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.

 

Video: Harvard School of Public Health: The Chronic #Pain Epidemic

NEJM: One man’s tragic try at “stem cell” therapy. Will we soon be seeing ads for overseas CRISPR clinics?

Capture
Ad for one program.

A local man has been crippled by a growth on his spine that developed after he traveled overseas to a so- called stem cell clinic. The growth was not from his own cells. So, not only is the treatment untested, doctors don’t know what to do about the bad outcomes.

Here’s the technical explanation from The New England Journal of Medicine:

Commercial stem-cell clinics have been highly publicized in the lay press and operate worldwide with limited or no regulation. We report the case of a 66-year-old man who underwent intrathecal infusions for the treatment of residual deficits from an ischemic stroke at commercial stem-cell clinics in China, Argentina, and Mexico. He was not taking any immunosuppressive medications. In reports provided to him by the clinics, the infusions were described as consisting of mesenchymal, embryonic, and fetal neural stem cells. Progressive lower back pain, paraplegia, and urinary incontinence subsequently developed. Magnetic resonance imaging (MRI) revealed a lesion of the thoracic spinal cord and thecal sac; a biopsy specimen was obtained

This from the Globe story

Brigham pathologists tested the tissue taken from Gass’s spine and determined it was a tumor-like growth but did not have mutations associated with cancer and therefore could not be treated with chemotherapy. Most of the cells were not Gass’s but from another source.

“It’s hard to know what to call it,’’ Chi said.

Doctors have treated Gass with radiation to shrink the mass, which has helped somewhat, but they are also searching for other solutions.

Doctors have been increasingly warning that stem cell clinics are proliferating around the world with little oversight. They are promoting their methods to patients suffering from strokes, amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease), Alzheimer’s, and other conditions for which there are few good options. Professional athletes have helped popularize the clinics by seeking out stem cell therapy for strokes and shoulder and knee injuries.

 The NYTimes also has a story. 

2 Boston studies: Breast cancer costs and medical records benefits

After pushing mammograms for years, breast cancer advocates have had a hard time pulling back. Still the evidence keep piling up that message about surviving breast cancer is more complicated than early detection.  What this study by Boston researchers doesn’t measure: the scores of women who say — If there’s a chance it’s cancer, I want to know.  From the AP, in the back pages of the Globe A section; buried in the web site.

Sharpening a medical debate about the costs and benefits of cancer screening, a new report estimates that the United States spends $4 billion a year on unnecessary medical costs due to mammograms that generate false alarms, and on treatment of certain breast tumors unlikely to cause problems.

On a lighter note, another study centers on the benefits of giving patients their own records. From the NYTimes.

ONC_PSA_BannerAd_300x250_Red_Button_1Some of the most advanced medical centers are starting to make medical information more available to patients. Brigham and Women’s, where Mr.  (Steven) Keating had his surgery, is part of the Partners HealthCare Group, which now has 500,000 patients with web access to some of the information in their health records including conditions, medications and test results.

Other medical groups are beginning to allow patients online access to the notes taken by physicians about them, in an initiative called OpenNotes. In a yearlong evaluation project at medical groups in three states, more than two-thirds of the patients reported having a better understanding of their health and medical conditions, adopting healthier habits and taking their medications as prescribed more regularly.

Here’s the Globe’s take.

Some patient advocates have been pushing for this for years, and having a little fun with it.

Coping with life in the snow maze #BOSnow

1st BOSnow Jan 27From CommonHealth

Debating Vitamin D: Leading Docs Still Wrangling On Best Dose For Patients

Globe on Snow Shoes for exercise. (It’s too deep to x-country ski.) 

Strap on your snowshoes and head out. Snowshoeing is one of the best winter exercises for staying fit, says Matt Heid, a contributing editor and blogger for the Appalachian Mountain Club. The cardio workout burns 420 to 1,000 calories per hour, depending on the conditions, according to a study conducted by the University of Vermont. Here are a few trappings for the newbies and experienced, with tips from Heid.

2nd BOSnow Feb  9From Our Bodies Ourselves:

What’s the Connection Between Snowfall in Boston and Health and Human Rights?

First, the health effects of extreme temperatures hit those with fewest resources — money, housing, safety, good health — hardest. It makes sense if you think about it: If you’re already sick, or living in a violent home or neighborhood, added difficulty getting around is much more serious than for healthy people who are safe at home.

Team Rubicon to the rescue:3rd BOSnow Feb 15

Team Rubicon has begun to receive requests for assistance with emergency snow removal across eastern MA and southern NH, focusing on the elderly and those who are not physically able to remove snow. Many of these residents have found themselves unable to move to/from their homes, or are not able to receive critical heating oil deliveries, a potentially dangerous situation with temperatures dropping across the region.

We are currently collecting availability for volunteers to assist with snow removal this weekend for part of or all of these days: Friday, 2/20, Saturday, 2/21, and Sunday, 2/21. We plan to shovel snow to clear pathways and potentially rake snow from roofs to prevent structural damage or collapse.

We are working with a range of other organizations (FEMA, VOADs, and various cities and towns throughout the impacted areas) to assess needs. A decision on whether to deploy strike teams will also depend on weather and safety considerations. Based on the response to this form, we will determine the appropriate area(s) of operation and timing. We could potentially have teams located in multiple areas. We will provide an update NLT 2100 on Thursday, February 19 to those who register their availability.

Can’t join in these areas this weekend? No problem. You can still participate in the #TRBigDig to ensure that first responders are able to access fire hydrants to operate safely and effectively during emergencies and to clear storm drains to prevent flooding when the snow melts. Let us know you took part by checking in athttp://bit.ly/TRbigdig.

 

 

Crumbs of pleasure: How to carry on after an unspeakable loss #grief

Tips on how to survive a sudden, life-altering loss.IMG_0376 Sleep, sing, love. go outside and ban perfection.

More from the CommonHealth blog.

In 2014 I became a widow, and my two young children lost their father. Needless to say our perspective and priorities have shifted radically.

Last year at this time, my New Year’s resolutions revolved around carbs, and eating fewer of them. This year, carbs are the least of my worries. My resolutions for 2015 are all about trying to let go of any notion of perfection and seek what my mother calls “crumbs of pleasure” — connection, peace and actual joy on the heels of a life-altering tragedy that could easily have pushed me into bed (with lots of comforting carbs) for a long time.

@CommonHealth: Wikipedia and “energy” therapist clash over definition of “respectable scientific journals”

ss We link to a CommonHealth guest post by a Spaulding Rehab doc Eric Leskowitz. He promotes new age approach to pain known as “energy medicine “ and says he’s  been dismissed by Wikipedia as a “quack” despite his peer-reviewed work and Harvard cred

Hard to disagree with the first part of Wikipedia’s response to a petition supporting Leskowitz…

 If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately..

.…except to say: What’s defines a “respectable”  journal.  True, not all peer review is equal, but who makes that call?

Wikipedia errs on the safe side and sets a high evidence bar. Still, Wikipedia’s ‘s citation of  Quackwatch — a virulently  anti-alt medicine web site — seems shaky. That site casts its net widely, ragging on everything from faith healers to acupuncture and massage therapy.

And the rest of Wikipedia’s response seemed kind of harsh…

What we won’t do is pretend that the work of lunatic charlatans is the equivalent of “true scientific discourse”. It isn’t.

At the same time, Leskowitz doesn’t do himself any favors by citing Dr. Mehmet Oz’s endorsement.  Dr. Oz has been known to promote less than substantiated therapies.

Energy Psychology has even gotten some fairly mainstream attention, from television’s Dr. Oz to The Huffington Post.