March 24: Harvard — and HuffPo — offer live update of #marijuana science

Selkoe to discuss #amyloid and #Alzheimer’s in wake of another disappointing drug study

A recent story in The Atlantic asks “Is the Leading Theory About Alzheimer’s Wrong?

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1905: Research at McLean

For years, scientist have been arguing about whether amyloid protein in the brain is a cause,or just a symptom of condition.  Pharma has been confident — or desperate — enough in the science to bet on amyloid clearing drugs, but they haven’t turned out to be very good bets. So far, none has proved effective.

On Tuesday morning, one of the chief proponents of the theory, Harvard’s Dennis Selkoe, will give a talk at McLean Hospital, the storied psychiatric facility in Belmont.  Entitled  “New Insights into the Protein Biology of Alzheimer’s and Parkinson’s Diseases,” it takes place at 11 am in room 132 of at the hospital’s de Marneffe Building.

And, if those in audience have read the Atlantic piece — in which Selkoe is quoted — they may have questions about Merck’s recent decision to abandon test on what was once considering a promising treatment. .

 

 

After Merck’s announcement last week, one neurologist told Bloomberg that “there is mounting evidence—of which this is another piece—that removing amyloid once people have established dementia is closing the barn door after the cows have left.” An advisor to a life-sciences venture-capital firm tweeted, “I’ve been a long-term adherent of the amyloid hypothesis, but starting to feel like this”: “This” was a gif of the Black Knight from Monty Python, arms missing but still adamant he had suffered nothing worse than a flesh wound.

And well, the amyloid hypothesis is not dead yet. Large clinical trials targeting amyloid are still underway—either using new, potentially more powerful anti-amyloid drugs or trying out the previously failed drugs in patients with less advanced Alzheimer’s. These trials will likely affirm the amyloid hypothesis or kill it for good.

Harvard, STATnews hold forum on “21sth Century Cures Act” #research #FDA #NIH

 

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NIH, Bethesda, Maryland

The Harvard Gazette, the school’s in-house newsletter, has a summary of the forum. A video will be available here at some point or find it on Facebook Live.

Note that NEJM editor Jeffrey Drazen said “The NIH is undergoing a slow strangulation,…Money is what drives research. You need the resources when you have an idea.”

Lots of people say this.If you argue that more money for research is always good, you agree. And if you are one of the many, many scientists trying to get the NIH money to fund a project, life is a lot harder. But, is there such a thing as evidence-based research funding? Are we getting outr money’s worth?

Note that NIH’s budget doubled between 1999 and 2003.  Funding started to decline with the 2008 financial crisis, and it’s been pretty level since then. That’s the equivalent of a decline with inflation.

Still,  to many, more is better and level is less. So the increased funding for NIH in the bill perhaps sweetened the provisions in the “21st Century Care Act”  that will speed FDA approval of new drugs. That’s good news for those who will get better and richer from new drugs. Bad news for those worried that FDA oversight is already lax. Two of the speakers expressed some “concern about speeding up the FDA’s drug approval process, saying that will result in decisions based on less-rigorous science.”

 

 

Report to call for state #oversight of #hospital rates in #Massachusetts

A little noticed story about a little noticed report. From the Globe:

download-1In an effort to tackle one of the biggest challenges to the Massachusetts economy, members of a special state commission on Tuesday called for regulating the growth in hospital rates to contain health care costs.

Commissioners said the Division of Insurance should have greater authority to oversee hospital-insurer contracts, including the amount hospital rates can increase each year. The controversial proposal comes after months of discussions at the commission, which was convened to study the wide variation in prices at Massachusetts hospitals. Studies have shown that price disparities contribute to higher health spending because the most expensive providers also tend to have the top reputations and attract the most patients.

On the same day, The Massachusetts Health Policy Commission (HPC) released its annual report on health care spending in Massachusetts in 2016.  Main drivers of health care cost growth are  prescription drug costs, hospital spending, health insurance enrollment changes, and  spending on long-term services. 

Why two commissions? On is a quasi-state agency, the other a one-off , set up when hospitals unions agreed not to pursue a ballot question that would have regulated insurance payment to hospitals. The commission was charged with “recommending steps to reduce price variation among different providers and issuing a report by March 15, 2017,” according to the Globe.

And this Sunday, the Globe reported on another attempt to limit the cost of Medicaid in the state”

Governor Charlie Baker “has been backed into a corner by the soaring expense of MassHealth, the state’s publicly subsidized health insurance program for lower-income residents. MassHealth now accounts for about 40 percent of the state budget, and he fears that even more people will choose it over their employer’s coverage.

To help keep that from happening, the governor last month unveiled a measure that would penalize companies that don’t offer adequate health insurance to their workers.”

 

PRI: #Diabetes undiagnosed in many Asians

From Public Radio International images

At the South Cove Community Health Center in Quincy, Massachusetts, Dr. Qiyue Hu conducts a checkup with his patient Jiping Chang. Chang is 76 and was diagnosed with Type 2 diabetes in 2009. He tells me that at the time, he was surprised. That’s because “I didn’t have any symptoms. I felt OK,” Chang says.

He wasn’t overweight either, traditionally a warning sign for Type 2 diabetes. But it turns out that isn’t uncommon among Asian Americans who develop the disease. In fact, they are two times more likely than whites to develop diabetes, despite having lower obesity rates. 

Jury: Double-booked surgery did not lead to injury

From The Globe.

A Boston jury on Monday found that a spine surgeon at Massachusetts General Hospital failed to i

nform a Westwood financial analyst that he planned to operate on two patients at once, but the jury concluded that the doctor’s divided attention did not cause the man’s quadriplegia.

As a result the jury awarded Tony Meng, a 45-year-old father of two, no financial damages…

Meng’s disastrous operation figured prominently in a Globe Spotlight Team investigation of simultaneous surgeries at MGH and other teaching hospitals. Many hospitals have since restricted the practice, also known as “concurrent surgery,” and a US Senate committee recently sought to curb it.

Two other former patients of Wood’s have sued him for medical malpractice alleging that double-booking contributed to their complications. One of the patients is former Red Sox relief pitcher Bobby Jenks, who blames Wood for what he alleges was a botched back operation in 2011 that ended his career.

For more on the Globe series, click on the link above or see this interview with Spotlight Team editor Scott Allen

At Harvard, heroes and villians, sugar and supplements

screen-shot-2017-01-16-at-9-04-30-pmGary Taubes’ sugar takedown continued in the NYTimes SundayReview, including reference to the late Fred Stare, founder of the nutrition department at the Harvard School of Public Health. In the 1970s Stare was  reportedly paid to exonerate sugar in journal supplement, “Sugar in the Diet of Man,

STATNews refers to the case of another Harvard doctor, this one who found himself on the wrong side of a supplement maker. 

The jury trial had momentous implications for the future of research into the safety of weight-loss and muscle-building pills; for the freedom of academics to speak out about matters of public health; and for our ability to learn what’s in the supplements on our kitchen counters.

 

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