January 15th, 2007 by Dr. Val Jones in News
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I came across a news headline: “Chewing gum drug could help curb obesity.” I couldn’t help but be intrigued, so I decided to dig a little deeper. The news release, as it turns out, is based upon the work of professor Steven R. Blum, a British researcher who is a consultant for many major pharmaceutical companies (Merck, GSK, Roche, Novartis, Pfizer, Astra-Zeneca, J&J and others). In addition to owning stock in Thiakis, a new biopharmaceutical company created in 2004, the professor has just received 19 million dollars in VC money (and a 5 million dollar grant from the Wellcome Trust) to further investigate the use of pancreatic polypeptide – an appetite suppressing hormone – for the treatment of obesity.
The amount of money flowing into Blum’s research tells me one thing for sure – Big Pharma is placing a bet on gut hormones as the next big breakthrough in obesity management. Whether this is money well spent, I’m not sure. Leptin (an appetite suppressant hormone produced by fat cells) proved to be a big disappointment to researchers, as obese individuals proved to be resistant to leptin. Pancreatic polypeptide also has a flaw that may prove to limit its use: it is rapidly broken down in the blood stream by enzymes, causing its appetite suppressing effects to be quite transitory.
Evidence to date is limited in humans (as far as I can tell previous studies have mostly focused on mice – I’ll let my GI colleagues correct me here) and Bloom cites a study in which 17 obese adults ate ~15 -25% less at a buffet after being injected with pancreatic polypeptide (compared to 18 others who were injected with saline).
I’d like to believe that gut hormones will lead to an appetite suppressing pill that will reverse or slow our obesity epidemic. But I remain skeptical at this point. What do other people think about this?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 9th, 2007 by Dr. Val Jones in True Stories
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An attorney from the hospital where I used to work called me out of the blue. He asked me if I remembered a Mr. So and So. “I’m not sure,” I said uneasily. “The name does sound familiar.”
Slowly the case came flooding back to me. I was on call on a weekend covering the neurosurgical step down unit. A nurse paged me to tell me that someone couldn’t move his legs. I asked if it was a new problem. “Yes, he could move them just this morning.”
I ran to the patient’s room and found an anxious appearing, young obese man lying flat in bed with a neck brace on. He had recently had a cervical laminectomy (a neck spine procedure). “I can’t move” he said, a bead of sweat trickling off his brow. “Can you feel anything?” I asked.
“Nothing below my neck.”
I took my metal tuning fork out of my coat pocket and pressed it firmly on his toe nail bed to see if he’d withdraw from pain. Not a flinch. My heart started racing. This is a surgical emergency.
I called the neurosurgery team and told them about the sudden paralysis. They arrived on the floor in under a minute, confirmed the diagnosis, grabbed the chart and took the patient to the O.R. immediately.
Hours later I heard that the man had had a rare complication of neck surgery – a small arterial hemorrhage that rapidly compressed the spinal cord. The surgeons evacuated the blood immediately – though it was anyone’s guess if the man would fully recover.
And apparently he didn’t. Four years later he was suing the hospital for malpractice, and I was named in the lawsuit.
“But I didn’t do anything wrong,” I told the attorney.
“Well, you’d better read the record,” he said ominously.
**See my next post for the end of the story!**
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 4th, 2007 by Dr. Val Jones in News
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So it seems that people who stay in school longer, live longer. But not for the reasons you might expect – it’s not because privileged kids are more likely to stay in school and also happen to get better healthcare. It seems that school teaches kids two things beyond the books: 1) discipline – the ability to delay gratification and 2) social networking skills. These two lessons go a long way to keeping people healthier long term.
Come to think of it, this makes a lot of sense – if a person can learn to avoid fast food for the “higher call” of health, they may live longer. If a person is well integrated in a social network, they’re more likely to seek out medical assistance earlier on – and have caring friends and family spur them on towards regular check ups, taking their meds, etc.
Now, I don’t know what YOU were doing in junior high and high school – but apparently the first hints of your discipline and networking skills were learned there. Although the research described in the NY Times article only made a link between total years in school, and total years of life – I wonder if your high school’s “expert networkers” – you know them, the ever-annoying popular kids – will fare best of all in the health arena?
Better go to your high school reunion to find out!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 31st, 2006 by Dr. Val Jones in News
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As I was reviewing some research articles for a blog I was planning about the benefits of pet therapy in pain management, I came across a recent Finnish study suggesting that pet owners are more likely to be overweight and unhealthy than those who had no pets. It just didn’t seem right to me – so I decided to go to the source and read the original article.
The researchers surveyed about 8 thousand people. They found that a total of 80% of those with pets and 82% of those without pets reported good health.
They also said,
“In the multivariate ordinal logistic regression analysis, perceived health was no longer associated with pet ownership. When investigating which explanatory variables included in the model caused the disappearance of the statistical significance, basic education, form of housing, or BMI did so.”
Translation: being at risk for poorer health is not really about your pet, it’s about your socio-economic status and the degree to which you are overweight.
But this still begs the question: why are Finnish people in poorer health more likely to have a pet?
The authors offer this explanation:
“Pets seem to be part of the lives of older people who have settled down and experience an increase in the number of illnesses, whereas young healthy single people have no time, need, or possibility for a pet.”
Hmmm. Would an American survey find similar results I wonder? Is there any cultural bias in these data? What do you think? Are American pet owners more likely to be overweight and socio-economically challenged than non-pet owners?
Source: Koivusilta, L. and Ojanlatva, A. PloS ONE, December 2006; vol 1: pp e109. News release, Public Library of Science.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 30th, 2006 by Dr. Val Jones in True Stories
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Good medical diagnosis and treatment often requires some detective work. One of my patients came to see me for foot pain recently. She described what sounded like a pretty typical case of plantar fasciitis – pain in the heel of her foot, worst with the first few steps in the morning, improving throughout the day. I recommended stretches, physical therapy, night splints, ibuprofen… but to my surprise nothing was really helping.
One wintery day she came back on a return visit and I happened to notice her footwear – boots with a very thin, flexible sole. Slowly I began to think of her tromping over ice, sand, gravel, and snow in these boots… I asked her if she could feel the ground under her feet.
“Yes, I can feel everything – I don’t like to walk around in the snow and ice because it kind of hurts to step on all the lumps and bumps. But I can’t just stay indoors all day, I have errands to run!”
I explained to my patient that I had a hunch that the rocks were bruising her plantar fascia, causing it to be inflamed and painful. I asked her to buy herself some thick soled boots – the kind where she couldn’t feel the lumps and bumps under her feet.
About a week later my patient called to tell me that her foot pain was much better. The new boots seemed to be doing the trick… “I never knew why my plantar fasciitis got worse in the winter times, doc. I thought it was the cold that made things worse.”
Well, I had learned a lot too… sometimes the best treatment option is not on the standard protocol list. The power of observation is one of a physician’s most important weapons.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
