Category Archives: Health Care

Placebo Effect

In fact the new study added nothing (and it was ridiculously badly reported): we already knew that antidepressants perform only marginally better than placebo, and the National Institute for Health and Clinical Excellence (Nice) guidelines has actively advised against using them in milder depression since 2004. But the more interesting questions are around placebo.
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Another study from 2002 looked at 75 trials of antidepressants over the past 20 years, but looked only at the response in the placebo arms of the trials, and found that the response to placebo has increased significantly in recent years (as has the response to medication): perhaps our expectations of those drugs have increased, or perhaps, conversely to our earlier example, the trial designs have become systematically more flattering. I’m giving you tenuous data, on an interesting area, because I know you’re adult enough to cope with ambiguity.

Scientists Reconsider Autism

Webcast – In My Language – about what gets considered thought, intelligence, personhood, language, and communication, and what does not.

Scientists Reconsider What They Think They Know

This movement is being fueled by a small but growing cadre of neuropsychological researchers who are taking a fresh look at the nature of autism itself. The condition, they say, shouldn’t be thought of as a disease to be eradicated. It may be that the autistic brain is not defective but simply different — an example of the variety of human development. These researchers assert that the focus on finding a cure for autism — the disease model — has kept science from asking fundamental questions about how autistic brains function.

A cornerstone of this new approach — call it the difference model — is that past research about autistic intelligence is flawed, perhaps catastrophically so, because the instruments used to measure intelligence are bogus. “If Amanda Baggs had walked into my clinic five years ago,” says Massachusetts General Hospital neuroscientist Thomas Zeffiro, one of the leading proponents of the difference model, “I would have said she was a low-functioning autistic with significant cognitive impairment. And I would have been totally wrong.”
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And that hurts autistic people, Dawson says. She makes a comparison with blindness. Of course blind people have a disability and need special accommodation. But you wouldn’t give a blind person a test heavily dependent on vision and interpret their poor score as an accurate measure of intelligence. Mottron is unequivocal: Because of recent research, especially the Raven paper, it’s clearer than ever that so-called low-functioning people like Amanda Baggs are more intelligent than once presumed.The Dawson paper was hardly conclusive, but it generated buzz among scientists and the media. Mottron’s team is now collaborating with Massachusetts General Hospital’s Zeffiro, a neuroimaging expert, to dig deeper.

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Collegiate Inventors Competition

A novel way to treat cancer has won the top honor at the 2007 Collegiate Inventors Competition, an annual program of the National Inventors Hall of Fame Foundation. Ian Cheong of Johns Hopkins University was announced as the grand prize winner, receiving a $25,000 prize, during a ceremony last night on the campus of the California Institute of Technology.

This year’s winners also include John Dolan of the University of California, San Francisco in the graduate category for his work on the Dolognawmeter, a device to measure the effectiveness of painkillers, and Corey Centen and Nilesh Patel of McMaster University in the undergraduate category for their work on creating a CPR assist device. The McMaster team and Dolan each received a $15,000 prize from the competition, which is sponsored by the United States Patent and Trademark Office (USPTO) and the Abbott Fund.

The Collegiate Inventors Competition has recognized and encouraged undergraduate and graduate students on their quest to change the world around them for 17 years. Entries for 2008 are due by 16 May 2008 and must be the original idea and work product of the student/advisor team, and must not have been (1) made available to the public as a commercial product or process or (2) patented or published more than 1 year prior to the date of submission to the competition. The entry submitted must be written in English.

The invention, a reduced-to-practice idea or workable model, must be the work of a student or team of students with his or her university advisor. If it is a machine, it must be operable. If it is a chemical, it must be complete with evidence of successful application of the idea. If it is a new plant, color photographs or slides must be included in the submission. If a new or original ornamental design for an article of manufacture is submitted, the entire design must be included in the application. In addition, the invention should be reproducible.

Ian Cheong, 33, arrived at Johns Hopkins University from his native Singapore prepared to focus on cancer therapy. Drugs used in cancer treatment routinely kill the healthy cells as well as the cancer cells because they are potent but nonspecific. Cheong took on the task of finding a way to make the cancer drugs more specific. He injected bacterial spores into the subject which made their way to oxygen-poor areas within cancerous tumors. Then, Cheong put a cancerfighting drug in lipid particles and injected those liposomes into a subject. The germinated bacterial spores also secrete a protein that makes liposomes fall apart when the drug-containing liposomes are in the proximity of the tumors, and the drug is released only in those specific areas. Cheong, originally educated as a lawyer, received his Ph.D. in cell and molecular medicine from Johns Hopkins and is currently working on postdoctoral research. His advisor, Bert Vogelstein, receives a $15,000 prize.

The idea for this post was submitted through our post suggestion page.

Funding Medical Research

Cheap, ‘safe’ drug kills most cancers

It sounds almost too good to be true: a cheap and simple drug that kills almost all cancers by switching off their “immortality”. The drug, dichloroacetate (DCA), has already been used for years to treat rare metabolic disorders and so is known to be relatively safe. It also has no patent, meaning it could be manufactured for a fraction of the cost of newly developed drugs.

Evangelos Michelakis of the University of Alberta in Edmonton, Canada, and his colleagues tested DCA on human cells cultured outside the body and found that it killed lung, breast and brain cancer cells, but not healthy cells. Tumours in rats deliberately infected with human cancer also shrank drastically when they were fed DCA-laced water for several weeks.

DCA attacks a unique feature of cancer cells: the fact that they make their energy throughout the main body of the cell, rather than in distinct organelles called mitochondria. This process, called glycolysis, is inefficient and uses up vast amounts of sugar.

Until now it had been assumed that cancer cells used glycolysis because their mitochondria were irreparably damaged. However, Michelakis’s experiments prove this is not the case, because DCA reawakened the mitochondria in cancer cells. The cells then withered and died

The University of Alberta is raising funds to further the research. Some look at this and indite a funding system that does not support research for human health unless there is profit to be made. Much of the blame seems to go to profit focused drug companies. I can see room for some criticism. But really I think the criticism is misplaced.

The organizations for which curing cancer is the partial aim (rather than making money) say government (partial aim or public health…), public universities (partial aim of science research or medical research…), foundations, cancer societies, private universities… should fund such efforts, if they have merit. Universities have huge research budgets. Unfortunately many see profit as their objective and research as the means to the objective (based on their actions not their claims). These entities with supposedly noble purposes are the entities I blame most, not profit focused companies (though yes, if they claim an aim of health care they I would blame them too).

Now I don’t know what category this particular research falls into. Extremely promising or a decent risk that might work just like hundreds or thousands of other possibilities. But lets look at several possibilities. Some others thoughts on where it falls: Dichloroacetate to enter clinical trials in cancer patients, from a previous post here – Not a Cancer Cure Yet, The dichloroacetate (DCA) cancer kerfuffle, CBC’s ‘The Current’ on dichloroacetate (DCA), Dichloroacetate (DCA) Phase II Trial To Begin (“Like hundreds (if not, thousands) of compounds being tested to treat cancer, DCA was shown by Michelakis’ group earlier this year to slow the growth of human lung tumors in a preclinical rodent model.”).
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Bacteria Can Transfer Genes to Other Bacteria

From page 115 of Good Gems, Bad Germs:

Microbiologists of the 1950’s did not appreciate the stunning extent to which bacteria swap genes… In 1959 Japanese hospitals experience outbreaks of multidrug-resistant bacterial dysentery. The shigella bacteria, which caused the outbreaks, were shrugging off four different classes of previously effective antibiotics: sulfonamides, streptomycins, chloramphenicols, and tetracyclines… In fact, the Japanese researches found it quite easy to transfer multidrug resistance from E. coli to shingella and back again simply by mixing resistant and susceptible strains together in a test tube.

Virus Engineered To Kill Deadly Brain Tumors

Yale Lab Engineers Virus That Can Kill Deadly Brain Tumors

A laboratory-engineered virus that can find its way through the vascular system and kill deadly brain tumors has been developed by Yale School of Medicine researchers, it was reported this week in the Journal of Neuroscience.

Each year 200,000 people in the United States are diagnosed with a brain tumor, and metastatic tumors and glioblastomas make up a large part of these tumors. There currently is no cure for these types of tumors, and they generally result in death within months.
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“Three days after inoculation, the tumors were completely or almost completely infected with the virus and the tumor cells were dying or dead,” van den Pol said. “We were able to target different types of cancer cells. Within the same time frame, normal mouse brain cells or normal human brain cells transplanted into mice were spared. This underlines the virus’ potential therapeutic value against multiple types of brain cancers.”

Pretty cool. Too bad these press releases never quite live up to the initial promise. Still this one is very cool, if it can succeed in helping even a small percentage of people it will be a great breakthrough. It is also just cool – using a virus to kill tumors – how cool is that?

Cats Prevent Heart Attacks

I suppose some people don’t know how great cats are 🙂 Here is news of a study showing that those with cats are less likely to have heart attacks.

Whether it’s a frisky kitten or a tubby tabby, a cat at home could cut your heart attack risk by almost a third, a new study suggests.
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In the new study, Qureshi’s team analyzed data on 4,435 Americans, aged 30 to 75, who took part in the federal government’s second National Health and Nutrition Examination Study, which ran from 1976-1980. According to the data in the survey, 2,435 of the participants either owned a cat or had owned a cat in the past, while the remaining 2,000 had never done so.

Qureshi’s team then tracked rates of death from all causes, including heart and stroke. Cat owners “appeared to have a lower rate of dying from heart attacks” over 10 years of follow-up compared to feline-free folk, Qureshi said. The magnitude of the effect — a 30 percent reduction in heart attack risk — “was a little bit surprising,” he added. “We certainly expected an effect, because we thought that there was a biologically plausible mechanism at work. But the magnitude of the effect was hard to predict.”

This is just one more example of cat power. As we have shown before: cats can be photographers and also protect you from bears.

Have a nice weekend.

The Risks of Scanning

The Risks of Scanning by Nayer Khazeni, M.D

When ordered by your doctor in the proper setting, any risks of CT scans are far outweighed by their potential benefits. They are one of modern medicine’s greatest diagnostic tools, used to examine any part of your body and, increasingly, to guide minimally invasive procedures previously performed with surgery. CT rapidly rotates X-ray beams around you, obtaining images from different angles that a powerful computer then compiles to build, slice by slice, highly detailed pictures of your insides.
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The impressive level of detail that CT provides can also cause confusion. In CTs of healthy adults, more than 90 percent of findings are “false positives.”
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Full-body CT scans cost $500 to $1,000. Insurance companies do not cover the cost, but may use any detected abnormality to raise your premiums or limit future coverage. There are no public health organizations that advocate the use of full body or cardiac CT scans in healthy adults, and the American College of Radiology and American Heart Association have released statements recommending against them.

Some Bacteria Might Fight Cancer

Cancer and the bacterial connection

today, some scientists think Coley had it right: Germs can teach our bodies how to fight back against tumors. Dr. John Timmerman, a cancer immunotherapy expert at UCLA’s Jonsson Cancer Center, says this revolution has produced “the most exciting sets of compounds in cancer immunolog
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The studies also imply that our cleaner, infection-free lifestyles may be contributing to the rise in certain cancers over the last 50 years, scientists say, because they make the immune system weaker or less mature. Germs cause disease but may also fortify the body, a notion summed up in a 2006 report by a team of Canadian researchers as “whatever does not kill me makes me stronger.”
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Other groups have been experimenting with injections of other types of heat-killed bacteria, including Myobacterium vaccae, a tuberculosis relative. In two studies in January’s European Journal of Cancer, researchers report that these bacteria may help fight certain lung and renal cancers.

The rich interplay of complex systems are often very difficult to grasp simply. I discusses this concept in the post on the excellent book, Parasite Rex.

One Reason Bacteria Gain Tolerance So Quickly

I recently read Good Gems, Bad Germs as part of my effort to learn more about bacteria, viruses, how are bodies work, cells, microbiology etc.. It is a great book, I highly recommend it. Page 111:

In 1951 the husband-wife team of Joshua and Esther Lederberg, microbiologists at the University of Wisconsin, demonstrated that their elegantly simple proof that preexisting mutations, not gradual tolerance, accounted for the many instances of new drug resistance… This meant that every new antibiotic became a powerful new force for bacterial evolution, winnowing away every bacterium but the otherwise unremarkable one that could survive its effects. With its competition gone, that lucky mutant could populate, giving rise to a newly resistant colony overnight.

Since bacteria can grow remarkably quickly, eliminating all but a small number just means that the new population boom will come from those few, resistant, ancestors. But that is not the only reason bacteria are so challenging to fight. They have been around billions or years and have survived because they can adapt well. Bacteria, in fact, can get their genes from distantly related bacteria. So if one bacteria gains immunity another bacteria can get that immunity by getting genes from that other bacteria (seems like science fiction but it is actually science fact).