Health Thread (nutrition, medical, longevity, etc)

[Crafty_Dog]

By Dana Sullivan Kilroy
 
October 6, 2012
A fascinating, if disconcerting, fact: More than 100 trillion so-called good bacteria thrive in or on the human body. A sizable chunk of them maintain residence in the human digestive tract. Probiotics, live microorganisms that benefit their human host, are among these beneficial bacteria.

Probiotics are also found in foods and supplements, and when consumed they change how the immune system responds to "bad" bacteria.

"Probiotics seem to enhance the intestinal flora and promote a healthier gut environment," says Jeannie Gazzaniga-Moloo, a registered dietitian in Sacramento and a spokeswoman for the Academy of Nutrition and Dietetics. Scientists don't know exactly how probiotics work, but they may also produce anti-microbial substances that destroy harmful microorganisms and stimulate an immune response.

Even though probiotics-infused foods may seem like a modern phenomenon, the idea that consuming living microorganisms could improve health was introduced more than 100 years ago. That's when Elie Metchnikoff, a Nobel-winning scientist, proposed the idea in his book, "The Prolongation of Life: Optimistic Studies."

"Certain dairy products, especially yogurt, contain probiotics naturally," Gazzaniga-Moloo adds, but more recently probiotics have been added to juice, cereal, cookies and more. There are also dozens of probiotic supplements — capsules, tablets and powders — on the market.

Why are food manufacturers adding bacteria to foods that don't contain them? Some studies suggest that probiotics may help prevent and treat vaginal yeast infections and urinary tract infections, may prevent eczema in children and may reduce the severity and longevity of colds and flu. Other studies have shown definitively that people who are suffering from antibiotic-associated diarrhea benefit from consuming probiotics. Most recently, an analysis that appeared in the May issue of the Journal of the American Medical Assn. found that people who are suffering from diarrhea because they are taking antibiotic medications may reduce the risk of diarrhea by 42% if they consume probiotics. While some advocates claim that probiotics reduce the symptoms of irritable bowel syndrome and Crohn's disease, the evidence doesn't yet bear this out. Nor has the U.S. Food and Drug Administration approved any health claims for probiotics.

"I have clients who swear that once they start eating more foods with probiotics they have less bloating and gastrointestinal discomfort, fewer colds and flu," says Gazzaniga-Maloo.

As we start to stare down cold and flu season, a 2009 study that was published in Pediatrics is worth revisiting. The study, which was funded by a company that makes products with probiotics, compared two groups of kids, 326 total, ages 3 to 5, who drank milk with either Lactobacillus acidophilus or Bifidobacterium animalis or plain milk twice a day. The kids who consumed the probiotics-infused milk ultimately got half as many fevers and fewer runny noses than the kids who drank plain milk. Their symptoms also didn't last as long, they took fewer prescriptions and missed fewer days of school than the kids who drank the plain milk.

health@latimes.com

Copyright © 2012, Los Angeles Times

[C Dr Dog]

Woof all - here is a blurb I wrote up for my middle son who is helping with a blood drive tomorrow - just a good reminder of the importance of donating blood when you are able.


I would like to ask all of you to please consider giving blood today. Here are a few facts from the Red Cross about blood donation.

Every 2 seconds someone in the US needs blood.

More than 44 thousand blood donations are needed every day.

A single car accident victim can require up to 100 pints of blood.

Different parts of the blood from a single donation may be used to save up to 3 different people.

5) Only 38 percent of the population are eligible to donate blood, which means if you are able to donate, you are really needed.

The average adult has 10 pints of blood of which we take only one.

The entire process from start to finish takes about an hour and fifteen minutes.

Let me ask you this - when is the last time that you could honestly say that you helped save someone’s life?   Come donate blood and you can say that TODAY.

Thank you.

C Dr Dog

[Crafty_Dog]

http://www.redorbit.com/news/health/1112723215/breakfast-sandwich-atherosclerosis-103112/

[Crafty_Dog]

An Outcast Among Peers Gains Traction on Alzheimer's Cure
By JEANNE WHALEN
 
Gareth Phillips for The Wall Street Journal
 
After years of effort, researcher Dr. Claude Wischik is awaiting the results of new clinical trials that will test his theory on the cause of Alzheimer's.
.Some people collect stamps, others vintage cars. As a young Ph.D. student at Cambridge University in the 1980s, Claude Wischik was on a mission to collect brains.

It wasn't easy. At the time, few organ banks kept entire brains. But Dr. Wischik, an Australian in his early 30s at the time, was attempting to answer a riddle still puzzling the scientific community: What causes Alzheimer's disease? To do that, Dr. Wischik needed to examine brain tissue from Alzheimer's patients soon after death. That meant getting family approvals and enlisting mortuary technicians to extract the brains, he says, "no matter the time of day or night." And it wasn't just a few brains: he collected more than 300 over about a dozen years.

He also embraced an idea that, if he is right, could ultimately spin Alzheimer's research on its heels—and raise new hopes for the roughly 36 million people world-wide afflicted with Alzheimer's or dementia.

 Alzheimer's researcher Claude Wischik has long backed a minority view: that a protein in the brain called tau-not plaque-is largely responsible. WSJ's Shirley Wang spoke with Dr. Wischik about his work on a new drug to treat the devastating disease.
.The 63-year-old researcher believes that a protein called tau—which forms twisted fibers known as tangles inside the brain cells of Alzheimer's patients—is largely responsible for driving the disease. It is a theory that goes against much of the scientific community: For 20 years, billions of dollars of pharmaceutical investment has supported a different theory that places chief blame on a different protein, beta amyloid, which forms sticky plaques in the brains of sufferers. But a string of experimental drugs designed to attack beta amyloid have failed recently in clinical trials, including two this summer from Eli Lilly LLY 0.00%& Co. and a partnership involving Pfizer Inc., PFE +0.04%Johnson & Johnson JNJ +0.32%and Elan Corp. DRX.DB +2.30%
After years on the sidelines, Dr. Wischik, who now lives in Scotland, sees this as tau's big moment. The company he co-founded 10 years ago, TauRx Pharmaceuticals Ltd., has developed an experimental Alzheimer's drug that it will begin testing in the coming weeks in two large clinical trials. Slowly, other companies are boosting investment in tau research, too. This summer, Roche Holding AG ROG.VX -0.11%bought the rights to a type of experimental tau drug from Switzerland's closely held AC Immune SA.

History is peppered with examples of scientists who struggled against a prevailing orthodoxy, only to be proved right. In 1854, British doctor John Snow traced a cholera outbreak in London to a contaminated water supply, but his discovery was rejected by other scientists, who believed bad vapors in the air caused the disease. In the 1880s, cholera was finally pegged to bacteria found in contaminated water. In 1982, when two Australian scientists declared that bacteria caused peptic ulcers, conventional wisdom had it that stress and lifestyle were to blame. The scientists won the 2005 Nobel Prize in medicine for their discovery.

It is far from clear whether Dr. Wischik will join their ranks. Although interest in tau is building, opinions about the cause of Alzheimer's remain deeply divided. Some scientists believe an interaction between beta amyloid and tau plays a central role. Others think there are many possible triggers, including some beyond beta amyloid or tau.

Dr. Wischik says he and other tau-focused scientists have been shouted down over the years by what he calls the "amyloid orthodoxy," a hard-charging group of researchers who believed passionately that beta amyloid was the chief cause of the disease. "Science is politics," he says. "And the politics of amyloid won."

Yet Dr. Wischik has also been hampered by inconclusive research. A small clinical trial of TauRx's drug in 2008 produced encouraging, but mixed, results. What's more, plenty of influential scientists still are backing the idea that beta amyloid plays a central role. Although Roche is investing in tau, Richard Scheller, head of drug research at Roche's biotech unit, Genentech, says the company still is a strong believer in beta amyloid. He thinks amyloid drugs need to be tested on Alzheimer's patients much earlier in the disease cycle in order to prove effective; Roche recently announced plans to conduct such a trial.

“Drugs tied to conventional theories on Alzheimer's causes haven't been effective.
”

Meanwhile, scientists Dr. Wischik accuses of wrongly fixating on beta amyloid, such as Harvard neurologist Dennis Selkoe, say the evidence for pursuing amyloid is strong. "Claude I think sees the world somewhat darkly…if we've made our case more potently for [beta amyloid], there is nothing wrong with that," Dr. Selkoe says. He adds that he supports tau research, as well, and believes drugs to attack both beta amyloid and tau will be necessary.

Alzheimer's disease is the leading cause of dementia in the elderly, and according to the World Health Organization, the cost of caring for dementia sufferers totals about $600 billion each year world-wide. The disease was first identified in 1906 by German physician Alois Alzheimer, who studied the brain of a deceased woman who had suffered from dementia and documented the plaques and tangles that riddled the tissue. The following decades brought few advancements in understanding the disease, in part because of the difficulty of studying the human brain, which unlike other tissues cannot be biopsied and examined until after death.

Still, in the 1960s, British scientist Martin Roth and colleagues showed that the degree of clinical dementia was worse for patients with more tangles in the brain. In the 1980s, Dr. Wischik joined Dr. Roth's research group at Cambridge University as a Ph.D student, and was quickly assigned the task of determining what tangles were made of, which launched his brain-collecting mission, and years of examining tissue.

Finally, in 1988, he and colleagues at Cambridge published a paper demonstrating for the first time that the tangles first observed by Alzheimer were made at least in part of the protein tau. Later research identified tau as the main ingredient. Like all of the body's proteins, tau has a normal, helpful function—working inside neurons to help stabilize the fibers that connect nerve cells. But when it misfires, tau can clump together to form harmful tangles that kill brain cells.

Dr. Wischik's discovery was important news in the Alzheimer's field: identifying the makeup of tangles made it possible to start developing ways to stop their formation. But by the early 1990s, tau was overtaken by another protein: beta amyloid.

Signs of Decline
View Interactive
.
.Several pieces of evidence convinced an influential group of scientists that beta amyloid was the primary cause of Alzheimer's. Among these was the discovery of several genetic mutations that all but guaranteed a person would develop a hereditary type of the disease. These mutations also appeared to increase the production or accumulation of beta amyloid in the brain, leading scientists to believe that amyloid deposits were the main cause of the disease.

The so-called "amyloid hypothesis" quickly gripped the field, and attacking the protein became the main strategy for fighting Alzheimer's. Athena Neurosciences, a biotech company whose founders included Harvard's Dr. Selkoe, focused in earnest on developing drugs to attack amyloid. Meanwhile, tau researchers say they found it hard to get research funding or to publish papers in medical journals.

"It was very difficult to have a good publication on tau, because the amyloid cascade was like a dogma," says Luc Buee, a tau-focused researcher at the French National Institute of Health and Medical Research. "For 15 years if you were not working in the amyloid field you were not working on Alzheimer's disease."

Dr. Wischik and his colleagues fought to keep funding from the UK's Medical Research Council for the repository of brain tissue they maintained at Cambridge, he says. The brain bank became an important tool. In the early 1990s, Dr. Wischik and his colleagues compared the postmortem brains of Alzheimer's sufferers against those of people who had died without dementia, to see how their levels of amyloid and tau differed. They found that both healthy brains and Alzheimer's brains could be filled with amyloid plaque, but only Alzheimer's brains contained aggregated tau. What's more, as the levels of aggregated tau in a brain increased, so did the severity of dementia. "We decided that amyloid isn't what is making people demented," Dr. Wischik says.

In the mid-1990s, Dr. Wischik discovered that a drug sometimes used to treat psychosis dissolved tangles in a test tube. He tried to set up a company to develop the drug as a treatment for Alzheimer's, but found that American and British venture capitalists wanted to invest in amyloid projects, not tau.

By 2002, Dr. Wischik scraped together about $5 million from Asian investors with the help of a Singaporean physician who was the father of a classmate of Dr. Wischik's son in Cambridge. TauRx is based in Singapore but conducts most of its research in Aberdeen, Scotland.

As his tau effort launched, early tests of drugs designed to attack amyloid plaques were disappointing. A vaccine developed by Athena Neurosciences failed to improve patients' cognitive function in a trial that ended in 2002.

To better understand these results, a team of British scientists largely unaffiliated with Athena or the failed clinical trial decided to examine the brains of patients who had participated in the study. They waited for the patients to die, and then, after probing the brains, concluded that the vaccine had indeed cleared amyloid plaque but hadn't prevented further neurodegeneration.

Commitment to the amyloid hypothesis persisted, however. Peter Davies, an Alzheimer's researcher at the Feinstein Institute for Medical Research in Manhasset, NY, recalls hearing a researcher at a conference in the early 2000s concede that his amyloid research results "don't fit the hypothesis, but we'll keep going till they do."

"I just sat there with my mouth open," he recalls.

In 2004, TauRx began a clinical trial of its drug, called methylene blue, in 332 Alzheimer's patients. Around the same time, a drug maker called Elan Corp., which had bought Athena Neurosciences, began a trial of an amyloid-targeted drug called bapineuzumab in 234 patients.

A key moment came in 2008, when Dr. Wischik and Elan presented results of their studies at an Alzheimer's conference in Chicago. The Elan drug failed to improve cognition any better than a placebo pill, causing Elan shares to plummet by more than 60% over the next few days.

The TauRx results Dr. Wischik presented were more positive, though not unequivocal. The study showed that, after 50 weeks of treatment, Alzheimer's patients taking a placebo had fallen 7.8 points on a test of cognitive function, while people taking 60 mg of TauRx's drug three times a day had fallen one point—translating into an 87% reduction in the rate of decline for people taking the TauRx drug.

But TauRx didn't publish a full set of data from the trial, causing some skepticism among researchers. (Dr. Wischik says it didn't to protect the company's commercial interests). What's more, a higher, 100-mg dose of the drug didn't produce the same positive effects in patients; Dr. Wischik blames this on the way the 100-mg dose was formulated, and says the company is testing a tweaked version of the drug in its new clinical trials, which will begin enrolling patients late this year.

Meanwhile, drugs designed to attack beta amyloid have continued to disappoint. This summer, a trio of companies that now own the rights to bapineuzumab—Elan, Pfizer and Johnson & Johnson—scrapped development of the drug after it failed to work in two large clinical trials.

Then in August, Eli Lilly & Co. said its experimental medicine targeting beta amyloid, solanezumab, failed to slow the loss of memory or basic skills like bathing and dressing in two trials involving 2,050 patients with mild or moderate Alzheimer's. Just recently, Lilly disclosed that in one of the trials, when moderate patients were stripped away, the drug slowed cognitive decline only in patients with mild forms of the disease. Lilly said it would talk to regulators before deciding what to do next with the experimental drug.

The trial failures have tempered support for the amyloid hypothesis, but there are still fervent believers who say beta amyloid needs to be attacked very early in the disease cycle—perhaps before symptoms begin—for such medicines to work. This spring, the U.S. government said it would help fund a $100 million trial of Roche's amyloid-targeted drug, crenezumab, in 300 people who are genetically predisposed to develop early-onset Alzheimer's but who don't yet have symptoms. Dr. Selkoe, one of the authors of the amyloid hypothesis, says this trial should help provide a "definitive" answer about the theory.

Scientists and investors, meanwhile, are turning more attention to tau. Roche this year said it would pay Switzerland's AC Immune an undisclosed upfront fee for the rights to a new type of tau-targeted drug, and up to CHF400 million in additional payments if any drugs make it to market.

Dr. Buee, the longtime tau researcher in France, says Johnson & Johnson asked him to provide advice on tau last year, and that he's currently discussing a tau research contract with a big pharmaceutical company. (A Johnson & Johnson spokeswoman says the company invited Dr. Buee and other scientists to a meeting to discuss a range of approaches to fighting Alzheimer's.)

With its new clinical trial program under way, TauRx is the first company to test a tau-targeted drug against Alzheimer's in a large human study, known in the industry as a phase 3 trial. With his passionate beliefs, Dr. Wischik admits he may be just as much a zealot about tau as he accuses others of being about beta amyloid. "I may be," he says. "In the end…it's down to the phase 3 trial."

Write to Jeanne Whalen at jeanne.whalen@wsj.com

[Crafty_Dog]

Where Salt Is Lurking on Restaurant Menus
Navigating Around Sodium When Dining Out Takes Inside Information
•   
By ALINA DIZIK
American adults eat in restaurants an average of five times a week—which means they probably eat way too much salt. Even fine-dining menus offer little escape from sodium overload.
Starting with the bread and salad and ending with the final plate of tiny cookies, many of restaurants' least salty-seeming options are significant sources of dietary salt.

Some of the tastiest dishes served in restaurants are loaded with salt, often taking health conscious diners by surprise. WSJ contributor Alina Dizik and nutritionist Kristy Lambrou join Lunch Break for a look at which foods are likely to serve up too much salt, and what do do about it. Photo: Ramsay de Give for The Wall Street Journal.
The desire to limit salt isn't just for heart-attack patients. Some 90% of Americans will have to contend with high blood pressure in their lifetimes, so it is important for almost everyone to limit their sodium intake, says Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health.
Yet restaurant diners who read menus closely tend to be looking to avoid fats, not sodium. "The consequence of too many calories is more conspicuous," Dr. Willett says. "The sodium issue is quite invisible until they have a stroke."
Salt is indispensable in restaurant kitchens beyond just how it makes food taste. It extends the shelf life of prepared foods, prevents bitterness in produce and encourages binding in breads, says Joy Dubost, director of nutrition at the National Restaurant Association, a Washington, D.C., industry group. Replacing salt with alternative preparations or seasonings, such as herbs, will almost always end up costing more.
Enlarge Image
CloseRamsay de Give for The Wall Street Journal
Jeremy Bearman, executive chef, with Kristy Lambrou, nutritionist, at Rouge Tomate.
Restaurants often salt raw steaks and chops before browning. And green salads can contain salt, whether added to the leafy greens or present in the dressing, cheese or meat add-ins. Chefs put a little extra vinegar in the dressing to balance out a salty-tasting salad.
"Something may have lots of salt in it but not taste salty," says Amy Chaplin, a New York recipe developer and personal chef preparing vegetarian cuisine.
Even simple cooked vegetables can sneak salt onto the menu, says Kristy Lambrou, a culinary nutritionist who works in the kitchen at Rouge Tomate, a New York restaurant whose menu focuses on healthful eating.
To help vegetables retain flavor, nutrients and color, restaurants blanch them, plunging them briefly into boiling salted water and then an ice-water bath. The salt absorbed will vary.
Cutting Down on Salt
View Interactive
Ramsay de Give for The Wall Street Journal (4)
Bread, luncheon meats, pizza, poultry, soups, burgers, cheese and pasta dishes are some of the most common sources of dietary sodium, according to the Centers for Disease Control and Prevention. Charcuterie and cheese plates are out of the question for diners limiting salt.
Diners also should avoid braised meats and sausages, which also often contain a lot of salt. Skip potatoes when possible, because they are usually prepared with a liberal dose of salt. Ditto soups, gravies, curries and other soupy or saucy dishes, which tend to require more seasoning because the liquid dilutes flavor.
Restaurants "use so much more salt than people realize," says Michael Stebner, brand executive chef at True Food Kitchen, a Scottsdale, Ariz., chain developed by Fox Restaurant Group and Andrew Weil, the author of books on integrative medicine. The chain uses recipes modified to require 25% less added salt.
Many health experts recommend cutting salt by 25% because they contend it won't drastically change the flavor. Chefs, though, say generous salting more than once in the cooking process helps bring out depth of flavor.
Enlarge Image
CloseRamsay de Give for The Wall Street Journal
Fresh Herb Tagliatelle
More Taste, Less Sodium
Chef Jeremy Bearman's Fresh Herb Tagliatelle with Maine Lobster has 690 milligrams of sodium—far less than the 1,600 milligrams or more found in a typical serving of traditional pasta and shrimp in tomato sauce.
•   About 60% of the sodium comes from the lobster itself. Colorful vegetables—leek, fennel, broccoli—provide sensory appeal and potassium to balance the lobster's saltiness.
•   Housemade pasta is flavored with saffron but not salt, rolled with fresh herbs and cooked in unsalted water.
•   Minimally salted pasta sauce begins with unsalted fennel stock. It contains leek purée made with saffron, lobster oil, lemon juice, Espellete pepper powder and a pinch of salt.
•   Lobster oil is made by roasting lobster shells with tomato, white wine, chili flake, peppercorns, tarragon, carrot, celery and onion and then steeping them in olive oil.
•   A squeeze of fresh lemon adds bright flavor.
Source: Rouge Tomate
"It opens up the pores on your tongue and enables you to taste the food better," says Mr. Stebner, former owner of the San Diego restaurant Region.
Some chefs rely on salt to enhance previously frozen meats or less-than-ripe vegetables, he adds. "Salt is being used to extract more flavor than the food actually has."
Sodium is a major cause of high blood pressure, which can lead to both heart attack and stroke, says Rachel Johnson, spokesperson for the American Heart Association and nutrition professor at the University of Vermont. Hypertension affects one in three Americans.
The average American consumes more than 3,400 milligrams of sodium per day, more than double the American Heart Association's recommended 1,500 mg, which is the equivalent of two-thirds of a teaspoon of table salt.
Restaurant foods are denser in sodium than home-prepared food, the CDC says, and contribute about 25% of sodium in the American diet.
Jeremy Bearman, chef at Rouge Tomate, balances sodium-rich ingredients with potassium-rich ingredients, Ms. Lambrou says. Mussels, which like other seafoods are naturally high in sodium, are often paired with tomatoes.
"One major [heart disease] contributor is not just having a lot of sodium, but also not having enough potassium," Ms. Lambrou says. "Those are two electrolytes that need to be in balance." The restaurant uses coarse salt, because "pinch for pinch" it has less sodium, she adds.
Potassium helps counteract sodium's effects on blood pressure, Dr. Willett says. Most U.S. adults get only about 3,000 mg of potassium a day, far short of the recommended 4,700 mg a day. Dr. Willett says frequent restaurant diners should try to eat more fresh fruits and vegetables, which naturally contain potassium.
Most menus don't offer much transparency when it comes to salt. Opt for simple vegetable and fish preparations with olive oil and lemon, grilled proteins and in-season vegetables, says Ms. Chaplin.
Spicy preparations can be a good lower-sodium alternatives. And drinking wine with the meal will naturally heighten your desire for more savory, salty flavors, Ms. Chaplin adds.
Janet Riccio, 55, a New York advertising executive, says tries to monitor her salt intake because of a genetic disposition to high blood pressure. At business meals, she'll ask the waiter about sodium content before ordering and will usually request sauce on the side.
Beyond that, though, there is only so much vetting she feels comfortable doing, out of consideration for the server and her fellow diners. "I hope I'm doing it in a way that doesn't offend anybody," she says.
Some restaurateurs are wary when diners request low-sodium preparations, because they don't want to send unappetizing food to the dining room.
At Maverick, in San Francisco, Emmanuel Eng, the executive chef, says omitting salt from the chicken liver mousse or the lobster bisque would leave diners unsatisfied. "A dish without salt is not as good as it could be," he says. "We're in the business of pleasing guests."
Diners who call ahead are more likely to find a restaurant willing to accommodate a low-sodium request. Ideally, call a day or two ahead so the chef can set aside unsalted portions. Start with restaurants whose menus emphasize fresh ingredients. "When [they] use fresh products, the restaurants can focus on adding lots of herbs and spices or doing reductions and layering flavors" instead of simply adding salt, says Darcie Ellyne, a Burlingame, Calif., nutrition consultant to chains including Una Mas Mexican Grill and Ruby's Diner.
If arriving unannounced, ask the server for recommendations. Try to be flexible.
When ordering, ask for "no salt where possible," Mr. Eng says. When diners pop in with surprise special dietary requests, "that can severely limit what we can do on the fly," he adds.

[G M]

http://www.scientificamerican.com/article.cfm?id=its-time-to-end-the-war-on-salt

It's Time to End the War on Salt
The zealous drive by politicians to limit our salt intake has little basis in science

By Melinda Wenner Moyer
 
For decades, policy makers have tried and failed to get Americans to eat less salt. In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products; New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.

This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine—an excellent measure of prior consumption—the greater their risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.

[Crafty_Dog]

A fair point , , , up to a point.

FWIW, I do better when I watch my salt consumption.

[Crafty_Dog]

Reliability unknown, source suspect:

http://news.yahoo.com/insight-evidence-grows-narcolepsy-gsk-swine-flu-shot-070212916--finance.html
 
 
STOCKHOLM (Reuters) - Emelie Olsson is plagued by hallucinations and nightmares. When she wakes up, she's often paralyzed, unable to breathe properly or call for help. During the day she can barely stay awake, and often misses school or having fun with friends. She is only 14, but at times she has wondered if her life is worth living.

Emelie is one of around 800 children in Sweden and elsewhere in Europe who developed narcolepsy, an incurable sleep disorder, after being immunized with the Pandemrix H1N1 swine flu vaccine made by British drugmaker GlaxoSmithKline in 2009.

Finland, Norway, Ireland and France have seen spikes in narcolepsy cases, too, and people familiar with the results of a soon-to-be-published study in Britain have told Reuters it will show a similar pattern in children there.

Their fate, coping with an illness that all but destroys normal life, is developing into what the health official who coordinated Sweden's vaccination campaign calls a "medical tragedy" that will demand rising scientific and medical attention.

Europe's drugs regulator has ruled Pandemrix should no longer be used in people aged under 20. The chief medical officer at GSK's vaccines division, Norman Begg, says his firm views the issue extremely seriously and is "absolutely committed to getting to the bottom of this", but adds there is not yet enough data or evidence to suggest a causal link.

Others - including Emmanuel Mignot, one of the world's leading experts on narcolepsy, who is being funded by GSK to investigate further - agree more research is needed but say the evidence is already clearly pointing in one direction.

"There's no doubt in my mind whatsoever that Pandemrix increased the occurrence of narcolepsy onset in children in some countries - and probably in most countries," says Mignot, a specialist in the sleep disorder at Stanford University in the United States.

30 MILLION RECEIVED PANDEMRIX

In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it contains an adjuvant, or booster, it was not used in the United States because drug regulators there are wary of adjuvanted vaccines.

GSK says 795 people across Europe have reported developing narcolepsy since the vaccine's use began in 2009.

Questions about how the narcolepsy cases are linked to Pandemrix, what the triggers and biological mechanisms might have been, and whether there might be a genetic susceptibility are currently the subject of deep scientific investigation.

But experts on all sides are wary. Rare adverse reactions can swiftly develop into "vaccine scares" that spiral out of proportion and cast what one of Europe's top flu experts calls a "long shadow" over public confidence in vaccines that control potential killers like measles and polio.

"No-one wants to be the next Wakefield," said Mignot, referring to the now discredited British doctor Andrew Wakefield who sparked a decades-long backlash against the measles, mumps and rubella (MMR) shot with false claims of links to autism.

With the narcolepsy studies, there is no suggestion that the findings are the work of one rogue doctor.

Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.
"We really do want to get to the bottom of this. It's not in anyone's interests if there is a safety issue that needs to be addressed," said GSK's Begg.

LIFE CHANGED

Emelie's parents, Charles and Marie Olsson, say she was a top student who loved playing the piano, taking tennis lessons, creating art and having fun with friends. But her life started to change in early 2010, a few months after she had Pandemrix. In the spring of 2010, they noticed she was often tired, needing to sleep when she came home from school.

But it wasn't until May, when she began collapsing at school, that it became clear something serious was happening.

As well as the life-limiting bouts of daytime sleepiness, narcolepsy brings nightmares, hallucinations, sleep paralysis and episodes of cataplexy - when strong emotions trigger a sudden and dramatic loss of muscle strength.

In Emelie's case, having fun is the emotional trigger. "I can't laugh or joke about with my friends any more, because when I do I get cataplexies and collapse," she said in an interview at her home in the Swedish capital.

Narcolepsy is estimated to affect between 200 and 500 people per million and is a lifelong condition. It has no known cure and scientists don't really know what causes it. But they do know patients have a deficit of a brain neurotransmitter called orexin, also known as hypocretin, which regulates wakefulness.

Research has found that some people are born with a variant in a gene known as HLA that means they have low hypocretin, making them more susceptible to narcolepsy. Around 25 percent of Europeans are thought to have this genetic vulnerability.

When results of Emelie's hypocretin test came back in November last year, it showed she had 15 percent of the normal amount, typical of heavy narcolepsy with cataplexy.

The seriousness of her strange new illness has forced her to contemplate life far more than many other young teens: "In the beginning I didn't really want to live any more, but now I have learned to handle things better," she said.

TRIGGERS?

Scientists investigating these cases are looking in detail at Pandemrix's adjuvant, called AS03, for clues.

Some suggest AS03, or maybe its boosting effect, or even the H1N1 flu itself, may have triggered the onset of narcolepsy in those who have the susceptible HLA gene variant.
Angus Nicoll, a flu expert at the European Centre for Disease Prevention and Control (ECDC), says genes may well play a part, but don't tell the whole story.

"Yes, there's a genetic predisposition to this condition, but that alone cannot explain these cases," he said. "There was also something to do with receiving this specific vaccination. Whether it was the vaccine plus the genetic disposition alone or a third factor as well - like another infection - we simply do not know yet."

GSK is funding a study in Canada, where its adjuvanted vaccine Arepanrix, similar to Pandemrix, was used during the 2009-2010 pandemic. The study won't be completed until 2014, and some experts fear it may not shed much light since the vaccines were similar but not precisely the same.

It all leaves this investigation with far more questions than answers, and a lot more research ahead.

WAS IT WORTH IT?

In his glass-topped office building overlooking the Maria Magdalena church in Stockholm, Goran Stiernstedt, a doctor turned public health official, has spent many difficult hours going over what happened in his country during the swine flu pandemic, wondering if things should have been different.

"The big question is was it worth it? And retrospectively I have to say it was not," he told Reuters in an interview.

Being a wealthy country, Sweden was at the front of the queue for pandemic vaccines. It got Pandemrix from GSK almost as soon as it was available, and a nationwide campaign got uptake of the vaccine to 59 percent, meaning around 5 million people got the shot.

Stiernstedt, director for health and social care at the Swedish Association of Local Authorities and Regions, helped coordinate the vaccination campaign across Sweden's 21 regions.

The World Health Organisation (WHO) says the 2009-2010 pandemic killed 18,500 people, although a study last year said that total might be up to 15 times higher.

While estimates vary, Stiernstedt says Sweden's mass vaccination saved between 30 and 60 people from swine flu death. Yet since the pandemic ended, more than 200 cases of narcolepsy have been reported in Sweden.

With hindsight, this risk-benefit balance is unacceptable. "This is a medical tragedy," he said. "Hundreds of young people have had their lives almost destroyed."

PANDEMICS ARE EMERGENCIES

Yet the problem with risk-benefit analyses is that they often look radically different when the world is facing a pandemic with the potential to wipe out millions than they do when it has emerged relatively unscathed from one, like H1N1, which turned out to be much milder than first feared.

David Salisbury, the British government's director of immunization, says "therein lies the risk, and the difficulty, of working in public health" when a viral emergency hits.

"In the event of a severe pandemic, the risk of death is far higher than the risk of narcolepsy," he told Reuters. "If we spent longer developing and testing the vaccine on very large numbers of people and waited to see whether any of them developed narcolepsy, much of the population might be dead."

Pandemrix was authorized by European drug regulators using a so-called "mock-up procedure" that allows a vaccine to be authorized ahead of a possible pandemic using another flu strain. In Pandemrix's case, the substitute was H5N1 bird flu.

When the WHO declared a pandemic, GSK replaced the mock-up's strain with the pandemic-causing H1N1 strain to form Pandemrix.

GSK says the final H1N1 version was tested in trials involving around 3,600 patients, including children, adolescents, adults and the elderly, before it was rolled out.

The ECDC's Nicoll says early warning systems that give a more accurate analysis of a flu strain's threat are the best way to minimize risks of this kind of tragedy happening in future.

Salisbury agrees, and says progress towards a universal flu vaccine - one that wouldn't need last-minute changes made when a new strain emerged - would cuts risks further.
"Ideally, we would have a better vaccine that would work against all strains of influenza and we wouldn't need to worry about this ever again," he said. "But that's a long way off."

With scientists facing years of investigation and research, Emelie just wants to make the best of her life.

She reluctantly accepts that to do so, she needs a cocktail of drugs to try to control the narcolepsy symptoms. The stimulant Ritalin and the sleeping pill Sobril are prescribed for Emelie's daytime sleepiness and night terrors. Then there's Prozac to try to stabilize her and limit her cataplexies.

"That's one of the things that makes me feel most uncomfortable," she explains. "Before I got this condition I didn't take any pills, and now I have to take lots - maybe for the rest of my life. It's not good to take so many medicines, especially when you know they have side effects."

(Reporting by Kate Kelland; Editing by Will Waterman)

[ccp]

IMO a good objective summary of the situation.  The urologists and radiation oncologists have too much financial stakes to be able to give rational explanations.   Don't get me wrong.   Their intentions were honorable in trying to combat this disease, but the fact of the matter is that PSA screening leads to a lot of testing, surgery radiation treatment and much anxiety among people who are found to have it.  I discus  with my male pts. the pros and cons and even give them a website to go to and read if they like and allow them to decide.   Some decide against.   Some appear incapable of understanding the controversies and usually opt for the test,  and a few still want it.   Bottom line I try to inform them the best I can and the choice is theirs.  One caveat about the family history as one reason for men to do the test.   If it is estimated 75% of men over 80 will have prostate cancer (though very few will ever know - unless we do a search and destroy mission) then most men, if they have ancestors who live long enough and get tested they now will have a family history.   When I think of family history being relevant it is more important if they have a family member who either died of the disease or was younger when diagnosed.   The risks are higher for Blacks for unknown reasons (NO it is not discriminatory or racist).

http://www.mayoclinicproceedings.org/article/S0025-6196(12)01091-9/fulltext

[ccp]

I don't know if anyone remembers from the DMG board years ago I pointed out my suspicion that the argument we should get people to stop smoking because they utilize more health care dollars while all the rest of us pay for their medical problems is flawed?

The concept that we will reduce costs in the long run by getting them to quit might be flawed.  If these people die at 50 or 60 rather than living to 80 or more the US might save a bundle in social security,  Medicare, and long term care costs.

Scott Gottlieb of FDA and (of Gilder's health stock letter fame and FDA guy) takes what I think is a tongue in cheek stance that we should just let the smokers (and obese) simply die.  Why should society pay for their health ills keeping them alive?

http://hosted.ap.org/dynamic/stories/U/US_MED_HEALTH_COSTS_REALITY_CHECK?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-01-26-10-03-12

[DougMacG]

CCP:  "I pointed out my suspicion that the argument we should get people to stop smoking because they utilize more health care dollars while all the rest of us pay for their medical problems is flawed...The concept that we will reduce costs in the long run by getting them to quit might be flawed.  If these people die at 50 or 60 rather than living to 80 or more the US might save a bundle in social security,  Medicare, and long term care costs."


Doc, you are correct (as usual).  Hubert Humphrey III made his mark with the states suing the tobacco companies for these 'costs'.  Key point in the trial was the ruling made by the judge that the fact these people died more quickly includes a health care coszt savings, not counting what you point out Social security etc., when they get sick with lung cancer, emphysema etc was inadmissible.

Despicable to use their early death as a cost savings - except for the fact that the lawsuit was all about costs.

A libertarian view (aren't we a libertarian country?) is that it is none of government's business whether you are obese or smoke.  Your mother, daughter, spouse, father, son, boss, neighbor or pastor can nag you about that, not the federal government.  Now every choice you make affects a public expenditure.  Every wet french fry you eat affects our currency relationship with China and the debt burden on children not yet born. 

George Orwell could not foresee the number of cameras and the data mining systems that will double check your compliance. 

Have you been told yet you to ask your patients about guns in the home yet?  It's a health care cost now.  The government will need to stop you from exercising your rights, based on false data and unconstitutional powers.

[ccp]

Hi Doug,

Yes.  The paradox and twisted logic for political correctness.    Saying that we should live like vegetarians,  walk or bike ride to work, take yoga, avoid sugars, fats, alcohol (except maybe that one red wine at night) sounds wonderful.  Some of us may even add a few years to our lives.  Yet the reality is that there will be more people living longer on SS and the entitlements share of the pie will expand even more.

OTOH if we can keep older people healthy in a way they can move around and continue to perform cognitively as well as physically and keep them working or volunteering longer they would become a vital store of experience wisdom and contribute to society rather then the opposite.  OF course we can't expect this now when it hurts to walk around, memories are not so good and people may have to wear diapers.  

"George Orwell could not foresee the number of cameras and the data mining systems that will double check your compliance."

In recent med journals (I forget which one) there are articles from  politburo members who are PhDs (nothing against PhDs but just the point that MBAs and PhDs are along with some MDs involved) in something like industrial engineering and work flow engineering.  If one is not in health care in the US we probably all have a relative who is who can attest to health care evolving into something more resembling an assembly line.   My mind is boggled every day with all the regulatory requirements and the absolute hair splitting of every single step in every single human interaction, function, task, as well as duplicate and triplicate controls.   Perhaps for younger people more attune to this view of the world and daily life because of electronic gadgets it is not so rough.  For me it is torture.  Like "Secret Agent Man"  they took away your name and gave you a number.

"Have you been told yet you to ask your patients about guns in the home yet?  It's a health care cost now."

The only time I ask anyone that is if I am concerned they are so depressed that they may commit suicide.  If they have a gun in the house I am more worried.

Other than that - no.  And I will not.   None of my damn business.  

I don't ask people if they wear their seatbelts either.  Enough is enough.  I am not their nanny.

I do try to help with cigarettes and weight where I can.

[DougMacG]

CCP  Thanks for the nice response. 

I'm all for having people's doctor helping them to live longer, a key reason we go there.  Governing is different.  Defend our shores, plow our streets etc. but not control all our behaviors and choices.  Cigarettes under current science seem kind of obvious.  Your odds of bad health consequences go way up.  I'm fine with the warning label mandates and all kinds of educational efforts. 

Problem is the government does not know where to stop.  For this board, I point out an obvious future target and hope no one in government reads it: Martial Arts has health risks.  And soccer, football, hockey, skiing, skydiving and eating breakfast lunch and dinner - all involve risk taking.  A friend just died of snow shoveling (heart attack).  Sex for older people they are already saying ask you doctor if that is okay for you, next could be prohibition.  We joked that after cigarettes, what's next, french fries and soft drinks?  It's not a joke anymore.  Give them that power and it becomes their responsibility forever and they won't always get the science right or respect personal choices. (understatement)

   -  "Have you been told yet you to ask your patients about guns in the home?  It's a health care cost now."   The only time I ask anyone that is if I am concerned they are so depressed that they may commit suicide.

Pediatricians ask here.  I let my daughter field the question, I had one at the time that she didn't know about.  The doctor meant no big invasion, it was in the context of kids wearing bike helmets for safety.  I just didn't like that it came as a direct question, as part of checklist, making a record on a very private matter he seemed compelled to ask.  Maybe I am sensitive but I see a distinction between informing us about safety and creating a very personal record easily breached. 

[Crafty_Dog]

Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one.

A study published in the Feb. 27 issue of the journal PLoS One links increased consumption of sugar with increased rates of diabetes by examining the data on sugar availability and the rate of diabetes in 175 countries over the past decade. And after accounting for many other factors, the researchers found that increased sugar in a population’s food supply was linked to higher diabetes rates independent of rates of obesity.
 
In other words, according to this study, obesity doesn’t cause diabetes: sugar does.

The study demonstrates this with the same level of confidence that linked cigarettes and lung cancer in the 1960s. As Rob Lustig, one of the study’s authors and a pediatric endocrinologist at the University of California, San Francisco, said to me, “You could not enact a real-world study that would be more conclusive than this one.”

The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).

The key point in the article is this: “Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence.” Thus: for every 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent. (The study found no significant difference in results between those countries that rely more heavily on high-fructose corn syrup and those that rely primarily on cane sugar.)

This is as good (or bad) as it gets, the closest thing to causation and a smoking gun that we will see. (To prove “scientific” causality you’d have to completely control the diets of thousands of people for decades. It’s as technically impossible as “proving” climate change or football-related head injuries or, for that matter, tobacco-caused cancers.) And just as tobacco companies fought, ignored, lied and obfuscated in the ’60s (and, indeed, through the ’90s), the pushers of sugar will do the same now.

But as Lustig says, “This study is proof enough that sugar is toxic. Now it’s time to do something about it.”

The next steps are obvious, logical, clear and up to the Food and Drug Administration. To fulfill its mission, the agency must respond to this information by re-evaluating the toxicity of sugar, arriving at a daily value — how much added sugar is safe? — and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply.

On another front, two weeks ago a coalition of scientists and health advocates led by the Center for Science in the Public Interest petitioned the F.D.A. to both set safe limits for sugar consumption and acknowledge that added sugars, rather than lingering on the “safe” list, should be declared unsafe at the levels at which they’re typically consumed. (The F.D.A. has not yet responded to the petition.)

Allow me to summarize a couple of things that the PLoS One study clarifies. Perhaps most important, as a number of scientists have been insisting in recent years, all calories are not created equal. By definition, all calories give off the same amount of energy when burned, but your body treats sugar calories differently, and that difference is damaging.

And as Lustig lucidly wrote in “Fat Chance,” his compelling 2012 book that looked at the causes of our diet-induced health crisis, it’s become clear that obesity itself is not the cause of our dramatic upswing in chronic disease. Rather, it’s metabolic syndrome, which can strike those of “normal” weight as well as those who are obese. Metabolic syndrome is a result of insulin resistance, which appears to be a direct result of consumption of added sugars. This explains why there’s little argument from scientific quarters about the “obesity won’t kill you” studies; technically, they’re correct, because obesity is a marker for metabolic syndrome, not a cause.

The take-away: it isn’t simply overeating that can make you sick; it’s overeating sugar. We finally have the proof we need for a verdict: sugar is toxic.

[ccp]

Interesting but is clearly political.

First in medicine we don't view epidemiological findings as "proof".  A real scientist would know this.   It generally results to a hypothesis that is then later tested in double blind placebo controlled trials that try to avid the bias this author OBVIOUSLY has.

Second.  Who the heck is PLoS?  It is some sort of scientific "advocacy" group.   Sounds like the climate change crowd.   The same crowd that would like to regulate our daily lives.

I am not aware that this is any legitimate journal.

Third, I don't see any mention of genetic differences between countries.  For example it is well know Latinos and Asians have much higher rates of diabetes even at lower weights.  Could it be partly due high rice and maybe sugar intake - yes.   But there is likely a genetic component as well. 

I would say this study which I have not reviewed, if well done, as claimed, is interesting but nothing more.

Of course, I am sure this pseudoscientist who seems to know how to promote his numbers game as some sort of definitive Earth shattering discovery, would be very pleased to get a couple hundred grand from Axelrod and corp to "study" this further.

I like to call a spade - a spade.

[Crafty_Dog]

Doctors have long assumed that saturated fat and cholesterol in red meat are what raise the risk of heart disease. But a study in the journal Nature Medicine fingers another culprit: carnitine, a compound abundant in red meat that also is sold as a dietary supplement and found in some energy drinks.

Carnitine typically helps the body transport fatty acids into cells to be used as energy. But researchers at the Cleveland Clinic found that in both humans and mice, certain bacteria in the digestive tract convert carnitine to another metabolite, called TMAO, that promotes atherosclerosis, or a thickening of the arteries.

The researchers, led by Stanley Hazen, chief of cellular and molecular medicine at the Cleveland Clinic's Lerner Research Institute, tested the carnitine and TMAO levels of omnivores, vegans and vegetarians, and examined records of 2,595 patients undergoing cardiac evaluations. In patients with high TMAO levels, the more carnitine in their blood, the more likely they were to develop cardiovascular disease, heart attacks, stroke and death.

 .Many studies have linked consumption of red and processed meat to cardiovascular disease and some cancers. The Harvard School of Public Health reported last year that among 83,000 nurses and 37,000 male health professionals followed since the 1980s, those who consumed the highest levels of red meat had the highest risk of death during the study, and that one additional serving a day of red meat raised the risk of death by 13%.

The new findings don't mean that red meat is more hazardous than previously thought. But they may help explain the underlying risk of eating red meat, which some researchers have long thought was higher than the saturated fat and cholesterol content alone could explain.

Dr. Hazen speculated that carnitine could be compounding the danger. "Cholesterol is still needed to clog the arteries, but TMAO changes how cholesterol is metabolized—like the dimmer on a light switch," he said. "It may explain why two people can have the same LDL level [a measure of one type of cholesterol], but one develops cardiovascular disease and the other doesn't."

One surprising finding, Dr. Hazen said, was how a long-term diet that includes meat affected the amount of TMAO-producing bacteria in the gut and thus magnified the risk. In the study, when longtime meat-eaters consumed an eight-ounce steak and a carnitine supplement, their bacteria and TMAO levels rose considerably. But when a vegan ate the same combination, he showed no increase in TMAO or bacterial change.

"Vegans basically lose their ability to digest carnitine," said Dr. Hazen.

The study, sponsored by the National Institutes of Health, didn't assess how little red meat people could consume and still have elevated TMAO. Nor did it look at how long someone had to abstain from red meat to end the process. "We know it will be longer than one week, but shorter than one year," Dr. Hazen said.

He and his colleagues have been exploring how altering gut bacteria might influence the risk of heart disease. "In the future, maybe there will be a heart-healthy yogurt, or a drug to block the formation of TMAO," he said.

Consumption of red meat—primarily beef, veal, lamb and pork—has been falling gradually since 1970.

Trade groups for meat producers have questioned the link to cardiovascular disease, saying studies that ask people to recall what they ate over long periods are imprecise.

"Cardiovascular disease…is a complex condition that appears to have a variety of factors associated with it, from genetics to lifestyle," said Betsy Booren, chief scientist at the American Meat Institute Foundation.

As a dietary supplement, carnitine is designated as "generally regarded as safe" by the Food and Drug Administration, but few studies have looked at its long-term safety. A 2006 risk assessment found no adverse effects when subjects consumed 2,000 milligrams a day for six months. (An eight-ounce steak has roughly 200 mg of carnitine.)

Ads for supplements promote carnitine as helping boost energy levels, particularly in endurance sports, and assisting in recovery after intense exercise; some also claim that it helps shed pounds and improve brain function.

Duffy MacKay, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a trade group for the supplement and energy-drink industries, called the study "a new, emerging hypothesis," but said the researchers were drawing large conclusions from small studies of mice, bacteria and human biomarkers. "The concept that one component of your diet, or one molecule, is responsible for your health woes is questionable," he said.

Dr. Hazen noted that some energy drinks have more carnitine in a single can than a porterhouse steak. "I worry about what happens in 10, 20 or 30 years of consumption," he said.

He said humans generally have plenty of carnitine in their diet, which also is found in small amounts in nuts, beans, vegetables and fruit, and don't need to take it in supplement form.

[ccp]

twenty five years ago hepatitis C wasn't even discovered.  We used to call it non-AnonB hepatitis and we used to infer a person was infected from the abnormal liver tests.  Since then we have discovered and characterized the virus produced a test to find if a person is infected and developed marginally good albeit getting better treatments.   Soon it will be curable or long term controllable like HIV.

http://www.huffingtonpost.com/2013/04/23/hepatitis-c-treatment-cures-abbvie_n_3139989.html

If only we had treatments for the common cold.

[Crafty_Dog]

CCP:

Interesting-- in addition to the health blessing for those with Hep C, it should be a helluva financial blessing for the company developing it

[ccp]

Agreed but I am not clear who is the winner(s).  I am afraid I have NEVER made money in an health stock.  I lost in corixa.  I lost with inhaled insulin.  Biomira. Pain therapeutics.
I read vivus drug was great for weight loss and almost bought at ten only to chicken out and a few days later it doubled when drug approved. 

Gilead sounds good but the train has left the station it seems.  I watched Sanofi fall to low 30's after its Plavix patent expired thinking it was a good buy.  I was right .  It is now in 50s.  Of course I didn't buy it.

[ccp]

works on different brain receptors than existing medicines:

http://www.huffingtonpost.com/2013/04/03/suvorexant-side-effects-sleeping-_n_3008709.html#slide=1328563

[Crafty_Dog]

Interesting.

My issue is not falling asleep, but staying asleep.  I often awake after 4.5 hours of sleep.

I tried the GABA stuff, but found out it tends to suppress breathing!  So much for GABA! 

[ccp]

"but found out it tends to suppress breathing"

Raises concern for sleep apnea.  Please look into this if not already done. 

[Crafty_Dog]

My solution was simple.  No more of this stuff!

[ccp]

"My solution was simple.  No more of this stuff!"

Thank goodness.   I hope the board continues for another 50 yrs!  )

Sometimes sedatives or hypnotics can unmask or worsen an underlying sleep apnea problem.

 

[ccp]

I am a little surprised Christie had lap band surgery.  It is easier and quicker but the success rate is far less than gastric sleeve or Roux - en - Y.

Something like 80% of lap band procedures fail by 5 yrs.  I don't even recommend it anymore.  I've seen and heard many problems with it.

Yet the fear of a permanent but slightly higher risk procedure usually still has people choosing this.

[ccp]

The new bible of mental disorders is filled many myths.   It is kind of like the real Bible - whatever one wants to believe:

http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes

[ccp]

I am only surprised the number is not higher.   What the study doesn't address is the prevalence of bias against the obese in the general population.   As for med students I have some points from my experience.

1- obesity treatments were not taught at all other the proverbial "diet and exercise" and simply admonishing a patient for not doing more in this regard.  I can tell you this never works.
Perhaps obesity treatment is taught better now ;  I don't know.
2- obesity treatment are often complicated and are a whole specialty unto itself though not a recognized one by the board of specialties - it should be.   
3- obesity is very difficult to treat - very.  Indeed the medical treatment is almost always with the realistic hope of some sustained weight loss not huge losses from obese to healthy.  I heard one physician who devotes his entire practice say during a lecture, "in my 25 yrs of treating obesity if I have had 2 or 3 patients get from a BMI of 45 (morbid obese - overweight by 100 pounds or more) to a BMI of 25 (top number designated healthy) and keep it off that is a lot".
4- Some experts appear to have thrown in the towel for medical treatment in those patients who are extremely overweight and from the very beginning steer them to bariatric surgery which has a DRAMATICALLY higher success rate.

****Many Medical Students Have Anti-Fat Bias, Study Finds
Healthday  13 hrs ago | By -- Mary Elizabeth Dallas   of HealthDay   

FRIDAY, May 24 (HealthDay News) -- Two out of five medical students have an unconscious bias against obese people, a new study found.

The study authors, from Wake Forest Baptist Medical Center, noted the anti-fat stigma is a significant barrier to the treatment of obesity. They concluded that teaching medical students to recognize this bias is necessary to improve care for the millions of Americans who are overweight or obese.

"Bias can affect clinical care and the doctor-patient relationship, and even a patient's willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school," study lead author Dr. David Miller, associate professor of internal medicine at Wake Forest Baptist Medical Center, said in a center news release. "Previous research has shown that on average, physicians have a strong anti-fat bias similar to that of the general population. Doctors are more likely to assume that obese individuals won't follow treatment plans, and they [doctors] are less likely to respect obese patients than average weight patients."

The study, which took place over the course of three years, involved more than 300 third-year medical students. Although all of the students attended a medical school in the southeastern United States from 2008 through 2011, they were originally from many different parts of the United States as well as 12 other countries.

Using a computer program called the Weight Implicit Association Test, the researchers were able to measure the participants' unconscious preferences for fat or thin people. The medical students also completed a survey to determine if they were aware of any weight bias they had.

The study revealed that 39 percent of the medical students had a moderate to strong unconscious anti-fat bias. Seventeen percent had a moderate to strong anti-thin bias. The researchers added that less than 25 percent of the students were aware of their biases.

"Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese," Miller said. "Medical schools should address weight bias as part of a comprehensive obesity curriculum."

The study was published online May 23 in the Journal of Academic Medicine.****