Category Archives: Health

Health And Aging: U.S. Will Need 33,000 Geriatricians By 2025, Only Has 7,000 Now

From a New York Times online article:

Journal of the American Geriatrics SocietyIf one geriatrician can care for 700 patients with complicated medical needs, as a federal model estimates, then the nation will need 33,200 such doctors in 2025. It has about 7,000, only half of them practicing full time. (They’re sometimes confused with gerontologists, who study aging, and may work with older adults, but are not health care providers.)

Geriatrics became a board-certified medical specialty only in 1988. An analysis published in 2018 showed that over 16 years, through academic year 2017-18, the number of graduate fellowship programs that train geriatricians, underwritten by Medicare, increased to 210 from 182. That represents virtually no growth when adjusted for the rising United States population.

“It’s basically stagnation,” said Aldis Petriceks, the study’s lead author, now a medical student at Harvard.

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Medicine: “Is It An Art Or Science?” (The Lancet)

From a The Lancet online article:

Effective physicians interrogate their patients’ choice of words as well as their body language; they attend to what they leave out of their stories as well as what they put in. More than 2000 years after Hippocrates, there remains as much poetry in medicine as there is science.

The Lancet LogoWHO’s definition of health is famously “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. One of the oldest medical texts we know of, The Science of Medicine attributed to Hippocrates, sets out the goal of medicine in comparable terms: “the complete removal of the distress of the sick”.

In my working life as a physician, I’ve never found the distinction between arts and sciences a particularly useful one. In the earliest ancient Greek texts, medicine is described as a techne—a word better translated as “know-how”. It conveys elements of science, art, and skill, but also of artisanal craft. The precise functions of medicine may have subtly shifted over the ages, but our need as human beings for doctors remains the same; we go to them because we wish to invoke some change in our lives, either to cure or prevent an illness or influence some unwelcome mental or bodily process. The goal of medicine is, and always has been, the relief of human suffering—the word patient, from the Latin patientem, means sufferer. And the word physician is from the Greek phusis, or nature: to be engaged in clinical work is to engage oneself with the nature of illness, the nature of recovery, the nature of humanity.

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Healthy Diets: “The Science Behind Fasting – Ketosis” (Infographic)

The Science Behind Fasting - Ketosis
Cellular Cleanup Crew Fasting and caloric restriction both can ramp up autophagy, a kind of cellular housekeeping. When cells are in famine mode and don’t have to break down food, they pause their usual tasks and stop dividing. Instead, they work on repairing and recycling damaged components, and cleaning out dead or harmful cell matter. Alison Mackey/Discover

…It seems fasting triggers a dramatic switch in the body’s metabolism, according Discover Magazine logoto a paper Mattson and colleagues published in February in the experimental biology journal FASEB. In humans, fasting for 12 hours or more drops the levels of glycogen, a form of cellular glucose. Like changing to a backup gas tank, the body switches from glucose to fatty acids, a more efficient fuel. The switch generates the production of ketones, which are energy molecules that are made in the liver. “When the fats are mobilized and used to produce ketones, we think that is a key factor in accruing the health benefits,” says Mattson.

Read more at Discover Magazine

Studies: New Protein Therapy Improves Cardiac Function, Scar Formation After Heart Attack

From a New Atlas online article (Jan 1, 2020):

Science Translational Medicine January 1 2020 cover“This is an entirely new approach with no current treatments able to change scar in this way,” says Associate Professor James Chong who led the research. “By improving cardiac function and scar formation following heart attack, treatment with rhPDGF-AB led to an overall increase in survival rate in our study.”

The research centers on a protein therapy called recombinant human platelet-derived growth factor-AB (rhPDGF-AB), which had previously been shown to improve heart function in mice that had suffered a heart attack. In a new study aimed at bringing the treatment closer to human trials, a team set out to discover if it produced similar results in large animals, namely pigs.

The researchers from the Westmead Institute for Medical Research (WIMR) and the University of Sydney found that when pigs that had suffered a heart attack received an infusion of rhPDGF, it did indeed prompt the formation of new blood vessels in the heart and led to a reduction of potentially fatal heart arrhythmia.

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Read article in New Atlas

Medical Technology: New Artificial Intelligence (AI) Model Predicts Breast Cancer More Accurately

A new Artificial Intelligence (AI) model predicts breast cancer in mammograms more accurately than radiologists, reducing false positives and false negatives, reports a large international study from Google, Northwestern Medicine and two screening centers in the United Kingdom (U.K.).

 

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https://www.nm.org/

Heart Studies: Alcohol Abstinence For Atrial Fibrillation Reduces Arrhythmia (NEJM)

Alcohol Abstinence for Atrial Fibrillation New England Journal of Medicine January 1 2020

Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. 

New England Journal of Medicine

January 2, 2020 Atrial fibrillation is the most common sustained arrhythmia,1 and alcohol is consumed by a majority of U.S. adults.2 The current study showed that among regular drinkers, a substantial reduction in alcohol consumption by patients with symptomatic atrial fibrillation was associated with a reduction in recurrence of atrial fibrillation and a reduced proportion of time spent in atrial fibrillation. Earlier meta-analyses showed that alcohol was associated with a dose-related increased risk of incident atrial fibrillation, with increased risk observed even among drinkers who consumed as few as 7 drinks per week.8 Current trends show a rise in alcohol consumption among adults older than 60 years of age,2coupled with greater prevalence of atrial fibrillation in this age group. The present study, with participants having an average intake of approximately 17 drinks per week at baseline, suggests that consumption at these levels may contribute to atrial fibrillation.

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New Years Resolutions: “Stop Making Excuses Not To Exercise!!” (NY Times)

From a New York Times online article:

The New York Time logoAt the moment, about two-thirds of Americans do not meet the standard exercise guidelines of about 30 minutes a day of moderate exercise, such as walking.

These findings might suggest that, if we adjusted our schedules and turned off the TV, phone or computer, most of us would have plenty of time to work out.

Screen Time vs Physical Activity vs Free Time Chart CDC

Almost all of the respondents — whatever their income, age, gender or ethnicity — reported about five hours a day of leisure time. Men tended to have more free time than women, older people more than the young, and African-American women the least of all. But no group reported less than about four and a half hours a day of free time.

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Interviews: Author Of “The First Cell” Azra Raza On Why Today’s Cancer Research Is Failing (Video)

Slash, poison, burn. That’s what a leading cancer doctor calls the protocol of The First Cell and the Human Costs of Pursuing Cancer to the last Azra Raza booksurgery, chemotherapy and radiation. We spend $150 billion each year treating cancer, yet a patient with cancer is as likely to die of it today — with a few exceptions — as one was 50 years ago. Today we spend the hour with renowned cancer doctor, Dr. Azra Raza, author of the new book, “The First Cell: And the Human Costs of Pursuing Cancer to the Last.” She argues that experiments and the funding for eradicating cancer look at the disease when it is in its later stages, when the cancer has grown and spread. Instead, she says, the focus should be on the very first stages — the first cell, as her book is titled. She says this type of treatment would be more effective, cheaper and less toxic.

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Dementia: Cognitive Loss Is Greatest At “Slightest Level Of Hearing Loss”

From a New York Times online article:

Hearing Loss…the researchers demonstrated that the biggest drop in cognitive ability occurs at the slightest level of hearing loss — a decline from zero to the “normal” level of 25 decibels, with smaller cognitive losses occurring when hearing deficits rise from 25 to 50 decibels.

Hearing loss is now known to be the largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation, according to an international analysis published in The Lancet in 2017.

the new findings on cognitive losses linked to subclinical hearing loss, gleaned from among 6,451 people age 50 or older, suggest that any degree of hearing loss can take a toll.

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Healthcare: “10 Drugs And Medical Devices Approved By FDA In Dec. 2019 (BHR)

From a Becker’s Hospital Review (BHR) online release article:

10 drugs and medical devices approved by the FDA since Dec. 6:

  1. Enhertu is Japanese drugmaker Daiichi Sankyo’s drug designed to treat HER2-positive breast cancer.
  2. Padcev is Astellas Pharma’s drug designed to target specific cancer cells to treat urothelial cancers.
  3. Control-IQ Technology controller is Tandem Diabetes Care’s insulin device, designed to help diabetes patients tailor their treatments to their individual needs.
  4. Vascepa is Amarin Pharmaceuticals’ drug, a fish oil-derived pill designed to treatVascepa benefits cardiovascular events.
  5. EXALT Model D is Boston Scientific’s device, the first fully disposable duodenoscope, designed to reduce the risk of infections in patients treated with the device.
  6. Vyondys 53 is Sarepta Therapeutics’ drug designed to treat Duchenne muscular dystrophy, which the FDA had previously rejected.
  7. GSP Neonatal Creatine Kinase-MM kit is PerkinElmer’s device, used to detect Duchenne Muscular Dystrophy in newborns.
  8. Unidose liquid system is AptarGroup’s device that uses a nasal spray to treat seizures. It is the first and only nasal treatment for patients with epilepsy.
  9. Avsola is Amgen’s drug, a biosimilar of Johnson & Johnson’s Remicade. It is designed to treat rheumatoid arthritis, Crohn’s disease, plaque psoriasis, psoriatic arthritis and ankylosing spondylitis.
  10. cobas vivoDx is Roche Molecular Systems’ device, designed to diagnose MRSA hours faster than traditional tests.

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To read article at Becker’s Hospital Review