Health – Page 69 – artdiamondblog.com

Iowa State Students Go Bananas to Save (or Harm?) African Children

(p. A11) Student activists at Iowa State University are up in arms after researchers offered to pay them almost a thousand bucks to eat some genetically modified banana. The bananas, created by an Australian scientist, contain high levels of beta carotene, which converts to vitamin A when eaten.
. . .
“Those students are acting out of ignorance,” Jerome Kubiriba, the head of the National Banana Research Program in Uganda, tells me. “It’s one thing to read about malnutrition; it’s another to have a child who is constantly falling sick yet, due to limited resources, the child cannot get immediate and constant medical care. If they knew the truth about the need for vitamin A and other nutrients for children in Uganda and Africa, they’d get a change of heart.”

For the full commentary, see:
JULIE KELLY. “Anti-GMO Students Bruise a Superbanana.” The Wall Street Journal (Tues., March 15, 2016): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date March 14, 2016.)

Androgen Lengthens Telomeres

(p. A3) Androgens, a kind of sex hormone, have been used to treat certain genetic blood disorders for decades. But doctors haven’t been able to pinpoint exactly why they seem to help some patients. A small study puts forth a theory behind androgens’ disease-fighting mechanism: They help stabilize and even rebuild telomeres, which increasingly diminish in certain conditions and aging.
. . .
The authors of the study, published Wednesday [May 18, 2016] in the New England Journal of Medicine, treated telomere-disease patients who had a variety of conditions with a high dose of a synthetic androgen called danazol. The goal was to test whether the treatment would help keep telomeres intact longer. Instead, they saw them lengthen.
. . .
Experts, including the study’s authors, . . . warned against concluding danazol is a fountain of youth for the healthy, based on research that suggests that shrinking telomeres may be involved in aging.
“That,” said Dr. Agarwal, “would be purely in the realm of speculation.”

For the full story, see:
DANIELA HERNANDEZ. “How Sex Hormones Might Treat Some Diseases.” The Wall Street Journal (Thurs., May 19, 2016): A3.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the story has the date May 18, 2016, and has the title “How Sex Hormones Might Treat Certain Diseases.” The print version starts with a one-sentence summary paragraph that is absent in the online version. The second paragraph in the print version differs slightly from the first paragraph in the online version. The version quoted as the first paragraph above, is the first paragraph of the online version.)

The academic article mentioned above (though the date given by the NYT above appears to be a day too early), is:
Townsley, Danielle M., Bogdan Dumitriu, Delong Liu, Angélique Biancotto, Barbara Weinstein, Christina Chen, Nathan Hardy, Andrew D. Mihalek, Shilpa Lingala, Yun Ju Kim, Jianhua Yao, Elizabeth Jones, Bernadette R. Gochuico, Theo Heller, Colin O. Wu, Rodrigo T. Calado, Phillip Scheinberg, and Neal S. Young. “Danazol Treatment for Telomere Diseases.” New England Journal of Medicine 374, no. 20 (May 19, 2016): 1922-31.

Certificate-of-Need Regulations Protect Incumbents and Hurt Consumers

(p. A11) An important but overlooked debate is unfolding in several states: When governments restrict market forces in health care, who benefits? Legislative majorities in 36 states believe that consumers benefit, because restrictions help control health-care costs. But new research confirms what should be common sense: Preventing qualified health-care providers from freely plying their trade results in less access to care.
Most states enforce market restrictions through certificate-of-need programs, which mandate a lengthy, expensive application process before a health-care provider can open or expand a facility. The story goes: If hospitals or physicians could choose what services to provide, competition for patients would force providers to overinvest in equipment such as MRI machines–and the cost could be passed on to patients through higher medical bills.
. . .
These restrictions have largely failed to reduce costs, but they certainly reduce services. A 2011 study in the Journal of Health Care Finance found that certificate-of-need laws resulted in 48% fewer hospitals and 12% fewer hospital beds.

For the full commentary, see:
THOMAS STRATMANN and MATTHEW BAKER. “Certifiably Needless Health-Care Meddling.” The Wall Street Journal (Tues., Jan. 12, 2016): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date Jan. 11, 2016.)

The “new research” mentioned by Stratman in the passage quoted above, is:
Stratmann, Thomas, and Matthew C. Baker. “Are Certificate-of-Need Laws Barriers to Entry?: How They Affect Access to MRI, CT, and Pet Scans.” Mercatus Working Paper, Jan. 2016.

Denmark Drones Saving Lives

(p. B1) Mr. McLinden is a member of a group of middle-aged emergency workers taking part in a trial to jump-start the use of unmanned aircraft by Europe’s emergency services. The goal is to give the region a head start over the United States and elsewhere in using drones to tackle real-world emergencies.
The “drone school” builds on Europe’s worldwide lead in giving public groups and companies relatively free rein to experiment with unmanned aircraft. If everything goes as planned, the project’s backers hope government agencies in Europe and farther afield can piggyback on the experiences, helping to transform drones from recreational toys to lifesaving tools.
“For us, this technology is a game-changer,” said Mr. McLinden, who traveled to Copenhagen (p. B4) for a three-day training course with two colleagues from the Mid and West Wales Fire and Rescue Service. They will start offering 24/7 drone support — allowing colleagues, for example, to monitor accidents from 300 feet above — across central Wales later this month.
“Drones aren’t going to replace what we do,” Mr. McLinden added. “But anything that we can do to give our crews an advantage, that’s great.”
. . .
In a somewhat stuffy classroom at a disused fire station in Copenhagen, Thomas Sylvest gave advice to Mr. McLinden and others from his two years of flying. As Denmark’s first, and so far only, emergency service drone pilot, Mr. Sylvest has responded to things as varied as missing person cases and fires, often receiving calls late at night.
Mr. Sylvest, a fast-talking 50-year-old, offered tips on how best to share videos streamed directly from drones to commanders on the ground. During a recent fire in downtown Copenhagen, Mr. Sylvest said, he was able to beam high-definition images from high above, allowing his bosses to judge if a building’s walls would collapse (they did not). And when the police called him out last year after a man was reported missing, he flew his drone along a stretch of train tracks to guide colleagues on where best to look. (The man was found.)

For the full story, see:
MARK SCOTT. “Emergency Workers Turn to Drones to Save Lives.” The New York Times (Mon., JUNE 20, 2016): B1 & B4.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date JUNE 19, 2016, and has the title “Europe’s Emergency Workers Turn to Drones to Save Lives.”)

Crony Credentialism Is Regulatory Barrier to Telemedicine

(p. A11) Telemedicine has made exciting advances in recent years. Remote access to experts lets patients in stroke, neonatal and intensive-care units get better treatment at a lower cost than ever before. In rural communities, the technology improves timely access to care and reduces expensive medevac trips. Remote-monitoring technology lets patients with chronic conditions live at home rather than in an assisted-living facility.
Yet while telemedicine can connect a patient in rural Idaho with top specialists in New York, it often runs into a brick wall at state lines. Instead of welcoming the benefits of telemedicine, state governments and entrenched interests use licensing laws to make it difficult for out-of-state experts to offer remote care.
. . .
Using its power under the Commerce Clause of the Constitution, Congress could pass legislation to define where a physician practices medicine to be the location of the physician, rather than the location of the patient, as states currently do. Physicians would need only one license, that of their home state, and would work under its particular rules and regulations.
This would allow licensed physicians to treat patients in all 50 states. It would greatly expand access to quality medical care by freeing millions of patients to seek services from specialists around the country without the immense travel costs involved.

For the full commentary, see:

SHIRLEY SVORNY. “Telemedicine Runs Into Crony Doctoring; State medical-licensing barriers protect local MDs and deny patients access to remote-care physicians.” The Wall Street Journal (Sat., July 23, 2016): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date JUNE 22, 2016.)

World Health Organization Praises Coffee, Reversing 1991 Warning

(p. A9) An influential panel of experts convened by the World Health Organization concluded on Wednesday [JUNE 15, 2016] that regularly drinking coffee could protect against at least two types of cancer, a decision that followed decades of research pointing to the beverage’s many health benefits. The panel also said there was a lack of evidence that it might cause other types of cancer.
The announcement marked a rare reversal for the panel, which had previously described coffee as “possibly carcinogenic” in 1991 and linked it to bladder cancer. But since then a large body of research has portrayed coffee as a surprising elixir, finding lower rates of heart disease, Type 2 diabetes, neurological disorders and several cancers in those who drink it regularly.

For the full story, see:
ANAHAD O’CONNOR. “Coffee May Protect Against Cancer, W.H.O. Concludes, in Reversal of a 1991 Study.” The New York Times (Thurs., JUNE 16, 2016): A9.
(Note: bracketed date added.)
(Note: the online version of the commentary has the date JUNE 15, 2016, and has the title “Coffee May Protect Against Cancer, W.H.O. Concludes.”)

“Entrepreneurs Can Appear in the Most Unpromising Environments”

(p. A11) Adam Fifield’s entertaining biography of the little-recognized Grant shows that entrepreneurs can appear in the most unpromising environments–such as within the dysfunctional bureaucracy of the United Nations.
. . .
While top-down planning is usually misguided in aid (and most everywhere else), it turned out to be suitable for the particular challenge of vaccinations. Unfortunately, the aid establishment learned the wrong lessons from Grant’s career. Instead of seeing him as an entrepreneur who saw a very specific unrealized opportunity to spread vaccination and oral rehydration salts, they viewed his success as vindicating top-down planning in general.
. . .
Those who came after Grant . . . seem to have developed even more of the paternalistic savior complex than he had–his counterparts today are the likes of Bono, Jeffrey Sachs and Bill Gates. But the condescending image of a powerful white male as the savior of helpless nonwhite children is thankfully a lot less acceptable today than it was in Grant’s time. Since 2000 we have witnessed the mainly homegrown economic growth of low- and middle-income countries surpassing that of rich countries–plus many other positive long-term trends from democratization to the explosion of cellphones. Aid alone cannot explain these large triumphs in poor countries. There is still room for humanitarian entrepreneurs like Grant to find new breakthroughs, but we can appreciate much more today that the poor are their own best saviors.

For the full review, see:
WILLIAM EASTERLY. “BOOKSHELF; The Father of Millions; The Unicef breakthrough on vaccinations and oral rehydration salts is still cited today as one of the few successes in foreign aid.” The Wall Street Journal (Fri., Oct. 16, 2015): A11.
(Note: ellipses added.)
(Note: the online version of the review has the date Oct. 15, 2015.)

The book under review, is:
Fifield, Adam. A Mighty Purpose: How Jim Grant Sold the World on Saving Its Children. New York: Other Press, 2015.

Majerus Did Not Need a Randomized Trial to Know that Aspirin Prevents Heart Attacks

(p. A21) Philip W. Majerus, a biochemist who was credited as being the first to theorize that taking small doses of aspirin regularly can prevent heart attacks and strokes in vulnerable patients, died last Wednesday [June 8, 2016] at his home in St. Louis. . . .
. . .
Even before his findings were confirmed in a study by other researchers a decade later, Dr. Majerus was taking aspirin daily.
“I was already convinced that aspirin prevented heart attacks,” he recalled in the journal Advances in Biological Regulation in 2014. “I was unwilling to be randomized into a trial where I might end up with the placebo. I refused to participate.”
Dr. Majerus recommended that “all adults should take an aspirin daily unless they are among the few percent of the population that cannot tolerate the drug.” The cardiovascular benefit of aspirin was fully achieved by 50 to 75 milligrams daily, he said, and “there is no evidence that branded aspirin, which is much more expensive, is in any way superior to the generic version.”
Later studies found that for people in their 50s who are vulnerable to heart disease, taking daily doses of aspirin reduces the risk of heart disease.
. . .
Investigating how aspirin inhibited clotting, Dr. Majerus concluded that the medicine modified an enzyme that leads to the formation of a platelet-made molecule that constricts blood vessels and aggregates platelets. The pills’ effect lasts for the platelets’ life span, typically about two weeks.
“Phil Majerus, more than any other individual, has produced the most original body of work on biochemistry of platelets as it relates to thrombosis,” Prof. Joseph L. Goldstein, a Nobel laureate at the University of Texas Southwestern Medical Center in Dallas, said when the Bristol-Myers Squibb Award was announced.

For the full obituary, see:
SAM ROBERTS. “Dr. Philip Majerus, Who Recognized Heart Benefits of Aspirin, Is Dead at 79.” The New York Times (Weds., JUNE 15, 2016): A23.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the obituary has the date JUNE 14, 2016, and has the title “Dr. Philip Majerus, Who Discerned Aspirin’s Heart Benefits, Dies at 79.”)

Tribe Uses Autonomy to Fight American Dental Association (A.D.A.) Credentialism

(p. A10) Mr. Kennedy, 56, a soft-spoken Tlingit Native Alaskan, is a dental therapist, the rough equivalent of a physician assistant. He is trained to perform the most common procedures that dentists do, from fillings to extractions. Since January, when he started at the Swinomish Dental Clinic, over 50 miles north of Seattle, he has been the only dental therapist on tribal land anywhere in the lower 48 states. He studied in Alaska, which has the nation’s only program — patterned after one in New Zealand — aimed at training therapists specifically to work in underserved tribal areas.
Laws here in Washington and most other states bar dental therapists, who have long been opposed by the American Dental Association, so the tribe created its own licensing system. The federal Indian Health Service, which pays for medical care on Indian lands, cannot compensate therapists unless authorized by the state, so the Swinomish (pronounced SWIN-o-mish) needed private foundation support and meticulous accounting so that no law was violated.
“We had to take matters into our own hands,” said Brian Cladoosby, the chairman of the Swinomish Senate and president of the National Congress of American Indians. The breaking point came in 2015, after Washington’s Legislature — pressured by the dental lobby, Mr. Cladoosby said — declined for the fifth year in a row to pass a bill allowing a therapist program. Asserting tribal sovereignty, the tribe forged ahead anyway.
“The American Dental Association is no friend to American Indian tribes,” Mr. Cladoosby said in an interview.
. . .
(p. A11) Dr. Rachael R. Hogan, a dentist who works at the Swinomish Clinic, supervises Mr. Kennedy’s work. At first she did not think the arrangement would work. The A.D.A.’s safety concerns made sense, she said.
“I was leery,” she said. But after watching Mr. Kennedy for the past four months and visiting the training school in Alaska, she has changed her mind. By practicing procedures over and over — more than most dental school graduates, who must also study a broad range of diagnostic and disease issues — therapists can hone procedures, she said, to an art.
“Their fillings are better,” she said. “Are we providing substandard care by providing a therapist? Actually, I would say it’s the opposite.”

For the full story, see:
KIRK JOHNSON. “Asserting Tribal Sovereignty to Improve Indian’s Dental Care.” The New York Times (Mon., MAY 23, 2016): A10-A11.
(Note: ellipsis added.)
(Note: the online version of the story has the date MAY 22, 2016, and has the title “Where Dentists Are Scarce, American Indians Forge a Path to Better Care.”)

If Rapamycin Works in Humans as in Mice, We Gain 20 Years in Good Health

“Dr. Matt Kaeberlein, a biology of aging researcher, with his dog Dobby in North Bend, Wash. He helped fund a drug study using his own money.” Source of caption: p. A12 of print version of the NYT article quoted and cited below. Source of photo: online version of the NYT article quoted and cited below.

(p. A12) But scientists who champion the study of aging’s basic biology — they call it “geroscience” — say their field has received short shrift from the biomedical establishment. And it was not lost on the University of Washington researchers that exposing dog lovers to the idea that aging could be delayed might generate popular support in addition to new data.
“Many of us in the biology of aging field feel like it is underfunded relative to the potential impact on human health this could have,” said Dr. Kaeberlein, who helped pay for the study with funds he received from the university for turning down a competing job offer. “If the average pet owner sees there’s a way to significantly delay aging in their pet, maybe it will begin to impact policy decisions.”
The idea that resources might be better spent trying to delay aging rather than to cure diseases flies in the face of most disease-related philanthropy and the Obama administration’s proposal to spend $1 billion on a “cancer moonshot.” And many scientists say it is still too unproven to merit more investment.
The National Institutes of Health has long been organized around particular diseases, including the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases. There is the National Institute on Aging, but about a third of its budget last year was directed exclusively to research on Alzheimer’s disease, and its Division of Aging Biology represents a tiny fraction of the N.I.H.’s $30 billion annual budget. That is, in part, because the field is in its infancy, said the N.I.H. director, Dr. Francis Collins.
. . .
“The squirrels in my neighborhood have a 25-year life span, but they look like rats that live two years,” said Gary Ruvkun, a pioneer in aging biology at Harvard Medical School. “If you look at what nature has selected for and allowed, it suggests that you might be able to get your hands on the various levers that change things.”
. . .
Over 1,500 dog owners applied to participate in the trial of rapamycin, which has its roots in a series of studies in mice, the first of which was published in 2009. Made by a type of soil bacterium, rapamycin has extended the life spans of yeast, flies and worms by about 25 percent.
But in what proved a fortuitous accident, the researchers who set out to test it in mice had trouble formulating it for easy consumption. As a result, the mice were 20 months old — the equivalent of about 60 human years — when the trial began. That the longest-lived mice survived about 12 percent longer than the control groups was the first indication that the drug could be given later in life and still be effective.
Dr. Kaeberlein said he had since achieved similar benefits by giving 20-month-old mice the drug for only three months. (The National Institute on Aging rejected his request for funding to further test that treatment.) Younger mice, given higher doses, have lived about 25 percent longer than those not given the drug, and mice of varying ages and genetic backgrounds have been slower to develop some cancers, kidney disease, obesity and symptoms of Alzheimer’s disease. In one study, their hearts functioned better for longer.
“If you do the extrapolation for people, we’re probably talking a couple of decades, with the expectation that those years are going to be spent in relatively good health,” Dr. Kaeberlein said.
. . .
. . . what dog lovers have long considered the sad fact that their pets age about seven times as fast as they do, Dr. Kaeberlein knew, would be a boon for a study of rapamycin that would have implications for both species. An owner of two dogs himself, he was determined to scrounge up the money for the pilot phase of what he and Dr. Promislow called the Dog Aging Project.
Last month, he reported at a scientific meeting that no significant side effects had been observed in the dogs, even at the highest of three doses. And compared with the hearts of dogs in the control group, the hearts of those taking the drug pumped blood more efficiently at the end. The researchers would like to enroll 450 dogs for a more comprehensive five-year study, but do not yet have the money.
Even if the study provided positive results on all fronts, a human trial would carry risks.
Dr. Kaeberlein, for one, said they would be worth it.
“I would argue we should be willing to tolerate some level of risk if the payoff is 20 to 30 percent increase in healthy longevity,” he said. “If we don’t do anything, we know what the outcome is going to be. You’re going to get sick, and you’re going to die.”

For the full story, see:
AMY HARMON. “CHASING IMMORTALITY; Dogs Test Drug Aimed at Humans’ Biggest Killer: Age.” The New York Times (Tues., MAY 17, 2016): A1 & A12.
(Note: ellipses added.)
(Note: the online version of the story has the date MAY 16, 2016, and has the title “CHASING IMMORTALITY; Dogs Test Drug Aimed at Slowing Aging Process.”)

An academic paper that discusses the wide variability in life span of different species in the order Rodentia (which includes short-lived rats and long-lived squirrels), is:
Gorbunova, Vera, Michael J. Bozzella, and Andrei Seluanov. “Rodents for Comparative Aging Studies: From Mice to Beavers.” Age 30, no. 2-3 (June 25, 2008): 111-19.

Technology Can Restore Hand Control to Quadriplegic

(p. A1) Five years ago, a college freshman named Ian Burkhart dived into a wave at a beach off the Outer Banks in North Carolina and, in a freakish accident, broke his neck on the sandy floor, permanently losing the feeling in his hands and legs.
On Wednesday [April 13, 2016], doctors reported that Mr. Burkhart, 24, had regained control over his right hand and fingers, using technology that transmits his thoughts directly to his hand muscles and bypasses his spinal injury. The doctors’ study, published by the journal Nature, is the first account of limb reanimation, as it is known, in a person with quadriplegia.
Doctors implanted a chip in Mr. Burkhart’s brain two years ago. Seated in a lab with the implant connected through a computer to a sleeve on his arm, he was able to learn by repetition and arduous practice to focus his thoughts to make his hand pour from a bottle, and to pick up a straw and stir. He was even able to play a guitar video game.
. . .
“Watching him close his hand for the first time — I mean, it was a surreal moment,” Dr. Rezai said. “We all just looked at each other and thought, ‘O.K., the work is just starting.'”
After a year of training, Mr. Burkhart was able to pick up a bottle and pour the contents into a jar, and to pick up a straw and stir. The doctors, though delighted, said that more advances would be necessary to make the bypass system practical, affordable and less invasive, most likely through wireless technology. But the improvement was significant enough, at least in the lab, that rehabilitation specialists could reclassify Mr. Burkhart’s disability from a severe C5 function to a less severe C7 designation.
For now, the funding for the project, which includes money from Ohio State, Battelle and private donors, is set to run out this year — and with it, Mr. Burkhart’s experience of restored movement.
“That’s going to be difficult, because I’ve enjoyed it so much,” Mr. Burkhart said. “If I could take the thing home, it would give me so much more independence. Now, I’ve got to rely on someone else for so many things, like getting dressed, brushing my teeth — all that. I just want other people to hear about this and know that there’s hope. Something will come around that makes living with this injury better.”

For the full story, see:
BENEDICT CAREY. “Quadriplegic Gets Use of Hand from Chip Placed in His Brain.” The New York Times (Thurs., APRIL 14, 2016): A1 & A16.
(Note: ellipsis, and bracketed date, added.)
(Note: the online version of the story has the date APRIL 13, 2016, and has the title “Chip, Implanted in Brain, Helps Paralyzed Man Regain Control of Hand.”)

The scientific article in Nature reporting the advance, is:
Bouton, Chad E., Ammar Shaikhouni, Nicholas V. Annetta, Marcia A. Bockbrader, David A. Friedenberg, Dylan M. Nielson, Gaurav Sharma, Per B. Sederberg, Bradley C. Glenn, W. Jerry Mysiw, Austin G. Morgan, Milind Deogaonkar, and Ali R. Rezai. “Restoring Cortical Control of Functional Movement in a Human with Quadriplegia.” Nature 533, no. 7602 (May 12, 2016): 247-50.