Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, July 31, 2017

Hope for the Future of Cancer Treatment

"The cancer was just melting away. Today I find out I'm in full remission -- how wonderful is that?"
"This is the hope of any cancer patient, that if you stay in the game long enough, the next treatment's going to be just around the corner."
Ken Shefveland, lymphoma patient, Vancouver, Washington

"We're talking, really, patients who have no other options, and we're seeing tumours and leukemias disappear over weeks."
"[But] there's still lots to learn [about cellular immunotherapy: CAR-T cells]."
Dr. Stanley Riddell, immunotherapy scientific director, Fred Hutchinson Cancer Research Center

"It shows the unbelievable power of your immune system."
Dr. David Maloney, medical director, cellular immunotherapy, Fred Hutchinson Cancer Research Center

"We can essentially make a cell do things it wasn't programmed to do naturally."
"Your imagination can run wild with how you can engineer cells to function better."
Dr. Philip Greenberg, immunology chief, Seattle immunotherapy clinic
CAR-T chimeric antigen receptor
Early studies in the United States saw 60 to 90 percent of patients whose last-resort attempts as trial patients for leukemia or lymphoma, experiencing the profound relief of seeing their cancer decrease or even become undetectable, in fairly short order after trying experimental CAR-Ts.  T-cells are the warriors of the body's immune system, they are geared to attack deranged cells. Even so, they often miss cancer cells, stopping immune attacks.

But the increasingly promising immunotherapy drugs named "checkpoint inhibitors" have the purpose of releasing a brake that T-cells place on an immune attack to protect the body from cancer cells. This new cellular immunotherapy process is purposed to become more powerful, allowing the patients' T-cells to become stronger and more functionally responsive to invasion by deranged cells.

The process remains in its experimental stages, where volunteer patients who no longer have much to lose because their cancer has become so devastatingly deadly and impossible to bring to a halt by any other means, take part in CAR-T cell therapies. The reaction to their use has been so encouraging that the therapies are now being evaluated in two different versions by the US. Food and Drug Administration for eventual use in hospital settings.

Scientists are not, however, sitting back on their heels in self-congratulation. This is the first major step in fighting cancer, and following steps are pressing at their heels. "The acid test" of the new immunotherapy is to determine how it could be successfully used to target common cancers where solid tumours attack lungs, breasts or appear as brain cancer. Cancers of various types kill some 600,000 Americans and 79,000 Canadians annually.

Another testy concern is that living cancer drugs such as are represented by these new therapies are effective in some people, and not so in others. Potentially life-threatening side-effects when the immune system is overstimulated as it is with the CAR-T process, occur in some patients and in a small number, deaths from brain swelling can occur. "It's a Model A Ford and we need a Lamborghini", stated Dr. Renier Brentjens of New York Memorial Sloan Kettering Cancer Center.
Bellicum Pharmaceuticals CAR-T therapy GoCAR-T

For 67-year-old leukemia patient Claude Bannick, the experience with a CAR-T study in 2014 was a positive one for a man whom chemotherapy, experimental drugs and a bone-marrow transplant had all failed. A machine filtered out his white blood cells containing T Cells, then his cells were raced to a facility to be reprogrammed. After his 14-day ordeal of suspenseful waiting, he now says that CAR-T is "giving me a second life".

CAR-Ts kill some healthy white blood cells because they cannot yet be completely accurate in identifying their targets. Along with cancerous cells some B cells are destroyed since both contain the same marker; yet another complication. An immune overreaction named "cytokine release syndrome" when CAR-T cells surround cancer cells can trigger high fevers and falling blood pressure where in severe cases organ damage may ensue.

This completely novel way to treat cancer holds immense promise, in the hope that scientists can successfully tweak it to work more safely. One-time infusions of supercharged immune cells have helped an astonishing number of patients suffering from leukemia or lymphoma, at their intractable stage, when nothing else gave them hope for the future. But another concern looms in that it is an unknown how long the cancer-cell responses will last.

According to the findings of a recent review of the therapy and its aftermath, it is expected that up to half of leukemia and lymphoma patients may ultimately suffer a relapse.

CAR-T therapy review CD19 antigen

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Sunday, July 30, 2017

Promoting Healthy Skin Microbiome

"Our hope is that by correcting bacteria on the skin, [eczema] patients won’t have to do constant treatment."
"Those bacteria [colonizing the skin of eczema patients] are deficient compared to the same bacteria taken from a healthy volunteer."
"We have done some genetic testing that tells us definitively that those bacteria are different. We took the bacteria from healthy people and we saw that the bacteria does everything you would want it to do to improve atopic dermatitis in a petri dish and in mice. In mice, we can actually make their disease go away with this bacteria."
Dr. Ian Myles, National Institute of Allergy and Infectious Diseases, National Institutes of Health
eczema skin on hand
Most eczema drugs are creams or lotions designed to soothe the inflammation that makes eczema so uncomfortable. aniaostudio / Getty Images
The human skin’s microbiome — the collection of bacteria, fungi and other microorganisms that live on the skin are there to protect us. New research appears to indicate that people suffering from eczema have faulty microbiome, which fail to do the work they have been assigned, to protect those whose skin they colonize. Now, it seems that a promising new treatment is on the horizon, and its cost, when proven beyond a doubt to represent the solution scientists hope it will, is estimated to be around $100 for treatment for a year.

That certainly compares most favourably with, for example, a new eczema drug which the Food and Drug Administration has recently approved called Dupixent, an injectable drug that comes with a $37,000 yearly price tag to help ease the intolerable itch, swelling, redness and crusting (typical of the most sever cases of eczema) that comes with eczema. And while most such medications come in the form of creams or lotions whose purpose is to soothe eczema inflammation (atopic dermatitis), this new drug alters the immune system response underlying inflammation, as a monoclonal antibody.

That's the old way of treatment, and Dr. Myles and his colleagues feel that they are on to something simpler and possibly far more 'natural', and useful in its capacity to overturn the disharmony of skin microbiota whose faulty presence promotes the presence of eczema. Dr. Myles and his researchers appear to have validated in their research that the species of bacteria populating the skin of people with eczema while appearing the same as those of healthy people, are in reality weak and incapable of guarding against harmful bacteria like Staphylococcus aureus.

Image: Mouse ear, eczema
From left, a mouse with ordinary eczema, a mouse treated with Roseomonas bacteria from an eczema patient and a mouse treated with healthy Roseomonas. Dr. Ian Myles, national Institute for Allergy and Infectious Diseases
Their laboratory results have been encouraging in the growth of bacteria resourced from healthy volunteers and those with a topic dermatitis, both. With the focus on one species in particular, Roseomonas mucosa, human skin cells in lab dishes and on mice render test results showing that healthy versions of R.mucosa are capable of eradicating eczema, producing healthier skin cells.
Theirs is not the only research team attempting to prove that good bacteria can help treat eczema.

The National Institutes of Health is also funding research whereby Dr. Richard Gallo of the University of California, San Diego and his colleagues are working on producing a lotion with two benign staph bacteria -- Staphylococcus hominis and Staphylococcus epidermidis -- to challenge the harmful effects of the Staphylococcus aureus.Dermatologist and biologist Dr. Gallo has concocted with his colleagues what is considered an innovative microbial eczema treatment.

The discovery that Dr. Gallo made was that Staphylococcus hominis and Staphococcus epidermis have the capacity as friendly microbiome, to kill Staphylococcus aureus, known to be involved in eczema production. S. hominis and S. epidermidis were swabbed from volunteers' skin with eczema  to grow the bacteria in the laboratory, then to produce a lotion incorporating the microbes. Following which the balm was applied experimentally to the forearms of volunteers, vastly increasing their own helpful skin bacteria.

The results were seen in 24 hours when the probiotic lotion succeeded in almost eliminating S.aureus from the volunteers' skin. Enabling the researchers to identify compounds used by the beneficial bacteria to deter S.aureus. Their results were published in Science Translational Medicine. Last year another study had Dr. Gallo and other researchers inject a beneficial strain of Staphylococcus epidermidis with food it digested into mice ears, thus encouraging the growth of S.epidermidis, in turn reducing both the number of P.acnes and the level of inflammation.

A team in South Korea and the United States demonstrated that an extraction from Heliocobacter pylori, commonly found in the human stomach, also can inhibit P.acnes, decreasing skin inflammation in mice, in 2014. It was demonstrated by scientists in Canada that people who take both probiotics and antibiotics result in significantly fewer acne lesions in the space of 12 weeks, in comparison with others taking only one or the other.

These promising new treatments' potential have alerted private companies to the obvious, that they want to be next in line to capitalize on a growing market for consumers prepared to switch their preferences to probiotic cosmetics, toiletries and topical treatments, even to the point where one enterprising biotech company now promotes a "live probiotic spray", to replenish beneficial skin bacteria.

As far as Dr. Gallo is concerned, his experimental lotion represents an "evolutionarily honed" treatment. "There are so many new potent medicines right under our nose", he stated.

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Saturday, July 29, 2017

Clashing Heads, Crashing Brain

"I did a list from the five teams I played for. I have come up with 15 guys I played with or are part of Ottawa football alumni who have either died from or are suffering from degenerative brain disease -- Alzheimer's, ALS, Parkinson's or CTE [chronic traumatic encephalopathy]."
"I define profound [incidents in head bashing] as sensing I was out of my own body. In each case, I played almost the entire game feeling as though I were floating above the field and watching myself down there, in slow motion."
Bob McKeown, former Ottawa Rough Riders lineman
NFL acknowledges CTE link with football. Now what?

Mr. McKeown played for the CFL (Canadian Football League) league between 1971 and 1975. The conditions under which he played as a lineman were not different then than they are now. Head bashing, concussions, repercussions and an unwillingness to withdraw from the game are now as they were then. Only back then the morbidity of the constant traumatic head injuries were an unknown. No one, it seems, even thought to consider the physical consequences of continuing head bashing.

Now, however, scientific enquiry is firm in its conclusion that concussion, brain trauma and degenerative brain disease result from the way that football is played, an energetic, violent exercise of the human body, treating the human cranium as though it were just a ball receiving rough treatment, and that whoever sustained an injury would simply "get over it". Likely the growing awareness of boxing's violent effect on the heads and brains of professional boxers led to the origins of the first awareness of the link between sustained head injury and brain deterioration.
Photos of a normal brain (top) compared with the brain of Greg Ploetz (bottom), who played defensive tackle for the Texas Longhorns and who suffered from severe chronic traumatic encephalopathy.  Boston University Photography

Back then, Bob McKeown, former Rough Riders lineman, just sucked it up like all his teammates. Now, he is an award-winning reporter for the CBC's Fifth Estate investigative journalism program. Back when he was a young footballer, he played in high school and that was his introduction to "profound" incidents that led to a succession of concussions. College (Yale) football continued the exposure and then finally, playing for the Canadian Football League.

He has not yet become aware of any brain disease symptoms in his own experience. But, hearing about the experiences later in life of all those he knew and played with, dying at an early age from progressive degenerative brain diseases, has convinced him that he would like his own brain to be studied after his death. He is very aware that back then, when he played football and suffered some of those physically devastating blows, playing the game through a fog of disorientation, he thought his playing was vastly improved during such episodes.

Research by brain scientists associated with Boston University representing the largest study of former football players ever to have been undertaken, revealed that almost all ex NFL players whose brains were examined indicated levels of CTE (chronic traumatic encephalopathy) present (110 out of 111 examined) ranging from mild to severe. That number included seven of eight former CFL players.
Two college football players collide head-first during a 2009 game. 
Donald Page/Southcreek Global/ZUMApress/Newscom
A previous study out of the Canadian Concussion Centre in Toronto indicated somewhat lower CTE rates to be present among the brains examined post-mortem. Irrespective of which the lead investigator of the Boston research, Dr. Ann McKee, concludes along with her scientific panel that no doubt whatever can exist any longer that there is a definite link between repeated blows to the human head and the eruption of brain disease in later life.

The National Football League in 2016 realized the futility of its denials of any such links. Which led them to make a $1-billion settlement with former players in hopes of compensating for issues relating to brain health. But while the NFL has made that admission and committed to a payout to those involved, the CFL has as yet done no such thing. Retired CFL players like their NHL counterparts filed a class-action damage suit, a claim on hold awaiting a jurisdictional decision.

Jacksonville Jaguars wide receiver Lamaar Thomas (center) is hit in the head by Tampa Bay Buccaneers linebacker Brandon Magee as cornerback Kip Edwards helps make the tackle a 2014 preseason game. Magee was penalized for the hit.
Phelan M. Ebenhack/AP

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Friday, July 28, 2017

Funding Neutrality in Research

"Research shows that industry-sponsored research almost invariably favours the interests of the industry sponsor, even when investigators believe they are immune from such influence."
Marion Nestle, professor, New York University

"[The trial will be immune from industry influence, an unbiased test whether alcohol] in moderation [does protect against heart disease]."
"This study could completely backfire on the alcoholic beverage industry, and they're going to have to live with it."
"The money from the Foundation for the National Institutes of Health [government agency] has no strings attached."
George F. Koob, director, National Institute on Alcohol Abuse and Alcoholism
istock-622924262.jpg
The alcohol industry has sponsored many scientists in the field / Getty
A new clinical trial to take place at Harvard University meant to determine whether there is validation in the alcohol industry's promotion of its products' presumed and touted good-health effects is being funded mostly by none other than the alcoholic beverage industry itself. The $100-million clinical trial whose purpose is to test whether a drink a day does indeed prevent heart attacks is set to proceed.

The funding doesn't come from the federal agency, unsurprisingly. Instead five companies representing the world's biggest alcoholic beverage manufacturers -- Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg -- pledged $67.7 million toward a foundation raising money for the NIH agency, and the National Institute on Alcohol Abuse and Alcoholism is prepared to supervise and oversee the study.

The plan is to recruit roughly eight thousand volunteers at 15 sites worldwide, age 50 or over at medical centers in the United States, Europe, Africa and South America where randomly-assigned participants agree to stop using alcohol altogether, or to consume a single alcoholic drink of their preference each day. They will be followed for six years to determine which group; moderate drinkers or abstainers, suffers more heart attacks, strokes and death.

gettyimages-71557307.jpg
The claim that moderate drinking is better than abstinence has never been fully investigated (Getty)

Volunteers will not be aware in advance which group they will be assigned to, and study organizers feel this could represent a stumbling block in recruiting volunteers. Harvard University where the clinical trial will be directed from, has itself a long historical link with the beverage industry. The Foundation for Advancing Alcohol Responsibility, founded by distillers, gifted Harvard $3.3-million in 2015 to fund the establishment of an endowed professorship in psychiatry and behavioral science.

In 2005, Harvard's School of Public Health attracted scrutiny when one of its professors promoted the health benefits of beer in partnership with Anheuser-Busch and Anheuser was moved then to donate $150,000 for doctoral students' scholarships. Moreover, Dr. Koob, assurances aside, himself served on the medical advisory council of the Alcoholic Beverage Medical Research Foundation from 1999 to 2003, (before it underwent a name change to the Foundation for Alcohol Research), the industry group that provided him with research grants of up to $40,000 yearly between 1990 and 1994.

Many other researchers who will be involved in the study also have either personal or through an institution, financial links to alcohol industry funding. Harvard associate professor of medicine, Dr. Kenneth J. Mukamal, identified as principal investigator of the study has stated never having received funding from the industry. "We have had literally no contact with anyone in the alcohol industry in the planning of this [research]", he pledged.

The hypothesis that moderate alcohol consumption is a positive for human health dates back one hundred years. A Johns-Hopkins scientist published a graph back then that appeared to demonstrate modest drinkers lived longer than heavy drinkers, and abstainers as well. On the other hand, critics of this received wisdom make the interpretation that healthy people are given to moderate drinking, not that doing so helps to make people healthy.

"People will react differently if [disseminated results of the study] it says the study is 'sponsored by N.I.H.' or 'sponsored by Anheuser-Busch'," pointed out Art Caplan, director of medical ethics at the N.Y.U. School of Medicine; adding that the role of the industry would best be disclosed on dissemination to the public of the study's findings.

Cultura RM Exclusive/Liam Norris/Getty Images



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Thursday, July 27, 2017

Examining The Issue

"If we will not change the ways that we are living and the environment and the chemicals that we are exposed to, I am very worried about what will happen in the future."
"Eventually we may have a problem, and with reproduction in general, and it may be the extinction of the human species."
Dr. Hagai Levine, epidemiologist, Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem

"I’ve never been particularly convinced by the many studies published so far claiming that human sperm counts have declined in the recent past." "However, the study today by Dr Levine and his colleagues deals head-on with many of the deficiencies of previous studies."
"The debate has not yet been resolved and there is clearly much work still to be done. However, the paper does represent a step forward in the clarity of the data which might ultimately allow us to define better studies to examine this issue."Professor Allan Pacey, Sheffield University, Great Britain 

"The extent of the decline in sperm counts in the Western world revealed in this study is shocking."
"As the authors point out this has major implications not just for fertility but for male health and wider public health."
"[It remains] an unanswered question [whether future generations of children will reflect this kind of reproductive damage resulting from current male declining sperm counts]."
"This study should act as a wake-up call to prompt active research in this area."
Dr. Daniel Brion, honorary professor, clinical embryology and stem-cell biology, Department of Reproductive Medicine, University of Manchester
baby embryo egg sperm fetus pregnancy
A doctor is silhouetted as he walks past a poster in a Rome fertility clinic. Alessia Pierdomenico / Reuters

This new study through the Hebrew University and the Icahn School of Medicine at Mount Sinai, New York of which Dr. Levine is the lead author, points out that men's sperm counts have fallen by close to sixty percent since the 1970s. And modern life, it would appear, may be regarded as the fuel that led to this volatile fertility crisis. Experts point to chemicals, pesticides, stress, obesity and tight underwear, reflecting the major factors responsible for the crisis.

The researchers engaged in this project tracked over 40,000 men to reach their conclusions. Their study results were published in the Human Reproduction Update journal. And what they point out is that this startling issue of lowered sperm count could be a harbinger of damage to men's health extending beyond fertility, since lower sperm count has linkage to higher death rates and increased potential of suffering other diseases.

Earlier studies have previously linked declining sperm quantity and quality to chemical and pesticide exposure, along with lifestyle factors that include stress and obesity. But this new research is considered to represent the first systematic review of trends in its examination of over 180 studies in a four-decade period to reach the conclusion that since 1973 overall sperm counts in the West have fallen by 59 percent, and sperm concentration by 52 percent.

"It shows the decline is strong and that the decline is continuing", warned Shanna H. Swan, one of the new study's authors. She added that it was her hope that this broad meta-analysis of previously published literature would stamp 'settled' to uncertainty surrounding the collapse of sperm count and its drivers. The decline is worldwide, but it is in the Western world where it appears to be most pronounced.

The emphasis on men in the West being hit particularly hard, appears to validate the exposure to chemicals connection as cause.

But then, according to Richard Sharpe of the MRC Centre for Reproductive Health at University of Edinburgh, delays in pregnancy with an increasing number of would-be parents prepared to wait while the female partner accomplishes other aspirations like completing her education or starting a business, then beginning a family over age 30, coupled with the declined sperm count of her male partner delivers twice the impact in conception difficulties.

Average sperm count concentration has fallen from 99 million sperm per ml to 47 million per ml, according to the World Health Organization which classes low sperm concentration in the field of less than 15 million per ml. Currently over 15 percent of young men have sperm counts that are sufficiently low to be interpreted as within the realm of impaired fertility, and that number is expected to grow in the future.

Beyond the issue of difficulty in conceiving, resulting from low sperm count and quality, the larger implications are again linked to cardiovascular issues, obesity, cancer, leading to higher rates of hospitalization and consequent mortality. At the present time, men's life expectancy is on the increase as a result of rapid advancement in medical care, nutrition and sanitation.

Expectations among experts, however, envision that trend reversing, should the issue of lower sperm count continue.

The concentration of sperm in the ejaculate of men in western countries has fallen by an average of 1.4% a year, leading to an overall drop of just over 52%, say researchers.
The concentration of sperm in the ejaculate of men in western countries has fallen by an average of 1.4% a year, leading to an overall drop of just over 52%, say researchers. Photograph: Alamy

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Wednesday, July 26, 2017

Cause, Treatment, Cure -- Theoretically

"We are closing in on what could actually cause the problem. The public should embrace that and feel that we can start to do something about it."
Brian Balin, neuropathologist, The Philadelphia College of Osteopathic Medicine

"Alzheimer's is ripe for a breakthrough, which I will predict is going to come in [this area of research]."
Annelise Barron, professor of bioengineering, Stanford University

"The World Health Organization has declared Alzheimer's disease a priority. If we can find the link, we can help a lot of people."
"This is the reason more of us [in medical science] are trying to do something."
Judith Miklossy, Swiss researcher,  Alzheimer International Foundation and International Alzheimer Research Center, Switzerland
Chlamydia bacteria. Image: ZEISS Microscopy/Flickr
According to Dan Blazer, J.P. Gibbons professor of psychiatry emeritus at Duke University, no conclusive evidence relating to the benefit of brain games to offset the potential of acquiring Alzheimer's exists. Similarly there is no evidence that vitamins, supplements or cardiovascular drugs have the potential to reduce someone's risk of dementia. "We are still looking for a magic bullet, but we have not found it", he declares.

There are,  however, other researchers who are convinced that they are on another, unproven track that may very well yield results in the efforts to understand the cause and possible cure of Alzheimer's. A body of scientific research appears to point to microbes as a possible cause of the disease, and the ubiquitous herpes virus is regarded by these believers as one of the links. 

Should a proven link arise between microbes and Alzheimer's it could ultimately develop in hopes for treatments, even a cure, at the very time when the medical world remains puzzled over the growing prevalence of Alzheimer's. This is known as the pathogen theory, one that some leading researchers feel confident will eventually lead to increased scientific knowledge and a breakthrough in treatment.

The followers of the microbe-Alzheimer's connection have faced scientific skepticism from their peers, since what they believe does not fall within the sphere of the dominant theory that the cause of Alzheimer's is the accumulation of plaque-forming beta-amyloid and tangles in the brain. But it is the belief that these are side effects by Alzheimer's-microbe researchers, caused by infection or the body's immune response, not reflective of the root cause of Alzheimer's.

In this July 29, 2013 photo, a researcher holds a human brain in a laboratory at Northwestern University's cognitive neurology and Alzheimer's disease centre in Chicago. SCOTT EISEN / CP
Internationally, thirty-one Alzheimer's researchers forwarded an argument for greater focus on the microbe-Alzheimer's connection, urging the world of science to alter its focus relating to the disease, its onset and possible treatment. They point to decades of useless effort in the treatment and hopes of preventing the disease, that it is time now to reassess evidence hinting that Alzheimer's could have a connection to microbes.

Such a reversal in focus could lead to vaccines and improved diagnostics, leading to earlier treatment, they suggest. Despite their efforts to convince colleagues that their theory and data collected auger for a change in investigative tactics, the supporters of the Alzheimer's-microbe link experience outsider status as far as Alzheimer's research is concerned. But they remain determined to forge ahead.

Characteristics of Alzheimer's disease in the brain. Image by National Institute on Aging/NIH

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Tuesday, July 25, 2017

Acquiring Lifeskills, Prioritizing Needs

"Theoretically what we think is that buying time protects people from the negative effects of time stress in daily life. When feeling pressed for time, that seems to take a bit of a toll on people's day-to-day happiness."
"It's not what comes to mind to people as a way to increase their happiness and the rates at which people are engaging in this type of expenditure are surprisingly low."
"People who don't feel like they're rolling in dough may feel like that's a frivolous way to spend money but what our research is showing is that even if you don't have tons of money, using money to get rid of your disliked tasks may be a pretty smart decision."
"People may feel like I can do this so I should do this, and so I hope our research helps to break through that perhaps misguided cultural assumption."
Elizabeth Dunn, psychology professor, University of British Columbia

While most of us don't have digs as fancy as the Royal Yacht Britannia in Edinburgh, seen in this 2012 file photo, new happiness research finds that even people of moderate means would be wise to allocate a small amount of their budget to time-saving services that free them of disliked chores.
While most of us don't have digs as fancy as the Royal Yacht Britannia in Edinburgh, seen in this 2012 file photo, new happiness research finds that even people of moderate means would be wise to allocate a small amount of their budget to time-saving services that free them of disliked chores. (David Moir/Reuters)

A study was undertaken in Vancouver out of the University of British Columbia, headed by psychology professor Elizabeth Dunn. In the experimental study sixty people who formed the nucleus of the study were given $40 and advised that the money should be used to access anything they wanted to spend it on as long as it was a material object that they thought they might like. When the test subjects reported back they indicated they had bought items such as wine, clothing and board games.

That led to the researchers posing the question to their study group to enable them to judge the level of happiness that resulted from those people buying the things they had chosen to spend their study-accessed funds on. For the second weekend, once again the participants were given $40 to spend as they saw fit, only this time they were expected, they were informed, to use the money to achieve time-saving.

As an example, to take a taxi rather than using public transit, or arranging to have someone cut their grass rather than do it themselves, and in another instance use the services of a boy in the neighbourhood to run errands. That done, the researchers compared the group's stated level of happiness that followed both spending activities, week one and week two, with their different emphasis and targets.

The researchers discovered that people appeared to be much happier buying themselves 'time', rather than objects. Reportedly, two percent of the group only, claimed they would use money to buy things that would give them more time for themselves. Professor Dunn reached the conclusion that even those with ample disposable income preferred not to pay others to perform tasks, to save themselves time.

On The Money Happiness and Time
Researchers surveyed 6,000 people in Canada, the U.S. and Europe found that those who doled out cash to save them time on things such as the meal delivery service seen in this 2014 file photo, were happier than those who don't. (Matthew Mead/Associated Press)
Those who were able to afford to have their groceries delivered continued to go out to the supermarket to shop regardless, or continued parking their cars themselves rather than making use of valet parking. That same study made a survey of 850 millionaires in the Netherlands, only to discover that close to half preferred not to spend money outsourcing their most disagreeable tasks.

A survey of 6,000 people in Canada, the United States and Europe indicated that those whose financial situation was healthy and could see benefit accruing from spending discretionary income ridding themselves of dreaded chores still preferred not to. People who do spend money as a time-saving device spend typically $80 to $100 monthly, according to Professor Dunn, adding that even $40 is capable of opening up some spare time.

Professor Dunn's study team's reason that people have an aversion to paying for giving themselves extra time in that they harbour a feeling of guilt for spending funds unnecessarily, since they feel they could do these chores themselves. The team plans a follow-up study hoping to come to a better understanding of why people prefer not to spend money to buy time. Age, gender, ethnicity and other issues could be identified as drivers for that reasoning.

Possibly, it might be an issue of self-respect? That people understand that having certain life skills is a measure of their capability of looking after themselves responsibly? What Professor Dunn and her colleagues are actually engaging in is validation of present-day society's penchant for farming out aspects of their lives that they view as inconvenient, certain responsibilities that hinder their plans, for example.

And, as good an example as any is that children are now commonly farmed out to others for their care and nurturance, depending on non-family members to raise them at critical times in their young lives, rather than their parents, busy with their own lives, absent their children. This study in fact applauds such choices. As it gives a tacit approval rating to failing to acquire the requisite skills and understanding as a parent to fulfill parental obligations to their dependent children.

Another such measure is the extent to which people will not bother learning how to prepare basic, nutritional meals for themselves, vastly preferring to believe that such commonplace tasks central to human existence are too difficult, too much of a nuisance, too interfering in their freedom to disport themselves as they wish, rather than to feel obligated to their own needs, to fulfill them in the most basic of ways, such as meal preparation.

So spending disposable income, or ensuring that whatever money is available is earmarked for fast foods, convenience and pre-prepared foods, or eating out, rather than becoming familiar with simple and wholesome meal preparations. The assumptions that this research team reached simply reflect what they wanted to find to fit their theory.

 What they discovered is that some people recognize they should acquire the skills and discipline to be self-sufficient in these measurable ways if for no other reason than mere self-respect. And they find this somewhat wanting in their estimation, expressing the hope that their research leading to their theories will give people the justification to surrender their agency to others rather than be wholly responsible to and for themselves.




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Monday, July 24, 2017

Egg Donor for IVF? Be Alert and Be Aware -- as in Beware!

"We don't know, of course, whether there is a likely connection between their egg donation and breast cancer. The only way to have a real answer is to begin keeping track of egg donors and to gather information on the long-term health risks of egg donation. Until then, potential egg donors need more realistic and clear explanations about the lack of knowledge about such risks."
"Egg donors are just not on anyone's radar. It's not the same as sperm donation, which doesn't involve hormone injections or any invasive treatments."
"In my opinion, egg donors need to be treated like all other organ donors -- their health should be monitored."
"All women who undergo ovarian stimulation, especially more than once, should be told that their long-term health risks are unknown."
Dr. Jennifer Schneider, Arizona Community physician
Video for Dr. Jennifer Schneider, ivf safety
Left, Jessica Grace Wing, Right, mother Dr. Jennifer Schneider : Still from video

Several doctors at a London fertility clinic about 20 years ago wrote of the "tragic case of a young woman who died of cancer of the colon after successfully donating eggs to her younger sister". This was published in the journal Human Reproduction. Strangely enough, scientific medical curiosity has not been aroused to the extent where research dedicated to discovering how and why high levels of hormones administered to egg donors through IVF techniques has been a dormant issue. Not quite as though no one is interested because there could not possibly be any threat to the future health of such donors.

Perhaps it's because research funding is notoriously scarce. Perhaps it also owes greatly to the fact that funding often comes from pharmaceutical companies and since they're the producers of the chemical hormones used in the process they have no interest particularly in spending any of their profit to determine whether the technique and the material they provide hastens the deaths of young women. It would definitely produce bad press and depress sales of their product. And nor would clinics specializing in IVF feel inclined to push for research that might affect their bottom line.

So the anecdotal reports, troubling, but guesswork at best, although based on keen observation and the identification of cause-and-effect and related informed theories, is all that is available at the present time. And that's strange, since the technique involved in in-vitro fertilization and the hormones associated with it are so widely used, impacting on the lives of thousands of people, from donors to recipients, their families and the children born of IVF.

Donors are informed, if they ask, that no credible research exists that links IVF to any future health problems. Except that isn't the way it's relayed, instead, those questioning the safety of the technique are simply informed that there are no known issues; so rest assured and proceed. And that is precisely what Jessica Grace Wing experienced. A tall, attractive woman with an athletic build who was a student at Stanford University. She made multiple donations of her eggs as a way to help pay for her tuition. And her donations led to the birth of five healthy children to three families.

Her mother, a general physician, had asked her daughter if she was satisfied that egg donation was safe, to which the young woman responded she had been informed that it indeed is. Yet it appears that beyond the short-term effects of the hormone injections used to stimulate the release of multiple eggs at a time, there was really no research specifically examining the possible long-term effects on donors, so the issue, in fact, is a large, open vacuum.

At the age of 29, which was four years following her third egg donation, the young woman was diagnosed with metastatic colon cancer and despite the state-of-the-art treatment she was given, her life ended at age 31, in 2003. Her mother, Dr. Schneider, entertained doubts in her grief whether the extensive hormone treatments her daughter had been exposed to, really had no risks attached, that the growth of the cancer her daughter developed might have been stimulated by the hormones involved in the treatments.

A look through the research results produced nothing since there hadn't been any research to give results. Egg donors may have been experiencing malign effects, but no one had ever bothered keeping track. So she herself conducted a study leading her to advocate for a registry whose results could be of use not only to egg donors but to women wishing to postpone pregnancy freezing their eggs for future use. It has been 14 years since the death of her daughter, fourteen years of neglect to initiate a registry.

Donors are not hard to find since fertility clinics and agencies devoted to finding egg donors advertise that $5,000 to $7,000 is available to anyone wishing to take part, to produce eggs for IVF. Those British doctors who wrote of a patient dying of cancer of the colon post-egg donation, had made note of the fact that long-term safety concerns had been raised in the British Medical Journal in 1989 amid concern over the high levels of hormones donors were administered, but evidently not enough interest was raised.

So Dr. Schneider and two co-authors reported in Reproductive Biomedicine Online on five cases among egg donors who had been diagnosed with breast cancer, four of whom were absent any genetic risk for the disease. None of the women, all in their 30s, had received information relating to long-term risks inherent in donation of their eggs, simply since there was no information to share with them, or with women supplying their own eggs for IVF undergoing similar hormonal treatment as egg donors.
Containers where harvested eggs are frozen and stored for in vitro fertilization. Credit Raymond McCrea Jones for The New York Times


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Sunday, July 23, 2017

Causes of Dreaded Dementia : Prevention?

"Although the brain becomes smaller with age, the shrinkage seems to be fast-tracked in older adults with hearing loss, according to the results of a study by researchers from Johns Hopkins and the National Institute on Aging. The findings add to a growing list of health consequences associated with hearing loss, including increased risk of dementia, falls, hospitalizations, and diminished physical and mental health overall."
"For the study, Frank Lin, M.D., Ph.D., and his colleagues used information from the ongoing Baltimore Longitudinal Study of Aging to compare brain changes over time between adults with normal hearing and adults with impaired hearing. The Baltimore Longitudinal Study of Aging was started in 1958 by the National Institute on Aging to track various health factors in thousands of men and women."
"Previous research from other studies had linked hearing loss with marked differences in brain structure compared to those with normal hearing, both in humans and animals. In particular, structures that process information from sound tended to be smaller in size in people and animals with impaired hearing. Lin, an assistant professor at the Johns Hopkins University schools of medicine and public health, says it was unknown, however, whether these brain structural differences occurred before or after hearing loss."
Johns Hopkins Medicine ... January 22, 2014
Dementia Hearing Loss Link Hearing Aid Ear
Adults with hearing loss are significantly more likely than adults with normal hearing to develop dementia. Istock

"The sharpness of an individual’s hearing has cascading consequences for various aspects of cognitive function. We’re only just beginning to understand how far-reaching these consequences are."
"Even if you have just a mild hearing loss that is not being treated, cognitive load increases significantly. You have to put in so much effort just to perceive and understand what is being said that you divert resources away from storing what you have heard into your memory."
Brandeis University Professor of Neuroscience, Dr. Arthur Wingfield

There seems to be general agreement in the highly specialized medical/scientific community that a link between hearing loss and dementia has been firmly established. That there are many potential causes of dementia, among which are depression, smoking, a sedentary lifestyle, social isolation, high blood pressure, lack of formal education as a child, and lastly peripheral hearing loss.

The prestigious medical journal Lancet had decided to strike a commission of several dozen experts in the field of cognition and risks of age-related cognitive decline. When the report was completed smoking and obesity were listed as major factors in the prevalence of dementia onset. Both smoking and obesity are well enough known as lifestyle predictors of a whole host of physical ills, not the least of which are cancer, heart disease, diabetes and stroke.

The commission authors studied the preventable risk factors potentially leading to dementia, then they estimated how much risk they believed to represent the intensification of each factor in establishing dementia. They settled on a global "population attributable fraction" by which to measure each of the possible underlying drivers toward dementia. As, for example, eliminating smoking would result in how much of a reduction in dementia?

Smoking, as it turned out, using the yardstick of the highest-to-lowest PAF on the established formula, ranked number three, while late-in-life depression (considered to be a preventable social issue) came in at number four. Further down the list of triggers to dementia came social isolation and physical inactivity, and so did high blood pressure. As for the second-placed trigger for mental decline, lack of secondary education fit that niche.

Lack of formal childhood education was placed in the "lifestyle factor" category, the risk given a 60 percent likelihood of potentially precipitating mental decline. Leaving school before attaining age eleven scored a high PAF, and it was ascertained through the calculations that 40 percent of the world population bears this risk factor. None however, ranked as high for the potential to move individuals into mental decline as peripheral hearing loss.

Studies have established the theory that people suffering peripheral hearing loss at or around age 55 double the ordinary individual's risk of dementia. Peripheral deafness is defined as hearing loss with no obvious central nervous system or brain causation, and as such the use of a hearing aid would alleviate the loss. Even so, the Lancet group concludes that it is unknown whether hearing aids have the capacity in their function to aid in halting cognitive decline.

So then, though midlife deafness may contribute to dementia as some neurologists posit, because the effort in attempting to interpret speech monopolizes "cognitive resources", it is still a theory. Theories abound, including one that loss of hearing leaves  the individual feeling sad which ages the individual more swiftly. Still others feel that hearing loss might possibly represent one of dementia's early symptoms.

There is obviously a long way to go in understanding the process, let alone establishing that some cases of dementia can be preventable.

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Saturday, July 22, 2017

Mind and Body: Nurturing the Child

"The damage that happens to kids from the infectious disease of toxic stress is as severe as the damage from meningitis or polio or pertussis."
Dr. Tina Hahn, pediatrician, Caro, Michigan
  • More than 1 in 4 U.S. kids experience a serious traumatic event by the age of 16, including abuse, neglect and household or neighbourhood violence, according to the National Center for Child Traumatic Stress.
  • More than 1 in 5 children have experienced at least two of these traumas and are more likely than others to have school difficulties, along with health and behavioural problems, a 2014 study found.
  • Nearly half of U.S. children younger than 18 live in families at or near the poverty level, U.S. Census data show.
  • The number of U.S. children in foster care climbed steadily after 2011, reaching nearly 430,000 in 2015, the most recent government data show. Neglect was the reason in nearly two-thirds of cases, with most of the rest due to drug abuse, according to a 2016 government report. Authorities believe the opioid epidemic has contributed to the trend. CBC News
Safe spaces, quiet times and breathing exercises for preschoolers are designed to help kids cope with intense stress so they can learn.
Safe spaces, quiet times and breathing exercises for preschoolers are designed to help kids cope with intense stress so they can learn. (Chuck Burton/Associated Press)

Pediatricians in the United States were urged by the American Academy of Pediatrics in 2012 to make an effort to convince parents of young children along with the public that the long-term consequences of toxic stress does long-term harm of both physical and psychological values to children exposed to situations and circumstances that create an insecure and fearful environment for them in their most formative years.

The push was on to call for new public policies and possible treatments geared at preventing or reducing the effects of stress in vulnerable child populations. Recent studies' outcomes appear to validate that the stress children suffer with lack of adequate nurturing, changes the body's metabolism, contributing to internal inflammation, potentially raising the risk of developing diabetes and heart disease.

Researchers at Brown University in 2015 reported findings of elevated levels of inflammatory markers in the saliva of children who had experienced some manner of adversity, including abuse. Animal study experiments suggest that persistent stress may have the capacity to alter brain structure where emotions and the regulation of behaviour is concerned.

"We know that if they don't feel safe then they can't learn", commented mental health specialist Laura Martin, of children who have experienced the treadmill of going in and out of foster homes, or the strained life they experience alongside parents struggling with drug and alcohol dependencies, supplemented by poverty, depression, and domestic violence. When they arrive at school they are unfocused and withdrawn.

This leads to social behaviours that become a problem the schools find they must deal with. Children who kick and scream at their classmates and their teachers. Aggressive discipline has been placed high on a shelf as a response that hasn't worked well in the past. Instead, methods whereby the children's insecurities can be addressed are attempted, in an effort to lead them away from the stress their normal lives burden them with.

At school, children in these programs called "trauma-informed" care, based on research pointing to potential biological dangers of toxic stress leading to a new approach for public health to identify and treat the effects of poverty, neglect, abuse and allied adversities, are leading the way. At home these children "never know what's going to come next", while at school there is quiet time and regularized routines, breathing exercises, and other aids to help angry children deal with conflicts.

Behind these new experimental teaching techniques is the acknowledged science that the brain and disease-fighting immune system, not yet fully formed at birth, remain vulnerable to damage from childhood adversity, according to studies, with the first three years the most critical. Children without nurturing parents or in the absence of other close relatives to step in to help cope with adversity are recognized as being most at risk.

Harvard University neuroscientist Charles Nelson explains that under normal stress conditions the response kicks in briefly to raise heart rate and levels of cortisol and allied stress hormones. But when that stress is severe and remains ongoing, the levels of stress have the potential to remain elevated, placing children in a persistent state of "fight or flight". Imaging studies show regions in the brain affecting emotions and behaviour tend to be smaller than normal in children who have suffered severe trauma.

Research carried out on neglected children in Romanian orphanages lead to the suggestion that early intervention may lead to a reversal of damage from toxic stress, so that orphans placed in the care of nurturing foster families before age two produced imaging scans years later demonstrating that their brains appeared similar to those of children never institutionalized. Whereas those children in foster care at a later age had diminished grey matter, their brains appearing similar to those of children remaining in orphanages.

"The science of how poverty actually gets under kids' skin and impacts a child has really been exploding", explained a former president of the American Academy of Pediatrics. The landmark U.S. government-linked research, called the Adverse Childhood Experiences study published in 1998 led the way to this later research, finding that adults exposed to neglect, poverty, violence, substance abuse, parents' mental illness and other domestic dysfunction were likelier than others to experience heart problems, diabetes, depression and asthma.

Adults with six or more such adverse childhood experiences in their early background died an average of twenty years earlier than those with no such adverse experiences, according to a follow-up study conducted in 2009.
Center on the Developing Child at Harvard University

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Friday, July 21, 2017

Living With Blacklegged Ticks

"There are a lot of ticks now that carry the bacteria that cause Lyme disease so we have to be able to provide some answers on how to better prevent infection and treat the disease."
"There are pockets of excellence in Canada on Lyme disease research but we want to bring them together to have more impact."
Dr. Mark Ouellette, scientific director, Institute of Infection and Immunity, Canadian Institutes of Health Research

"It's a complicated disease that is quite difficult to understand -- and it's turning out to be more complex than people originally thought."
Dr. Tara Moriarty, infectious disease researcher, University of Toronto
Lyme Disease
This is the two-year life cycle of ticks. (Centers for Disease Control and Prevention)

Awareness of Lyme disease spread through infected deer ticks has been an issue for decades. Less of an issue in Canada than it has been in the United States, until the blacklegged ticks, aka deer ticks, began spreading into Canada. And now that they have, and continue to spread more widely it is not only Canadians visiting deer-tick-vulnerable places in the United States that contract Lyme disease, but those being exposed to the ticks increasingly right in Canada.

It isn't of course, only humans that are susceptible to Lyme disease, but animals as well. And just as people are cautioned to be aware when they are in wooded areas, of the presence of deer ticks, and to check for ticks clinging to clothing or to human skin, veterinarians warn dog owners of the risks to animals, and that anyone spending time in forested areas would do well to check their dogs for ticks as well. For dogs there is an oral medication to protect against ticks.

For humans, avoidance is the key for the present time. Which is to be alert to the presence of these tiny ticks and if they are found, to remove them as expeditiously as possible, within a 24-hour window representing the time it takes for bacterial transmission once the tick has latched on to human skin. Those troublesome ticks can appear anywhere in an outdoor environment, but mostly in forests and tall grasses.

They don't fly, and depend on animals or people passing by so that when they brush past where the ticks are perched with their front legs outstretched on grasses or leaves, they find their victims. Insect repellent is recommended, containing DEET, as is wearing long sleeves and long pants whenever in wooded areas. If a companion animal picks up an infected tick (not all deer ticks are infected with the Lyme bacteria) it can be easily transferable to a human.
Tick bite
Health authorities have found an increase in cases of Lyme disease and blacklegged ticks. A tick bite can leave a bull's-eye-shaped rash on the skin. (CBC)

And nor do all people who have been bitten by an infected tick suffer Lyme symptoms. It is a small minority of people who develop the hard-to-treat and painful form of the disease. Scientists do not yet know whether Lyme disease leaves biomarkers in the bloodstream representing an opportunity for doctors to diagnose Lyme while yet in its earliest, treatable stages. There is more not known about Lyme disease and its threatening effects than is yet known.

And it is precisely the need to know what it is about the bacteria Borellia burgdorferi that makes people so ill when it spreads within the human body. Dr. Moriarty's laboratory has discovered that in laboratory test mice, obesity and diabetes cause greater susceptibility to the bacteria and it can be the cause of bone loss as well, in mice.

The federal government has just announced a new initiative to spur Lyme disease research to create a network  to establish a nation-wide cohort of patients for the purpose of studying and tracking their experiences with Lyme disease to better understand how the disease manifests itself in those it infects, how to best diagnose and treat it, and how it persists even in people who have received treatment.

Lyme disease cases in Canada saw 144 diagnoses in 2009. An increase in prevalence and diagnoses raised that number to 917 in 2015, and growing nationwide. Estimates by public-health researchers now posit that 80 percent of Eastern Canada's population will live in areas where the ticks have established themselves by 2020, as opposed to the 18 percent represented in 2010 living in areas at risk of Lyme disease exposure.

Authorities caution people that ticks should be removed with tweezers grasping the head, to ensure that the entire tick, a member of the arachnid family, is removed. Discovered in its early stages, the illness the disease creates with flu-like symptoms generally is successfully treated with antibiotics. Untreated, arthritis can ensue, along with numbness, paralysis, heart disorders and neurological problems.

How to avoid tick bites

The best way to prevent Lyme disease is to prevent tick bites by:
  • covering up
  • using insect repellent
  • double-checking yourself
  • washing and drying thoroughly
  • checking your pets

Cover up

Your clothing gives you an important layer of protection. Make sure to wear:
  • light-coloured clothing so you can spot ticks and remove them before they bite
  • a long-sleeved shirt or jacket tucked into long pants
    • tuck the pants into your socks for extra protection
  • socks and closed footwear

Use insect repellent

Use an insect repellent, or bug spray, containing DEET or Icaridin on clothes and exposed skin. Always read the label for directions on how to use it.

Double-check yourself

When you go to an area where blacklegged ticks live, check – and recheck – yourself by:
  • paying close attention to areas such as your scalp, ankles, armpits, groin, naval and behind your ears and knees
  • using a mirror to check the back of your body or having someone else check for you
When you’ve double-checked yourself, don’t forget to do the same for children in your care.

How to remove a tick

Removing a tick is the same for humans and animals. Follow these steps to remove ticks:
  1. If the tick is attached to you, use fine-tipped tweezers or tick removal tool to grasp the tick as close to your skin as possible. Do not use your fingers.
  2. Pull the tick straight out, gently but firmly making sure to remove the entire tick (including the head). Don't squeeze it – avoid crushing the tick’s body.
  3. After removing the tick, place it in a secure container, such as a screw-top bottle used for medication.
  4. Give the tick to your health care professional or local health unit.
  5. Thoroughly clean the bite site with rubbing alcohol and/or soap and water.

Lyme disease symptoms

Common symptoms include:
  • fever
  • headache
  • muscle and joint pain
  • spasms, numbness or tingling
  • facial paralysis
  • fatigue
  • swollen glands
  • expanding skin rash
People with Lyme disease often see symptoms within 1-2 weeks. But symptoms can appear as early as 3 to 30 days after a bite from an infected blacklegged tick.
Province of Ontario website

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