Inspirational Medicine

March 19, 2008

539w.jpg

Cancer is difficult.  In every sense of the word.  It is difficult to detect early(in some forms), it is difficult to treat, it is difficult to deal with.  Individuals and families are devastated by the effects of the disease and even by the treatment.  It is particularly heart wrenching to read stories about childhood cancers.  But it is important.  The things learned from the study of end stage cancer is often among the most cutting edge research.  People will be open to may treatment courses when the alternative is death.  While the vast majority of last minute experiments fail, and no magic cure is discovered, there are always exceptions.  Those exceptions are beautiful to read and I encourage you to read the following article.

Full Article

From a human stand point, it is always refreshing to see the triumphant story of an underdog that overcomes some great challenge.  From clinical stand point, the same holds.  Many of the greatest achievements and breakthroughs in science have been laughed at originally and dismissed too quickly.  While the antiangiogenic chemotherapy may or may not go on to play a significant role in the treatment of cancer in the future, its pioneers like Dr. Judah Folkman who change the course of history.  Taking a different approach, trying new combinations of existing medicines, and being innovative in the treatment of cancer Dr. Judah Folkman saved Melanie McDaniel.  The McDaniel family is sharing her story as a tribute to Dr. Folkman who passed away in January.


Eugenics is apparently making a comeback

October 19, 2007

I love me some DNA, but I am not loving James Watson right now. The Nobel winning biologist most famous for his part in the discovery of DNA structure has hit some nerves across the country with his racist remarks.

LONDON, England (CNN) — Nobel laureate biologist James Watson was suspended Friday from his longtime post at a research laboratory and canceled his planned British book tour after controversial comments that black people are not as intelligent as white people. Watson, 79, an American who won the 1962 Nobel prize for his role in discovering the double-helix structure of DNA, apologized Thursday for his remarks — but not before London’s Science Museum canceled his talk there, planned for Friday evening.

The controversy began with an October 14 interview Watson gave to the Sunday Times, which quoted him saying he was “inherently gloomy about the prospect of Africa” because “all our social policies are based on the fact that their intelligence is the same as ours, whereas all the testing says not really.” Watson also asserted there was no reason to believe different races separated by geography should have evolved identically, and he said that while he hoped everyone was equal, “people who have to deal with black employees find this is not true.” The biologist apologized “unreservedly” Thursday for his comments and said he was “mortified” by the words attributed to him.

Watson is no stranger to controversy; he has a history of saying offensive and often scientifically inaccurate statements:

In 1997, Britain’s Sunday Telegraph quoted Watson as saying that if a gene for homosexuality were isolated, women who find that their unborn child has the gene should be allowed to have an abortion. During a lecture tour in 2000, he suggested there might be links between skin color and sexual prowess and between a person’s weight and their level of ambition. And in a British TV documentary that aired in 2003, Watson suggested that stupidity was a genetic disease that should be treated.

I have a theory about his statements. My theory is that the old man in a racist homophobe who feels superior to most people and is now senile enough to say what he thinks in public. I mean theory in the scientific way, like the theory of evolution.


New HIV Drug

October 13, 2007


(CNN) — The Food and Drug Administration on Friday approved the first of a new class of HIV drugs that attacks the virus in a different way. Isentress, developed by Merck & Co., is designed for patients who have shown resistance to current treatments.

The drug has been approved for adults who already have been receiving treatment, but more testing is necessary before it is approved for new HIV patients or children, the company said in a statement. Isentress belongs to a class of drugs called integrase inhibitors. These drugs work by blocking the integrase enzyme, which helps HIV replicate by inserting its DNA into new cells. Isentress is the first drug in the class to win FDA approval.

“Its mechanism of action is particularly important in that it blocks the ability of the virus to integrate itself into the genes of cells,” Fauci said. “This property of the virus to integrate is important in establishing the reservoir of virus in the body that has made it extremely difficult to eradicate HIV, even with prolonged treatment.”

Two earlier classes of anti-HIV drugs — protease and reverse transcriptase inhibitors — also work by blocking different enzymes involved in HIV replication. Friday’s decision by the FDA will give doctors a new tool to help patients who have developed resistance to existing drugs or who are infected with drug-resistant strains of HIV. Like protease and reverse transcriptase inhibitors, Isentress will also be prescribed for patients in combination with other drugs to maximize the number of ways the virus is being attacked. The cost of the recommended daily regimen of Isentress — a 400 mg tablet taken twice a day — will be comparable to protease inhibitors, with a wholesale price of $27, Merck said.


MMR Vaccine and Autism Questions

October 7, 2007

Many parents are asking if there is a link between the MMR vaccine and autism. The questions are out there so I am going to try to help people find the answers.

Does or can the MMR vaccine cause autism?

The Answer: NO

Then why are we hearing about them together so much recently?

The Answer: The short answer is irresponsible journalism. The long answer includes multiple factors, the news loves to pick up stories that will draw big reactions, more people are speaking publically about their children’s autism, many parents of autistic children have a hard time comprehending how this happened to their child and try to think back to what happened near the onset of the disease, MMR vaccines are given at the same age that many children begin expressing symptoms, and the most recent thing to draw attention to this theory is a couple celebrity moms of autistic children have come forward in support. While I cannot understand the plight of a child with autism’s mother, I can understand their desire to blame something. The problem is this theory holds no scientific weight and gives mothers a scapegoat. The theory of a link between autism and MMR vaccination is widely held, the problem is it is held mainly by parents not doctors, and parents make better news stories.

Do some researchers believe there is a link?

A researcher Dr. Wakfield is the only person to suggest a link. So all this hoopla is over a paper he published in 1998. He believes that the vaccine leads to gut inflammation which leads to vitamin and nutrient deficiencies that might cause developmental disorders including autism. It was only based on 25 kids and large based on what their parents not doctors thought. Of the 12 researchers on his team, 10 have come forward to denounce the research.

Is there any proof of a link between autism and MMR vaccines?

Here is the Center for Disease Control and Prevention’s official explanation:

Autism is a developmental disorder. Children with autism usually have trouble communicating verbally and non-verbally and experience difficulty interacting socially. The media reported that there was a link between MMR and autism following the publication of a paper by Dr Wakefield, in The Lancet (a medical journal) in 1998.

Dr Wakefield’s theory was that the MMR vaccine might lead to gut inflammation, which decreases the amount of vitamins and nutrients that children can absorb. As a result, he suggested, this might cause developmental disorders such as autism. This theory was based on two studies involving 25 children. Dr Wakefield’s study was of poor quality because it included only vaccinated children and was based primarily on what parents could remember. Parents understandably are more likely to link changes in behaviour with memorable events like vaccination.

A number of much better designed studies, involving large numbers of both vaccinated and unvaccinated children, have tested this theory. These studies have concluded that there is no link between MMR vaccine and autism. The best study looked at autism and MMR vaccination in all children born in Denmark over a number of years. No link was found.

In March 2004, 10 of the 12 researchers who worked with Dr Wakefield published a retraction in the Lancet stating that “no causal link was established between MMR vaccine and autism as the data were insufficient”.12

Here are some links that I think will clarify even more for you the importance of MMR vaccination in children and the infeasibility of a link between the vaccine and autism.

            Quack Watch: A site the debunks medical myths in lay terms

Statistical Research in Japan: The rate of autism continues to rise after Japan stops giving the MMR vaccine and switches to administering each of the single dose vaccines separately (due to a problem with one of the components that they were fixing).

Global Research: This is a more technical explanation, it links out to papers from all around the world showing there is no link.

National Institute of Health: A counter point to the feeling “aren’t the diseases protected by MMR mild compared to the lifelong problem of autism”

Take Home Message?

There is no reason to believe there is any link between autism and the MMR vaccine. In countries where the rate of people getting the MMR vaccine has declined, autism rates have either stayed the same or increase, and the incident of mumps, measles and rubella have increased, particularly measles which can be fatal. The diseases have the potential to be eradicated worldwide if there is concerted effort and global immunization. But like all vaccines, allergies and immune problems can alter the effects (not to cause autism or any other developmental disorder). So you should always talk to your doctor for his or her opinion specifically related to your child’s medical health. Just remember no matter how emotionally convincing, you should be taking doctor’s not upset mother’s advice when it comes to your child’s health.


Noble Causes, Nobel Prizes

October 7, 2007

The Ig Nobel Prizes are a mock of the Nobel Prizes and are given each year in October for achievements that “first make people laugh, and then make them think.” Organized by the Annals of Improbable Research (AIR Magazine) and presented by a group that includes genuine Nobel Laureates at a ceremony at Harvard University. I just wanted to share some of the best winners with you. My favorite of course is the US Air Force’s brilliant plan to make a gay bomb. The Air Force is indeed funded by our tax money.

2007 Ig Nobel Winners

Medicine – Brain Witcombe, of Gloucestershire Royal NHS Foundation Trust, UK, and Dan Meyer for their probing work on the health consequences of swallowing a sword.

Physics – A US-Chile team who ironed out the problem of how sheets become wrinkled.

Chemistry – Mayu Yamamoto, from Japan, for developing a method to extract vanilla fragrance and flavoring from cow dung.

Linguistics – A University of Barcelona team for showing that rats are unable to tell the difference between a person speaking Japanese backwards and somebody speaking Dutch backwards.

Peace – The US Air Force Wright Laboratory for instigating research and development on a chemical weapon that would provoke widespread homosexual behavior among enemy troops.

Nutrition – Brian Wansink of Cornell University for investigating the limits of human appetite by feeding volunteers a self-refilling, “bottomless” bowl of soup.

Economics – Kuo Cheng Hsieh of Taiwan for patenting a device that can catch bank robbers by dropping a net over them.

Aviation – A National University of Quilmes, Argentina, team for discovering that impotency drugs can help hamsters to recover from jet lag.


When Pedophillic Amoebas Attack

October 5, 2007

 This is gross.  You all laugh when I hold my nose while swimming.

artherrera.jpg

(CNN) — Ray Herrera does not mince words about what his 12-year-old son, Jack, went through.  “It’s beyond description to watch your most precious, beautiful, wonderful, loved one become a vegetable essentially and then die,” Herrera said.  In August, Jack returned from summer camp that included swims in Texas’ Lake LBJ. Five days after coming home he was dead, killed by a microscopic amoeba.

Jack is one of six people to die this summer in the United States from the naegleria fowleri amoeba.  The amoeba enters the human body through the nose. It then travels to the brain, where it begins to feed.  Symptoms of the amoeba’s rampage begin 1 to 14 days after infection and resemble the flu. At the onset of those symptoms the amoeba victim’s health swiftly declines.  “Folks lapse into a coma, there are abnormal movements of the eyes and a terrible cascade of events leading to the actual death of parts of the brain.”

Although exposure to the amoeba is usually fatal, Sherin says a cocktail of drugs can fight the amoeba if administered in time. The key, he says, is identifying the amoeba early.

Until this summer there were only 24 known cases of the virus in the U.S. since 1989, according to the CDC.  Health officials cannot explain the spike in cases this summer, except that weather plays a factor.

Another question health officials have is why the amoeba seems to appear more often in young males. All six victims this summer were male, ages 10 to 22 years old.  But other than wearing nose plugs while swimming or staying out of freshwater above 80 degrees Fahrenheit, there is little people can do to prevent exposure to the amoeba.

Health officials say federal or local governments have few tools to combat the amoeba.  The health department has posted signs at 15 swimming and boating areas where people may face exposure to the amoeba.  The effectiveness of the signs appears mixed.  As he sunbathed near a sign warning of amoebas, John Walters seemed unconcerned about danger possibly lurking beneath the clear, inviting waters. “Its no worse I suppose than the gator signs over there and somebody did get attacked here once.”


Got allergies? Need relief? Thank George

September 30, 2007

For some people allergies and allergic reactions can be terrible. For example Alex is a gross to be near booger-bag for several weeks a year, and Christina has an itch fest when exposed to sulfonamides. I am lucky enough to only be mildly allergic to Tide and tomato plants, but I do seem to be developing an allergy to my basement, or the fluffy cat that lives there. But when your eyes puff up, or hives appear, or your nose is running, or you can’t stop sneezing what do we turn to? Benadryl. I thought a brief mention of the man behind Benadryl would be worth posting. I am not sure if it is all pharmacy schools or just Temple, but antihistamines come up at least 3 times a day. Somehow my professors can work it into any lesson (from anatomy to immunology to pharmaceutics or even medicinal chemistry)

George Rieveschl, a chemical engineer (not a medical doctor) whom millions of sufferers of allergies, colds, rashes, hives and hay fever can thank for the relief they receive by swallowing a capsule of beta-dimethylaminoethylbenzhydryl ether hydrochloride — the antihistamine he invented and renamed Benadryl — died Thursday in Cincinnati. He was 91

Dr. Rieveschl (pronounced REE-va-shell), who had a Ph.D. in chemistry, was an assistant professor researching muscle-relaxing drugs at the University of Cincinnati in the early 1940s when he realized the powerful potential of that 19-syllable antihistamine compound, then being tested as a muscle relaxer.

Histamines are chemicals made in some cells that can damage the tiny blood vessels called capillaries, allowing blood plasma to leak into body tissues and cause swelling, itching and redness. Antihistamines are manufactured compounds that block receptors in the capillaries, preventing those irritating and sometimes even fatal effects.

“What George Rieveschl did was synthesize a compound that is much more tolerable because it causes much less drowsiness,” said Dr. I. Leonard Bernstein, a professor of medicine at the University of Cincinnati and a former president of the American Academy of Allergy, Asthma and Immunology. “It’s a very benign drug that most people can tolerate.”

The discovery of Benadryl was also significant because it was the first finding that specific receptors in capillaries can be affected by different compounds. “So there are now a whole series of antihistamines that will counter these different histamine receptors,” Dr. Bernstein said. “It was a key discovery.” It was also a profitable one.

Based on sales that rose to about $6 million a year by the early 1960s, that proved quite lucrative for him, Dr. Rieveschl told The Cincinnati Post in 1999. However, he said, he did not benefit from the huge profits Parke-Davis made after the Food and Drug Administration allowed Benadryl to become an over-the-counter drug in the 1980s. Sales then jumped to more than $180 million a year.

“He did this on his own, in the days before we had research teams,” Dr. Bernstein added. “He understood this concept because he was a good organic chemist.”

By DENNIS HEVESI

Published: September 29, 2007



5 Commonly Misdiagnosed Disease

September 27, 2007

Just thought this was interesting. It is 5 of the most commonly misdiagnosed diseases. Some seem understandably hard to detect while others seem hard to miss. It just goes to show why it is important to ask questions and take your health seriously. Being proactive about health is the best way to avoid misdiagnoses for you and your family. I know a lot of you out there have aging parents (myself included) and it is important to be there as they get older and doctors tend to push them aside. I worked in the geriatric portion of a hospital and saw it first hand, doctors sometimes make quick assumptions/decisions and don’t think it is worth their time to discuss it with the patient or the family in sufficient detail. It also points to the need for doctors to be more thorough when examining patients. The 5 specifically mentioned in the article are:

1. Aortic dissection

2. Cancer

3. Clogged arteries

4. Heart attack

5. Infection:

Check Out CNN for the full story


TB and Me

September 26, 2007

Tuberculosis is a disease that I have always found fascinating. It is one of the oldest document diseases. There is evidence of it in animals almost 20,000 years ago. They had it in ancient Egypt, Rome, and pretty much throughout the whole world at some point or another. Historically it has been called different names, but its characteristics are usually identifiable in written history. It was believe to be linked with vampirism, because of the pale appearance and coughing blood. Growing up I only knew about it in passing conversation and in novels. I thought it was a disease like small pox that had been eradicated. It wasn’t until middle school or high school even when I discovered just how prevalent it still is. In college I had to have the PPD test for TB, which is basically a skin test to see if you have been exposed to it. A positive result doesn’t mean you have it, just that you have been exposed, usually it is followed up with a chest x-ray. I actually have a TB skin test for pharmacy school next week. Like most hospitals, you can’t work at Temple without the test.

TB rarely gets the attention it deserves in our world. I think that is because the subset of the population it generally affects is not the upper class. Most middle and upper class Americans will never get TB, unless an outbreak occurred in a retirement home or somewhere like that. Because poor communities and immigrant communities are more often in smaller living spaces with more people around, they naturally are more susceptible. According to Wikipedia the following communities are most likely to be exposed: “include people in areas where TB is common, people who inject illicit drugs (especially when sharing needles), residents and employees of high-risk congregate settings, medically under-served and low-income populations, high-risk racial or ethnic minority populations, children exposed to adults in high-risk categories, patients immunocompromised by conditions such as HIV/AIDS, people who take immunosuppressant drugs, and health care workers serving these high-risk clients. It is so insane to me that a treatable and generally preventable disease still claims so many lives. More shocking is that inadequate control programs have led to a resurgence of the disease in recent years. Now there is also the added concern of drug resistant TB which has evolved over last 20 years. But there is always hope, the global initiative “Stop TB Partnership” is setting ambitious goals and is dedicated to ridding the world of TB.

Anna Cataldi, who served as UN Messenger of Peace from 1998 to 2007, has joined the global fight against tuberculosis (TB). Ms Cataldi, who was appointed as an Ambassador of the Stop TB Partnership, will raise awareness worldwide about the unfair burden of TB on refugees, migrants, people living in poverty and other disadvantaged groups. The Stop TB Partnership’s goal is to eliminate TB as a public health problem worldwide. In 2005 there were 8.8 million new cases of TB. The disease kills 4400 people every day, even though it has been treatable and preventable for more than half a century. “Anna Cataldi has an extraordinary track record of galvanizing people to confront issues that cause human suffering,” said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership. “She will be a strong voice calling for access to TB prevention, diagnosis and treatment as a human right.” The Stop TB Partnership has set out an ambitious plan: The Global Plan to Stop TB (2006-2015). Launched by the Stop TB Partnership in January 2006, the plan is a roadmap for treating 50 million people for TB between now and 2015 and save about 14 million lives. It aims to halve TB prevalence and deaths compared with 1990 levels by 2015.

TB Article


Pfizer’s new HIV drug

September 25, 2007

After the unfortunate failure of the Merck HIV vaccine, I figured I should share a promising development in the battle against HIV/AIDS.


LONDON, Sept 24 (Reuters) – Pfizer Inc., the world’s largest drugmaker, said on Monday the European Commission had approved its AIDS drug Celsentri, the first in a new class of oral HIV medicines. The drug — which is known generically as maraviroc and as Selzentry in the United States — is the first designed to keep the HIV virus that causes AIDS from entering healthy immune cells. Older AIDS medicines attack the virus itself. It works by blocking the CCR5 co-receptor that serves as a main doorway for the HIV virus into immune cells. The green light from the European authorities had been expected after a panel of EU experts recommended the product in July. The medicine was also cleared by the U.S. Food and Drug Administration last month. Celsentri is approved for use in patients who have tried other medicines and for whom a diagnostic test has confirmed their HIV strain is linked to the CCR5 receptor. New York-based Pfizer is counting on new medicines such as Celsentri to help drive profits as several blockbusters lose patent protection and its top-selling Lipitor cholesterol treatment faces strong competition. Industry analysts have projected annual Celsentri sales of about $500 million by 2011.