September 4th, 2007 by Dr. Val Jones in News
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I subscribe to Eureka Alert Breaking News – and although a lot of their press releases are on small studies of questionable relevance, I do think that some of the basic science research is provocative. Let’s see if I can pique your interest with the best of this week’s Petri dish news:
1. Tylenol may inhibit bone growth? A small study conducted at the University of Granada suggested that bone forming cells (called osteoblasts) were inhibited by a Tylenol bath. As far as pain killers are concerned, we’ve known for a while that non steroidal anti-inflammatory medications (NSAIDs) may indeed inhibit bone growth. But since Tylenol is not an NSAID, we were hoping that it would not adversely affect bone healing. Could this mean that Tylenol is not so great for bone surgery pain after all? That’s a stretch… but an interesting question.
2. Can you clean blood with a laser? Boy it sure would be nice to be able to kill all the potential viruses in blood used for transfusions. Apparently there’s a new pulsed laser technique that shows some promise in fracturing viruses with laser vibrations. So far, the laser was successful in reducing bacterial viruses by 1000x. Next up? Let’s see what the technique can do to Hepatitis C and HIV viruses.
3. Skinny people might have a “skinny gene.” Scientists have been studying a gene called Adipose (Adp) for over 50 years now. It was first discovered in fat fruit flies (I kid you not). Apparently if the Adp gene doesn’t work well, the flies become fat and “have difficulty getting around.” Worms, mice, and humans seem to have the same gene. Further analysis might unlock the secret to the genetics of thinness. Or maybe we should just eat less and exercise more?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 3rd, 2007 by Dr. Val Jones in Expert Interviews
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Dr. Susie (Sunanda) Kane is a Crohn’s Disease expert who just moved from the University of Chicago to join a team of researchers and clinicians at the Mayo Clinic in Rochester, Minnesota. Susie was kind enough to answer some questions about Crohn’s recently. We used the phone interview to create a short article at Revolution Health, but I think that listening to the entire conversation could be of benefit to those who desire deep and broad information about the disease.
In fact, a dear blogger friend of mine has a daughter with severe, fistulizing Crohn’s disease. She has been in the hospital for 2 months, unable to eat. It is my sincere hope that interviews like this one will go a long way to frame the discussion of the multiple treatment options for those struggling with this challenging disease.
We asked Dr. Kane what the common misconceptions are about Crohn’s disease, then she described the 3 types of Crohn’s disease, how they’re diagnosed and treated, and the latest cutting edge research that make a substantial improvement in the lives of those living with the disease. The interview is about 30 minutes in total. Enjoy!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 30th, 2007 by Dr. Val Jones in Health Policy, Opinion
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Labor Day was founded in the late 1800’s as a way to thank
American workers (as Peter J. McGuire, a cofounder of the American Federation
of Labor put it): “who from rude nature have delved and carved all the grandeur
we behold.” There is some debate
about who originated the concept of the holiday, but one truth remains:
“All other
holidays are in a more or less degree connected with conflicts and battles of
man’s prowess over man, of strife and discord for greed and power, of glories
achieved by one nation over another. Labor Day…is devoted to no man, living
or dead, to no sect, race, or nation… It
constitutes a yearly national tribute to the contributions workers have made to
the strength, prosperity, and well-being of our country.”
Resident physicians are on my mind with Labor Day
approaching. I know that they are toiling away in hospitals across the nation,
and many of them do not get to take Labor Day off for vacation. Physicians work for 3-7 years after
graduating from medical school, and are paid (on average) about the equivalent
of a home health aide or a medical secretary but work about twice the hours
during residency. In fact, if you calculate
out the salary by the hours they work, resident physicians are paid about $9
-$10/hour which is roughly $1.50 more than minimum wage.
Not surprisingly, resident physicians have joined unions to
lobby for more reasonable wages and caps on the number of hours they must work
per week. The national cap is now at 80
hours per week – about 20 hours more than a truck driver is allowed to work
(for “safety reasons”). Research from Harvard
suggests that errors made by overworked residents increase by 700% when they
have worked more than 24 hours in a row.
Residents from the University of New Mexico, for example, received wages in the lowest 1% for resident physicians in their region, and
were denied a salary increase until they recently joined forces with CIR (the Committee of Interns and Residents) to
negotiate more reasonable salaries and working conditions. The New
Mexico contract adds one more CIR chapter to the more
than 70 hospitals — each with multiple residency programs — that are part of
CIR.
Founded in 1957 to improve patient care and resident working
conditions, CIR has remained true to those two goals throughout the decades. In
1975, CIR won an end to every other night on-call in New
York City, and created the first-ever Patient Care Fund in Los Angeles, where
residents could purchase equipment or create innovative programs to help
patients. Campaigns to prevent needle stick accidents by moving to safer needles,
or needle-less equipment, have also improved working conditions for residents.
CIR has been on the forefront of safe and humane work hours
for residents, helping to win the 80 hour regulations in New York State
in 1989, which became the foundation for the 2003 national guidelines. But
evidence shows that this is still too many hours, and so the advocacy around
hours continues unabated.
So please have safe travels on your Labor Day weekend – we
wouldn’t want you to wind up at a hospital where the residents work more than
24 hours in a row for ~$9/hour. Resident
physicians are one group of laborers who don’t have much to celebrate yet this
Labor Day. But with CIR’s help, next
year might be a little brighter.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 29th, 2007 by Dr. Val Jones in Expert Interviews, News
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We’ve known for quite a while that lowering your cholesterol can reduce your risk of heart disease, heart attack, and stroke. Low fat diets, weight loss, and exercise can help people to control their cholesterol levels – but for those who do not succeed with these methods, a class of medications have been developed (known as “statins”) to reduce cholesterol. These drugs have been so successful at reducing cholesterol that some doctors have joked about putting statins in the water supply. In fact, 36 million Americans take a statin every day, generating annual sales of
$15.5 billion for the manufacturers, and making two statins – Lipitor and
Zocor – the top two best-selling drugs in the USA.
Four new studies were published in the past week about these drugs. I thought I’d summarize the findings for you to keep you up to speed with the very latest statin information.
Statins May Reduce Mortality After Having A Stroke
Spanish researchers followed the progress of 89 stroke patients who were already taking statins. For the first three days after the stroke, 46 patients received no statins, and 43 got their normal dose. After three months, 27 people – 60 % of the “no statins”
group – had either died or were disabled to the point that they needed
help to live a normal life, compared with 16 people from the group
allowed to keep taking statins.
This small study suggests that stroke patients should not stop taking their statins. More research is needed to clarify the role of statins in stroke.
Statins May Reduce The Brain Plaques Associated With Alzheimer’s Disease
Researchers at the University of Washington examined the brain tissue of 110 people who had donated their brains to research upon their death. They found there were
significantly fewer plaques and tangles (the hallmarks of Alzheimer’s disease) in the brains of people who had taken statins compared with those who had not. This is good news, but will require further research to determine whether or not statins could be used (or should be used) specifically for the treatment or prevention of Alzheimer’s Disease.
Statins Don’t Seem To Reduce The Risk of Colon Cancer
A group of Greek researchers conducted a review of the scientific literature to see if there may be a reduction in colon cancer rates among people who take statins. They found no evidence that statins reduce the risk of colon cancer.
Statin Side Effects Appear To Be Ignored By Some Physicians
The journal Drug Safety surveyed 650 patients about their experience with statins. Eighty-seven percent of patients reportedly spoke to their physician
about the possible connection between statin use and a symptom.
Physicians were more
likely to deny than affirm the possibility of a connection. Rejection
of a possible connection was reported to occur even for symptoms with
strong literature support for a drug connection. This report is concerning since it seems to suggest that physicians don’t take patient complaints as seriously as they should.
I asked Dr. Frank Smart what he thought about the side effects of statins and whether or not physicians should be more aware of them.
“The statin side effects exist
but in my opinion are overplayed. In my practice about 5% of people on statins
have some muscle issues. Most improve with dose reduction or change to a more
hydrophyllic compound.
Physicians should be better educated about side effects and the one who
should do the educating is pharma, and websites like Revolution Health. Most docs are as
familiar with statin side effects as they are with other drug classes, so good
but not great. We would all love to raise the bar but it is tough as you
know.”
As many as 30% of patients reportedly experience a side effect from statins (including: headache, nausea,
vomiting, constipation, diarrhea, rash, weakness, and muscle pain) though severe muscle damage is very rare (for example, one article reported 24 cases in 252,460 patients.) Overall, statins have many health benefits and are well tolerated by the majority of patients.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 21st, 2007 by Dr. Val Jones in Uncategorized
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I had an interesting dialog with Dr. Bruce Campbell recently. In his blog he described a patient who lost about 60 pounds after losing his sense of taste. The patient had undergone radiation therapy for throat cancer, and in the process lost his ability to taste food. He soon lost interest in eating, and eventually dropped 60 pounds – not from the cancer, but from the side effect of radiation therapy. In this case there was a happy ending (his sense of taste eventually returned and he regained some of his weight) but it made me think about the relationship of flavor to obesity.
Just as I was musing on this very fact, a new research study was published in the journal Neurology. It suggested that unexplained weight loss was an early warning sign of dementia. They speculate that this could be linked to another early sign of dementia: loss of the sense of smell. Of course taste is largely a function of smell, so we can easily understand how people lose interest in eating when they can’t enjoy the flavor of food.
Wouldn’t it be interesting if we could temporarily alter a person’s sense of taste in order to affect weight loss? I doubt I’m the first to think of this… has anyone else heard of such a strategy? Surely this would be a little bit less invasive and dangerous than bariatric surgery.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
