Health – Page 18 – artdiamondblog.com

Rage That Transplant Medicine Stagnates

The essay quoted below provides one more example of why we should unbind medical entrepreneurs to allow them to bring us more and faster cures.

(p. 8) Today, I will explain to my healthy transplanted heart why, in what may be a matter of days or weeks at best, she — well, we — will die.

. . .

Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors.

. . .

Over the last almost four decades a toxic triad of immunosuppressive medicines — calcineurin inhibitors, antimetabolites, steroids — has remained essentially the same with limited exceptions. These transplant drugs (which must be taken once or twice daily for life, since rejection is an ongoing risk and the immune system will always regard a donor organ as a foreign invader) cause secondary diseases and dangerous conditions, including diabetes, uncontrollable high blood pressure, kidney damage and failure, serious infections and cancers. The negative impact on recipients is not offset by effectiveness: the current transplant medicine regimen does not work well over time to protect donor organs from immune attack and destruction.

. . .

I am speaking for my transplant cardiologist, the finest physician I have ever known, who sat across from me last month and cried into his palms when he told me I had incurable cancer.

For the full essay, see:

Amy Silverstein. “My Donor Heart And I Will Die Soon.” The New York Times, SundayOpinion Section (Sunday, April 23, 2023): 8.

(Note: ellipsis added; in the original, the word “we” in the first sentence is in italics.)

(Note: the online version of the essay has the date April 18, 2023, and has the title “My Transplanted Heart and I Will Die Soon.”)

Simple Beeping Pagers Tell Patients a Doctor’s Distraction Is Work-Related

(p. A10) Pagers, those pre-cellphone, one-way devices that alert the carrier that someone is trying to reach them, can seem like something out of a time capsule.

. . .

There are people who just refuse to let their pagers go, including some doctors and bird watchers. They say pagers allow them to separate parts of their life in a way phones don’t, and that the lower-tech one-way communication of a pager is less distracting than looking at a phone full of alerts and apps.

. . .

Another advantage of the pager? It’s easy for staff to throw one in frustration instead of turning on each other, according to Dr. Colm McCarthy, an orthopedic surgeon in Fall River, Mass.

Tired during a busy on-call night once, he chucked his pager in a closet where it broke.

He gave up his pager when he got his current job, and transitioned over to the apps on his phone. Now, though, when he gets a message on his phone, it’s awkward to answer it, he says. If he’s looking at the phone, he worries patients might wonder what he’s paying attention to while with a pager, it’s obvious it’s work.

He has multiple apps on his phone. Last year, his hospital adopted the fourth app that connects him to patients. When a patient wants to reach him, he gets a message with a phone number. He then has to call that number to get a message with the patient’s phone number.

The mute function on the apps is easily overridden by alerts, so to separate work from home life, he keeps his phone on silent altogether, he says. He often misses messages from family and friends because of that.

For the full story, see:

Ariana Perez-Castells. “What the Beep? Die-Hards Refuse to Let Go of Their Pagers.” The Wall Street Journal (Monday, May 20, 2023): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the story has the date May 19, 2023, and has the same title as the print version.)

Communists Want Us to Forget the 1.6 Million Chinese They Murdered in Cultural Revolution

(p. A23) It would seem impossible to forget or minimize the Cultural Revolution in China, which lasted from 1966 to 1976, resulted in an estimated 1.6 million to two million deaths and scarred a generation and its descendants. The movement, which under Mao Zedong’s leadership sought to purge Chinese society of all remaining non-Communist elements, upended nearly every hallowed institution and custom. Teachers and schools long held in esteem were denounced. Books were burned and banned, museums ransacked, private art collections destroyed. Intellectuals were tortured.

But in China, a country where information is often suppressed and history is constantly rewritten — witness recent government censorship of Covid research and the obscuring of Hong Kong’s British colonial past in new school textbooks — the memory of the Cultural Revolution risks being forgotten, sanitized and abused, to the detriment of the nation’s future.

The Chinese government has never been particularly eager to preserve the memory of that sordid decade. When I spent six weeks traveling in China in 1994 — a slightly more open time in the country — I encountered few public acknowledgments of the Cultural Revolution. Museum placards and catalogs often simply skipped a decade in their timelines or provided brief references in the passive voice along the lines of “historical events that took place.”

But in her new book, “Red Memory: The Afterlives of China’s Cultural Revolution,” the journalist Tania Branigan notes that under Xi Jinping, China’s top leader, efforts to suppress this history have intensified — with troubling implications for the political health of the country at a time when it looms larger than ever on the world stage. “When you’ve had a collective trauma, you really need a collective response,” she told me recently. “I can see why the Communist Party wants to avoid the rancor and bitterness, but when you don’t have that kind of acknowledgment, you can move on — but you can’t really recover.”

For the full commentary, see:

Pamela Paul. “The Decade That China Cannot Delete.” The New York Times (Friday, May 19, 2023): A23.

(Note: the online version of the commentary has the date May 18, 2023, and has the title “The Decade That Cannot Be Deleted.”)

The book on the cultural revolution mentioned above is:

Branigan, Tania. Red Memory: The Afterlives of China’s Cultural Revolution. New York: W. W. Norton & Company, 2023.

Mice on Taurine Lived 10% Longer and Looked Healthier

(p. A3) Scientists are exploring a new biological link to longer life.

Boosting levels of an amino acid called taurine made mice and worms live longer, according to research published Thursday [June 7, 2023] in the journal Science. Middle-aged monkeys given taurine supplements became healthier, researchers said. In humans, lower levels of taurine were associated with age-related problems.

“This is a very promising molecule,” said Vijay Yadav, an assistant professor of genetics and development at Columbia University, who co-wrote the paper.

People have been searching for life-extending substances for millennia. Other recent studies have explored antiaging properties of compounds including resveratrol, found in red wine, and the immunosuppressive drug rapamycin. Yadav said he first suspected taurine’s connection with aging over a decade ago when his lab compared the contents of blood drawn from people of different ages.

. . .

Researchers gave daily doses of taurine to hundreds of 14-month-old mice, considered middle-aged, and compared their average lifespans to mice that didn’t get extra taurine. The female mice given taurine lived 12% longer on average and male mice that got taurine lived 10% longer, researchers said.

Mice that received taurine also appeared to be healthier.

For the full story, see:

Dominique Mosbergen. “Amino Acid Found To Slow Down Aging.” The Wall Street Journal (Friday, June 9, 2023): A3.

(Note: ellipsis, and bracketed date, added. The online version is longer, but the passages quoted above appear in both versions.)

(Note: the online version of the story was updated June 9, 2023, and has the title “Is Taurine the Key to Longer Life? It Made Monkeys Healthier.”)

The Science paper on taurine mentioned above is:

Singh, Parminder, Kishore Gollapalli, Stefano Mangiola, Daniela Schranner, Mohd Aslam Yusuf, Manish Chamoli, Sting L. Shi, Bruno Lopes Bastos, Tripti Nair, Annett Riermeier, Elena M. Vayndorf, Judy Z. Wu, Aishwarya Nilakhe, Christina Q. Nguyen, Michael Muir, Michael G. Kiflezghi, Anna Foulger, Alex Junker, Jack Devine, Kunal Sharan, Shankar J. Chinta, Swati Rajput, Anand Rane, Philipp Baumert, Martin Schönfelder, Francescopaolo Iavarone, Giorgia di Lorenzo, Swati Kumari, Alka Gupta, Rajesh Sarkar, Costerwell Khyriem, Amanpreet S. Chawla, Ankur Sharma, Nazan Sarper, Naibedya Chattopadhyay, Bichitra K. Biswal, Carmine Settembre, Perumal Nagarajan, Kimara L. Targoff, Martin Picard, Sarika Gupta, Vidya Velagapudi, Anthony T. Papenfuss, Alaattin Kaya, Miguel Godinho Ferreira, Brian K. Kennedy, Julie K. Andersen, Gordon J. Lithgow, Abdullah Mahmood Ali, Arnab Mukhopadhyay, Aarno Palotie, Gabi Kastenmüller, Matt Kaeberlein, Henning Wackerhage, Bhupinder Pal, and Vijay K. Yadav. “Taurine Deficiency as a Driver of Aging.” Science 380, no. 6649 (June 9, 2023): eabn9257.

So-Called “Inflation Reduction Act” Mandates Pharma Firms Dishonestly Say They Voluntarily Negotiated Prices

(p. A15) The pharmaceutical company Merck claims in a lawsuit filed this week that the “Drug Price Negotiation Program for Medicare,” part of last summer’s Inflation Reduction Act, is an unconstitutional taking of company’s property and a violation of the company’s freedom of speech. If successful, this lawsuit will prevent the unconstitutional practice of forcing drug companies to sell drugs to the U.S. government at a government-determined price.

To make the provision of the 2022 law constitutional, Congress could have imposed price controls, or it could have bargained with pharmaceutical companies using the massive marketing power of Medicare, which accounts for some half of all American drug spending. Instead, Congress tried to prevent pharmaceutical companies from walking away from any potential deal. Under the act, secret negotiations force pharmaceutical companies to agree to government-determined prices amounting to massive discounts off market-based prices, under the threat of crippling taxes and penalties.

Americans tend to support pharmaceutical “price negotiations,” but oppose “price controls.” Knowing this, Congress set up a ruse.

. . .

. . ., the law essentially requires a company to communicate that it agreed to the set price—compelled speech that is prohibited by the First Amendment. Time and again, the Supreme Court has declared forced speech beyond the power of the government. The government’s only seeming interest is to pretend that a system of unilateral price controls and mandated sales is actually a system of voluntary negotiations.

For the full commentary, see:

Daniel E. Troy. “An Unconstitutional Offer Drug Companies Can’t Refuse.” The Wall Street Journal (Friday, June 9, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 8, 2023, and has the same title as the print version.)

Man Died When Pharmacist Refused to Give Him EpiPen Without the Mandated Prescription

(p. A15) Rates of hospital admissions for asthma, nut allergies in children, and prescriptions for EpiPens (used to treat extreme reactions) have all tripled in recent decades. Not only are food allergies now more common in children, but they are less likely to be outgrown with age than in years past.

The causes and consequences of this epidemic are the subject of “Allergic,” an important and deeply researched book by Theresa MacPhail, a medical anthropologist who memorably portrays the human face of disease. . . . Ms. MacPhail . . . has a personal connection to this subject: Her father died after being stung by a bee on the main street of the New Hampshire town where she grew up. (His girlfriend drove him to a drugstore instead of a hospital; even though he was in extremis, the pharmacist refused to dispense an EpiPen without a prescription.)

For the full review, see:

John J. Ross. “BOOKSHELF; Runny Noses, Itchy Eyes.” The Wall Street Journal (Wednesday, May 24, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date May 23, 2023, and has the title “BOOKSHELF; ‘Allergic’ Review: Runny Noses, Itchy Eyes.”)

The book under review is:

MacPhail, Theresa. Allergic: Our Irritated Bodies in a Changing World. New York: Random House, 2023.

Data Set Too Small to Support Claim of 250,000 Annual ER Deaths Due to Misdiagnosis

(p. A17) A shocking headline recently claimed that every year 250,000 people in the U.S. die after misdiagnosis in the emergency room. Even more shocking, the statistic was extrapolated from the death of one man—in a Canadian emergency room more than a decade ago.

. . .

The statistical methods used to arrive at the report’s estimate of 250,000 deaths are very bad, resulting in inaccurate findings that exaggerate potential harm in ERs. The estimate was derived from a single study that included only 503 patients discharged from two Canadian emergency rooms from August to December 2004. Researchers found that among the 503 patients, one person unexpectedly died related to a delay in diagnosis by an ER physician. The patient had signs of an aortic dissection—a tear in the major vessel that carries blood from the heart. For reasons we don’t know, the diagnosis was delayed for seven hours.

The goal of the Canadian study was to measure all kinds of medical errors, not to estimate the death rate from erroneous or late diagnoses. The sample size wasn’t big enough for that. Had nobody in the study sample died, would that mean that ERs never make fatal errors? Obviously not.

The AHRQ report misused this single death to estimate a death rate across the entire U.S. Dividing one death by 503 patients, the researchers estimate a death rate of 0.2%. They then multiply 0.2% by total annual ER visits in the U.S.—130 million—and come up with 250,000 deaths.

For the full commentary, see:

Kristen Panthagani. “A Study Sounds a False Alarm About America’s Emergency Rooms.” The Wall Street Journal (Friday, Dec. 30, 2022): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date December 29, 2022, and has the same title as the print version.)

Longevity Proof of Concept–A Jellyfish That Can Return to a Younger Form

(p. A15) When Benjamin Franklin wrote that “nothing can be said to be certain, except death and taxes,” he must have thought he was stating an eternal truth. But if biotechnology researcher Nicklas Brendborg is to be believed, Franklin’s joke may need some updating. According to Mr. Brendborg, scientists have discovered a jellyfish the size of a fingernail that responds to stress by “ageing backwards,” reversing the normal direction of its development to become a bottom-dwelling polyp. This trick can be repeated over and over again with “no physiological recollection of having been older,” he explains, making this jellyfish “an example of the holy grail of ageing research—biological immortality.”

This tiny Methuselah is one of the striking examples in Mr. Brendborg’s breezy survey of the science of longevity, “Jellyfish Age Backwards,” which the author has translated from the Danish with Elizabeth DeNoma.

. . .

Short chapters built from short, declarative sentences combine with familiar material to give “Jellyfish Age Backwards” the feel of an introductory survey rather than a novel argument. Perhaps its piecewise construction is only a reflection of the disjointed state of the subject, where researchers are pulling on various threads but have not yet managed to knit them into a coherent whole. Mr. Brendborg finishes with a ringing declaration that the “noble” efforts of medical science will “eventually defeat” aging. But biology is complicated, as the author admits, and the strands of this multivariate and complex phenomenon may eventually prove to be tangled in some unresolvable knot.

For the full review, see:

Richard Lea. “BOOKSHELF; Dying Young At a Late Age.” The Wall Street Journal (Friday, Dec. 30, 2022): A15.

(Note: the online version of the review has the date December 29, 2022, and has the title “BOOKSHELF; ‘Jellyfish Age Backwards’ Review: Dying Young at a Late Age.”)

The book under review is:

Brendborg, Nicklas. Jellyfish Age Backwards: Nature’s Secrets to Longevity. Translated by Elizabeth DeNoma. New York: Little, Brown & Company, 2023.

Firing an Actor “Early Could Be a Motivator for the Remaining Cast”

The ability to fire at will gives the entrepreneur (and the movie director) the ability to put together the right team for a project. Keeping those employed who are not doing their jobs, can be demoralizing for those who are doing their jobs.

(p. C1) When the writer and director Mike Nichols was young, he had an allergic reaction to a whooping cough vaccine. The result was a complete and lifelong inability to grow hair. One way to read Mark Harris’s crisp new biography, “Mike Nichols: A Life,” is as a tender comedy about a man and his wigs.

. . .

(p. C5) Harris is the author of two previous books, “Pictures at a Revolution: Five Movies and the Birth of the New Hollywood” and “Five Came Back: A Story of Hollywood and the Second World War.” He’s also a longtime entertainment reporter with a gift for scene-setting.

He’s at his best in “Mike Nichols: A Life” when he takes you inside a production. His chapters on the making of three films in particular — “The Graduate,” “Silkwood” and “Angels in America” — are miraculous: shrewd, tight, intimate and funny. You sense he could turn each one into a book.

Nichols was an actor’s director. &nbsp. . . But he had a steely side.

He fired Gene Hackman during week one on “The Graduate.” Hackman was playing Mr. Robinson and it wasn’t working, in part because, at 37, he looked too young for the role.

Sacrificing someone early could be a motivator for the remaining cast, he learned. He fired Mandy Patinkin early in the filming of “Heartburn,” and brought in Jack Nicholson to play Meryl Streep’s faithless husband.

For the full review, see:

Dwight Garner. “BOOKS OF THE TIMES; The Wit and Wigs Of a Star-Studded Life.” The New York Times (Tuesday, January 26, 2021): C1 & C5.

(Note: ellipses added.)

(Note: the online version of the review was updated Jan. 29, 2021, and has the title ‘BOOKS OF THE TIMES; ‘Mike Nichols’ Captures a Star-Studded Life That Shuttled Between Broadway and Hollywood.”)

The book under review:

Harris, Mark. Mike Nichols: A Life. New York: Penguin Press, 2021.

Recent Degrowth Policies Will “Reduce Medicare and Social Security Tax Revenue by at Least $400 Billion”

(p. A13) President Biden released his 2024 budget request Thursday while continuing to accuse Republicans of scheming to cut benefits for seniors. But he’s got it backward. By advancing policies that hinder the economic growth that drives prosperity, Mr. Biden and his Democratic colleagues are the ones depriving Social Security and Medicare of the hundreds of billions of dollars those programs need to remain solvent.

. . .

My own research on the Biden agenda’s effect on Social Security and Medicare makes clear that low economic growth translates into smaller benefits for seniors. These programs give the elderly a share of the earnings of the nation’s current workers. The more people who work, and the more each worker earns, the more payroll tax revenue is available to fund Social Security and Medicare. I estimate that degrowth policies since 2020 will cumulatively reduce Medicare and Social Security tax revenue by at least $400 billion—and perhaps as much as $900 billion. The tax base will shrink even more if Mr. Biden succeeds in levying higher wealth and business taxes.

For the full commentary, see:

Casey B. Mulligan. “Biden’s Assault on Social Security.” The Wall Street Journal (Monday, March 10, 2023): A13.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date March 9, 2023, and has the title “Biden’s Budget Is an Assault on Social Security.”)

A somewhat more detailed version of Mulligan’s argument can be found in:

Mulligan, Casey B. “Payroll Tax Revenues Down $400 to $900 Billion Due to Lower Wages and Less Growth.” Washington, D.C.: Committee to Unleash Prosperity, March 2023.

“The Reliability of Science Is Based” on Free Speech

Theoretical physicist Carlo Rovelli’s argument should be pondered by global warming and Covid scientists who want to censor and cancel those with whom they disagree. They should also read John Stuart Mill’s On Liberty.

(p. C5) Science is a process that builds upon existing theories and knowledge by continuously revising them. Every aspect of scientific knowledge can be questioned, including the general rules of thinking that appear to be most certain.

. . .

Consider a folk healer’s herbal medicine. Can we say this treatment is “scientific”? Yes, if it is proven to be effective, even if we have no idea why it works. In fact, several common medications used today have their origin in folk treatments, and we are still not sure how they work. This does not imply that folk treatments are generally effective. To the contrary, most of them are not. What distinguishes scientific medicine from nonscientific medicine is the readiness to seriously test a treatment and to be ready to change our minds if something is shown not to work.

Exaggerating a bit, one could say that the core of modern medicine is not much more than the accurate testing of treatments. A homeopathic doctor is not interested in rigorously testing his remedies: He continues to administer the same remedy even if a statistical analysis shows that the remedy is ineffective. He prefers to stick to his theory. A research doctor in a modern hospital, on the contrary, must be ready to change his theory if a more effective way of understanding illness, or treating it, becomes available.

. . .

What makes modern science uniquely powerful is its refusal to believe that it already possesses ultimate truth. The reliability of science is based not on certainty but on a radical lack of certainty. As John Stuart Mill wrote in “On Liberty” in 1859, “The beliefs which we have most warrant for, have no safeguard to rest on, but a standing invitation to the whole world to prove them unfounded.”

. . .

There is no secure method for avoiding error. Our point of departure is always just the ramshackle, error-filled totality of what we think we know. But uncertainty does not make knowledge worthless. If our theory is contradicted by experiment, this remains a real fact, solid as rock, even if we don’t yet know with clarity where our mistake lies. The fact that the assumptions in our reasoning can be mistaken doesn’t change the fact that scientific reasoning is our best cognitive tool.

For the full essay, see:

Carlo Rovelli. “The Best Reason to Trust Science.” The Wall Street Journal (Saturday, March 11, 2023): C5.

(Note: ellipses added.)

(Note: the online version of the essay has the date March 9, 2023, and has the same title as the print version.)

Rovelli’s essay quoted above is based on his book:

Rovelli, Carlo. Anaximander and the Birth of Science. New York: Riverhead Books, 2023 (2011).

Mill’s wonderful defense of freedom, mentioned above, is:

Mill, John Stuart. On Liberty and Other Essays, Oxford World’s Classics. New York: Oxford University Press, USA, 2008 (1859).