19 Burst results for "New England 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
"new england 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.
"new england journal medicine" Discussed on The Peter Attia Drive
"The big toe has painted the joint from crystals. You treated with colchicine and you memorize these pairs and what you lose is the sense of the threshold of treatment. The appropriateness of care what comes out are these doctors that are entitled sometimes burnout. We've beat him down there. Speaking a different language that has its own value system mm-hmm now. This is not everybody i mean this is the sort of risk or the hazard along the path to me. I think of the exceptions i think crisan day he's to me. The most special one komo special residents i ever knew i don't know i always looked at chris and thought and chris by the way as he's now running the transplant program at the university of michigan but there was just something about that guy emotionally vulnerable vulnerable yeah and maintained his humanity under any circumstance and always i guess i've never met a human in the context of medicine and i've met some amazing people people but it's hard to say like you've met one person who took everything that you would wanna be able to do to the highest level. Yes i always wonder why couldn't everybody myself included included that is be like chris and it's hard to me. You're one of the most disciplined people i've ever known in my life but it's hard not to get beaten down. Oh man i was so jaded. That's the beauty of someone like chris and you never really got jaded either. I mean you are also in this. Thank you group of people who just never 'cause. You pointed this out yesterday. When we were having dinner at came up. It's like most of us when we become jaded become sarcastic that became are coping tool of we just became sort of snarky sarcastic. Bastards astor's copen tool yeah cope until mid. I remember my first day in the clinics. In medical school. I was assigned a primary care office and i was working with the doc. Who's an internal medicine doc. I shop a little early and he says the charts are in the door. Here's the schedule feel free to just go in and and see the patient and i go in to see the first patient at eight o'clock and there's a fifteen minute slot and they're getting into all these deeper issues and they're asking me about medication. Interactions chins and i'm thinking i think there's an interaction that i gotta look it up and basically i leave the patient with. I'm going to get back to you. There's a lot of stuff here unpack and then i go to the next patient at eight fifteen a and then the next patient at eight thirty four patients in the hour each one. I feel like i kind of half baked and it's like this is insane. I stopped at nine o'clock and i i looked at the head doctor and i said i am giving you brief presentations here for a minute. You're going in for a minute that were treatment plan minute of documenting and i get ten minutes the way are we going like this till five o'clock because like i'm ed or an hour into this. This is crazy is a co yeah. Yeah you do this. Every day is a why do it four days. A week and i have an administrative day. Like how are you not going bananas. How would you possibly manage manage. This is like well. You know you get comfortable with certain diagnoses the reality show me somebody in america today whose practicing office based high volume medicine who's not burn out. I mean it's probably i don't know twenty thirty percent but you talk to folks. I was talking to an editor the new england journal medicine at the brigham when i was visiting and we met and she said i just came back from clinic endocrinology clinic and i said oh how was it and she's like i only do it one day every two weeks or something because 'cause i'm worked for the new england journal medicine but it's clear to me everybody. There is burnout. I'd like how could you not be office space medicine. I mean what's the solution to this. We have a population appellation..
"new england 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.
"new england journal medicine" Discussed on Mark Bell's Power Project
"It's not just calories. It's the signals. So Kitone Shane the way that genes are expressed. If they literally alter these so-called histone deacetylases inhibitors, the so called H tax people can refer to them when we exercise we affect these same. H jacks. Lot of the oncology and cancer research is focused on these metabolic, signaling hubs for how they protect our DNA and so forth. What turns out that a lot of things in food affect these as well, including key tones. So key tones offer unique signaling properties to our metabolic machinery in our DNA that other macronutrients don't and so going back to where the hell do I start would I benefit from Kito you might be sending sending unique signaling to yourselves. So that you don't get that weight loss associated suppression in your metabolic rate that leads to this yo yo effect because we know if you just look at calories the biggest loser studied, did you guys see that came out a few years ago? It was tracking for you. Yeah. So these these people their wages bounced around right because of this so-called suppression in your metabolic rate New England Journal medicine actually did a study where they tracked individuals for twelve. Weeks. I said, okay, we're going to here's your energy expenditure on a given day. Okay. We're going to drop that by forty percent. Okay. So it's just like a pretty aggressive low calorie diet, they tracked him for eighteen months. The diet was only twelve weeks. So just three months, right? Over eighteen months later, they still had a suppression in their metabolic rate and all these hormones, the Gretl in adiponectin, the lamb leptin were all suppressed, they're all out of whack some were higher than you know. But yeah, they were they were misaligned shall we say? So we don't necessarily see that with Kito thoughts. What I'm saying? Now, of course, I want to just throw this out there. I'm very biased because I've covered interviewed a lot of ketogenic experts. I've personally benefited from this when I was younger put a lot of action sports football. My older brother beat me up. Pretty good often. So I'm worried about head trauma and things like that. So that's why that's my bias. When just wanna throw that out there. So a lot of people listening are athletes, and they're probably pretty concerned about going on Kito because there's you know, some people say that if you eat too much protein on Akito diet, it'll knock you out of. Ketosis? So first off is that true. And then the second thing I want to add onto that is like depending on the individual. Let's say they're pretty active what Graham propound of protein, would you suggest that this individual should try and intake Mia? These are beautiful questions. Well, I think that idea that if you have protein on Akito diet, it will kick you out of ketosis old science. Yeah. And a lot of people talked about that. So what they're referring to is this process known as glucose, Neo Genesis. And that Z the body's ability to create loops from a new because let's face it all three of us sitting here right now, we're both burning sugar fats and carbs, maybe key tones, depending upon what you had this morning last night. It just what we're talking about. With Kito says, it's a matter of proportions it's causing more of your muscle tissue. More of your brain to utilize these fats Glucon agendas. If you're in ketosis glucose, Neo Genesis that that is making glucose from a new is happening. You can't fight. It. You want that to happen because your red blood cells parts of your dream.
"new england 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..
"new england 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..
"new england 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..
"new england 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
"new england 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..
"new england journal medicine" Discussed on The mindbodygreen Podcast
"Ourselves from invasive of. Digital media and regaining connection at multiple levels. You didn't say gluten no I wouldn't put that on the top of the list. So that's my next question sugar. Gluten it sounds like of sugar Gooden. What's worse? It sounds like in your opinion, sugars worse. Well, by far, I mean that gets us to the grain conversation. And the biggest issue with grain is the effect. It has on our blood sugar quite apart from whether it does or does not contain. Gluten gluten is an issue. That's for sure. So we'd barley and rye should obviously be off the table, quite literally. And you know, interestingly years ago when we published grain brain that was five and a half six years ago now. We we made that statement and recognized that well beyond the one point four percent of Americans who have Celia disease. Many people should really do their best. If not all people, and I believe it should be people avoid gluten because we were we had talked about something called non Celia gluten sensitivity, meaning that you don't have Celia disease. You have none of the genetic markers for none of the antibodies for it. And yet you seem to react negatively to gluten, and we propose this back in two thousand and thirteen and boy that raised a lot of eyebrows and was very disruptive gratefully. Now, a we've as, you know, revised grain brain and are able to leverage like the two thousand seventeen study published in the American Medical Association journal by researchers at Harvard that absolutely validates the notion of non Celia gluten sensitive. Entity, which can cause extra intestinal issues. Meaning well beyond the gut the joints the skin and dare I say, yes, the brain. So when the journal the American Medical says, the Asian really dials in on this a couple of years after you've written a book about it. That was a little bit a little bit eruptive. Well, good the more the more the better a lot of it. Well, you know grain brain, and now the revision very much challenged and challenge the status quo. Thank goodness. I mean, the status quo is not great as you know, just recently. It was announced that for the first time American life expectancy in both men and women is declining. So something's wrong. We haven't changed genetically. But in terms of our metabolism that has changed dramatically by exogenous factors over which we have control our lifestyle choices. So this is important information. It is extant information. So what is the latest and greatest side since Green Bay. You. You mentioned that on report from the what else is new out there that strongly and one of the things that grain brain was all over that some science that we didn't have access to although we certainly recognized the relationship between blood sugar, and even diabetes and brain degeneration that was published back in two thousand and twelve in September in the New England Journal medicine what we now know is that this relationship is far more aggressive than we had figured out in the past that you need to do everything you can to not become even close to being a diabetic so diabetes. Type two diabetes is really powerfully influential in terms.
"new england 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.
"new england journal medicine" Discussed on TED Radio Hour
"Okay. So so this is about courage we've heard from a war correspondent. And we just heard from Kimberly, Molly who represents women in Afghanistan. And now it's now it's your turn. I don't think that this is the right show for me. I mean, I love your I love your show. I'm very honored and thrilled to be guy. I just don't think that this is the right episodes. Should we should we like find a different one for you to be? So this is Lena when and she definitely belongs in this episode Lena's emergency physician by training and a pretty polarizing figure in medicine, which will explain why in a moment. You don't think your courageous? I think I'm determined. I think that I am not afraid to speak up when it's about defending my patients in any my community and defending people really care about. And what makes her so unpopular in the medical establishment? Is that Lena thinks you have a right to know more about your doctor. Where's the money comes from? And the story of how she came to the view began with her mother. Here's Lena win on the Ted stage when I was eight my parents, and I'm moved to the US and ours became the typical immigrant narrative, my parents, cleaned, hotel rooms and washed dishes and pumped gas. So that I could pursue my dream. Eventually, I learned enough English by parents were so happy day that I got into medical school and took my oath of healing and service. But then one day everything changed. My mother called me to tell me that she wasn't feeling well that she had this cough, wouldn't go away the shoe with sort of breath and tired while I need that. My mother was someone who never complain about anything for her to tell me something was the matter. I knew something had to be really wrong. And a was we found out that she had staged for breast cancer cancer, then had spread longs her bones and our brain. My mother was braved. Oh shit. Hope she went through surgery and radiation and was on her third round of chemotherapy wish loss to address book should try to look up around colleges phone number on the internet, and she found it, but she found something else too on several websites. He was listed as a highly paid speaker to a truck company, and in fact, often spoke on behalf of the same chemo regimen the here prescribed her Chicago in Panikin. I didn't know what to believe. Maybe this was the right chemo regimen for her. But maybe a wasn't. So what did you do? I mean, 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 that seat of fear blossomed, and my mother no longer trusted his recommendations, even when he prescribed antibiotics for pneumonia. Shoot wonder is it because it's the right medication for me. Or is it getting paid by the company and that made me look into the literature to and at the time in two thousand eight a New England Journal medicine paper found that ninety four percent of doctors have some affiliation with Trump 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 start up to survey patients about their healthcare one after another. Our respondents told us that that doctor patient relationship is deeply intimate one that the show their doctors their bodies, and tell them that deeper secrets they want to I understand their doctors valley's people want to know about their doctors first so that they can make informed choice. As a result of this. I formed a campaign who's my doctor that calls for total transparency medicine participating doctors voluntarily disclosed on a.
"new england 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.
"new england journal medicine" Discussed on Something You Should Know
"Y. s. k. Hokka ONA ONA it's time to fly. So Dr Carol, I want to run down a list of foods that people have strong opinions about often bad opinions about. I just want to run down this list and get a sentence or two from you as to what the evidence says, and we'll start with coffee coffee's. One of those where I thought it was going to be sort of down the middle, some good, some bad. My gosh, the collected research on coffee is shockingly positive and very little of it is. Randomized controlled trials, but there's almost no evidence that this is a vice that people need to avoid almost overwhelmingly positive evidence. So if you had surely have high blood pressure and you are eating too much salt, there's probably a benefit to reduce your levels of salt, but if you don't have high blood pressure, and certainly if you're not eating a ton of salt, there's very, very little evidence for low very low salt diet. Even though everyone keeps pushing them and a growing body of evidence that eating such diet is bad for you, especially if you don't have high blood pressure eggs yet there's nothing. There's no reason to avoid them at all. We thought for years, that eggs within the cholesterol or something going to be bad for us. We all started eating egg way omelettes which are like a crime against nature. But there's almost no evidence that we know of now to say that eating cholesterol is what gives us high cholesterol. And even the last set of guidelines from the USDA said cluster, all is no longer nutrient of concern. There's very little reason to avoid an extra. Great. Lately, I've heard a lot. A lot of talk about how the common kitchen cooking oils are, except for olive oil are just ghastly. So I think there's a some evidence, you know, some of the oil, especially if you're frying and it's getting into your air because they're aerosolize and you bring them in that can be really, really bad for you. But you know the the math is that we do very, very little head to head research between a lot of these cooking oils. I would say that they're all probably reasonably equivalent and you should use them in moderation like you do anything else. You know, trying to get a good Sierra on your food with a little oil is probably equivalent to using butter butter is fine too, but certainly you don't want to overdo with any of these. And certainly none of them should be considered like health food that you should, you know, SuperFood that should be going after. But olive oil has certainly risen above the crowd as as the perfect oil. It really hasn't. I think part of that is because for cooking purposes, it's so good, but there's been a backlash recently with a lot of the Mediterranean diet research on. How much you follow this. But the big big randomized controlled trial that got a lot of press in the New England Journal medicine. A couple years ago was just recently retracted because of some serious errors they'd made in the random ization of follow up. There's still probably a reasonable amount of evidence that a Mediterranean diet, which of course focuses very heavily on on things like olive oil is fine, but the idea that it's the superior diet that has a weight of evidence behind it..
"new england 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.
"new england 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.
"new england 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.