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Is the Emperor naked? National dietary guidelines called to account

When the government speaks, people listen. Well, even though they may not necessarily do everything it says, they–including many family doctors–do take the principles to heart. So the flip-flop of that ubiquitious “National Dietary Guidlines” triangle from top-heavy with meat and protein back when baby-boomers were flooding the world, to today’s somewhat inverted version stressing healthy carbs and low fat (hmmmm…how many of the dietary guideline formulators are boomers and how many are Gen X, Gen Y?), does that mean healthy eating has changed? Or does it mean the government doesn’t actually know? A couple of docs writing in the New England Journal of Medicine posit that the real situation is that the government doesn’t know–and that that’s okay. But that they shouldn’t, then, be issuing guidelines that many people will follow.

Seems like a no-brainer, doesn’t it? If you don’t know for sure, you don’t pontificate on the subject. But that’s not the way the human mind and heart work. When your “subjects” look to you for guidance, you tend to really want to give it to them–to have them see you as strong and wise. And if you don’t give it to them, they tend to get very nervous and insecure. So the temptation for you, the emperor, is to just make your best educated guess. Read the story here:National Nutrition Guidelines worthless?

Exhaled nitric oxide real clue to symptoms in mitral stenosis

Patients with moderate to severe mitral stenosis (calcifiation of the mitral valve generally precipitated by an earlier case of rheumatic fever) experience varying levels of inhibition in their breathing and exercise abilities. But sometimes patients exhibit symptoms that are more severe than the level of stenosis indicated by a regular echocardiogram would warrant. In this study, researchers used cardiopulmonary exercise testing and measured exhaled nitric oxide to try to uncover reasons for the discrepancy. By measuring nitric oxide output both before and after exercise, they found nitric oxide has a significant role in regulating the tone of the patient’s pulmonary cardiovascular system, and thus the pressure within the heart.

So if you have mitral stenosis and you feel worse than your doctor says you should, ask him/her about doing an exercise stress test. You don’t want to submit to open-heart surgery unless it’s absolutely called for–and this may be a way to tell.

Forwarding email jokes good for health?

I couldn’t resist this one. Seems a recent study has show incontrovertibly that the mere anticipation of having a laugh reduces stress hormones. In their earlier work, the same researchers had found that just thinking of laughing increased health-protecting hormones like endorphins (that alleviate depression) and human growth hormone (that boosts immunity).

So now you know when a trainer comes in and tries to get people to laugh, or a politician has writers put lots of funny stuff into a speech, it’s not just about “breaking the ice”—participants who are less stressed will literally react more openly to what’s presented. What’s more, and of course this is my extrapolation, people receiving email jokes at work can be expected to experience these little boosts in good stuff and reductions in bad stuff—which is bound to contribute to increased productivity, despite the few minutes used “non-productively” to review the jokes.

Anyway, here’s the study, so you can draw your own conclusions.

Some invasive surgeries overdone

Angioplasty and coronary bypass pay well. And many patients are convinced these are the answers when they’re having clogged-arteries issues. But recent news says angioplasty is no more effective than medication in a very large percentage of heart patients. And in a recent editorial in the New England Journal of Medicine, Cardiologist David Hillis, MD. says neither of these procedures really fixes anything.

Unnecessary surgeries cost Americans in the billions, and many cause needless deaths. Today the Rand Corporation estimates that 30 percent of all surgeries are unnecessary. Hmmm. Small wonder our health care costs are out of control.

The hit list for questionable surgical procedures is long: many angioplasties and bypasses, a huge proportion of knee surgeries, prostate surgery (even the testing for which is painful, invasive, and expensive), more. Too many tests (blood, MRI, PSA, etc.) reveal things that look scary to a patient but are really just part of normal bodily deterioration and would would heal by themselves with rest and/or medication.

The bottom line is, don’t let yourself be railroaded or intimidated (some surgeons literally use scare tactics to get patients to agree to operations). Educate yourself, be skeptical, make up your own mind. Read the whole story at Men’s Health.

More on non-invasive cancer treatments

Scientists are getting more creative in finding ways to treat cancer cells without destroying surrounding tissue. A Chicago-based company NEOPHARM is working on a protein with one part that targets tumors (IL13) and the other that kills the cancer cell (PE38). Here’s how it works:

The two-part recombinant protein is CINTREDEKIN BESUDOTOX (IL13-PE38QQR). Malignant glioma cells carry IL13 receptors , but healthy brain cells almost never do. The protein is designed to bind to IL13 receptors on the tumor like a key fits in a lock. The cancer cell latches onto and absorbs the IL13 and the attached PE38. As a result, the cancer cell dies. Healthy brain cells are expected to be unharmed because they do not have the IL13 receptors, and thus do not ingest the PE38.

This drug has already been in a Phase 3 clinical trial. And the best part is the FDA is so excited about this work that it has designated it an Orphan Drug (meaning it won’t require prescription drug user fees) both in Europe and the US. They’ve also included it in their new Continuous Marketing Application pilot program–and THAT means the FDA is all over helping develop the drug. Congratulations to NEOPHARM investigators.

I’ve heard some horror stories about how the FDA has been known to stand in the way of certain developments. So it’s nice to see them out there finding ways to get good stuff released.

A enlightening function of nitric oxide

It’s St. Patrick’s day, and though I haven’t been out partaking of the early-am parties, I do feel like sharing a light-hearted notation about good old nitric oxide.

Seems some company has invented a fake lightning bug–or at least come up with a way to imitate the effect they produce in our temperate-zone backyards on warm spring nights. These fake fireflies use electronic energy to light up, but the secret of the glow of real lightning bugs is nitric oxide in their abdomens.

Interesting how science provides its own enchantment. Doesn’t spoil my enjoyment of lightning bugs one bit to know where their magic comes from.

Peer-Reviewed Journals continue to cite invalidated studies

Yes, the question remains–as Groucho Marx used to ask–Who do you trust? Seems some medical experts support continue to support their conclusions with data from studies that have long been invalidated in clinical trials. This report says they’ve proven this so far for at least Vitamin E, estrogen, and beta carotene. Here are the facts on estrogen:

“For estrogen, 61.7% of 47 articles published in 2006 indicated the hormone may protect against Alzheimer’s disease on the basis of a 1996 observational study, even though a clinical trial in 2004 found a trend for increased risk of dementia in postmenopausal women taking estrogen. Of the remaining articles, 29.8% were equivocal, and 8.5% were unfavorable. “

Reminds me of the joke about the elephant–each person describes the creature according to how much of which parts he can feel. That’s how it is the world of Internet marketing these days, too. What constitutes “truth” can change so rapidly that most people can never catch up to it all.

And we want better from everyone–but especially our medical professionals.

A safer way to replace a pulmonary heart valve–the sky's the limit now


Of course, with the evolution of stem cell science, we’ve all just been waiting with bated breath to hear about using them for replacing pieces of the heart (well, I have anyway). And now, here’s the first piece of research that’s not just “dreaming big” but is actually approved by the FDA.

Scientists have found a way to strip a human heart valve (from a cadaver) of the cells and debris a heart normally contains. Then after cleaning and decontaminating it, what remains of the “heart valve” to be transplanted is a web of connective tissue that has a lower chance of triggering the body’s immune response/rejection mechanisms. Two big benefits of this approach: eliminates the need for lifelong blood-thinning medications, and the replacement has less chance of calcifying than a pig or cow heart valve. So far, they’ve done this for the heart’s pulmonary valve (check out the illustration).

This is a huge step forward in our ability to combat heart and other organ diseases. Congratulations to CryoLife Inc. on its CryoValve SynerGraft Pulmonary Valve and Valved-Conduit Allograft.

Supressing herpes doesn't lessen HIV susceptibility

One of those cases of a great theory gone sour. Stats indicate that those with herpes simplex II (genital herpes) run a doubly higher risk of acquiring HIV (the AIDS virus). Scientists ran a study in both Peru and Africa wherein they used acyclovir to suppress the occurrences of HSV-2 in sexually active adults in the hope of finding a concurrent reduction in the number of those who developed HIV. Sadly, although acyclovir did reduce occurrence of genital disease outbreaks, it had no relationship whatever to who did or didn’t get HIV.

Researchers had hoped they’d found an important key to HIV-prevention and were very disappointed. But perhaps the most surprising statement came from Connie Celium, MD when she reported on the study at the Conference on Retroviruses and Opportunistic Infections:

“…one in four people in the U.S. has genital herpes and 99% don’t know it. Had the acyclovir worked, she said, ‘we had hoped this would be something we could apply today to drive down the susceptibility to HIV infection.'”

If 99% of people with serious gential disease are unaware of it, the chances of stemming the spread are pretty thin.

So I checked for more stats. Found that number confirmed and this information on the occurrence in the US and internationally of several types of herpes–all of which can be transmitted without any symptoms present. “More than one-third of the world’s population has recurrent clinical HSV infections.” That’s a lot of people potentially transmitting an STD. And there’s a lot of ignorance about an incurable disease.

Nanostructures like Diamonds can deliver cancer drugs precisely

Nano looks like it may provide a newly precise way of aiming only at cancer cells and avoiding inflammation, thus leaving healthy cells in their natural state. Nanoengineers Mine Tiny Diamonds For Drug Delivery. Fascinating to learn that these “diamonds,” which are structurally not unlike their namesake minerals, are welcomed by cells because they are so carefully organized. When cells welcome a substance, according to this report, they tend not to go haywire and express it with inflammation. Hmmm. Seems like a big useful clue in that statement for future researchers.

The technique here is to cluster several nanodiamonds together, apply the drug to the surfaces (which allows more drug to be used than with the spherical nanoparticles currently used), deliver it to the cancer site, and there let it break up–which then releases the drug.

They’ve even found that they can deliver nanodiamonds (without drugs) into the body and no harm comes to surrounding cells. These new guys could become the next-generation stem-cell-type magic.