19 Burst results for "Journal Of Medicine"
Gilead's Remdesivir Efficacy Still Uncertain! Is Stemline Therapeutics a Buy?
"So I'm glad to be back and I have a great show for you all today. We have some real spicy stuff to get into. Some of them have commented on twitter. But yet it's it should be good so I'm GONNA start off today by talking about some biotech news. Some little updates that we got some press releases and then a follow up by talking about Gillian ads at Rim decively data. We're going to touch a little bit. On the New England Journal. Medicine study that they published followed up by a report that was provided by our friends at Stat News. So that's going to be good and then the final topic. I WanNa talk about is stem line. So you know. One benefit of being in this volatile environment is that there are buying opportunities right now and one that I do see is a company called stem line. So we're GONNA talk about them and why think thereby right now so with that? Let's get to some of the news that we saw this week and first thing I wanted to touch on his after sys mostly because I just talked about them in the last video but we saw actually in the last couple of weeks that the FDA has authorized after says to initiate a pivotal clinical evaluating multi stem cell therapy in patients with Cova nineteen with induced acute respiratory distress syndrome. So some of the stuff that I talked about in my previous video was that I wasn't sure if the face to that. They're currently undergoing with their collaborator. In Japan was going to be a pivotal study. And it looks like it will be for the Japanese system and then this study that they're launching that they launched in the last couple of weeks is going to be the pivotal study for them domestically here in the United States so the primary endpoint is ventilator. Free Days Through Day. Twenty eight and they're beginning to open sites this quarter so I'm not sure exactly what that means in terms of when we can expect data. I would think maybe late Q. Three probably in Q. Four we'd see some data for this which could be a big boost for the company. Also what we learned in at the risk of opening another can of a drama this company they announce a public offering a twenty two million shares at two dollars and twenty five cents for about fifty million dollars in proceeds. I did say that I was expecting them to announce another offering and that is what we saw earlier than I expected. I really thought that they were GonNa wait until maybe later in the year to do this but while the songs doing okay I guess it's a it's an opportunity to do so so with another fifteen million dollars in cash. This should give them another six months or so and you know if they do see some good data from this pivotal study it would likely boost the stock quite a bit more before they have to go ahead and raise money again. So that's after says. I'm still saying on the sidelines. I'm still not super confident. In that data we originally with their phase one so I have no real sense on whether or not I think the date is GonNa be positive but I hope it is that this can get rolled out and it can actually start helping patients that have covert nineteen and areas going to move quickly to immunogenetics which is a company that kind of fell off my radar ticker symbol. Is I m you? They have a compound called says a to Mab Guven Akin and yes. I did practice. That's all I can say. A properly for metastatic triple negative breast cancer and I kind of talked about is the potential for this drug. It's it's a unique formulation so that they can really target the cancer cells and hit them with this tailored that is toxic to all sales. But because it's tethered to something that specifically targets cancer cells it would primarily affect them and kill them so the primary indication they're looking for is triple negative breast cancer and they had done in a sense study to confirm their previous face through results and there was some concern with safety but the sense that he was actually stopped for compelling efficacy. So that's great news for them the PDF date is June. Second of this year. And we'll see if the FDA is going to go ahead and approve the drug so that they can search treating metastatic triple negative breast cancer patients. They have a plan readout for your cancer in the second half of twenty twenty and they're also still enrolling patients for positive her two negative medicine breast cancer so I think that that trial read out is going to be particularly important for the company. And I'M GONNA keep them on my radar and pay a little bit better attention because I think that if they do see positive data there. The company has a a much larger patient population. Go after so Yeah so it's good for them and hopefully they'll see a positive result at the PDF eight anime. Keep an eye out for that trial moving on. I WanNa talk a little bit about Amarin. Because they had their earnings report while ago and what we learned is that they're cute. One Twenty twenty revenue beat estimates at one hundred and fifty million dollars and I had said previously that. I thought their estimates were sandbagged in anticipation of better results. And that is what happened but unfortunately none of this matters because they do not have pan protection in the United States given the ruling that we heard a little while ago so regarding to the appeal and the generics the CEO is not expecting at risk launches. But they are willing to file an injunction. I've talked about that in the past. This is not new news but they did also say that. In the event of an appeal loss Amarin would be willing to launch a brand engineering version. So this is an interesting strategy in order to allow them to maintain market share in the space because if they launch a generic version immediately. You know by the time another generic comes to the stage Amazon's already going to generic Kinda solidifies their position in the markets. There's not going to be really an advantage to patients taking a another third party. Generic other than Amazon's now the only issue with this is that the generic price is going to have to be competitive with the other companies. That launched generics as well. So in this way they're gonNA lower the amount of total revenue. Get but there's a lot of uncertainty in the company. I'm still not sure what I'm GonNa do with my shares. The stock has bounced back a little bit. But you know if they don't win appeal I assume they're gonNA see further downside until we actually start to see the kinds of numbers that start coming in given the new pricing of generic version of Amarin. So we'll see we'll keep you posted on what I do. I'm tempted to buy a little bit more and lower my cost basis by I'm I don't feel great about that either. So we'll see all right. Let's talk about Gilead. Everybody so first thing I want to touch on with Gilead is this New England Journal. Medicine studied that they released regarding the compassionate use of Rendez severe for patients with severe cove. In nineteen so Gillian been at the forefront of the media when it comes to this rendez severe drug that they're hoping to get approved and they initially had rendez severe offered only as compassionate use for patients as is still undergoing phase. Three trials right now so some people who are really severe severely affected by cove nineteen could apply to to take severe and what they did is they published a study with fifty three patients who had taken it under this program and really it wasn't a placebo controlled trial so for me. There's no real conclusion to be drawn. They said that a majority of patients were discharged. But because there's nothing to compare it to doesn't really mean much Another thing that's worth complaining about for the studies that they didn't even measuring viral load. So we don't even know if patients that were taking Severe head lowered viral loads in. You know we could figure that out by comparing baseline to treat a data. But they didn't do that so it's Kinda left in the dark here. The company itself has terminated a study in China with severe patients because of low enrollment. And they're awaiting the publication of these data to announce in-depth review the result. So that's one thing that we can also look forward to see is the data that we're getting from this low enrollment patient population in China. And they are doing a mild to moderate disease study in China. So that's still ongoing. Takes been seeing on twitter. Pretty disappointing a lot of people complaining that the New England Journal of Medicine shouldn't publish the study given that it was you know. There's a conflict of interest and there's no placebo and you're not new to academia. You know it's a cartel. The big name journals really only published stuff. That's like really hot off the press type thing. So of course there's huge problems with this study and Gillian's not even shy to mention them in the discussion so they clearly outlined limitations of the study. And everybody that I've seen on twitter isn't really taking that into consideration they think Gilead just willfully blind to the fact that there's no control. Obviously they know that. And if you want to throw the New England Journal Medicine under the bus or publishing this year but throw the entire institution appear review under the bus. It's a horribly flawed system as somebody. Who's coming from academia? I've seen this all the time you know. These journals are a cartel that gate keep science. So that unless you know people or your science is so particularly compelling that they'd be willing to publish it but if you WanNa talk about the academic system and publishing. Let's have that conversation but to call out this study in particular is being. The true hope written the true problem in the world of publishing. This is not the one for you
"journal medicine" Discussed on The Peter Attia Drive
"And rick johnson actually has a paper that in the new england journal medicine that goes through this case rix on some some really interesting work you talked about the out of africa migration rix looked at the euro case mutation that occurred after we so one civilization sation left africa to go to europe it turned out that this mutation of euro case allowed us to store much more energy in the form of fat from fructose and and one of the byproducts of that is generating uric acid but this became really a beneficial mutation to acquire because fruit is at its ripest in the fall so it's gonna abi sweetest so you could actually really eat a ton of fruit and actually store it as energy in the form of fat and you generate your gas it along the way and it seems that only the subset of our ancestors of the primates that developed that mutation were able to survive these european winters and then come back to africa and so he argues. I i think convincingly although i haven't had him on the podcast yet to go into this in gory detail but talk with them about this tonnon read his papers that it was this ability to actually turn fructose through through developer genesis into fat as a byproduct to generate uric acid. That's actually what allowed us to come back to africa to have survived a european winter and then typically proliferate so this ability to to generate uric acid is not unique to all species. It's something quite unique to those came from the lineage of of having to survive basically cold winter without much food. Hey a peter real quick before i forget is speaking of energy output the other thing that you see an insulin resistant individuals especially south asians is when you compare them when you actually put them through exercise testing.
"journal medicine" Discussed on EconTalk
"Supply chains of behavioral surplus so for example you know android when they when they develop android Google there was a there was a a bunch of people Google said great now we can finally we finally had something we can we can <hes> sell it with a hefty margin and we can finally compete with apple but other minds prevailed and mind said no no no just the opposite if we can give this away. Let's give it away because this is going to be our most powerful supply chain interface. This is going to be the way you know. We'll claim that it's the mobility revolution and this is going to be the way that we streamed dream data from all over the place. This is gonNA free us from the but if we didn't like all that streaming we wouldn't use the free phone. That's that's the only point through his we don't know about it. This is the fundamental issue. You know I write about this. <hes> this <hes> research that was published in the American Journal Medicine where they investigated a bunch of <hes> health related applications specifically in this case diabetes applications that are approved by the F._d._a.. Because now the F._D._A.. Actually approved certain applications and they discovered but in in this requires forensic renchik analysis people don't know this because it's designed so that they can't know it every single diabetes application that they reviewed was was first of all streaming data to third parties that had nothing to do with the with the health domain and again many of those domains the majority of those domains owned by Google and facebook but they're also doing other things the second you even just download an application diabetes application. They're doing things like taking your contact lists in some cases than they use the contact list to contact phones of your contacts and they take those contact lists many of them commandeer the microphone that camera the <hes> learn about other applications on your phone. Your message is your email. This is.
"journal medicine" Discussed on Invest Like the Best
"We studied the stuff we find that it doesn't work, and then it keeps happening and we, we try to write about it to stop that. But that keeps happening again or other new strategies because my interest in this is both health, but also the investing parallels are so obvious that we don't even need to go through them, this just relentless amount of information and strategies and ideas, that are clearly, useless, or wrong, yet perpetuate. What do you think we're doing wrong trying to debunk this stuff? Why can we not beat the inertia? I mean, I think in one of the reasons like I use the last chapter in range of talk about doctors and scientists as partly because those people are viewed from the outside as the enemy of specialists, and I wanted to get to say, okay, even within these things that compared to the world at large are quite specialized, how do we harness some of the advantages of breath? And I think Arturo cost of all is one of the characters now last chapter who's arguably the most renowned immunologists in the world went to Johns Hopkins to try to start a new education. Program, where instead of teaching all the specialized techniques to future doctors and scientists he starts with how to scientific thinking work more broadly how do we evaluate evidence? How do we know what is true, and that I think that program is going to have a huge impact partly because of his own renown? But I think I confess in the book that I when I was a grad student, I committed unknowingly statistical malpractice talk about a week learning environment on the project that got me a masters degree from Columbia. Okay for sows embarrassed about that. Now, I'm just mad about it and it's because I was shuffled into this very narrow set of knowledge before I even knew what the statistical programme I was hitting buttons on actually even did in a deeper sense. And I think recognition is important, I think it's gonna be generational change. I think it's gonna take some generational change. But I think changing the way we educate doctors and scientists to teach as our tro says, all the world's knowledge is available on your phone got people walking around with all the world's knowledge and no idea, how to integrate it or evaluated. And so he's dispatch allies. Ing educate. Of doctors and scientists and saying, let's start with how information is evaluated and how scientific thinking works. And when I saw him on a panel saying that the editor editor of the New England Journal medicine was on the panel and said, no, you can't add all these classes about scientific thinking and stuff to doctors training, it there's already too much time, and New England Journal medicine, by the way, when the most retraction journals in the world. And our show said, yeah, get rid of all that other stuff. They can learn that stuff like in practice. They need to learn how to think and I think he's really hit on something. And he's noticed that we have no ability to correct, because our specialists not just are specialists in general, we don't have a good. Ability to evaluate new information. And so I think some destabilizing of education is gonna help I think, but I think some of these problems are devilishly hard to the stent issue. So all these studies show that stents don't work for stable disease, but they do work for heart attacks. So there have been examples of hospitals, where the doctors are so sure that still work right there so committed to this idea 'cause it's bio plausible. This is a term that Mike Joyner a physiologist at the mayo clinic, sort of uses that I really like bio possible. Meaning there's a clogged artery. How could opening it up not work? It's gotta work. Except it turns out the bodies much more complicated than like a kitchen sink. And we didn't design it, and it's the disease is much more diffuse. And so some of these doctors started saying show up making emergency room appointments, they'll say shop in the emergency room.
"journal medicine" Discussed on Ben Greenfield Fitness
"You wanted to save fiber? Well, the other thing that people hear about fiber is that either that it is beneficial. Guard to cancer or precancerous lesion cardiovascular disease as well. Well, yes, so that we can talk about that as well. So I can talk about all three of those things so fiber is just this whole. This whole interesting topic to explore so with regard to precancerous lesions, which are called adenomas tubular villas villas adenomas in the colon, which are pre-cancerous lesions. There is no evidence that either fiber in the diet or five or settlement Titian improves that. And this is quite contrary to what people might be thinking. I mean, there is simply no evidence from studies in the New England Journal medicine interventional trials that either fiber in the diet or inclusion of fiber as a supplement improves adenoma recurrence or colon cancer progression in some studies. The addition of is fabulous husks, which are in the same genus as Cillian which has Metamucil actually worsened adenoma recurrence. So what we're seeing here is quite contrary to what many people may have been told that if you look at the data, not only fiber, not helpful for diverticulitis. It might be associated. I it's not helpful for constipation, it probably causes constipation for a lot of people. Potentially through. Overgrowth mechanisms like small tests about over growth, which we know the methane from some of the machine producers in a small small tested to your overgrowth situation may paralyze the entire gut nervous system. So fiber may worsen constipation of worsen bloating, it certainly worsens gas, which is no fun for anyone. And in terms of at Noma or precancerous lesions and colon cancer recurrence. There's no benefit. And in some cases, with Metamucil like is fabulous supplementation. It actually worsens it. And so it's interesting many of the benefits of fiber are attributed to its effects on the microbiome and on short chain fatty acid production and particularly the colon including most notably Buta rate. And this is very interesting all link to this article just came out this week on on the verte health website has a host of evidence showing that beta hydroxybutyrate bodies, which we would find if you were eating Kito SIS based diet. Whichever's which which I actually after after comment on this. I would love you to compare and contrast toasts and converse. But basically beta hydroxybutyrate key tones, which you would have if you reading a well structured carnivore or key Todic diet simulate all of the values that short chain fatty acids, including tirade produce in the gut. So you kind of have your option you could do a high fiber diet for short chain fatty acid production. But at the same time get some of the risks that you've just talked about including everything from gas and bloating constipation today. Ridiculous diverticulitis or you could lower your fiber intake, definitely low your carbohydrate intake shift into a key Todic diet, which and ky-ko's different than at Carver Dighton into certain extent, which I'll let you comment on and get those same benefits that you get from fiber by simply generating a lot of ketones. Right. Exactly. That has to do with the idea that Buterere may be fuel for the colonic and Tara sites. Right. So. The epithelial cells at the level of the colon small intestine may use Buterere eight as a fuel and for in many circles, there was a concern that if you didn't eat enough fiber that you wouldn't make enough of the short chain fatty acid beauty eight well as that article in verte illustrated as I was talking about with lane when you were eating carnivorous diet. What happens is pretty amazing. There are also microbes in your gut that can use protein and fatty acids to make short chain fatty acids, so the shorting Patty acids, beauty is not the only one we can also have isobutane appropriate and those can feed the colonic terrace sites or the Kitone bodies can be directly used by the colonic and Tara sites as fuel. So what we're seeing here is you don't need fiber to have a healthy gut lining, which is one of the main concerns of a low fiber diet. So, and then you also mentioned something that I want to touch on for people..
"journal medicine" Discussed on Mark Bell's Power Project
"So the problem is that healthy user bias is the main problem that can founds all of these dean logic studies lane, we cannot look at a meta analysis of people with fiber say for every ten grams was a decrease in cardiovascular outcomes. There's absolute Joe's, that's healthy user bias. You can't say that that is actually a valid correlation. Because the reverse is also true all those that don't agree with your wife's. But individual studies that agreement bias are totally fine. Well, the thing is that when there are conflicting studies we have to consider are there alarm, healthy user bias affect is there a larger healthy user bias happening. How do you explain the lack of benefit in a serial supplement the lack of benefit on a high fiber low fat? What isolated by? Acidic circumstance. The Roth is an interesting story for you. So yes, there is there can be absolutely in fact years ago when a bunch of anti meet papers came out I for me. And if you look at the data is associated colon cancer of the long association coin kits. When you actually people who. Eat less, fiber or people in higher rates. Indie fiber, one of the corrections. You can do the date is go back and correct with a difference. Environ- take in what you see when you correct for that a lot of the association of meat cancer, colon cancer goes away. If fiber was causative for that. Why would you see that? They're not saying fibers causative. You just did, you know, I think five it doesn't benefit on saying gonna fit. Fit. I'm saying there's a lack of benefit this other study. This is the new internal medicine. He's our New England Journal medicine studies dietary fiber and risk of colorectal cancer and adenoma and women, right? Our data do not support the existence of important protective effect dietary fiber against colorectal cancer. Anoma? What I am saying is that fiber has no benefits in adenoma recurrence. No benefit in. Colorectal cancer. Right. But ten harmful in the study where they added Metamucil, which is Fagla while Metamucil Cillian, but it's fabulous in the same family. Now that affects of harm was mitigated when they added calcium. We can talk about calcium in the at in that God is well, but generally calcium in the gut has been found protective against colon cancer. That's a whole separate idea. But what I'm saying is that there is no benefit to fiber in colon cancer. What you are saying is that the data around meat and fibre when normalize for the absence of fiber showed no significant association that doesn't mean that fiber is protected for the meat is causing it. And what I'm not. Arguing I'm not arguing the fibers causing cancer arguing there's no benefit. I see fiber. As basically useless filler. You could get the same thing by eating toilet paper..
"journal medicine" Discussed on The Peter Attia Drive
"This is a big, no, no in scientific, communication and publication. But also, the increased risk this alleged increased risk of breast cancer was not statistically significant. It wasn't statistically significant in my business. You don't get to go into publication and say, gee, you know, we didn't get any significant results. Here we found something that looks problematic or interest. And maybe we need to do more research, but not significant, and that's what really I gave us pause. Why are they heralding this strange finding for what purpose, and why are we wanting to scare an audience in advance of actually offering the real data? And that's what got are skeptical neurons flaring, I wanna come back because we're going to go really deep on the difference between absolute risk relative risk the difference between the versus this e plus MPA gr-. I wanna go deep on that. But I wanna pause here from into ask you, an honest question, which is you hear this, and it stinks of conspiracy theory, except that I'm the most anti conspiracy theory guy out there, I typically attribute to incompetence rather than malice. I mean like it's Oswald killed Kennedy. There's enough to as about it. We don't want to believe that we wanna create a bigger narrative because Kennedy was so significant Oswald was so insignificant. But the reality of it is conspiracy theories almost never hold up was there conspiracy. I mean, I'm using the word loosely, and I'm trying to I'm asking in the loaded way. But when you look back at it through the lens of what we know today. It seems improbable that this cluster could've taken they were behaving. Just like scientists who went into this research with a strong belief that HR tea is harmful to women and in particular increases, the risk of breast cancer, shock whistle. Who is the cardiologists who led the women's health initiative had published an article in? I don't remember what heading nineteen Ninety-six basically saying it's time to bring the HR bandwagon to a halt the HR bandwagon. These too many women are are on H R T. This is not a good thing. And it's time to. Stymie to stop the rolling bandwagon. So he himself clearly head some kind of bias going into the direction of this study. I don't think it's a it's not a conspiracy you as a reader of mistakes were made. But not by me know that when you go into a research project with a belief that you really are. Sure of you see in the data what you expect to see in the data. I mean, I remember years ago, the first book I ever wrote, which was on anger in those days people thought that alters were caused by suppressed anger, and I would go and look at these journal articles these were not malevolent people or fraudulent researchers. But they so deeply believed that suppressed anger causes ulcers that they would say, well, we didn't actually get a significant result here. But it's looking like, that's what it would be. If it were significant. I mean, really let me two things to that. If I can I a the article says, this is the two thousand two article. Of the women's health initiative says that this increased risk of breast cancer almost reached nominal statistical significance. I don't know of any other article anywhere that states that statistically significant doesn't mean it's true. But it means the finding has a less than one in twenty chance of being a coincidence. So it's worthy of investigation. But almost reached nominal statistical significance. That sounds like you're straining to reach a conclusion that you didn't reach, but there had to be other accomplices here. So on some level the journals had to at least make a case here, by the way out of curiosity. Why did this end up in jam not New England Journal medicine, the initial publication, and he they've published in both JAMA and the New England Journal of medicine, but the first one I one of this JAMA Jammie accepted at I and JAMA came out with the press. Sra lease. I don't know of any other situation where JAMA or the knowingly journal came out with a press release before the published article was available to doctors to read. Well, and you saw course in our chapter on this Robert Langer writing last year why he waited so long. We don't know. But he was one of the investigators who revealed the background story about this. There were forty principal..
"journal medicine" Discussed on 710 WOR
"So that's a cost issue cost then. Yeah. Less end up in the emergency room and who wants to be an emergency room. Nobody wants to be in the emergency room, unless there's no other choice, but to go to a hospital, you're more likely to be stuck in an emergency room. And then there's another article this week by Peter Loftus. And this is in the Wall Street Journal, and it's looked at a three decade long study about prostate cancer treatment, and it was a comparison study. So so many men think oh, you don't need cancer. Are let's say so many men are led to believe I mean, historically were all led to believe if you have cancer, you should get out of your body's you get a treated out of your body a cancer in your body's not going to do anything useful. And for some reason men have been pushed to do nothing about cancer. Well, here's a study a three. Decade-long study that looked at treatment versus no treatment for advanced prostate cancer in men, they looked at what happened to the men who got treatment versus didn't get treatment. And the study suggested that the benefits were in the men who got treated for advanced cancer. And it was published in the New England Journal medicine. The study started to see three decades have started before nineteen eighty nine and they'd go on to note that prostate cancers and number two cause of cancer deaths in men number one is lung cancer. There's one hundred sixty four thousand cases of prostate cancer in America in nearly thirty thousand men die year.
More men with low-risk prostate cancer are forgoing treatment, study finds
"And it's looked at a three decade long study about prostate cancer treatment, and it was a comparison study. So so many men think oh, you don't need cancer. Are let's say so many men are led to believe I mean, historically were all led to believe if you have cancer, you should get out of your body's you get a treated out of your body a cancer in your body's not going to do anything useful. And for some reason men have been pushed to do nothing about cancer. Well, here's a study a three. Decade-long study that looked at treatment versus no treatment for advanced prostate cancer in men, they looked at what happened to the men who got treatment versus didn't get treatment. And the study suggested that the benefits were in the men who got treated for advanced cancer. And it was published in the New England Journal medicine. The study started to see three decades have started before nineteen eighty nine and they'd go on to note that prostate cancers and number two cause of cancer deaths in men number one is lung cancer. There's one hundred sixty four thousand cases of prostate
"journal medicine" Discussed on Untangle
"Of type two diabetes. How blindness in kidney failure amputations and heart attacks and strokes impotence? And so on that if you get it down with either lifestyle, you generally prevent it in, you know, you know, not how these horrible side effects anymore. And in the case of men with early stage prostate cancer there now been to randomized trials in the New England Journal medicine, and they showed that men with early stage. Prostate cancer did nothing after ten years led as long as those who had surgery radiation, accept these treatments. Often main guys in the most personal ways are often either impotent or and continental boat for no real benefit at huge economic and huge personal costs in turns out that maybe one out of forty nine men as a really aggressive form of early stage. Prostate cancer really does benefit from the surgery radiation with the rest dome and yet at the only choices between doing nothing watchful waiting or doing something. Most guys, you know, they have a tumor growing wanted quote do something about it. Even if the treatment is worse than the disease. Let's take a moment to dive into the Enderlein biological mechanisms. And then I wanna get into what your purse grip shins. unquote are. So let's talk about mechanisms that are common amongst each of these disease cases, well, chronic inflammation, is something that's seen in most of these different diseases. And again, it's not that we're hard wired wrong or that we've evolved wrong. It's just that these mechanisms are designed to be short term that when you get an infection, or if you have an injury, you one inflammation to occur and helps to you know, when you when you sprain your ankle. You don't wanna be walking on it because way hurt so you can it swells up. So you body can get a chance to heal swells up because it brings more blood and more nutrients and helps to bring the the cells in there that can help keep you healthy and prevent infection..
"journal medicine" Discussed on KQED Radio
"Here prescribed her Chicago made a panicking. I didn't know what to believe. Maybe this was the right chemo regimen for her. But maybe it wasn't. So what did you do? Did you did you feel like he was compromised? It's hard to know we never asked him about it. Probably because there was just too much fear. I mean, how do you ask your doctor? Whether he or she is getting influenced by the money that he or she is getting right? That's a very difficult question to ask. So we never found out. What how you that seed of fear blossomed, and my mother no longer trusted his recommendations, even when he prescribed antibiotics for pneumonia should wonder is it because it's the right medication for me. Or is it getting paid by the Trump company, and that made me look into the literature to and at the time in two thousand and eight a New England Journal medicine paper found that ninety four percent of doctors have some affiliation with truck companies or medical device companies. And there were dozens of studies to show that those affiliations do in fact influence prescription behavior. And that really shocked me and made me want to do something about it. And at that point the thing she wanted to do was to find out whether this kind of stuff bothered other people too. So she gathered a team of researchers and they started to survey patients about their healthcare one after another. Our respondents told us at that doctor patient relationship is a deeply intimate one that the show their doctors their bodies and tell them the deepest secrets they want to I understand their doctors valley's people want to know about their doctors first so that they can make them form choice. As a result of this. I formed a campaign who's my doctor that calls for total transparency in medicine participating doctors voluntarily disclosed on a public website. Not just information about where we went to medical school, and what specialty were but also our conflicts of interests, we go beyond the government sunshine act about drug company affiliations, and we talk about how we're paid. Then we go one step further. We add our values when it comes to women's health LGBT health alternative medicine, preventive health and end of life decisions. We pledged our patients that we are here to serve you. So you have a right to know who we are. We believe that transparency can be.
"journal medicine" Discussed on Science Friday
"The every injury every every injury. No matter how severe that injury is at the site. There's millions of helping her on flow that injury. Why do we not know that before? So while the reason is is because there's long been controversy that which humans because our miraculously brain must control everything. So regardless of that healthy final chord in less. We regenerated the loss. Neurons cross across the injury. There was nothing that we could do. So that's what our team's been looking at. We've been challenging that hypothesis for the last twenty five years, and so we focused on a little bit differently than the Swiss study, we've Okasan looking at motor completes. So motor complete are those that by all international standards, all clinical current standards would have no viable cells across the injury level. And so we in the mayo clinic in the same week in nature us New England Journal medicine published showing people could also walk with the stimulator overground. And to us that was that proof of principle that it was the circuitry. So So you. you so you could try to mimic create sophisticated circuitry that could control the muscle. Yes. So there's actually three other individuals reported who have motor complete injury who are who are walking over overground as well. And so that demonstrated that that circuitry, and so now the Swiss study has followed up with three other individuals now they are incomplete. And so there's a distinction between the two populations still very very important, and they have fibers motor vibes. That were known to be there that go all the way down to the spinal cord now, what's really important about that. Is that shows this plasticity because all of these people had been injured for years, and by all medical standards had. So for his for those patients in the Swiss study, they had reached all recovery that was ever thought possible. So again by taking this human circuitry rejuvenating if you will training it stimulated in a in a sophisticate. Way they were able to drive much more motor recovery as individuals. So I think if you take the studies collectively what it tells us is that there's much more. We can do for people with spinal cord injury than we ever thought. We could do listener Donal tweets very, very incisive question. He says fascinating. Would this also worked for quadriplegic patients? Yes. In fact, our so the one of the two people that we showed was a quadriplegic. So again it theoretically, it does not matter where the injury is. Because you are functioning below the injury with.
"journal medicine" Discussed on The Peter Attia Drive
"On understand f h could be thousand. Phenotype. Dominant summer hetero disorders various genes, but the FINA type is illegal cholesterol above one hundred ninety. And then you fast forward to about two thousand four, two thousand five. Maybe it was two thousand six, but even I remember this and again, this is before I became kind of a lipid wanna be, but I would still redoing journal medicine just because it's sort of interesting and there was the discovery of the Hypo functioning PCS canine folks. And I really do remember this and I'm surprised I remember when African Americans I Jackson child. That's exactly right. And these were folks that were walking around with an LDL cholesterol between ten and thirty milligrams per deciliter, and they were completely event free. And of course, the first one hundred percent, but your significant reduction and the reductions, I believe we actually went back and did a calculation to see if they're reductions, how congruent they were with some of the more recent Mandel, Ian rand. Commiserations and they're very similar and it's not surprising because that's how you would model a reduction lifetime exposure reduction. The thing that interested me because I remember at the time like many people, I'm sure I sort of had this concern which is, will God if cholesterol levels. I mean, now realize I was being naive, but my concern was God. If if your LDL is low, that must mean you can't make hormones, it must mean that you're going to get some other awful disease. And so the interesting thing to me was those people didn't have any of these other types. They didn't seem to have an efficiency deficits as a result of that. And of course, I think that trial is what was the catalyst for Amgen Sonoko fee in these other companies to start working on these drugs? Yes. And by the way they since studied in these people where they've blown away yelled cholesterol, ten fifteen years have been zero affect on reproductive hormones, or adrenal hormones goes back to what I just told you. Glenn synthesize all cholesterol, they.
"journal medicine" Discussed on This Is Only A Test
"The software in terms of sort of representation of of the data because so it's not about the print no okay i thought there was something about the three printing them no but we will try this wilson data have when we can see how it works all right the biggest story that i wanted to touch on this week is about breast cancer treatments so there's a recent study in the new england journal medicine again believe that analyzed about ten thousand early stage breast cancer patients and early stage breast cancer is one of the more common forms of breast cancer in this case it is a her two negative breast cancer which is that sort of the hormonal pathway you can get a genetic test for this that shows that you have this early stage treatment so right now even though a lot of people test positive for this the most common treatment is chemo and chemo is obviously a very difficult treatment regimen well new analysis came out looking at the essentially like genetic severity there i mean there's ways to tease out what what that means but you can look at the severity of of the cancer and they found that a wide majority of patients could actually placed on hormonal therapy rather than kema which has many less side effects and chief the same treatment results so this genetic tests that's being done on these patients or these provides that level of information and so they did a double blind study where they're able to offer hormonal treatment to these that these patients that fell into a category of less severe breast cancer.
"journal medicine" Discussed on KDWN 720AM
"The new england journal medicine so the research team randomly selected thirty two hundred households in puerto rico and local scientists surveyed them over the course of three weeks january and people in those homes reported a total of thirty eight deaths then the scientists extrapolated that finding to the island's total population of three point four million to i guess estimate the number of test then the research we torture subtracted jesper according to that same period and they found that the mortality rate had actually jumped sixty two percent in the three months following the storm so do we have exact numbers of people who were affected in terms of heart attack or stroke or infection or dehydration or then succumbing to the flu it's variable also subjective you know did somebody die because the flu or did time because they were stress they weren't living in their own home they were subjected to nonsterile visions and then they got sick so what does that mean for your hat as well you know we really need to take seriously the aftermath of the after repair of hurricanes you know one is you know we wanted to be very very expeditious until about getting people to evacuate then displacement of people and the displacement of people is one of the most dangerous times post post tragedy because they're not in their home with their microbiome and you know getting their sleep and eating their food and being a part of their routine and we really underestimate how important routine is i talk about on the show all the time how you'll have you know cincinnati and say well the reason why they lived a larger ten or one hundred seventeen is because they have their daily routine they have their egg in the morning they have a glass of wine at night they did their daily walk and they had daily routines and older individuals like to stick to that routine because you know that routine is working that hopefully that routine doesn't stop and they don't die so a lot of people like to keep to their routine and these stress of not having that routine you know i don't know if they've done studies of people who vacation a lot or people that live in multiple areas and how that.
"journal medicine" Discussed on Newsradio 950 WWJ
"So important to get tested for prostate cancer in two thousand twelve the us preventive task force said nobody should be screened for psa testing the data didn't meredith and now in studying europe with longer follow up showing clear survival to the people who are tested and should they change the recommendations so that people age fifty five to sixty nine now should talk to their doctor so it's discussion with your doctor about whether you should be tested or not based on your own value system the problem is there's some false positives so not everybody should be tested but the discussion should happen fifty five to eight sixty nine the new england journal also found this week in that same topic they released a study that looked at the use of mri is for that screening it's so cool right wednesday the us preventive task for said we have a problem with biopsies too many false positives but we have to do it could save some lives the next day the new england journal medicine has an article about a better way to do biopsies showing that if you mri and nowhere to stick the needle you get fewer false positive you find them more aggressive cancers and fewer people need biopsy so in advance happened the next day pretty exciting these false positives are really scary i had one i mean there's nothing more terrifying is i mean is it really possible to have a test that's essentially foolproof for this not even close you know what we know is that since we started screening the death rate has died of prostate cancer so i'm a believer in screening getting an aggressive prostate cancer that has left the prostate is also very scary that's medical correspondent dr david edges on cbs this morning wbz news time four twenty two star date may fifteenth the senior citizens.
"journal medicine" Discussed on WDRC
"Us from the new england journal of medicine and it's so remarkable article because new england journal medicine generally is about promoting new medications and promoting new surgical techniques and this is an article that he is critical of our rush to judgment in terms of performing surgery on men with early prostate cancer though it may seem totally counterintuitive because if you got cancer your first impulse is get it out take it out and that was the principle that guided early cancer surgery the more radical surgery the better and this lead two such outrages as the radical hall stood mastectomy whereby they took virtually half the chest wall of women away when they had their first innovation of breast cancer it was a type of surgery that held rain for forty years or more in starting nearly parts of the 20th century there became recognised that uh more sparing surgery for breast cancer was equally effective and now they're looking at prostate cancer and what they're saying is that radical prostatectomy four early prostate cancer in men doesn't make a difference not only in terms of the ultimate outcome which is how long you're gonna live mortality but it may not even make that much of a difference in terms of whether you're going to die of prostate cancer so here's what i think is happening and this is actually something thing the validates an approach that i've been taking along with such pioneering urologists as dr aaron cats who's better frequent guest to my podcast he coined the term uh not just watchful waiting but active holistic surveillance yes you've got cancer don't you stand there or do nothing or rather do something change your lifestyle take the right supplements that are healthy for your prostate exercise which also seems to reduce mortality from prostate cancer and i was very happy the other day to see one of our men whose on that regiment he of prostate cancer was early prostate cancer week urged him to do active holistic surveillance and that doesn't mean being irresponsible i'm just leaving medicine altogether we said make sure that at least for the first couple of years that you get repeat biopsies vibes these are no fun but it's important to identify whether the cancer is coming roaring back at work which point you adjust your strategy and you say well maybe maybe you do need surgery radiation but in this case i was very happy.
"journal medicine" Discussed on WDRC
"Item comes to us from the new england journal of medicine and it's so remarkable article because new england journal medicine generally is about promoting new medications and promoting do surgical techniques and this is an article that he is critical of our rush to judgment in terms of performing surge three men with early prostate cancer though it may seem totally counterintuitive because if you got cancer your first impulse is get it out take it out and that was the principal that guided early cancer surgery the more radical surgery the better and this led to such outrages as the radical hall stood mastectomy whereby they took virtually half the chest wall of women away when they had their first innovation of breast cancer it was a type of surgery that held rain four forty years or more in starting the early parts of the 20th century there became recognised that uh more sparing surgery for breast cancer was equally effective and now they're looking at prostate cancer and what they're saying is that radical prostatectomy four early prostate cancer in men doesn't make a difference not only in terms of the ultimate outcome which is how long are you going to live mortality but it may not even make that much of a difference in terms of whether you're gonna die of prostate cancer so here's what i think is happening and this is actually something the validates an approach that i've been taking along with such pioneering urologists uh as dr aaron cats who's been a frequent guest of my podcasts he coined the term uh not just watchful waiting but active holistic surveillance yes you've got cancer don't you stand there do nothing or rather do something change your lifestyle take the right supplements that are healthy for your prostate exercise which also seems to reduce mortality from prostate cancer and i was very happy the other day to see one of our men who saw that regimen he of prostate cancer was early prostate cancer week urged him to do active holistic surveillance and that doesn't mean being irresponsible i'm just leaving medicine altogether we said make sure that at least for the first couple of years that.
"journal medicine" Discussed on Christopher Kimball's Milk Street Radio
"The problem is that i think partially it takes so many years for these things to trickle down from individuals studies into clinical practice let alone into sort of the general mindset of the american people or or the people of the of the world but we don't even notice i i saw this study in the new england journal medicine medicine an blew my mind i mean it absolutely a drove me crazy and i said i have to write about this and then i just started to look into the data and i was shocked because this was not the first study to to tell the story and yet i didn't even know about it there have been previous studies in the journal in american medical association and other regional that found similar findings that when they looked at health professionals because there are a bunch of longterm coloured studies that follow nurses and doctors people who are consuming very lowsalt diets had higher risks of problems there were even a couple randomized controlled trials mostly an older people who found that if the if they reduced the sodium diet of elderly people it actually again lead to worse outcomes if they went very low and the the the kicker is they follow this up year later with even further data what did showed was that people who have high blood pressure if there consuming more than seven grammes it's absol today that's a real problem that can lead to increased issues such as heart attacks strokes death but people with normal blood pressure even if they consume high levels of salt at that level then they really see no bad outcomes it's only people with hypertension who are consuming this high level of salt that are really a risk and consuming low levels of solve for every one very low levels can be really problematic can actually doors outcomes.