Some of My Best Friends Are Germs

A long but good read by the author Michael Pollen...
Uvealblues
I can tell you the exact date that I began to think of myself in the first-person plural — as a superorganism, that is, rather than a plain old individual human being. It happened on March 7. That’s when I opened my e-mail to find a huge, processor-choking file of charts and raw data from a laboratory located at the BioFrontiers Instituteat the University of Colorado, Boulder. As part of a new citizen-science initiative called the American Gut project, the lab sequenced my microbiome — that is, the genes not of “me,” exactly, but of the several hundred microbial species with whom I share this body. These bacteria, which number around 100 trillion, are living (and dying) right now on the surface of my skin, on my tongue and deep in the coils of my intestines, where the largest contingent of them will be found, a pound or two of microbes together forming a vast, largely uncharted interior wilderness that scientists are just beginning to map.
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o the extent that we are bearers of genetic information, more than 99 percent of it is microbial. And it appears increasingly likely that this “second genome,” as it is sometimes called, exerts an influence on our health as great and possibly even greater than the genes we inherit from our parents. But while your inherited genes are more or less fixed, it may be possible to reshape, even cultivate, your second genome.
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The Scientific 7-Minute Workout

Exercise science is a fine and intellectually fascinating thing. But sometimes you just want someone to lay out guidelines for how to put the newest fitness research into practice.

An article in the May-June issue of the American College of Sports Medicine’s Health & Fitness Journal does just that. In 12 exercises deploying only body weight, a chair and a wall, it fulfills the latest mandates for high-intensity effort, which essentially combines a long run and a visit to the weight room into about seven minutes of steady discomfort — all of it based on science.

“There’s very good evidence” that high-intensity interval training provides “many of the fitness benefits of prolonged endurance training but in much less time,” says Chris Jordan, the director of exercise physiology at the Human Performance Institute in Orlando, Fla., and co-author of the new article.

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Editor’s blog: Significance of no statistical difference - See more at: http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/editor-s-blog-significance-no-statistical-difference#sthash.Kja7CIBI.dpuf

Seattle—As of Tuesday afternoon at this year's Association for Research in Vision and Ophthalmology (ARVO) meeting, all of the head-to-head comparison studies involving the efficacy and the safety of ranibizumab (Lucentis) and bevacizumab (Avastin) are officially IN.

The final verdict (NO drumroll, please): bevacizumab and ranibizumab are statistically NO different in the treatment of neovascular age-related macular degeneration (AMD).

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On Tuesday, the results of the Inhibition of VEGF in Age-related Choroidal Neovascularisation 2 (IVAN2) Study and the Groupe d’Evaluation Français Avastin versus Lucentis (GEFAL) Study, the French comparison study, were presented. The conclusion for both studies pretty much coincided with the results presented in the Comparison of AMD Treatment Trials (CATT), CATT2, and the original IVAN studies that were presented at previous ARVO meetings: That both drugs are basically equal (with some minor differences) in the treatment of AMD.

Hopefully, the debate between the use of both drugs is finally put to rest and ophthalmology can move forward (unless the French ophthalmic community decides to drag this on for another year with a GEFAL2). The foregone conclusion of these trials pretty much came to the same conclusion on most points that "there was no statistical difference between ranibizumab and bevacizumab."

Most of the ophthalmic community should be good with those conclusions. Even Genentech, the manufacturer of both drugs, has pretty much accepted these conclusions. The bevacizumab supporters have proven their point that their drug is just as good as the FDA-approved drug—at a fraction of the cost.

This is where a "statistical difference" can be found—the price. Ranibizumab costs about $2,000 an injection, while bevacizumab costs less than $100. That is a really big statistical difference, especially to a patient who has limited income or whose insurance may not be so generous to pay. To help patients get their treatments, physicians have that right to utilize that off-label option.

One hospital charges $8,000 — another, $38,000

In the actual article from the Washington Post, there is an interactive module in which you can insert the name of your state and see how your state compares to national averages for common surgical procedures...
Uvealblues

Consumers on Wednesday will finally get some answers about one of modern life’s most persistent mysteries: how much medical care actually costs.
For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services.

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A Sense of Where You Are

The workings of the grid cells show that in the brain “you are constantly creating a map of the outside world,” said Cori Bargmann, of Rockefeller University, who is one of the two leaders of a committee set up to plan the National Institutes of Health’s contribution to President Obama’s recently announced neuroscience initiative.

Often, the workings of billions of neurons that produce our thoughts are opaque. But electrical recordings of signals emitted by grid cells show a map “with a framework and coordinates that are completely intuitive,” Dr. Bargmann said. And to find such a straightforward system is, in its own way, “just mind-boggling.” What is the brain doing being so mysteriously unmysterious?

The implications of the discovery are both practical and profound. The cells have been proved to exist in primates, and scientists think they will be found in all mammals, including humans. The area in the brain that contains the grid cell navigation system is often damaged early in Alzheimer’s disease, and one of the frequent early symptoms of Alzheimer’s patients is that they get lost. The Mosers do not work on humans, but any clues to understanding how memory and cognitive ability are lost are important.

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Hammurabi’s Code and U.S. Health Care

Interesting that the economist, Uwe Reinhardt, opted for citation of eye surgery in this article!
There are also some good letters to the editor at the end of the article... (hit the link button below)
UvealBlues

Sometime around 1780-70 B.C., the Babylonian King Hammurabi promulgated the now famous Code of Hammurabi, covering both civil and criminal law.

TODAY’S ECONOMIST

Perspectives from expert contributors.

The code is said to have informed both Jewish and Islamic law. Remarkably, it has echoes also in modern health policy in the United States.

Among the 282 laws in Hammurabi’s Code, nine (215 to 223) pertain to medical practice:

215. If a physician make a large incision with an operating knife and cure it, or if he open a tumor (over the eye) with an operating knife, and saves the eye, he shall receive 10 shekels in money.

                216. If the patient be a freed man, he receives five shekels.

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Not all of these laws have survived the millennia. Relative to Hammurabi’s draconian medical malpractice code, for example, modern medical malpractice penalties represent mere slaps on the wrist.

On the other hand, our modern, differentiated payment system for health care does resemble the Code of Hammurabi in some respects.

To illustrate, for a primary care office visit with a new patient of 30-minute duration (using Current Procedural Terminology, or C.T.P. codes, in this case Code 99203), New Jersey’s Medicaid in 2012 paid a nonspecialist $25 and a board-certified specialist $32.30. The comparable fees paid physicians for commercially insured patients are jealously guarded trade secrets, but it is reasonable to assume them to be $100 to $200. Other fees in the C.P.T. code are similarly low for Medicaid.

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Physicians clearly understand this relative valuation being signaled to them. According to a recent estimate, almost a third of American physicians are unwilling to accept any new patients covered by Medicaid. In New Jersey in 2011, only 40 percent of physicians accepted new Medicaid patients (seeExhibit 4). Given the insulting valuations many state Medicaid programs put upon the physicians’ work, that’s understandable.

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Doctors Denounce Cancer Drug Prices of $100,000 a Year

These same cost issues described in the article below apply to drugs used in treating retinal disease, in which companies charge 2000-3000$ per injection. Some patients need these monthly...and in each eye...for the rest of their life...

Uvealblues

With the cost of some lifesaving cancer drugs exceeding $100,000 a year, more than 100 influential cancer specialists from around the world have taken the unusual step of banding together in hopes of persuading some leading pharmaceutical companies to bring prices down.

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Prices for cancer drugs have been part of the debate over health care costs for several years — and recently led to a public protest from doctors at a major cancer center in New York. But the decision by so many specialists, from more than 15 countries on five continents, to join the effort is a sign that doctors, who are on the front lines of caring for patients, are now taking a more active role in resisting high prices. In this case, some of the specialists even include researchers with close ties to the pharmaceutical industry. 

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Eggs, Too, May Provoke Bacteria to Raise Heart Risk

For the second time in a matter of weeks, a group of researchers reported a link between the food people eat and bacteria in the intestines that can increase the risk of heart attacks.

The lecithin study, published Wednesday in The New England Journal of Medicine, is part of a growing appreciation of the role the body’s bacteria play in health and disease. With heart disease, investigators have long focused on the role of diet and heart disease, but expanding the scrutiny to bacteria adds a new dimension.

“Heart disease perhaps involves microbes in our gut,” said the study’s lead researcher, Dr. Stanley Hazen, chairman of the department of cellular and molecular medicine at the Cleveland Clinic Lerner Research Institute. 

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To show the effect of eggs on TMAO, Dr. Hazen asked volunteers to eat two hard-boiled eggs. They ended up with more TMAO in their blood. But if they first took an antibiotic to wipe out intestinal bacteria, eggs did not have that effect.

To see the effects of TMAO on cardiovascular risk, the investigators studied 4,000 people who had been seen at the Cleveland Clinic. The more TMAO in their blood, the more likely they were to have a heart attack or stroke in the ensuing three years. 

Why listening to music is as good as sex: Scientists say listening to tunes stimulates the senses giving pleasure

Why listening to music is as good as sex: Scientists say listening to tunes stimulates the senses giving pleasure

The more the listener enjoyed what they were hearing, the stronger the connections were

Researchers even say they can predict whether we will buy a song based on the reaction of our brain

Read more: http://www.dailymail.co.uk/sciencetech/article-2308020/How-listening-new-music-really-CAN-make-happy-Scientists-say-hearing-new-tunes-rewarding.html#ixzz2R7XONLYr

'ReadingMate’ reduces treadmill eye bobble

PURDUE (US) — New technology makes it easier for aspiring multi-taskers to read while they run on thetreadmill.
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The Wikipedia of Biomarkers: Interview with Jean-Emmanuel Bibault and Charles Ferté, Co-Founders of CancerDriver

Every year nearly 13 million people in the world are diagnosed with cancer. 7.6 million die from it, making it the leading cause of death in developed countries and the second leading cause of death in the developing world.

While cures for cancer are hard to come by, there are promising avenues for diagnosis. Cancer biomarkers are one of them; they are molecular aberrations found in the tumors that predict the aggressiveness of a disease or the response to a treatment. Unfortunately, too few patients are tested for biomarkers and too many with identified biomarkers are not referred to the right drug or the right trial.

Enter CancerDriver, a free repository of cancer biomarkers intended to improve access to biomarker information for patients, physicians, researchers, and pharmaceutical companies. CancerDriver contains a database of all known biomarkers in oncology. It can be found on the web and soon on iOS and Android mobile platforms.

We had a chance to speak with Jean-Emmanuel Bibault and Charles Ferté, Co-Founders of CancerDriver, to discuss this revolutionary site.

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Doctors driven to bankruptcy

As many doctors struggle to keep their practices financially sound,some are buckling under money woes and being pushed into bankruptcy.

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The Surprising Truth About 8 Common Diet Strategies

Who has the time to keep up with weight-loss research? It's so technical...and confusing...and often contradictory! And yet if you don't know what's going on in the world of calorie counting, you may not be seeing the pounds drop off as fast as you think they should. In one European diet-and-exercise study, for example, participants who were given detailed explanations of the research itself were more likely to improve (exercise more or eat better or both) than a less clued-in group. Fortunately, we have dug into the latest research. And as we did, we noted that a surprising number of dieting tactics accepted as gospel have recently been shown to be dead wrong. Knowing which still hold up and which are big (fat) lies can mean the difference between winning and losing at weight loss.

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