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Leader In The Field Discusses Pharmaceutical Industry

Dr. Jerry Avorn

Americans spend more than $300 billion a year on prescription drugs. How we use these drugs, and how effective they are, have become important subjects for public health researchers. A leader in this area is Dr. Jerry Avorn, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School. Avorn is the author of numerous articles and the book Powerful Medicines.

For an article in the Harvard Health Letter, editor Peter Wehrwein spoke with Avorn about generic drugs, the pharmaceutical industry, the high cost of cancer drugs, and more. Here’s an excerpt from their conversation; you can read the complete interview at www.health.harvard.edu. Read more »

*This blog post was originally published at Harvard Health Blog*

Do Chronic Diseases Begin In Utero?

Heart disease. Stroke. Diabetes. Asthma. Osteoporosis. These common scourges are often pegged to genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. David Barker, a British physician and epidemiologist, has a different and compelling idea: these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta.

Barker was the invited speaker at this year’s Stare-Hegsted Lecture, which is a big deal at the Harvard School of Public Health. In just over an hour, he covered the basics of what the British Medical Journal used to call the Barker hypothesis. It has since come to be known as the developmental origins of chronic disease. (You can watch the entire talk here.)

It goes like this: During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows programs a child’s development and sets the stage for health or disease. Barker and others use low body weight at term birth is a marker for poor fetal nutrition.

When a fetus is faced with a poor food supply, it Read more »

*This blog post was originally published at Harvard Health Blog*

Cancer Patients: How Will Treatment Affect Other Aspects Of Health?

The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising, was yet another tragedy for one of the country’s most prominent political families. It also offers a reminder of the possible long-term effects of cancer and its treatment.

In 2002, Kennedy was diagnosed with lung cancer that her doctors initially said was inoperable. Her father refused to accept that diagnosis, according to an article in the Boston Globe. He found doctors at Brigham and Women’s Hospital in Boston who thought they could treat the cancer. They removed a portion of Ms. Kennedy’s right lung and then administered radiation and chemotherapy. She lived for another nine years, in apparently good health.

While the cause of Kennedy’s death has not yet been confirmed, the long-term effects of her lung cancer treatment could have played a role. Cancer survivors are often at increased risk of heart disease. That’s because the treatments used to fight cancer—drugs, radiation, and hormones—can damage the heart and arteries. (These are detailed in a Harvard Heart Letter article on cancer therapy and heart disease.)

If life were completely fair, cancer survivors would be exempt from future health problems. Sadly, that isn’t the case. Read more »

*This blog post was originally published at Harvard Health Blog*

Harvard Revamps MyPlate To Create A Guide To Healthy Eating

Back in June, federal authorities unveiled MyPlate, an icon designed to help Americans follow healthy eating patterns. It’s a nice, colorful image that was a welcome successor to the misguided MyPyramid. But it doesn’t offer much in the way of useful information.

A group of my colleagues at Harvard Health Publications worked with nutrition experts at the Harvard School of Public Health to create a better version. We call it the Healthy Eating Plate. “We gave MyPlate a makeover to provide consumers with an easy to use but specific guide to healthy eating based on the best science available,” says Dr. Anthony Komaroff, a professor of medicine at Harvard Medical School and Editor in Chief of Harvard Health Publications.

The Healthy Eating Plate uses visual elements of MyPlate as a starting point, because the government’s icon is already becoming a recognized teaching tool. But the resemblance ends there: Read more »

*This blog post was originally published at Harvard Health Blog*

Inspiring Story About A Man Making Changes To Transform His Life

It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories about people who run marathons a year after surgery to bypass cholesterol-clogged arteries or who climb Mt. McKinley after being diagnosed with diabetes are interesting, but they don’t resonate with me. Mostly it’s because they often leave out the hard work needed to change and the backtracking that invariably accompanies it.

I ran across a truly inspiring story the other day in the American Journal of Health Promotion—one that shows how most of us ultimately manage to make changes that improve our lives. The journal’s founder and editor, Michael P. O’Donnell, wrote a moving essay about his father, Kevin O’Donnell. Once an overweight workaholic who smoked and drank heavily, ate mostly meat and potatoes, and didn’t exercise—and who eventually needed a double bypass—Kevin O’Donnell gradually made changes to improve his health. Now, at age 85, he has the cardiovascular system of a 65 year old and is working on a house-building project in North Korea.

How did Kevin O’Donnell engineer such a remarkable transformation? Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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