representing about 6 percent of all new cancer cases. About 10,000 young adults die from cancer annually, more than from any other disease. This is not the best statistic to stumble on when you are looking online for hope, as I did in September 2006 after my doctor told me he found a growth in my colon. There I was—nonsmoker, athlete, young—diagnosed with colon cancer, the disease that more commonly afflicts overweight, elderly men. And all I could think was: how inconvenient. I was a travel writer and had just scheduled trips to Rome and Cologne for the following week. Bummer. I would have to reschedule those flights.

Read the entire story at http://www.newsweek.com/id/209319

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