What We Know and What We Think
ROBERT McNUTT, MD
What matters is what we know, not what we think
In the late 1980’s I cared for a pregnant woman with breast cancer. Breast cancer is the most common cancer in pregnancy, but uncommon in number, occurring in about 1 in 3000 pregnancies. It is a compounded emotional treating experience for sure, and at that time uncertainty in how to treat was the norm. The woman had a mastectomy but did not take chemotherapy based on concern for her baby.
Three months after her delivery, now getting chemotherapy for her aggressive breast cancer, the woman asked me to consider treating her newborn child with “mild” ch...
Source: The Health Care Blog - December 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
What Know and What We Think
ROBERT McNUTT, MD
What matters is what we know, not what we think
In the late 1980’s I cared for a pregnant woman with breast cancer. Breast cancer is the most common cancer in pregnancy, but uncommon in number, occurring in about 1 in 3000 pregnancies. It is a compounded emotional treating experience for sure, and at that time uncertainty in how to treat was the norm. The woman had a mastectomy but did not take chemotherapy based on concern for her baby.
Three months after her delivery, now getting chemotherapy for her aggressive breast cancer, the woman asked me to consider treating her newborn child with “mild” ch...
Source: The Health Care Blog - December 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The Implementer ’ s Dilemma
By DAVID SHAYWITZ, MD
One word: implementation.
Increasingly, I’m convinced that the underappreciated challenges of implementation describe the ever-expanding gap between the promise of emerging technologies (sensors, AI) and their comparatively limited use in clinical care and pharmaceutical research. (Updated disclosure: I am now a VC, associated with a pharma company; views expressed, as always, are my own.)
Technology Promises Disruption Of Healthcare…
Let’s start with some context. Healthcare, it is universally agreed, is “broken,” and in particular, many of the advances and conveniences we now take for ...
Source: The Health Care Blog - December 12, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Daimler Benz AG David Shaywitz Innovation Source Type: blogs
One Last Story on How Life Sucks After Breast Cancer
Okay, maybe I have been in a rut because I have been stuck at home after knee surgery because I can ' t drive. Or maybe because I have a cold that I am obsessing on crappy lives after cancer. Or maybe the internet gods had their stars align and all these stories ended up on my laptop in the same time period. But I hope this will be the last one for a while.Here ' s the story of a young woman who lost both her husband and her sister because of her lengthy cancer treatment." “The reality is that probably four out of seven days I’m in bed,” explains the 39-year-old, who lives with her mother at Bundall.“I’ve had my ...
Source: Caroline's Breast Cancer Blog - November 6, 2017 Category: Cancer & Oncology Tags: being a patient breast cancer bonds breast cancer treatment stress Source Type: blogs
A first-hand account of single-payer health care
I am sitting in my hospital room in a bone marrow transplant unit in a European city. I am a patient who has recently received a stem cell transplant. I am U.S. citizen, but I am a resident of a country with a single-payer health system. The insurance system here covers 85 percent of the population. And participation is mandatory, although high earners can opt out by purchasing private insurance. Citizens and working residents pay a tax of about 15 percent of their earnings for their government-financed health care coverage. The insurance is administered by one of several non-profit organization that differ very little in ...
Source: Kevin, M.D. - Medical Weblog - September 29, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/darrel-moellendorf" rel="tag" > Darrel Moellendorf < /a > Tags: Patient Oncology/Hematology Washington Watch Source Type: blogs
What Does an Ideal Healthcare System Look Like?
By ASHISH JHA, MD
Austin Frakt and Aaron Carroll recently approached me about a New York Times UpShot piece aiming to rank eight healthcare systems they had chosen: Australia, Canada, France, Germany, Singapore, Switzerland, the United Kingdom, and the United States. This forced me to think about a pretty fundamental question: what do we want from a healthcare system?
I would argue that most people want a healthcare system where they can get timely access to high quality, affordable care and one that also promotes innovation of new tests and treatments. But underlying these sentiments are a lot of important issues that nee...
Source: The Health Care Blog - September 20, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Fight Aging! Newsletter, August 21st 2017
This study didn't measure whether receiving the cardiosphere-derived cells extended lifespans, so we have a lot more work to do. We have much to study, including whether CDCs need to come from a young donor to have the same rejuvenating effects and whether the extracellular vesicles are able to reproduce all the rejuvenating effects we detect with CDCs."
Cardiac and systemic rejuvenation after cardiosphere-derived cell therapy in senescent rats
Cardiosphere-derived cell (CDC) therapy has exhibited several favourable effects on heart structure and function in humans and in preclinical models; however, the ...
Source: Fight Aging! - August 20, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Cell Banking for Future Autologous Cell Therapies Seems Pointless
I'll start here by pointing out the most useful application for cryopreservation of cells and tissues: it greatly reduces the cost of logistics in transplant medicine. When you need to coordinate people and cells and places on timescales of a few days, weeks, or months, the ability to confidently put the cells into safe storage for short period of time changes the whole tenor of the affair. Just look at the organ transplant field, for example, which is defined by the fact that this storage cannot yet be achieved. Organ transplantation is enormously expensive not just because the donor pool is limited, but also because orga...
Source: Fight Aging! - August 18, 2017 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
Following up on a very old case: Abraham Cherrix is alive and well because he finally rejected alternative medicine
Although I haven’t discussed it here in depth, the case of Abraham Cherrix is an instructive example. Eleven years ago, he and his parents chose quackery over science-based medicine to treat his cancer. He’s alive now because he finally realized the error of his decision and underwent chemotherapy and a bone marrow transplant. (Source: Respectful Insolence)
Source: Respectful Insolence - August 7, 2017 Category: Surgery Authors: Orac Tags: Cancer Complementary and alternative medicine Quackery Abraham Cherrix chemotherapy Hodgkin's lymphoma Hoxsey therapy Source Type: blogs
Outbreaks of Non-tuberculous Mycobacterium Infection in the United States
To date, 114 known outbreaks of human infection by non-tuberculous mycobacteria (NTM) have been associated with medical / other invasive procedures. 37 of these (32%) have reported from the United States. The following chronology is abstracted from the Gideon e-book series. [1] Primary references are available from the author.
1987 17 cases of Mycobacterium chelonae otitis media in Louisiana caused by contaminated water used by an ENT practice
1988 8 cases of Mycobacterium chelonae infection associated with a contaminated jet injector used in a Podiatry office.
1989 – 1990 16 cases of Myco...
Source: GIDEON blog - June 26, 2017 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: General Source Type: blogs
Fight Aging! Newsletter, June 19th 2017
This study is the first to show that downregulation of PAPP-A expression in adult mice can significantly extend life span.
Importantly, this beneficial longevity phenotype is distinct from the dwarfism of long-lived PAPP-A KO, Ames dwarf, Snell dwarf and growth hormone receptor (GHR) KO mice with germ-line mutations. Thus, downregulation of PAPP-A expression joins other treatment regimens, such as resveratrol, rapamycin and dietary restriction, which can extend life span when started in mice as adults. In a recent study, inducible knockdown of the GHR in young adult female mice increased maximal, but not median, lif...
Source: Fight Aging! - June 18, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Revisiting Whole Body Induced Cell Turnover as a Therapeutic Strategy
Last year some of the researchers associated with the Biogerontology Research Foundation proposed a class of therapy they call whole body induced cell turnover. I noticed a new paper and publicity materials on this topic today. In essence the goal is to augment the normal processes of cell turnover with therapies that remove and replace more cells than would normally be the case, thus clearing out the damage in those cells along the way. Since aging is caused by cell and tissue damage, in the ideal case this approach should act as a form of rejuvenation therapy. Obviously there are some limits here, such as areas of the br...
Source: Fight Aging! - June 15, 2017 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Tomorrow, we may fail you: Vignettes of pre-existing conditions
Today, I cleaned the laceration above your eye from where he punched you with a closed fist. As I was stitching up the gaping wound with two layers of sutures, I told you that the scar would fade into the line of your eyebrow. I helped you apply your foundation on your neck to cover the bruising from where he strangled you. I monitored you for any swelling of your airway. I wrote down the names of the local battered women’s shelters and hotlines and slipped the paper in your shoe. I offered to call the police for you no fewer than ten times. I told you how I feared the next time you would not be discharged home. Today, I...
Source: Kevin, M.D. - Medical Weblog - May 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/amanda-guarniere" rel="tag" > Amanda Guarniere, CRNP < /a > Tags: Conditions Emergency Source Type: blogs
Physicians can choose to nurture their human side
A keynote address to Gold Humanism Honor Society Induction Ceremony, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
As an intern, I was assigned to 9 weeks over the year on the bone marrow transplant inpatient unit. It was medically fascinating but emotionally draining and anxiety provoking. I began to get nauseated going to work because I was having such a hard time with the rotation. As I sank deeper into anxiety and self-doubt as patient after patient died or had terrible complications, I met a patient who forever changed my attitude towards humanism in medicine, and I’d like to te...
Source: Kevin, M.D. - Medical Weblog - April 12, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/gretchen-diemer" rel="tag" > Gretchen Diemer, MD < /a > Tags: Physician Primary care Source Type: blogs
Hobson ’ s Wrong Answer
By JIM PURCELL
Thomas Hobson was his name, a licensed carrier of passengers, letters, and parcels between Cambridge and London in the years surrounding 1600. He kept horses for such purpose, and rented them when he wasn’t using them. Naturally, the students all wanted the best horses, and as a result, Mr. Hobson’s better mounts became badly overworked. To remedy this situation, he began a strict rotation system, giving each customer the choice of taking the horse nearest the stable door or none at all. This rule became known as Hobson’s Choice, and soon people were using that term to mean “no choice at all” in a...
Source: The Health Care Blog - April 6, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Biogen Boston Globe Hobson Source Type: blogs
