Category: Health

In Africa Lions “Are Objects of Terror”

(p. A17) Winston-Salem, N.C. — MY mind was absorbed by the biochemistry of gene editing when the text messages and Facebook posts distracted me.
So sorry about Cecil.
Did Cecil live near your place in Zimbabwe?
Cecil who? I wondered. When I turned on the news and discovered that the messages were about a lion killed by an American dentist, the village boy inside me instinctively cheered: One lion fewer to menace families like mine.
My excitement was doused when I realized that the lion killer was being painted as the villain. I faced the starkest cultural contradiction I’d experienced during my five years studying in the United States.
Did all those Americans signing petitions understand that lions actually kill people? That all the talk about Cecil being “beloved” or a “local favorite” was media hype? Did Jimmy Kimmel choke up because Cecil was murdered or because he confused him with Simba from “The Lion King”?
In my village in Zimbabwe, surrounded by wildlife conservation areas, no lion has ever been beloved, or granted an affectionate nickname. They are objects of terror.
. . .
We Zimbabweans are left shaking our heads, wondering why Americans care more about African animals than about African people.
. . .
. . . please, don’t offer me condolences about Cecil unless you’re also willing to offer me condolences for villagers killed or left hungry by his brethren, by political violence, or by hunger.

For the full commentary, see:
GOODWELL NZOU. “In Zimbabwe, We Don’t Cry for Lions.” The New York Times (Weds., AUG. 5, 2015): A17.
(Note: ellipses added.)
(Note: the online version of the commentary has the date AUG. 4, 2015,)

Breakthrough Surgeon “Defied Skepticism”

(p. D8) Dr. Johnson was a reluctant surgeon — early on, he once recalled, “I disliked surgeons and their pompous attitudes” — but he applied the crocheting skills he had learned from his mother, who was a home economics teacher, and the needlecraft he was taught in a seventh-grade sewing class (he got an A), to perform more than 8,500 heart bypass operations over four decades.
. . .
Doctors had experimented with coronary artery surgery since the 1950s, the goal being to remove accumulated plaque caused by cholesterol deposits, which can block blood flow and cause the stabbing pain of angina. One method was to remove the clogged portion of an artery and graft on a replacement patch of cardiac membrane or a segment of vein from a leg.
In 1968, Dr. Johnson and his team took another path, sewing segments of veins from multiple arteries end to end and stitching them directly into the aorta, the body’s main artery, bypassing cardiac ducts where the flow of blood was impeded.
His breakthrough, reported the next year, defied skepticism within the medical profession and heralded a new era of successful double, triple and quadruple bypass surgeries.
“It was perhaps the presentation of Johnson in the spring of 1969 that had the greatest impact on the widespread use” of coronary artery bypass grafting, Dr. Eugene A. Hessel II wrote in “Cardiac Anesthesia: Principles and Clinical Practice,” published in 2001.
To facilitate surgery, Dr. Johnson made another breakthrough by temporarily stopping the heart and slowing the body’s metabolism by cooling and circulating the blood through a heart-lung machine.
. . .
Dr. Johnson’s multiple bypass surgeries, which could take as long as nine hours and were often accompanied by classical music in the operating room, were credited with saving an untold number of lives.
But in an interview with Dr. William S. Stoney for “Pioneers of Cardiac Surgery” (2008), Dr. Johnson said “the single biggest thing I ever did to lower mortality” was to prescribe the drug allopurinol, which is ordinarily used to inhibit the production of uric acid (high levels of it can cause gout), but which has also been found to improve survival in cardiac patients by improving their capacity for exercise.
. . .
“The coronary artery bypass graft operation does nothing for the basic cause of the disease,” Dr. Johnson said, adding, “Prevention is, of course, the ultimate answer.”

For the full obituary, see:
SAM ROBERTS. “W. Dudley Johnson, Heart Bypass Pioneer, Dies at 86.” The New York Times (Mon., OCT. 31, 2016): D8.
(Note: ellipses added.)
(Note: the online version of the obituary has the date OCT. 30, 2016, and has the title “W. Dudley Johnson, Heart Bypass Surgery Pioneer, Dies at 86.”)

Stoney’s book mentioned above, is:
Stoney, William S. Pioneers of Cardiac Surgery. Nashville: Vanderbilt University Press, 2008.

Those Who See, and Fill, Big Unmet Needs Are Often “Weirdos”

(p. A11) . . . “A Truck Full of Money” provides a portrait of a strange, troubled man who happens to be one of the smartest minds in the Route 128 tech corridor.
. . .
The book is being marketed as inspirational, but I found it to be the opposite. No one could read it and become Paul English, or want to. Most tech startups think too small, but the few people with the vision to identify big unmet needs seem to be, for whatever reason, weirdos. The split-second fare comparison that Kayak did is something no human being could do–it requires super-computing–and it has an enormous value, since 8% of the U.S. economy is travel. But once you’ve solved a problem like that, what do you do next?
Paul English hasn’t figured that out, so this book sort of peters out–he may do his once-in-a-lifetime charity project, or he may follow through on Blade–and he has retreated back into the familiar, running a company called Lola that is sort of the opposite of Kayak: It gives you live access to travel concierges. But how could Mr. Kidder’s ending be anything but inconclusive? Mr. English is just 53. Undoubtedly he has another billion-dollar idea nestled in that overactive brainpan, but his investors have to make a leap of faith–that they’ve bet on the right weirdo. God bless these genius geeks, who make our economy leaner by constantly finding more efficient ways to do old things. And God bless the pharmaceutical industry, which protects and preserves them.​

For the full review, see:
JOHN BLOOM. “BOOKSHELF; The Man Who Built Kayak; During one episode of hypomania, Paul English bid $500,000 on an abandoned lighthouse. Recently, he decided to become an Uber driver.” The Wall Street Journal (Thurs., Sept. 27, 2016): A11.
(Note: ellipses added.)
(Note: the online version of the review has the date Sept. 26, 2016.)

The book under review, is:
Kidder, Tracy. A Truck Full of Money: One Man’s Quest to Recover from Great Success. New York: Random House, 2016.

“My Fate Lies with Me, Not with Heaven”

(p. A7) . . . Dr. Unschuld, who is as blunt as he is outspoken, stands at the center of a long and contentious debate in the West over Chinese medicine. For many, it is the ur-alternative to what they see as the industrialized and chemicalized medicine that dominates in the West. For others, it is little more than charlatanism, with its successes attributed to the placebo effect and the odd folk remedy.
Dr. Unschuld is a challenge to both ways of thinking. He has just finished a 28-year English translation of the three principal parts of the foundational work of Chinese medicine: the Huangdi Neijing, or Yellow Emperor’s Inner Classic, published by the University of California Press. But unlike many of the textbooks used in Chinese medicine schools in the West, Dr. Unschuld’s works are monuments to the art of serious translation; he avoids New Age jargon like “energy” or familiar Western medical terms like “pathogens,” seeing both as unfair to the ancient writers and their worldviews.
But this reflects a deep respect for the ancient authors the detractors of Chinese medicine sometimes lack. Dr. Unschuld hunts down obscure terms and devises consistent terminologies that are sometimes not easy to read, but are faithful to the original text. Almost universally, his translations are regarded as trailblazing — making available, for the first time in a Western language, the complete foundational works of Chinese medicine from up to 2,000 years ago.
. . .
. . . then there is the issue of efficacy. With his extremely dry humor, Dr. Unschuld likens Chinese medicine to the herbal formulas of the medieval Christian mystic Hildegard von Bingen. If people want to try it, they should be free to do so, he said, but not at taxpayer expense. As for himself, Dr. Unschuld says he has never tried Chinese medicine.
. . .
His purely academic approach, . . . , makes him a difficult figure for China to embrace. While widely respected for his knowledge and translations, he has done little to advance the government’s agenda of promoting Chinese medicine as soft power. Echoing other critics, he describes China’s translations of the classics as “complete swindles,” saying they are done with little care and only a political goal in mind.
For Dr. Unschuld, Chinese medicine is far more interesting as an allegory for China’s mental state. His most famous book is a history of Chinese medical ideas, in which he sees classic figures, such as the Yellow Emperor, as a reflection of the Chinese people’s deep-seated pragmatism. At a time when demons and ghosts were blamed for illness, these Chinese works from 2,000 years ago ascribed it to behavior or disease that could be corrected or cured.
“It is a metaphor for enlightenment,” he says.
Especially striking, Dr. Unschuld says, is that the Chinese approach puts responsibility on the individual, as reflected in the statement “wo ming zai wo, bu zai tian” — “my fate lies with me, not with heaven.” This mentality was reflected on a national level in the 19th and 20th centuries, when China was being attacked by outsiders. The Chinese largely blamed themselves and sought concrete answers by studying foreign ideas, industrializing and building a modern economy.

For the full story, see:
IAN JOHNSON. “The Saturday Profile; An Expert on Chinese Medicine, but No New Age Healer.” The New York Times (Sat., SEPT. 24, 2016): A7.
(Note: ellipsis added.)
(Note: the online version of the story has the date SEPT. 23, 2016, and has the title “Gandhi the Imperialist – Book Review.”)

The recently finished book mentioned above, is:
Unschuld, Paul U. Huang Di Nei Jing Ling Shu: The Ancient Classic on Needle Therapy. Oakland, CA: University of California Press, 2016.

Working Longer May Result in Longer Life

(p. D1) Retiring after age 65 may help people live longer, says a study published online in the Journal of Epidemiology & Community Health. The risk of dying from any cause over the study period was 11% lower among people who delayed retirement for one year–until age 66–and fell further among people who retired between the ages of 66 and 72, the study found.
Even workers who retired for health reasons had a lower risk of dying, compared with those leaving work at 65.
The benefits of remaining in the workforce occurred irrespective of gender, lifestyle, education, income and occupation, the analysis showed.
Postponing retirement may delay the natural age-related decline in physical, cognitive and mental functioning, reducing the risk of chronic illness, the study suggests.

For the full story, see:
ANN LUKITS. “RESEARCH REPORT; Retiring After 65 May Extend Life.” The Wall Street Journal (Tues., May 3, 2016): D1.
(Note: the online version of the story has the date May 2, 2016, and has the title “RESEARCH REPORT; Retiring After 65 May Help People Live Longer.”)

Wu, Chenkai, Michelle C. Odden, Gwenith G. Fisher, and Robert S. Stawski. “Association of Retirement Age with Mortality: A Population-Based Longitudinal Study among Older Adults in the USA.” Journal of Epidemiology and Community Health 70, no. 9 (Sept. 2016): 917-23.

Toy Car Gives Child with Cerebral Palsy Mobility and Control

HauschildMadelineDrivingModifiedToyCar2016-09-11.jpg“Madeline Hauschild, 3, is thrilled to be at the wheel of her modified toy car at the UNMC Student Life Center on Wednesday [August 10, 2016]. Cars such as Madeline’s enable children with little mobility to get around without feeling reliant on parents or siblings.” Source of caption and photo: online version of the Omaha World-Herald article quoted and cited below.

(p. 1B) Now Madeline Hauschild will be able to drive a toy car just like her brother.

On Wednesday [August 10, 2016] Madeline, 3, received a battery-operated toy car modified so that she could sit in it and make it go forward by pushing a large button on the steering wheel. Madeline, who has cerebral palsy, was one of six small children who received cars through a program overseen by the University of Nebraska Medical Center and Children’s Hospital & Medical Center.
. . .
The cars give children with little mobility the opportunity to play, explore and socialize rather than feeling stuck and dependent on parents or siblings to move them around.
. . .
(p. 5B) Cerebral palsy is a disorder that causes movement, posture and other developmental problems. Among Madeline’s challenges: She can’t walk or bear any weight on her legs.
Madeline, of Syracuse, Nebraska, smiled and pounded the button, giving her a herky-jerky ride.
. . .
“Is that fun?” Madeline’s mother, Kelly Hauschild, asked as her daughter enjoyed the erratic drive in a room at UNMC’s Student Life Center. “You do like it, don’t you?”
. . .
“I loved seeing her be able to operate it all by herself, and her smiles,” Hauschild said.

For the full story, see:
Ruggles, Rick. “Toy Cars Give Kids Vroom to Maneuver.” Omaha World-Herald (Thurs., Aug. 11, 2016): 1B & 5B.
(Note: ellipses, and bracketed date, added.)

Cancer 1.7 Million Years Ago in Human Ancestor

(p. D3) Carcinogens abounded 1.7 million years ago in Early Pleistocene times when a nameless protohuman wandered the South African countryside in what came to be known as the Cradle of Humankind.
Then, as now, ultraviolet radiation poured from the sun, and radon seeped from granite in the ground. Viruses like ones circulating today scrambled DNA. And there were the body’s own carcinogens, hormones that switch on at certain times of life, accelerating the multiplication of cells and increasing the likelihood of mutations.
That, rather than some external poison, was probably the cause of a bone tumor diagnosed as an osteosarcoma found fossilized in Swartkrans Cave, a paleoanthropological trove northwest of Johannesburg. A paper in the current South African Journal of Science describes the discovery, concluding that it is the oldest known case of cancer in an early human ancestor.
. . .
The seemingly small number of malignant tumors reported by anthropologists is probably an illusion. The only cancers that can be found in long-decomposed remains are those that originated in the skeleton or somehow left a mark there. They include cancers that spread from other organs or, like myeloma, could scar the skeleton in other ways. For most ancient cancers, the evidence rots away. Mummified bodies are rare, but here, too, an occasional cancer has been found.

For the full story, see:
Johnson, George. “RAW DATA; After 1.7 Million Years, a Bone Cancer Diagnosis.” The New York Times (Tues., AUG. 23, 2016): D3.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date AUG. 22, 2016, and has the title “RAW DATA; The Known: Cancer Is Really, Really Old. The Unknown: How Common It Was.”)

The academic article mentioned in the passage quoted above, is:
Edward, J. Odes, S. Randolph-Quinney Patrick, Steyn Maryna, Throckmorton Zach, S. Smilg Jacqueline, Zipfel Bernhard, Augustine Tanya, Beer Frikkie De, W. Hoffman Jakobus, D. Franklin Ryan, and R. Berger Lee. “Earliest Hominin Cancer: 1.7-Million-Year-Old Osteosarcoma from Swartkrans Cave, South Africa.” South African Journal of Science 112, no. 7/8 (July/Aug. 2016): 1-5.

“Giving Peas a Chance”

(p. C1) Thank heavens Gregor Mendel was a lousy priest. Had he shown even the faintest aptitude for oratory or ministering to the poor, he might never have determined the basic laws of heredity. But bumbling he was, and he made a rotten university student to boot; his failures drove him straight to his room, where he bred mice in secret. The experiment scandalized his superiors.
“A monk coaxing mice to (p. C4) mate to understand heredity was a little too risqué, even for the Augustinians,” writes Siddhartha Mukherjee in “The Gene: An Intimate History.” So Mendel switched — auspiciously, historically — to pea plants. The abbot in charge, writes the author, acquiesced this time, “giving peas a chance.”
Love Dr. Mukherjee, love his puns. They’re everywhere. I warn you now.
. . .
Many of the same qualities that made “The Emperor of All Maladies” so pleasurable are in full bloom in “The Gene.” The book is compassionate, tautly synthesized, packed with unfamiliar details about familiar people.
. . .
But there are also crucial differences. Cancer is the troll that scratches and thumps beneath the floorboards of our consciousness, if it hasn’t already beaten its way into the room. The subject immediately commands our attention; it’s almost impossible to deny, and not to hear, the emotional clang of its appeal. In Dr. Mukherjee’s skilled hands, the story of this frightening disease became a page-turner. He explained its history, politics and cunning biological underpinnings; he traced the evolving and often gruesome logic underlying cancer treatment.
And in the middle of it all, agonizing over treatment protocols and watching his patients struggle with tremendous existential and physical pain, was the author himself.
There are far fewer psychological stakes in reading about the history of genetics. “The Gene” is more pedagogical than dramatic; as often as not, the stars of this story are molecules, not humans.
. . .
But any book about the history of something as elemental and miraculous as the gene is bound, at least indirectly, to tell the story of innovation itself. “The Gene” is filled with scientists who dreamed in breathtakingly lateral leaps.
Erwin Schrödinger in particular was one visionary cat: In 1944, he hazarded a guess about the molecular nature of the gene and decided it had to be a strand of code scribbled along the chromosome — which pretty much sums up the essence of DNA.

For the full review, see:
JENNIFER SENIOR. “Books of The Times; In Molecular Pursuit of the Genetic Code.” The New York Times (Mon., MAY 9, 2016): C1 & C4.
(Note: ellipses added.)
(Note: the online version of the review has the date MAY 8, 2016, and has the title “Books of The Times; Review: Siddhartha Mukherjee’s ‘The Gene,’ a Molecular Pursuit of the Self.”)

The book under review, is:
Mukherjee, Siddhartha. The Gene: An Intimate History. New York: Scribner, 2016.

Presence of Biomarkers Predicts Whether Checkpoint Inhibitor Works

(p. D1) A collaboration between an immunologist helping his stepmother fight cancer and the oncologist who treated her led to a discovery that could help many more patients benefit from a transformative new therapy.
A new class of drugs called checkpoint inhibitors works by releasing a molecular brake that stops the immune system from attacking tumors. So-called immunotherapy has been approved for several types of cancers and found to extend lives of patients with advanced disease for many years. The problem is that for most patients immunotherapy doesn’t work.
The researchers, from University of California, San Francisco, said they identified a unique type of immune-system cell that “robustly” predicts whether patients will respond to one of the medicines–an achievement has the potential to significantly expand the number of cancer patients who benefit from checkpoint inhibitors.
The new discovery is based on a high-tech analysis of melanoma tissue from 40 patients treated with a checkpoint inhibitor from Merck & Co. called Keytruda, which targets an immune-system brake called PD-1. Although researchers say it will take further research to determine its value in treating patients, the finding offers fresh insight into the complex relationship between the immune system and tumor cells.
. . .
(p. D3) The researchers analyzed results of a study involving Keytruda before it was approved. They looked at the CD8 cells that had infiltrated the melanoma tumors of 20 patients treated with the drug and found that if at least 30% of those cells were marked by PD-1 and CTLA-4, the patient responded to treatment. When fewer than 20% of the infiltrated cells had those markers, not one patient responded.

For the full story, see:
RON WINSLOW. “Road to a Cancer Advance.” The Wall Street Journal (Tues., Aug. 16, 2016): D1 & D3.
(Note: ellipsis added.)
(Note: the online version of the story has the date Aug. 15, 2016, and has the title “Chance Collaboration Yields an Advance in Cancer Treatment.”)

Lack of Control at Job Causes Stress, Leading to Cardiovascular Disease

(p. 6) Allostasis is not about preserving constancy; it is about calibrating the body’s functions in response to external as well as internal conditions. The body doesn’t so much defend a particular set point as allow it to fluctuate in response to changing demands, including those of one’s social circumstances. Allostasis is, in that sense, a politically sophisticated theory of human physiology. Indeed, because of its sensitivity to social circumstances, allostasis is in many ways better than homeostasis for explaining modern chronic diseases.
Consider hypertension. Seventy million adults in the United States have it. For more than 90 percent of them, we don’t know the cause. However, we do have some clues. Hypertension disproportionately affects blacks, especially in poor communities.
. . .
Peter Sterling, a neurobiologist and a proponent of allostasis, has written that hypertension in these communities is a normal response to “chronic arousal” (or stress).
. . .
Allostasis is attractive because it puts psychosocial factors front and center in how we think about health problems. In one of his papers, Dr. Sterling talks about how, while canvassing in poor neighborhoods in Cleveland in the 1960s, he would frequently come across black men with limps and drooping faces, results of stroke. He was shocked, but today it is well established that poverty and racism are associated with stroke and poor cardiovascular health.
These associations also hold true in white communities. One example comes from the Whitehall study of almost 30,000 Civil Service workers in Britain over the past several decades. Mortality and poor health were found to increase stepwise from the highest to the lowest levels in the occupational hierarchy: Messengers and porters, for example, had nearly twice the death rate of administrators, even after accounting for differences in smoking and alcohol consumption. Researchers concluded that stress — from financial instability, time pressures or a general lack of job control — was driving much of the difference in survival.

For the full commentary, see:
SANDEEP JAUHAR. “When Blood Pressure Is Political.” The New York Times, SundayReview Section (Sun., AUG. 7, 2016): 6.
(Note: ellipses added.)
(Note: the online version of the review has the date AUG. 6, 2016.)

The commentary quoted above is distantly related to Jauhar’s book:
Jauhar, Sandeep. Doctored: The Disillusionment of an American Physician. New York: Farrar, Straus and Giroux, 2014.

Greenland Shark Likely to Have Lived to at Least 272 Years Old

(p. A11) The mysterious Greenland shark lives at extreme depths in dark, icy waters, which have long protected it from scientists’ prying eyes.
But now, an international group of researchers has estimated the dark brown cartilaginous fish may live as long as 500 years–which would make it the longest-living vertebrate on the planet.
The work, published Thursday [Aug. 11, 2016] in the journal Science, “offers the first hard evidence of how long-lived this poorly understood shark species can be,” said Steve Campana, a shark expert at the University of Iceland in Reykjavik, who wasn’t involved in the study.
. . .
. . . the 11-person team of researchers turned to math models and radiocarbon dating, a technique typically used to date fossils. They focused their work on the eye lens nucleus of each shark, a structure that stops developing at birth and therefore serves as a rough proxy of birth date. They measured the levels of carbon-14 in the tissue, which animals stop accumulating when they die.
The oldest shark in the study, which measured more than 16 feet, lived an estimated 392 years, according to the scientists. Because the study had a margin of error of 120 years for that fish, the researchers concluded the sharks could live up to about 500 years.

For the full story, see:
DANIELA HERNANDEZ. “Enigmatic Shark Can Live for Centuries, Study Says.” The Wall Street Journal (Fri., Aug. 12, 2016): A12.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the story has the date Aug. 11, 2016, and has the title “Mysterious Greenland Shark May Live Hundreds of Years, Scientists Say.” The online version included several additional sentences, interspersed through the article, that were not included in the print version. The sentences quoted above, appeared in both versions, but the formatting of the quotes above, most closely follow the print version.)

The research article reporting findings discussed above, is:
Nielsen, Julius, Rasmus B. Hedeholm, Jan Heinemeier, Peter G. Bushnell, Jørgen S. Christiansen, Jesper Olsen, Christopher Bronk Ramsey, Richard W. Brill, Malene Simon, Kirstine F. Steffensen, and John F. Steffensen. “Eye Lens Radiocarbon Reveals Centuries of Longevity in the Greenland Shark (Somniosus microcephalus).” Science 353, no. 6300 (Aug. 12, 2016): 702-04.