This won't hurt a bit

Barack has showed us that it's okay to bad mouth your opponents. It's the Chicago way, the way Saul Alinsky taught all radicals, and the way Harry Reid conducts himself in the Senate.

So in that spirit, I hope all of you who voted for Hussein enjoy the coming chaos in our medical care. What you've done will make my life a lot harder. Thank you!

Michael Tanner, a senior fellow at the Cato Institute, writes:

Under ObamaCare, employers with 50 or more full-time workers must provide health insurance for all their workers, paying at least 65% of the cost of a family policy or 85% of the cost of an individual plan. Moreover, the insurance must meet the federal government’s requirements in terms of what benefits are included, meaning that many businesses that offer insurance to their workers today will have to change to new, more expensive plans, 

ObamaCare’s rules make expansion expensive, particularly for the 500,000 US businesses that have fewer than 100 employees. 

Suppose that a firm with 49 employees does not provide health benefits. Hiring one more worker will trigger the mandate. The company would now have to provide insurance coverage to all 50 workers or pay a tax penalty. 

In New York, the average employer contribution for employer-provided insurance plans, runs from $4,567 for an individual to $ 12,748 for a family. Many companies will likely choose to pay the penalty instead, which is still expensive — $2,000 per worker multiplied by the entire workforce, after subtracting the statutory exemption for the first 30 workers. For a 50-person company, then, the tax would be $40,000, or $2,000 times 20. 

That might not seem like a lot, but for many small businesses that could be the difference between survival and failure. 

Under the circumstances, how likely is the company to hire that 50th worker? Or, if a company already has 50 workers, isn’t the company likely to lay off one employee? Or cut hours and make some employees part time, thus getting under the 50 employee cap? Indeed, a study by Mercer found that 18% of companies were likely to do exactly that. It’s worth noting that in France, another country where numerous government regulations kick in at 50 workers, there are 1,500 companies with 48 employees and 1,600 with 49 employees, but just 660 with 50 and only 500 with 51.

Blogger Rick Moran adds to the joy:

Individuals and families who will be forced to buy their own insurance when companies drop their health insurance plans will be in for a shock. Even with subsidies, some families will end up paying nearly 10% of their gross income for health insurance. 

The bottom line is mass confusion. Put simply, the American people are unprepared for such a massive change in their lives. Most people don’t realize that their current insurance coverage is inadequate. They actually believed the president when he looked into the cameras during his 2010 State of the Union address and assured citizens that they could keep the insurance plan they have now. Instead, government-mandated coverage for a wide variety of services that many current insurance plans don’t cover will radically alter health insurance for millions.

Good luck!

The rise of tick-borne diseases

Researchers from the Centers for Disease Control and Prevention announced the discovery of a new tick-borne virus this week, one of several newly identified pathogens that ticks are passing to humans. Why are so many new tick-borne diseases being reported?

Improvements in medical technology, mostly. The newly discovered tick-borne diseases have probably been infecting humans for years, but they’re not easy to spot. Many victims never realize a tick has bitten them, and the symptoms, such as fevers, aches, and fatigue, are not distinctive and mirror those of common summer viral infections. The patient’s immune system usually fights off the illness unassisted, so doctors don’t bother running the battery of tests required to identify a new pathogen.  

Only in the rare cases when a patient struggles with the infection are physicians likely to make a genuine discovery. (The disease identified this week, a member of the phlebovirus family, hospitalized two men in Missouri.) They order blood smears or antibody tests to identify the presence of a pathogen, and genetic analyses—which were either inefficient or completely unavailable to doctors just a few years ago—alert researchers to the presence of the previously unidentified bug. Researchers have also become more aggressive recently, with some searching within ticks themselves for evidence of new pathogens.

Lyme disease is a classic example of how long a disease can exist in a population without being identified.

Genetic research has suggested that the pathogen responsible for Lyme disease has afflicted humans for more than 5,000 years. Examinations of a mouse specimen collected from Central Park in the late 1800s suggest that the disease has been present in the United States for more than a century, and case reports indicate that Europeans were carrying the disease at about the same time.  

In the early 1970s, fishermen in Long Island complained of a form of arthritis they called “Montauk knee,” but it wasn’t until later in the decade that doctors figured out that it was caused by an infectious agent. In 1982, researchers finally identified the spirochete that carried the illness. And Lyme disease, with its telltale bull’s-eye rash, is usually easier to identify than many other tick-borne illnesses.

Read the full article for more.

What we're learning about Obamacare

“We have to pass the bill so that you can find out what is in it.”

-- Nancy Pelosi

What we're finding out:

"Why don't you just bend over."

Take a rain check: Get ready for healthcare gridlock. Once the new healthcare law fully takes effect, all Americans will be entitled to a long list of preventive services with no out-of-pocket costs, but the healthcare system won’t have enough doctors to provide them. The shortage will create longer waiting periods that some patients will be able to cope with better than others. Lower income patients will be worse off, according to the Independent Institute.

Someone always gets rich. It turns out that Obamacare is going to be a very lucrative gig for a new crop of government bureaucrats. A subcommittee of the board charged with establishing a healthcare exchange is considering creating 24 positions and pay those employees a total of more than $3 million annually. The average annual salary of a health benefits exchange employee would exceed $125,000 under the plan. The highest salaries would be paid to the CEO ($200,400) and chiefs of finance, operations and communications would make $165,000 each.

Bad hospital, bad: A provision of ObamaCare is set to punish roughly two-thirds of U.S. hospitals evaluated by Medicare starting this fall over high readmission rates, according to an analysis by Kaiser Health News. Starting in October, Medicare will reduce reimbursements to hospitals with high 30-day readmission rates -- which refers to patients who return within a month -- by as much as 1 percent. The maximum penalty increases to 2 percent the following year and 3 percent in 2014.

This would be your death panel: Peter Orszag, the former White House budget director, derieds  the idea that better incentives can reduce costs. Mr. Orszag's alternative: the Independent Payment Advisory Board composed of 15 philosopher kings who will rule over U.S. health care. Who are these Orszag 15? Well, nobody knows. The board was supposed to be up and running by the end of September, but the White House is avoiding naming names for Senate confirmation until after the election. No one knows, either, what this group of geniuses will propose, but that too is part of the grand Orszag plan.

How it works in Canada: There are two tiers of men with advanced prostate cancer in Ontario: Those who get access to a remarkable drug through private insurance, and those who get a death sentence. The grim news is often delivered at the London Regional Cancer Program to men whose shoulders sag and jaws drop when told Ontario's Health Ministry has for 15 months refused to pay for a medication covered by every other Canadian province.

Alive but dumb: Parents and students facing sky-high state-run college tuitions aren't likely to be thinking about ObamaCare. But perhaps they should, since  ObamaCare will likely end up making college still more expensive. Why? Because ObamaCare relies heavily on Medicaid — the federal/state program that provides health insurance for the poor — to expand coverage. But Medicaid is already swallowing up state budgets, forcing states to cut back on everything else, especially support for public colleges.

Miracles and wonders: lab in a shoebox

Checking to see if she has a brain.

A scientific instrument featured on CSI and CSI: Miami for instant fingerprint analysis is forging another life in real-world medicine, helping during brain surgery and ensuring that cancer patients get effective doses of chemotherapy.

The instrument, called a "desorption electrospray ionization" mass spectrometer, or DESI, is about the size of a shoebox. Students have  carried it into a grocery store and held it close to fruits and vegetables to detect pesticides and microorganisms. 

It has also been used to identify biomarkers for prostate cancer and to detect melamine, a potentially toxic substance that showed up in infant formulas in China in 2008. In addition, DESI can detect explosives on luggage.

Now scientists want to  test the instrument in the operating room during brain cancer surgery, comparing it with traditional analysis of tissue samples by pathologists.

DESI can analyze tissue samples and help determine the type of brain cancer, the stage and the concentration of tumor cells. It also can help surgeons identify the margins of the tumor to assure that they remove as much of the tumor as possible.

 Innovations in medicine like this are happening all the time, and we are hardly aware of them.

If your'e a chicken, don't smoke

Smoked fish.

If you were annoyed to learn recently that eggs are once again bad for you, relax.

A study looked at patients with an average age of 62, some of whom really loved eggs and some of whom really loved cigarettes. Researcher David Spence then measured the amount of plaque in their arteries.

The results? Both smoking and eating eggs were independently associated with plaque increases, and eggs were almost as bad as cigarettes. “The effect size of egg yolks appears to be approximately 2/3 that of smoking,” Spence wrote. “Probably egg yolks should be avoided by persons at risk of vascular disease.” 

The problem is that the conclusion is based on self-reported lifetime history of smoking and egg-eating  -- and only smoking and egg-eating.

While it’s entirely possible that people who ate a bunch of eggs filled the rest of their diets with kale and dust and steel-cut oats, it’s just as possible they were eating those eggs alongside bacon and sausage and Hollandaise sauce. In other words: Maybe eggs aren’t solely to blame here.

In fact, we have no way of telling, based on this study, what role eggs specifically played in the development of these arterial plaques.

Antonis Zampelos, a nutrition professor, told Canada’s CBC News that these results lack validity. “The results are not as strong as the statement that came out … I’m not saying that this is not an interesting study. I’m saying that you can’t really make such a strong statement about smoking.”

“This is very poor quality research that should not influence patient’s dietary choices,” Steven Nissen, chair of the department of Cardiovascular Medicine at the Cleveland Clinic Foundation, told ABC News. “It is extremely important to understand the differences between ‘association’ and ‘causation’.”

So maybe you can take care of me

I've been doing some retirement planning this week, and I'm not too far away from signing up for Medicare. I sure hope they have some good-looking nurses.

It is discomforting to absorb the impressions in the media -- President Obama has cut $716 billion from the program; Republican Veep nominee wants to "end Medicare as we know it."

I'm less concerned with how my retirement portfolio is doing than where I'll get healthcare. (Note to financial advisor: ignore this.)

So which is which? You should care, too, because you don't want me knocking on your door in a few years and asking for help with a catheter.

(That is just disgusting. I can't believe you said that.)

It looks as though it's correct that Obama is cutting funds to Medicare to fund Obamacare. The Washington Post, which no one will accuse of having a Republican bias, confirms it. The article's headline: "Romney’s right: Obamacare cuts Medicare by $716 billion. Here’s how."

And it shows where the cuts will come from in this chart.

That's not encouraging. Moreover, a bureaucratic panel of 15 men and women will enforce a spending cap by decreeing how medicine should be practiced and how doctors and hospitals are organized. Did anybody say "Death Panel?" How about "Catheter Committee?"

So what do Romney and Ryan have in mind? I use as sources FactCheck.org and the Kaiser Family Foundation for this:

• For seniors who are now in Medicare, nothing changes. They can stay with the traditional program as it is.
• Beginning in 2023, 65-year-olds would have their choice of insurance plans — private and traditional — on a new Medicare exchange. A premium-support payment, like a subsidy, would be sent to the plan of their choice.
• If the chosen plan costs more than the premium-support, the senior would pay the difference.
• The Medicare eligibility age would be slowly raised to 67 by 2034.
• All plans on the Medicare exchange would offer a base level of benefits, and they would be regulated by the Centers for Medicare and Medicaid Services.
• The premium-support payments would be tied to the second-cheapest plan, which can’t grow more than gross domestic product plus 0.5 percentage points. If the cost does grow faster, Congress would be required to step in and take some action to keep costs down.

I know that if Medicare "as we know it" isn't changed, it's going to collapse on top of my head, pretty nurses and all.

I'll take my chances with Romney and Ryan.

Miracles and wonders: swallow this, touch that

Take two and call me in the morning.

I don't think we fully appreciate that we're in the midst of a revolution in medicine.

According to the mortality tables, there’s a two-thirds chance that a male who’s age 55 today will live to age 80. If you  plan on being among those who die before age 80, but don’t. Some saying that you should plan on living to age 105, or at least 30 years in retirement. One expert: a 65-year-old husband with a 60-year-old wife would require a 40-year planning horizon to be 90% confident of covering the last to die.

The US Food and Drug Administration has approved a grain-sized ingestible digital sensor that can be swallowed in a pill to track health data from inside the body. The idea is that the data can be used not only by patients themselves, but also by caregivers and doctors to individualize their care. The signal that it sends from the stomach travels through the patient's body to a patch worn on the skin. The patch contains technology that senses the signal and records the exact time the ingestible sensor was swallowed.

University of Florida researchers have moved a step closer to treating diseases on a cellular level by creating a tiny particle that can be programmed to shut down the genetic production line that cranks out disease-related proteins. By combining a protein enzyme and a DNA molecule on gold nanoparticles to mimic the gene regulatory mechanism called RNA interference, a “nanozyme” was able to destroy hepatitis C virus in human liver cells and in the livers of mice.

It is clear that all kinds of products and services  would be available online if we had the bandwidth. Programs that involve massive transfers of data or frequent two-way video communications would be two obvious examples. What’s interesting is how many of these new products and services involve healthcare: Jeff Pfaff of Overland Park, Kan., says he hopes to use the service to “push the limits” of a health-monitoring system he’s building. It would enable at-home patients to teleconference with doctors and family members via a camera hooked up to a TV set and a remote control.

European researchers say they have developed the world's first real-sized, five-fingered robotic hand able to grasp and manipulate objects with human-like dexterity. The team  built a hand using strings that are twisted by small, high-speed motors in five fingers, each with three segments. The device was able to handle a delicate Easter egg and lift a five kilogram load. Light sensors were attached to the hand, making it possible to calculate the force required for the fingers to grasp an object without squashing it or losing its grip.

The story of your health in a black box

Yikes! That hurts!

For years I thought that one answer to our broken healthcare system was electronic health records. I still think so, but with a lot of caveats.

The federal government is pushing hard for their adoption. Physicians, driven by the promise of better care, cost savings and nearly $23 billion in new federal incentive payments, are racing to turn their scribbled medical records into digital files, Smart Money reports.

Thirty-five percent of hospitals now use such systems, more than double the share two years ago, according to U.S. government figures. But for all the hype about electronic records, little attention has been paid to what some say is a serious weak spot: When those sensitive bits and bytes fall into the wrong hands, it's often patients who feel the pain.

Here's the trouble.

Since 2009, there have been more than 420 security breaches involving the records of some 19 million patients, according to the U.S. Department of Health and Human Services' Office for Civil Rights. And such breaches are on the rise. A December 2011 report by the Ponemon Institute, a security-research firm, found that the frequency of data losses and thefts among health care organizations increased 32 percent over the previous year.

This is one reason I'm a skeptic about a national healthcare system. Already too many computer systems are familiar with my body.

A doctor in your hand

Is there a doctor in the House?

Health-related apps for smart phones are coming of age. Here are some of the latest.

• One of the latest device-and-app creations to pass muster with the federal Food and Drug Administration is iBGStar, a blood glucose meter that attaches to iPhones or iPads for diabetes monitoring. It's a product of Bridgewater, N.J.-based Sanofi, and sells at Apple retail stores and Walgreens drugstores for about $100 and $75, respectively.

• Heart-EKG uses the iPhone's microphone or camera flash to calculate users' average number of heartbeats per minute or to take their pulse, after placing the phone over an artery, and activating the app. Dallas-based Surich Technologies says the app is handy for aerobic workouts, but isn't intended as a lifesaving monitoring device. It's downloadable from iTunes, for $2.99.

• The iHealth Wireless Blood Pressure Wrist Monitor, expected on the market in September, measures users' blood pressure directly from their iPhone, iPad or iPod Touch. Its app records systolic/diastolic numbers, heart rate and pulse wave, and can chart blood pressure readings, says Karyn Anderson, spokeswoman for Mountain View, Calif.-based iHealth Lab.

• AliveCor Heart Monitor has developed an electrode-studded cellphone case that turns the iPhone 4 into an electrocardiogram device that users hold in their hands or place on their chests to detect irregular heart rhythms. Combined with the app, the monitor can analyze, transmit and store an ECG reading for diagnosis. The heart monitor has been through several clinical trials, said physician David Albert, the device's inventor and co-founder of San Francisco-based AliveCor. He hopes to introduce it for veterinarians' use for dogs, cats and horses later this summer. The device doesn't yet have FDA approval.

• A cellphone-based E. coli sensor for water and other fluids is under development by a University of California-Los Angeles research team. Commercial manufacture of the system, which uses a lightweight attachment to the phone's camera, could be only two years away, said team leader Aydogan Ozcan, a UCLA associate professor for electrical engineering.

• San Francisco-based CellScope's otoscope attaches to the phone's camera lens and will enable parents to photograph their child's eardrum, and e-mail the images to medical professionals checking for an ear infection. CEO Erik Douglas says he hopes to get this to market in about a year.

You'll wanna stay awake for this

Good advice.

"If I told you that I had a neurological disease which meant that for eight or more hours a day I lost control of my faculties, bade farewell to the outside world, and was subject to complex hallucinations and delusions – such as being chased by a grizzly bear at Stockport Railway Station – you would think I was in a pretty bad way. If I also claimed that the condition was infectious, you would wish me luck in coping with such a terrible disease, and bid me a hasty farewell.

"The fact that we accept without surprise the need for a prolonged black-out as part of our daily life highlights our tendency to take for granted anything about our condition that is universal. We don’t see how strange sleep is because (nearly) everyone sleeps.

"Since all animals sleep, we assume it has a biological purpose. The trouble is, we don’t know what that purpose is. There are many theories – energy conservation, growth promotion, immobilisation during hours of darkness when it might be dangerous to be out and about, consolidation of memories – but they are all open to serious objections. William Dement, one of the leading researchers of the last century and co-discoverer of Rapid Eye Movement sleep, concluded from his fifty years in the forefront of the field that 'the only reason we need to sleep that is really, really solid, is that we get sleepy.'"

-- Raymond Tallis

Miracles and wonders: a new hand, zapping cancer

Tickling the ivories, digitally.

The real news in healthcare is coming out of the laboratories, not bureaucracies in Washington.

A research team from Georgia Tech has been working on a rehab glove that is already showing effectiveness for people with limited hand motor skills and proprioception due to spinal injury. The electronic Mobile Music Touch (MMT) glove works with a piano and vibrates individual fingers to point to which keys should be pressed. Using the MMT, people in the study practiced playing the piano for thirty minutes three times a week, and followed up with the glove but without the piano (air piano?), and saw considerable improvement at a time when traditional therapy is usually no longer effective.

Damaged and aged heart tissue of older heart failure patients was rejuvenated by stem cells modified by scientists. "Since patients with heart failure are normally elderly, their cardiac stem cells aren't very healthy," said Sadia Mohsin, Ph.D., one of the study authors and a post-doctoral research scholar at San Diego State University's Heart Institute in San Diego, Cal. "We modified these biopsied stem cells and made them healthier. It is like turning back the clock so these cells can thrive again."

Devising effective drugs is only half the battle faced by pharmaceutical companies. The other half is delivering them to the place in the body they are needed. Some researchers, therefore, are exploring an alternative: building tiny factories that make and release a drug precisely where it is needed. Among these investigators is Daniel Anderson, a chemical engineer at the Massachusetts Institute of Technology. And as he reports in Nano Letters, he and his colleagues have built a device which might do just that. Dr Anderson’s drugmaking machine is a simplified, artificial version of a living cell.

A new method of mapping people's DNA promises to make the procedure more accessible to patients and to help doctors zero in on gene mutations that may cause disease, according to a report Wednesday in the journal Nature. The latest advance in whole-genome sequencing requires only a small amount of DNA to produce a more complete picture of someone's genome, and to immediately determine whether a faulty gene is inherited from the mother, the father or both. That finding could be critical to interpreting results.

In a significant step forward for the development of a potential new cancer treatment, scientists have found how a common cold virus can kill tumors and trigger an immune response, like a vaccine, when injected into the blood stream. Researchers said that by hitching a ride on blood cells, the virus was protected from antibodies in the blood stream that might otherwise neutralize its cancer-fighting abilities. The findings suggest viral therapies like this, called reovirus, could be injected into the blood stream at routine outpatient appointments -- like standard chemotherapy -- making them potentially suitable for treating a range of cancers.

Miracles and wonders: fake jellyfish, perfect teeth

Ersatz jellyfish.

Teenagers today will see extraordinary things in their lifetimes.

Researchers have designed a bioengineered jellyfish that can swim, an early step in scientists' quest for a way to make fresh tissue for patients with damaged hearts. The lab-made jellyfish is created with a mix of silicone and rat-heart cells. Although it isn't a living organism, the robot's muscular structure closely resembles that of a real jellyfish, enabling it to swim freely through water. Scientists hope that such techniques will make it possible to harvest cells from one organism and then reorganize them in sophisticated ways to make a bioengineered system for human use, such as a heart pacemaker that wouldn't require battery power.

Thanks to tiny microneedles, eye doctors may soon have a better way to treat diseases such as macular degeneration that affect tissues in the back of the eye. That could be important as the population ages and develops more eye-related illnesses – and as pharmaceutical companies develop new drugs that otherwise could only be administered by injecting into the eye with a hypodermic needle.

A nationwide team of scientists successfully used stem cells to further the goal of creating personalized medical treatments for Parkinson's disease. Because scientists were able to isolate the disease outside the body with the help of stem cells, they could control for certain variables which allowed them to test treatments in a more systematic way. "This study points the way to screening patients with Parkinson’s for their particular variation of the disease, and then treating them with drugs shown effective to work on that variation, rather than trying to treat all patients with the same drugs, as is generally done now." 

Johns Hopkins tissue engineers have used tiny, artificial fiber scaffolds thousands of times smaller than a human hair to help coax stem cells into developing into cartilage, the shock-absorbing lining of elbows and knees that often wears thin from injury or age. Investigators produced an important component of cartilage in both laboratory and animal models. While the findings are still years away from use in people, the researchers say the results hold promise for devising new techniques to help the millions who endure joint pain.

Happy, happy, happy.

A new chemical could make human teeth 'cavity proof' -- and do away with the need for visits to the dentists forever. The molecule has been called 'Keep 32' - after the 32 teeth in a human mouth. The chemical wipes out all the bacteria that cause cavities in just 60 seconds in tests. The chemical could be added to any current dental care product, turning toothpaste, mouthwash and chewing gum into 'super cleansers' that could get rid of the underlying cause of tooth decay.

Research: prostate surgery not so helpful

Here's another data point for men worried about prostate cancer: surgery was no better in saving lives than observation over a 10-year period, according to one of the first rigorous studies to compare the two approaches in American men with early-stage disease.

The U.S.-funded study assigned 731 men across the country with early prostate cancer to have the gland surgically removed or be observed without any attempt at curative treatment. Ten years later, 47 percent of men in the surgery group had died, mostly from other diseases, versus 49.9 percent who were just watched, results published in the New England Journal of Medicine found. The difference wasn’t statistically meaningful.

“There is no question in my mind that what we have been doing in the United States for the last 20 years has hurt a lot of men needlessly,” said Otis Brawley, chief medical officer for the American Cancer Society. “We need to be telling men that there is tremendous evidence that a large number of men with prostate cancer could be watched and don’t need to be treated.”

In May, the U.S. Preventive Services Task Force recommended against using the prostate-specific antigen (PSA) blood test to spot the disease, saying the screening leads to overtreatment and unnecessary side effects.

Currently, only 10 percent of American men with prostate cancer who are eligible for observation choose observation, according to a National Institutes of Health report last year.

The vast majority elect surgery or various forms of radiation in an attempt to cure their cancer. Both forms of treatment have side effects, including impotence. “When men hear cancer they want something done,” said Durado Brooks, director of prostate and colorectal cancers for the cancer society. The idea that some prostate cancers aren’t life-threatening is “very difficult for people to accept because they are accustomed to thinking of cancer as this ravaging, always-lethal condition.”

After a median of 10 years, 171 of 364 men assigned surgery had died, while 183 of 367 assigned to observation died. In the surgery group, 5.8 percent of the men died from prostate cancer compared with 8.4 percent of the men in the observation group. Neither difference was statistically significant.

More than 1 in 5 patients in the surgery group had complications within 30 days of the operation. Urinary incontinence and erectile dysfunction were much more common in men who got the surgery, while men who got observation had a higher rate of developing bone metastases.

“The results are consistent with emerging science suggesting that for the vast majority of men observation can be a wise and preferred treatment choice” if they have localized prostate cancer, said Timothy Wilt, a researcher at the Center for Chronic Disease Outcomes Research at the Minneapolis Veterans Affairs Health Care System, and the study’s lead author.

Follow the link to the full article, print it out, and take it to your doctor to discuss.

The power of suggestion

We're all familiar with the placebo effect, in which a sugar pill makes people feel better. Researchers have now identified a nocebo effect, in which suggesting side effects of a fake drug cause people to experience those effects.

If you tell a group of trial volunteers that they’re testing a new drug that may relieve the pain of migraines, a significant number of volunteers will experience pain relief after taking the drug — even if they’ve been randomly assigned to the placebo group and are receiving nothing but sugar pills. The placebo effect in action. 

But here’s where it gets interesting. If you tell the volunteers that the side effects of this new medicine may include dry mouth, tingling in the hands and feet, and slight dizziness, some volunteers will experience precisely these side effects — inboth groups. In fact, some volunteers who are taking nothing but sugar pills will be made so uncomfortable by these symptoms that they will choose to drop out of the trial early.

The relevance of the nocebo effect is not limited to clinical trials.

A particularly nasty demonstration of its power can be provided by patients who are being treated for Parkinson’s disease with small doses of electrical current delivered to certain structures in the brain. This technique, known as Deep Brain Stimulation (DBS), has been shown to be effective in controlling tremor and other motor issues in patients who are resistant to drugs. But if you tell a DBS patient that the current has been switched off — even though it remains on — their coordination and other motor functions will abruptly decline until you tell them that the juice has been switched on again. Classic nocebo.

Someone suggested that I look tired and will probably need a nap this afternoon. Wow, they're right!

Why don't you just light up and watch TV?

Won't live forever.

Yet another study says that lack of exercise is as deadly as smoking.

People across the world are falling so far short on exercise that the problem has become a global pandemic, causing nearly a tenth of deaths worldwide and killing roughly as many people as smoking, researchers warned this week as an alarming series of studies was published in the Lancet.

Eight out of 10 youngsters age 13 to 15 don't get enough exercise, according to one of the Lancet studies released Tuesday, and nearly a third of adults fall short. The problem is even worse for girls and women, who are less active than boys and men, researchers found.

I'm going to make this real easy. This costs nothing.

More good news about aspirin

Taking low-dose aspirin for five years halves the risk of developing colon cancer, according to data published two years ago by Peter Rothwell, from Oxford University. The problem is it causes stomach bleeding in some people. Now there may be a solution.

A mass-screening programme foar 50- to 70-year-olds could cut the risk of stomach bleeds experts have said. About a third of this group carry the bacterium Helicobacter pylori, which makes stomach bleeds three times more likely - and antibiotics eradicate it. Professor Jack Cuzick told the BBC's that screening would make the choice to take aspirin to help protect against cancer a "no-brainer". He said the test is easy to do and eradication only takes five days.But Prof Cuzick told Newsnight the most up-to-date data showed "much stronger results".

Last year, research indicated daily low-dose aspirin cut the risk of dying by 66% for oesophageal cancer and 25% for lung cancer. When researchers looked at all solid cancers together, the risk also fell, by 25%.

This year, the team looked at aspirin's effect on the spread of cancer, and found it reduced the risk of secondary spread to the lungs, liver and the brain by "about half". Low-dose aspirin is already recommended to cut the risk of heart attack and stroke, but there are no national guidelines on who should consider taking it to prevent cancer, or how much to take.

Because of the risk of bleeding you should consult your doctor before gulping these things down. 

Get thee to a CPR course

Marla Sewall: lucky to be alive.

A year ago I hauled myself down to the firehouse a couple of evenings to learn CPR. If you're like me, and the last time you had a course was 137 years ago in the Boy Scouts, it's time for a refresher.

That's because we have portable defibrillators today, and they're marvelous machines. They basically tell you -- a voice talks to you -- what to do. And the how-to of chest compressions has changed. I was surprised to see how hard you actually have to push on a chest, and how often. 

I thought about this after reading a post by Helen Smith. It's said that half a million people die from sudden cardiac arrest each year and that 90 percent of people who have sudden cardiac arrest die --  the other 10 percent get defibrillated and live.

It can strike even those who are athletic and active.

Just ask Marla Sewall. By 2011, the 42-year-old had 11 marathons under her belt. She’d also made quite the name for herself on the tennis court. By Labor Day weekend, the University Park mother was even combining the two, running 20 miles one day and then competing in a three-hour tennis tournament in the next.  

For good measure, Sewall ran 10 miles the day after that and played in the same tennis tournament for three more hours. Which is why it was so shocking when her husband found her face-up unconscious in the family’s tub one night. This woman’s husband luckily knew CPR and saved her life. 

 The best argument I can make for staying inside and taking a nap.

Please sit down to read this

This family is doomed.

Restricting the amount of time spent seated every day to less than 3 hours might boost the life expectancy of U.S. adults by an extra 2 years, according to an analysis of published research in the British Medical Journal. And cutting down TV viewing to less than 2 hours every day might extend life by almost 1.4 years.

Several previous studies have linked extended periods spent sitting down and/or watching TV to poor health, such as diabetes and death from heart disease/stroke. 

The researchers used data collected for the National Health and Nutrition Examination Survey (NHANES) for 2005/6 and 2009/10, to calculate the amount of time US adults spent watching TV and sitting down on a daily basis.

To be precise:

The results of life table analyses indicates that cutting the amount of time spent sitting down every day to under three hours would add an extra two years to life expectancy. Similarly, restricting time spent watching TV to under two hours daily would extend life expectancy by an extra 1.38 years.

"Given that the results from objective monitoring of sedentary time in NHANES has indicated that adults spend an average of 55% of their day engaged in sedentary pursuits, a significant shift in behaviour change at the population level is required to make demonstrable improvements in life expectancy," they conclude.

This distresses me so much that I think I'll turn on a rerun of NCIS and take a nap.

(Thanks, Jim)

The real answer to our health care woes

Yesterday, as the Supreme Court was declaring that Obamacare is a tax, some researchers in Canada were announcing a step toward a cure for diabetes.

University of British Columbia scientists, in collaboration with an industry partner, have successfully reversed diabetes in mice using stem cells, paving the way for a breakthrough treatment.

After the stem cell transplant, the diabetic mice were weaned off insulin, a procedure designed to mimic human clinical conditions. Three to four months later, the mice were able to maintain healthy blood sugar levels even when being fed large quantities of sugar. Transplanted cells removed from the mice after several months had all the markings of normal insulin-producing pancreatic cells.

According to the American Diabetes Association, 25.8 million children and adults in the United States—8.3% of the population—have diabetes. Another 79 million people have prediabetes. The total cost of diabetes in 2007 was $218 billion.

You won't improve your health care by funneling your taxes through bureaus and agencies in Washington, which will take their share and make decisions on how or if to send it back to your doctor's office.

The current tsunami of medical discoveries will make Obamacare obsolete before it's fully implemented.

Oh, yesterday we also learned that:

• Johns Hopkins researchers have generated stem cells from skin cells from a person with a severe, early-onset form of Huntington's disease (HD), and turned them into neurons that degenerate just like those affected by the fatal inherited disorder. By creating "HD in a dish," the researchers say they have taken a major step forward in efforts to better understand what disables and kills the cells in people with HD, and to test the effects of potential drug therapies on cells that are otherwise locked deep in the brain.

• Vertex Pharmaceuticals announced positive final results from a Phase 2 combination study of Kalydeco™ and a potential cystic fibrosis drug called VX-809. Cystic fibrosis patients with two copies of the most common mutation, Delta F508, showed significant improvements in lung function while taking the combination therapy.

I say it's a watermelon

Likes Obamacare.

We live in strange times. The Supreme Court has pronounced Obamacare, under which the federal government will take over your health care and mine, a "tax." We all know it's not a "tax." Even Obamaman himself argued that it wasn't a tax.

So a law passed in late-night, weekend maneuverings on a strictly party-line vote, even as polls showed the American people opposed, and which nobody actually read before voting on it -- as Nancy Pelosi pointed out -- a law that assumes control of one-sixth of the economy, the one-sixth that will determine how long and how well we live, is a "tax."

Fine. A watermelon is a tax. Whatever.

I think we'll learn in six months that John Roberts has a brain tumor affecting his thinking.

The whole notion of federally-run healthcare is DOA. With computers, the Internet and cell phones, central control of anything is a dinosaur.

I saw a program on Bell Labs the other evening. It's where the transistor was invented -- the invention that eventually would make Bell Labs unnecessary. From its peak of 25,000 employees, it's now down to 1,500. Xerox' famous Palo Alto lab went the same way. The reason: companies today can tap into scientific minds anywhere in the world at any time -- without hiring them. They go to websites, post problems, and scientists bid on solving them.

Hierarchical corporations have collapsed -- all the action is on the edge of the network, not in the DOA ranks of middle management once needed to communicate and control.

The media were once centrally controlled. You had to own a printing press to make a newspaper or a TV network or a TV station to broadcast. Youtube anyone?

It's interesting that Obamaman has taken over student loans just as higher education is going through the "change." Middle class kids can't afford college anymore. And yet one university after another is offering courses for free online. The action is in your family room at your computer, not in an ivy-covered building on some far-off campus.

In the same way, forefront of health care is now a smart phone on a doctor's belt that can tell him everything about the patient in front of him, everything in the research about his condition, soon everything about his genetic makeup, and that can image his abdomen and help with a diagnosis.

This can not be helped in any way by bureaucrats and boards and politicians buying and selling votes and power in Washington.

The forces of change are irresistible, and Obamacare will fall under its own weight. It will just be very messy to watch.

Dan Henninger, the Wall Street Journal columnist, wrote before he knew what the decision was:

From day one, the Obama health-care legislation was swimming against the tides of history. It was a legislative monolith out of sync with an iPad world. In the era of the smartphone, ObamaCare was rotary-dial health reform. 

The signs this was so were everywhere, but Barack Obama and the Pelosi-Reid edition of the Democratic Party blew past them. Years before it arrived at the Supreme Court's door, the Obama health-care law was unpopular with the American public. With occasional exceptions, its unfavorables have been above 50% for nearly three years. And why not? It runs counter to the daily experience of virtually everyone.

Electronics, foods, fashion, entertainment, apps, social media, appliances—pretty much anything that escapes the cold hands of a public agency is laid before us in a dazzling, unprecedented array of choices. Despite all the incoming, people learned to navigate the options. Virtually everyone has become adept at customizing a personal milieu that suits them. Given a reasonably growing economy, they'll be able to sustain these choices. 

In this context, the Affordable Care Act gave new meaning to the word "outlier." Starting with the insurance mandate. Of course most people hated it. They're living in a world turning more anti-mandate by the minute, and the Democrats are ordering them all into a national health-insurance pool.

The Affordable Care Act is the exhibit du jour, but there is a disconnect nearly everywhere between governments and the reality of the way life is lived by the people they govern. Across Europe, the young are being drowned by something known as "the welfare state." It sounds more Orwellian than it did the first time. Other than the crude imperatives of survival amid a modernizing people, the Chinese Communist Party is clueless.

If you're counting on Social Security and whatever Medicare will become, you know somewhere deep in your soul that they won't be there. Neither will Obamacare (and now, with Nancy, I guess we'll have to read it to find out what the Supreme Court found in it). The future is elsewhere.

By the way, the name of Henninger's column is "Wonder Land."

It's ok to sleep through this post

Will live forever.

Many baby boomers are embracing lifestyles that could lead to a long and rewarding life – with two exceptions, new research suggests.

 More than seven in 10 centenarians – 71% – say they get eight hours or more of sleep each night. By contrast, only 38% of boomers say they get the same amount of rest. And when it comes to eating right, more than eight in 10 centenarians say they regularly consume a balanced meal, compared with just over two-thirds (68%) of baby boomers.

The report begins with some startling numbers. As of late 2010, the U.S. had an estimated 72,000 centenarians, according to the Census Bureau. By the year 2050, that number – with the aging of the baby-boom generation – is expected to reach more than 600,000. Meanwhile, an estimated 10,000 boomers each and every day – for the next decade – will turn 65.

How to reach 100?

Centenarians point to social connections, exercise and spiritual activity as some of the keys to successful aging. Among surveyed centenarians, almost nine in 10 – fully 89% – say they communicate with a family member or friend every day; about two thirds (67%) pray, meditate or engage in some form of spiritual activity; and just over half (51%) say they exercise almost daily. 

In each of these areas, baby boomers, as it turns out, match up fairly well. The same percentage of boomers as centenarians – 89% – say they’re in touch with friends or family members on a regular basis. Sixty percent of surveyed baby-boomers say spiritual activity is an important part of their lives, and almost six in 10 boomers (59%) exercise regularly.

Sleep and diet are the two areas where baby boomers come up short. Not surprisingly, the one area where boomers are more active is the workplace. Three-quarters (76%) of surveyed baby boomers say they work at a job or hobby almost every day; that compares with 16% of centenarians.

What's for dinner?

What's for dinner?

"Increasing evidence suggests that the alarming rise in allergic and autoimmune disorders during the past few decades is at least partly attributable to our lack of exposure to microorganisms that once covered our food and us. As nature’s blanket, the potentially pathogenic and benign microorganisms associated with the dirt that once covered every aspect of our preindustrial day guaranteed a time-honored co-evolutionary process that established “normal” background levels and kept our bodies from overreacting to foreign bodies. This research suggests that reintroducing some of the organisms from the mud and water of our natural world would help avoid an overreaction of an otherwise healthy immune response that results in such chronic diseases as Type 1 diabetes, inflammatory bowel disease, multiple sclerosis and a host of allergic disorders.

"In a world of hand sanitizer and wet wipes (not to mention double tall skinny soy vanilla lattes), we can scarcely imagine the preindustrial lifestyle that resulted in the daily intake of trillions of helpful organisms. For nearly all of human history, this began with maternal transmission of beneficial microbes during passage through the birth canal — mother to child. However, the alarming increase in the rate of Caesarean section births means a potential loss of microbiota from one generation to the next. And for most of us in the industrialized world, the microbial cleansing continues throughout life. Nature’s dirt floor has been replaced by tile; our once soiled and sooted bodies and clothes are cleaned almost daily; our muddy water is filtered and treated; our rotting and fermenting food has been chilled; and the cowshed has been neatly tucked out of sight. While these improvements in hygiene and sanitation deserve applause, they have inadvertently given rise to a set of truly human-made diseases."

-- Jeff D. Leach

Miracles and wonders: escalation in war on cancer

Breakthroughs in the world of medicine.

New research shows a sharp escalation in the weapons race against cancer, with several high-tech approaches long dreamed of but not possible or successful until now. At a conference of more than 30,000 cancer specialists, scientists reported:

• New “smart” drugs that deliver powerful poisons directly to cancer cells while leaving healthy ones alone.
• A new tool that helps the immune system attack a broad range of cancer types.
• Treatments aimed at new genes and cancer pathways, plus better tests to predict which patients will benefit from them.

“I see major advances being made in big diseases” such as breast and prostate cancers, said Dr. Richard Pazdur, cancer drug chief at the federal Food and Drug Administration.

A laboratory test used to detect disease and perform biological research could be made more than 3 million times more sensitive, according to researchers who combined standard biological tools with a breakthrough in nanotechnology. The increased performance could greatly improve the early detection of cancer, Alzheimer's disease and other disorders by allowing doctors to detect far lower concentrations of telltale markers than was previously practical.

Scientists have for the first time transformed skin cells—with a single genetic factor—into cells that develop on their own into an interconnected, functional network of brain cells. The research offers new hope in the fight against many neurological conditions because scientists expect that such a transformation—or reprogramming—of cells may lead to better models for testing drugs for devastating neurodegenerative conditions such as Alzheimer's disease.

Scientists have developed a new approach to visualize how proteins assemble, which may also significantly aid our understanding of diseases such as Alzheimer's and Parkinson's, which are caused by errors in assembly. Understanding how a protein goes from being one thing to becoming another is the first step towards understanding and designing protein nanomachines for biotechnologies such as medical and environmental diagnostic sensors, drug synthesis of delivery.

One of the grimmest legacies of the war in the Pacific is still being fought 70 years on, but a victory over dengue, the intensely painful "breakbone fever" which that conflict helped spread around the world, may be in sight. The U.S. Army, which like its Japanese enemy lost thousands of men to the mosquito-borne disease in the 1940s, has piled resources into defeating the tropical killer. But it may be about to see the battle to develop the first vaccine won not in the United States but by French drug company Sanofi. The Paris-based firm hopes for positive results in September from a key trial among children in Thailand that would set it on course to market a shot in 2015 which would prevent an estimated 100 million cases of dengue infection each year. Of 20,000 annual deaths, many are of children.

More good news about dark chocolate

Go ahead, live forever.

Eating dark chocolate daily can reduce cardiovascular events, including heart attacks and strokes in people with metabolic syndrome, i.e. a combination of factors that increase the risk of developing heart disease and diabetes, according to a study in the British Medical Journal.

Dark chocolate with a cocoa solid content of at least 60% is rich in flavonoids that are known to protect the heart. However, the protecting effects have so far only been assessed in short-term studies. To predict the long-term effects, Australian researchers used a mathematical model to predict the long-term health effects and economic effectiveness of eating dark chocolate daily. They recruited 2,013 people who were high-risk candidates for heart disease. 

All participants were hypertensive and met the criteria for metabolic syndrome, yet they had no previous history of heart disease or diabetes and did not take medication to lower their blood pressure. 

The best-case scenario, i.e. a compliance of 100%, meant that eating dark chocolate daily would be able to prevent 70 non-fatal and 15 fatal cardiovascular events per 10,000 people over a 10-year duration. By reducing the compliance rate to 80%, they could potentially prevent 55 non-fatal and 10 fatal events respectively, which is still a substantial reduction and effective intervention. 



I'm definitely gonna comply. I may start right now. BTW, itt's gotta be the dark kind, people, not milk chocolate, and it has to have a cocoa content of at least 60-70% cocoa.

However, any kind of chocolate that comes in ice cream is okay, according to me.

Lighten up, live forever

Will live forever.

Researchers have found that personality traits like being outgoing, optimistic, easygoing, and enjoying laughter, as well as staying engaged in activities, may be part of the longevity genes mix.

"When I started working with centenarians, I thought we'd find that they survived so long in part because they were mean and ornery," said Nir Barzilai, M.D., the Ingeborg and Ira Leon Rennert Chair of Aging Research, director of Einstein's Institute for Aging Research and co-corresponding author of the study. 

"But when we assessed the personalities of these 243 centenarians, we found qualities that clearly reflect a positive attitude towards life. Most were outgoing, optimistic and easygoing. They considered laughter an important part of life and had a large social network. They expressed emotions openly rather than bottling them up." 

In addition, the centenarians had lower scores for displaying neurotic personality and higher scores for being conscientious compared with a representative sample of the U.S. population.

The scientists wouldn't say it, but I will: jerks will die off more quickly. I've got a list.

Miracles and wonders: think to drink coffee

"While American companies operate in radically different ways than they did 40 years ago, the sheltered, government-dominated sectors of the economy — especially education, health care and the welfare state — operate in astonishingly similar ways," David Brooks writes in The New York Times.

That is the most worrisome thing about Obamacare. In corporate America, command-and-control is dead, having given way to "edge of network," hierarchies are flattening, and knowledge is being sucked in from everywhere, including outside of the company. Companies post technical problems on special websites and researchers around the world bid to solve them.

Against this, we have Washington doing its best to consolidate power and decision-making in its bureaucratic hallways. Paradoxically, this is an era of miracles and wonders -- every day brings some new astounding breakthrough in medicine. These usually mean some more effective and more efficient way to cure something -- which means cheaper.

For example:

Researchers have long tried to get the optic nerve to regenerate when injured, with some success, but no one has been able to demonstrate recovery of vision. A team at Boston Children’s Hospital reports a three-pronged intervention that not only got optic nerve fibers to grow the full length of the visual pathway (from retina to the visual areas of the brain), but also restored some basic elements of vision in live mice.

Tiny, wearable gadgets that monitor and record the data of the body’s weight, heart rate, activity levels and other vital signs can change the game in health care. Sonny Vu, co-founder of the medical-device company AgaMatrix, has already developed the first FDA-approved mobile attachment for Apple’s iPhone that acts as a sensor in detecting glucose levels. Vu believes this is one of the many devices that our bodies will harness to keep us up-to-date on what is going on with our health. Mobile devices are popular and will continue to gain popularity, so it makes sense to integrate it with the healthcare system. People can text, check Facebook and ensure that they have normal blood pressure because everything is readily available like the shirt on their back.

An ultrasensitive biosensor that could allow for early detection of cancer and for personalized medicine tailored to the specific biochemistry of individual patients has been developed by Purdue University researchers. The biosensor combines a mechanical sensor, which identifies a biomolecule based on its mass or size, with an electrical sensor that identifies molecules based on their electrical charge. The sensor makes it possible to detect small quantities of DNA fragments and proteins deformed by cancer long before the disease is visible through imaging or other methods.

A woman who lost the use of her limbs after a devastating stroke nearly 15 years ago has taken a sip of coffee by guiding a robotic arm with her thoughts. The 58-year-old used a brain implant to control the robot and bring a flask of the coffee to her lips, the first time she had picked up anything since she was paralysed and left unable to speak by a catastrophic brain stem stroke. Doctors hailed the feat as the first demonstration of an implant that directly controls a reaching and gripping robotic arm by sensing and decoding the patient's brain signals. Watch it here:

Snoring kills. Good.

Snoring and other types of "sleep disordered breathing," as it is known, can deprive the body of enough oxygen for hours at a time. And scientists now believe having low blood oxygen levels can trigger the development of cancerous tumors, by promoting the growth of the vessels that feed them.

Researchers in the US looked at cancer rates in more than 1,500 people, in a study of sleep problems that has been going for 22 years. They found those with severe sleep disordered breathing (SDB) were 4.8 times more likely to develop cancer than those who had no such problems.

This is good news for two reasons. First, it's nature's way of eliminating annoying people. Second, it introduces yet another acronym for hypochondriacs to call their doctors about. SDB. Sound serious.

Exercise and ADHD

Exercise clears the mind. It gets the blood pumping and more oxygen is delivered to the brain. This is familiar territory, but Dartmouth's David Bucci thinks there is much more going on.

"In the last several years there have been data suggesting that neurobiological changes are happening -- [there are] very brain-specific mechanisms at work here," says Bucci, an associate professor in the Department of Psychological and Brain Sciences. From his studies, Bucci and his collaborators have revealed important new findings:

• The effects of exercise are different on memory as well as on the brain, depending on whether the exerciser is an adolescent or an adult.

• A gene has been identified which seems to mediate the degree to which exercise has a beneficial effect. This has implications for the potential use of exercise as an intervention for mental illness.

Bucci began his pursuit of the link between exercise and memory with attention deficit hyperactivity disorder (ADHD), one of the most common childhood psychological disorders. 

Bucci is concerned that the treatment of choice seems to be medication. "The notion of pumping children full of psycho-stimulants at an early age is troublesome," Bucci cautions. "We frankly don't know the long-term effects of administering drugs at an early age -- drugs that affect the brain -- so looking for alternative therapies is clearly important."

"The implication is that exercising during development, as your brain is growing, is changing the brain in concert with normal developmental changes, resulting in your having more permanent wiring of the brain in support of things like learning and memory," says Bucci. "It seems important to [exercise] early in life." 

When I was in school -- and this was first grade through 12th -- we had physical education for one hour every single day. That's not happening now. What's it like at your school?