Archive for category Medicine

No More Anti-rejection Drugs?

Posted by on Tuesday, 14 January, 2014

 

Cartoon about anti-rejection drugs

THE END OF ORGAN REJECTION DRUGS?

ORGAN TRANSPLANTS – A BIG STEP FORWARD

A diseased lung, a diseased liver –  even a mangled finger –   can be replaced with one from a donor assuming you can find someone to do the donor-ing.

It isn’t as simple as it sounds. (Does it sound simple?).

First of all, to get a  donor organ you  have to be “lucky” . Unless you have a near relative who is willing to donate  (giving up a heart isn’t allowed) you may have to go “on the list”. Some of those lists stretch to the moon.  The criteria for selection can be stiff. Not sick enough won’t work. Too sick might not work either – not if you’re a bad risk.  And if you do get a transplant your immune system might attack the donated organ. Only matches that are very close are likely to get along well with your immune system and if your body does reject the organ, the entire effort will have been a total waste and you may even be worse off than when you started.

To keep this from happening, doctors give patients anti-rejection drugs. Those drugs are taken forever. Until the patient dies. And, you know what? They aren’t cheap and  they  have side effects – some so bad that you wonder “What was I thinking?”

If you mess up and forget to take your anti-rejection drugs?

That’s bad too.  You could – let’s be honest, okay? – you could die or, at least, be real sick. And you could reject the organ.

That’s the destiny of many recipients of a transplant- a lifetime of drugs that are often hard to tolerate.

BREAKTHROUGH

My news is good.

Two doctors at MGH (Mass General Hospital), James F. Markmann and Tatsuo Kawai, did a small study (Science Translational Medicine but referenced here in Bioscience and Technology) .  For many of their patients they had donor organs that weren’t such a good match. So they did the transplants and followed up not with anti-rejection drugs but with stem cell transplants from the donors.

It worked!

MISTER ScienceAintSoBad wishes he he could adequately express his enormous joy at this fantastic research. I would write an ode if I knew how.

It is still a work in progress even though another group had similar success. More tests have to be done before this can be considered “standard of care” or even be introduced into the clinic. But if it sounds exciting, that’s because it is exciting.

ScienceAintSoBadRating = 10 well deserved points.

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The drawing is mine.

Click “comments” (just under the headline for this article) to leave a comment.


Unnecessary Surgery For President Bush?

Posted by on Saturday, 11 January, 2014

 

Cartoon about G W Bush

MYSTERY SURROUNDING THE HEART OF G W BUSH

 

MISTAKEN SURGERY FOR GEORGE BUSH

President George W Bush recently got a stent for his heart.

Were it not for his great healthcare, he wouldn’t have.

He didn’t have pain or shortness of breath. No symptoms. No nothing. But those (few) of us who are former presidents have exemplary health care. Evidently, one of President Bush’s exemplary set of physicians said “Uh oh, Mister Former President, I don’t like the way that artery looks.”  One thing led to another and, before you knew it, the former President of the United States was  recovering from heart surgery.

Here’s the thing. The British Medical Journal isn’t sold on this.

Who asked them? I can not say. But their take is that this stenting was too aggressive and was unjustified by the data. Even if his arteries were a lot worse, they say, there’s no data to support such aggressive surgery with the attendant risk to former presidents and such.

“No data” isn’t the science equivalent of “expletive deleted” but it’s close. Modern medicine is supposed to adhere fairly close to the evidence.  Dr. Aseem Malhortra (Royal Free Hospital in London) was the author of the article.

MISTER ScienceAintSoBad loves the concern of the British Medical Journal. To be honest? I didn’t think anyone over there in England cared much whether GW Bush leads a long and happy life or not. He wasn’t too popular over there when he was in charge here.  Anway, Dr. Malhortra’s point has merit, I suppose, but I would say that doctoring is about striking the right balance. Evidence is a good guide. But it shouldn’t handcuff. There’s still room  for judgement from those on the other end of the scalpel I hope.

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The drawing is mine.

Please leave comments by clicking “comments” just to the right under the headline for this article.


BRAIN SURGERY THAT HURTS!!

Posted by on Saturday, 4 January, 2014
Cartoon about a dumb teenager

BRAIN SURGERY

 

SOMETIMES A HOLE HELPS

It wasn’t as good as modern medicine but, at least you could get an appointment. The ancient Peruvians healers cured by drilling a hole in the head with a hand drill. It’s called trepanation. 

Danielle Kurin (UC Santa Barbara) was the lead researcher. Her team looked at Peruvian skulls from a 250 year period beginning in 1000 AD. She looked at skulls that had holes in them – holes that had  been made  by someone on purpose. Old time surgery.

Is it crazy to drill a hole in a guy’s head with a hand tool? Especially when you don’t have any of the modern stuff to prevent infection? When you don’t have anything to put the guy out, or control the bleeding? And when  knowledge of anatomy and physiology is iffy?

Of course it is.

But if you are a Peruvian shaman, you follow tradition.This is what you do.  An ancient Peruvian with a serious head injury and a subdural haematoma – a bleed inside the head – would have had a good chance of dying unless the pressure  was  somehow relieved.

Here’s the thing.

If the head was whacked hard enough, you can probably skip the anesthesia anyway. And, even though infection’s a bad thing, the ancients had their tricks. Honey, for example.

For a bad head injury, what the Peruvian healers were doing was reasonable. Kurin’s team saw skulls where the holes had healed. “They must have gotten better,” she said. because “both the original wound and the trepanation healed”.

MISTER ScienceAintSoBad can’t say he likes this approach  for the spiritual or psychosomatic illness cases which Kurin says were also treated in that way. But what do I know? Am I a shaman? 

We’re lucky. We live in a time when so much is possible.

It’s great to see how we got here.

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The drawing is mine.

The article appears in the American Journal of Physical Anthropology.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

 

 


Are Doctors Nice Enough?

Posted by on Tuesday, 31 December, 2013
Funny cartoon about a "caring" doctor.

BEST NOT TO OVER DO IT

 

WHY are doctors so arrogant and uncaring !!!

“They just speak to you about your symptoms for 5 seconds then prescribe you medication for the wrong diagnosis without first checking you out!!! I’M SICK OF THEM, then they complain that you’re a hypochondriac because they weren’t able to treat you for the same problem in the first place!!! 
They ignore your real symptoms and only derive what they wrongly think is causing your troubles.”   – from a Yahoo Pain Management forum

 

IS YOUR DOCTOR TOO “COLD”?

Doctors should be “caring”.

Every day. Every minute.

Does it really matter if it’s been a long horrible day for the doctor? Isn’t a patient entitled to a dose of sympathy along with whatever treatment is prescribed?

Once upon a time, when doctors carried black bags, they clucked over you constantly. They were sympathy machines.

“My, my. That looks just terrible!,” they would say.

In those day, doctors were your best friend. They knew all the kids. they knew you before you got married. They knew your secrets. They were very wise.

Why did they cluck over you so much?

What else would he or she (oh let’s stop this she crap – it was always a he) do? A stem cell transplant? I don’t think so. They offered sympathy because, often,  it’s all they had to give.

I have to ask. Does this  still make sense?

You’re talking to a stranger. A busy, busy stranger. You’re the 18th patient and there are two waiting in other rooms while you get seen. I know you feel bad. I know a little sympathy would be nice. But can we be realistic for a minute? That guy doesn’t even like you. You’re not his friend. He’s trying to fix what’s wrong with you, okay? Isn’t that what should matter?

I’m just asking.

Evidently, doctors buy into this emotional fraud because I’m looking at an article from the journal Health Expectations which aims to teach doctors how to speak the language of compassion.

Oh boy! The language of compassion! If you don’t feel it, at least learn to sound like you do.

Ronald Epstein, M.D.( University of Rochester, Center for Communication and Disparities Research) was the lead guy.  He worked with a group of oncologists, studying how they interacted with  some very sick patients.  They  worked on tone of voice, ways of expressing tenderness and understanding, and so on. Non-verbal communication too. Were the pauses and sighs right? The pitch? The tone? Metaphorical language? You really don’t want to choose a clumsy metaphor.

Here’s the thing.

The physicians who are involved in this stuff ARE  caring. They’re putting themselves through all this because they want things to be good for their patients. They know it sucks to be sick and they want, somehow, to be more comforting.

But there’s a risk.

“Getting the script right” can be dangerous. People sense it when you aren’t “real”. It can backfire. I’ve worked with doctors most of my professional life and, honestly? I think they’re great. Not one real clunker among the many I know.

MISTER ScienceAintSoBad thinks the emoting can be overdone.

Fix the disease.

That’s good enough for me.

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The drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.


APPLE A DAY IS FOR REAL: STUDY

Posted by on Monday, 23 December, 2013
cartoon about apples

AS GOOD AS STATINS

HEALTH (AGAIN)

Science has lots of busy corners. Technology, even more. I can’t use up all my blog time on health related stuff. It wouldn’t be fair to physics, chemistry, biology, and North Korean tablets. But I  would be a b-a-d science blogger if I didn’t tell you about apples.

Seriously.

You know about statins? They’re drugs that  lower cholesterol. Doctor’s love them. Pitivistatin, lovostatin, atorvastatin, , zocor are statins. Others too. Long list.

Statins are amazing. They don’t just  lower cholesterol, it seems they do other good stuff. They help with cataracts and dementia, and gum inflammation. They also reduce the incidence of  heart attacks and strokes, and one study even says that statins might slow aging by protecting your telomeres. Supposedly they can cause some problems with muscles but, for most people, that shouldn’t be a problem.

I’ve seriously toyed with  trying to talk my way on to statins, myself.

Well here’s the thing.

Dr Adam Briggs (BHF Health Promotion Research Group at Oxford University)  looked at the effect of eating a single apple each day (that’s right – “an apple a day”) vs statins. The results, cardiovascular wise, were about the same for apples as statin drugs. Dr. Briggs’ conclusion was that you could do as good a job for yourself eating apples as taking statins (probably because apples contain pectin which has similar effects on cholesterol to statins).

If you can lower your cholesterol and lower your heart risk without taking drugs, who am I to say you shouldn’t?

This report didn’t get into whether apples did all  the good stuff that statins do.

Still.

Apples? Hot dang!

A final point:  Statins, like anything, have pluses and minuses. Don’t rush off and stuff yourself full of statins on my account. First go over the particulars with your doctor. Better yet? Try fruit.

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A reader left a comment (see comments) suggesting that this study from the BMJ is less than serious. Perhaps so. But you’ve gone out and bought all those apples, right? You might as well eat them.

What could it hurt?

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I drew that apple!

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

 

 

 


INJURED BRAIN REPAIR

Posted by on Sunday, 15 December, 2013

Humorous cartoon about a kid and his dad

 

 

 BRAINS ARE SENSITIVE

You would be surprised how easy it is to hurt a brain.  It doesn’t take much. With babies, just a little shaking. With grownups, a single rough football game or a minor motorcycle accident with the helmet still nicely attached to the rack.

Who wears a helmet when it’s this nice, right?

The men and women who fight our wars for us know about brain injuries. A handmade explosive can rip away a soldier’s future permanently. Happens all the time.

Until now, the options were very limited for brain injured patients. But researchers from Case Western Reserve University/University of Kansas Medical Center have come up with something amazing.

WOW!

Dr. Pedram Mohseni (Case Western Reserve) developed a “brain prosthesis” . A brain prosthesis is  an artificial thing which helps a brain work right. Dr. Mohensi’s device is a very small computer which can connect up parts of the brain that got disconnected because of an injury. It’s a bridge for the signals between the separated parts. The device uses powerful signal processing techniques to extract useful signals and then injects them where needed to “complete the circuit”. Although this may sound simple to an electronic hobbyist, this is several levels above “miracle” as far as medical science is concerned. It is amazing and startling and shocking and wonderful.

I’m not exaggerating.

Except – (good guess) – it’s the damn rats again. They have all the luck, don’t they? This has so far only been demonstrated on lab vermin. Experiments on lab animals are very important (although sometimes morally repugnant) but MISTER ScienceAintSoBad tries to “keep it real” with articles about things that are closer to the clinic or the drugstore. This research is remarkable though. How could I deny it mention? And a cartoon of its own.

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The drawing is mine. The kid, hopefully, is not.

COMMENTS: To leave a comment, click on “comments”. It’s just under this article’s headline (toward the right).

 


EXCELLENT DISCOVERY FOR RHEUMATOID ARTHRITIS

Posted by on Wednesday, 11 December, 2013
funny cartoon about arthritis

NO LONGER AN EXCUSE?

 

ARTHRITIS

You can count on your joints hurting as you get old. Degenerative changes in joints (osteoarthritis) is the result of the fact that joints and cartilage lose their baby smoothness. It doesn’t feel too good but you get used to it.

There’s another kind of arthritis –  rheumatoid arthritis. Personally, MISTER ScienceAintSoBad thinks it should be called something else. It’s not like regular arthritis except for the joint part. The rheumatoid stuff is an immune system disease – another one of those stupid, stupid things where the immune system goes haywire. In rheumatoid arthritis,  cells of the immune system attack the lining of the joints which,  then,  gets inflamed. The inflammation can cause damage to the joint – especially if the disease started early in life or is a particularly nasty form of the disease. In bad cases, joints can be deformed. Sometimes, surgery is even needed. There can even be organ damage.

What to do.

Well. There are treatments.

Diet modification and physical therapy are often on the menu along with nonsteroidal anti-inflammatory drugs (Aleve, Advil, etc) for inflammation and pain. Steroids are very common too.  The newer stuff includes  “biological” drugs which are designed to “make it go away” instead of just managing swelling and pain. Methotrexate or hydroxychloroquine are used for this.

NOT A PERFECT WORLD

NSAIDs and steroids reduce the pain and swelling but they can be a challenge for long term use. You’re always dancing with the side effects. The biologicals can be effective but their trick is based on dialing back the immune system. You have an immune system  for a reason, right? People with suppressed immune systems can get infections and other stuff.

GOOD NEWS

Why would I put you through this if I didn’t have some good news?

Dr. Patrick R. Griffin  (The Scripps Research Institute) just published a study in Arthritis & Rheumatism. The drug is called SR2211 . It blocked all symptoms of rheumatoid arthritis in mice within 10 days and their joints did way better as far as bone loss is concerned. This drug aims for only the part of the immune system that releases “inflammatory mediators” .  And since it’s an oral drug (the other biologicals are injected) if  you think you’re getting an infection, you can skip a few pills til things settle down.

That’s the theory.

There’s no mention of when this stuff goes to clinical trials. MISTER ScienceAintSoBad, sympathetic, as ever, to our mouse friends, has a strong bias toward getting this stuff out and into human hands.  Can we get cracking on this please?

Thank you.

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The drawing is mine

 


A Surprise: Marijuana Doesn’t Cause Cancer!

Posted by on Monday, 9 December, 2013

 

Cute cartoon about smoking pot

MARIJUANA NOT A CARCINOGEN

Have you ever smoked a joint?Because those things aren’t exactly full of wonderful stuff.  There are a lot more cancer causing things in marijuana smoke than in cigarette smoke. And marijuana smoke causes pre-cancerous changes in bronchial tissue and leaves four times as much tar in the lungs as cigarettes.

Even worse. Pot smokers hold the smoke in their lungs four times longer.

So just how bad is marijuana for you?

SURPRISE!

That’s the thing. A study by Donald Tashkin, M.D., of the University of California in Los Angeles was a big surprise. For pot smokers – even heavy pot smokers – there was  no detectable cancer effect in the head, neck and lungs. None at all. None.

The study was an epidemiological study that looked at hundreds of cigarette and marijuana smokers. Dr. Tashkin speculates that maybe marijuana smoke is so potent that the cells that are affected are too damaged to even become cancerous cells. I hope you find that comforting. Other studies seem to show there’s something in marijuana that inhibits cancer.One shows its active ingredient cutting the growth of lung tumors in half.

What does MISTER ScienceAintSoBad think?

The result seems crazy. Maybe another study will refute this one. Or not. There were some studies that pointed to long term brain damage but they got upended too. Newer studies say no. Seriously. There isn’t much proof that this potentially bad thing is a bad thing.

If you’re a grown up, you can make your own call but don’t forget it’s not exactly legal most places, okay?

If you’re a kid, don’t be s-t-u-p-i-d. You don’t need this.

MISTER ScienceAintSoBad is surprised about all this. Maybe I missed something? Let me know, okay?

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The drawing is mine

And don’t forget the old saying “Better safe than high.”


THE ETERNAL ONES. IMMUNE TO OLD AGE.

Posted by on Saturday, 7 December, 2013
Cute cartoon about tinkering with everlasting youth.

YOU’RE STILL HERE??

BEATING AGING

MISTER ScienceAintSoBad wishes he could immunize you against old age but, what can I do? It’s nature, right?

Is there a way to “change the rules”?

Maybe there is.

Dr. Aziz Aboobaker (Proceedings Of The National Academy Of Sciences) studies planarian worms. Planarians – those that reproduce asexually –  don’t get old. They  don’t get wrinkles or gray hair, don’t hobble around on canes and don’t need hearing aids.

Being worms.

But get this! They do repair skin, muscles, brain, and bones so that they stay pretty much daisy fresh throughout their weirdly long lives. The secret? Dr. Abbobaker says its the way they regenerate all the stuff in their body whenever needed. Their cells  don’t “run out” of the ability to keep dividing. Ours do. If we could learn their trick, we would be beautiful and healthy for a ridiculously long time.

Chromosomes have a  telomere “cap” at the end. In humans, the cap gets shorter. When it gets too short, it can’t keep the strands of DNA in place and cell division goes haywire.

Planarians don’t have that problem Their telomere caps don’t  shorten  so cell division remains orderly. If we can teach our telomeres to maintain their length,  we’re on  our way to 125 years.

I’m not kidding.

What are the planarians doing that that we non-worms aren’t? There’s an enzyme (telomerase) which is responsible.  It’s more active in the worms that reproduce asexually, protecting the length of their telomere caps. It seems to make these particular worms “immortal”.

Could this work for humans? Would we want it to work?

We are a long way,  biologically speaking,  from asexual worms. What works for them might not work for us in a million ways. And,  If it did? Old age is “natural”, right? It was always thus. You’re a kid,  then a youth,  then your first grey hair. A little pot belly that just won’t quite  go away.  Some wrinkles. Grandchildren. And then golf.

A lot of golf.

Fix the cap on a telomere and all that could change in ways we can’t foresee. A Pandora’s box of unforeseen consequences.

Am I nervous? Well no. This is a nice piece of science but it seems unlikely to rock that boat. More needs to be done to fully understand what this “lab curiosity” means for biology.

A lot more before you can tear up your will.

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The drawing is mine.

 


Brain Tumor Study Does Great.Optimism Rises.

Posted by on Saturday, 30 November, 2013

 

Cartoon about brain tumor news

MISSING THE POINT

BRAIN CANCER TRIUMPH

Glioblastoma multiforme is crappy news.

To start with, it’s a brain tumor. I’ve never run into anyone who wanted brain cancer.

Also, glioblastoma multiforme is hard to kill off completely. Up until now, it’s been more devious than the doctors who have tried to tame it. The “It’s a miracle” thing is somewhat overdone but – you know what? – If you’ve beaten glioblatoma multiforme, I’m not arguing.  Long term survival is very, very poor. With the “standard” treatment –  surgery plus chemo –  one year and 3 months on average.

Now I’ve got a miracle.

Dr.  Surasak Phuphanich (Cochran Brain Tumor Center and  Cedars-Sinai) is the lead researcher on a study being reported to the Fourth Quadrennial Meeting of the World Federation of Neuro-Oncology. There were 16 patient, all with glioblastoma multiforme .  Eight of the patients made it past five years.

THAT”S a bloody miracle!

And, by the way, it’s a huge scientific triumph!

This was a “targeted” treatment, using a newly developed experimental vaccine where the study, itself, was only a “phase 1” human trial which, technically, is to see if the drug is safe to use and to find the best dosage.

MISTER ScienceAintSoBad doesn’t want to raise false hopes but this sure sounds like a great result that would justify more extensive testing.

Added later:

And, in fact, a phase II trial has begun. MISTER ScienceAintSoBad has high hopes things continue to go well.

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The cartoon is mine.