South Of Heaven

Cashiers at 7-11s knew this

Decades ago.

Loss of appetite is common among cancer patients, either because the cancer itself or its treatment affects the sense of taste and smell, leading to decreased enjoyment of food. This, in turn, can lead to weight loss, anorexia, a worse quality of life and decreased survival; therefore, finding effective ways of helping patients to maintain a good diet and consume enough calories is an important aspect of their treatment.

Researchers in Canada ran a small pilot study from May 2006 to December 2008in 21 adult patients with any advanced cancer (except brain cancer) who had been eating less as a result of their illness for two weeks or more. All were either being treated with chemotherapy or had been in the past. The patients were randomly assigned to receive medication from a pharmacist in a double-blind manner, which meant that neither the patients nor the doctors knew which treatment they were receiving. Eleven patients received oral capsules containing delta-9-tetrahydrocannabinol (THC) -- the main psychoactive ingredient in cannabis -- and eight patients were assigned to the control group to receive placebo capsules. The active capsules contained 2.5mg of THC and the patients took them once a day for the first three days, twice a day thereafter, and they had the option to increase their dose up to a maximum of 20mg a day if they wished; however, most followed the dosing protocol, with three patients in both groups increasing their dose to three times a day. The treatment ran for 18 days.

From patient answers to questionnaires conducted before, during and at the end of the trial, the researchers found that the majority (73%) of THC-treated patients reported an increased overall appreciation of food compared with patients receiving placebo (30%) and more often stated that study medication "made food taste better" (55%) compared with placebo (10%).

The majority of THC-treated patients (64%) had increased appetite, three patients (27%) showed no change, and one patient's data was incomplete. No THC-treated patients showed a decrease in appetite. By contrast, the majority of patients receiving placebo had either decreased appetite (50%) or showed no change (20%).

As we prepare for the Super Bowl

 
It turns out that, surprise surprise, retired NFL players are more likely to abuse painkillers. In other news, NFL owners are more likely to abuse their privileges at the yacht club.

Of the respondents who used opioids as players, 71 percent reported "misusing" them—using more than prescribed or obtaining them without the guidance of a prescribing physician. More troubling, perhaps, is that for some players the misuse of painkillers did not end with their playing careers, according to ESPN:

When asked about their prescription painkiller use within the past 30 days, 7 percent of the retired players surveyed said they either used more prescription pain medication than prescribed by their doctors, used the medication without a prescription at all, or both.

That is three times the rate among all U.S. males age 26 and up, according to one national survey. ESPN interviewed Dan Johnson, a tight end for the Miami Dolphins from 1983–1987, who said he became addicted following two back surgeries to address football injuries. "I was taking about a thousand Vicodins a month," he told the sports network. "You know, people go, 'That's impossible. You're crazy.' No, that was exactly what I was taking."

The publication of the study is not the first time that the role of prescription pills in football has been called to light. In the 1990s, star quarterback Brett Favre, then with the Green Bay Packers, entered rehab for addiction to Vicodin, a medication he had begun taking to counter the aches and pains of playing the game.

Blast from the past: a doctor's radio network

Back in the mid-seventies I worked at the VA Hospital in San Francisco. I had a friend who was a psychiatrist there. At the time a lot of guys were back from Vietnam with with PTSD as well as guys whose whose schizophrenia blossomed while in uniform. And, of course, plenty of veterans from the previous wars who may have needed psychiatric assistance.

In any case, Ed played jazz guitar and as I was interested in all guitar he and I played together for a time. At a certain point I threw my lot in with some punk rockers, the Vah-Mitz (the name derived from the VA Hospital), and Ed, upset at my abandonment of jazz for punk, parted ways.

 
Long story short. When we played together Ed would pass along a lot of the free junk that the doctors used to get from the pharmaceutical companies. For example, he gave me a big blue paperweight in the shape of a stelazine tablet. I had that for years. Lost it somewhere along the line.

Another thing he gave me was a special radio, meant only for doctors. It picked up a sub-frequency that broadcast information only for doctors' ears. Mostly, the programming consisted of advertisements by drug companies, but it also broadcast what appeared to be lectures. Quite honestly, I didn't understand much of it. I thought listening might make me more knowledgeable in all things medical, but nothing stuck. It mostly put me to sleep.

At some point the radio stopped working and I tossed it. From time to time I wondered if this alternate channel of communications still existed, or if it had moved to another frequency. Whatever.

Well, the internet has the answer to all things. Here is a story from the New York Times in 1981 discussing the demise of the network. Bet most of you never knew of this.

The Physicians Radio Network, a round-the-clock service sponsored by several giant pharmaceutical companies, will discontinue broadcasts on May 31.

In 1974, Visual Information Systems, a division of the Republic Corporation, initiated the station exclusively for doctors - it currently reaches 80,000 physicians in 69 cities. Jay E. Raeben, president of Visual Information, said that his company had ''failed to persuade enough of the industry that the radio was a medium important to use.''

Transmitting on an FM sideband frequency, or subchannel, which could not be picked up on a standard radio dial, the network permitted doctors to communicate among themselves, more freely perhaps than might be possible before a listening lay public. This feature, however, contributed to the station's downfall. The necessary special receivers were distributed to doctors upon request and without charge. Mr. Raeben said that the cost of manufacturing and mailing such equipment had diminished revenues substantially. Used by Advertisers

Physicians rank as the profession most vigorously sought by adverstisers, because their prescriptions largely determine the profits of billion-dollar drug companies.

''Surveys show that P.R.N. affected sales very positively, especially as it impacted new products,'' said Robert E. Devinna, director of advertising for Roche Laboratories, one of the sponsoring companies. Eight minutes of every hour on the air are devoted to advertising. Programming focused on scientific breakthroughs and significant operations, such as the recent surgery on the Pope.

''P.R.N. rarely announces new drugs,'' said Mr. Raeben, who also acts as managing director of the station. ''We made a very considerable effort to insure that programming was not in the interest of the advertisers.'' If a new drug were announced, it would have to be newsworthy in itself, he asserted. May Turn to Journals

Mr. Devinna of Roche Laboratories thinks that some of the major drug companies that advertised on the network will probably turn more to medical journals now. He views this as ''shortsightedness of the marketing industry,'' and added, ''Traditional advertising channels are cluttered - it's a shame to see P.R.N. die.''

Of course, now the drug companies advertise during "Jeopardy!" and "Wheel Of Fortune".

Something else to lower BP

I don't know about curds, but apparently whey can lower blood pressure.

Beverages supplemented by whey-based protein can significantly reduce elevated blood pressure, reducing the risk of stroke and heart disease, a Washington State University study has found.

Research led by nutritional biochemist Susan Fluegel and published in International Dairy Journal found that daily doses of commonly available whey brought a more than six-point reduction in the average blood pressure of men and women with elevated systolic and diastolic blood pressures. While the study was confined to 71 student subjects between the ages of 18 and 26, Fluegel says older people with blood pressure issues would likely get similar results.

"One of the things I like about this is it is low-cost," says Fluegel, a nutritional biochemistry instructor interested in treating disease through changes in nutrition and exercise. "Not only that, whey protein has not been shown to be harmful in any way."

Terry Shultz, co-author and an emeritus professor in the former Department of Food Science and Human Nutrition, said the findings have practical implications for personal health as well as the dairy industry.

"These are very intriguing findings, very interesting," he said. "To my knowledge, this hasn't been shown before."

The study, which Fluegel did for her doctorate in nutritional biochemistry, notes that researchers in a 2007 study found no blood-pressure changes in people who took a whey-supplemented drink. At first, she saw no consistent improvement either. But then she thought to break out her subjects into different groups and found significant improvements in those with different types of elevated blood pressure. Improvements began in the first week of the study and lasted through its six-week course.

The supplements, delivered in fruit-flavored drinks developed at the WSU Creamery, did not lower the blood pressure of subjects who did not have elevated pressure to begin with. That's good, said Fluegel, as low blood pressure can also be a problem.

Other studies have found that blood-pressure reductions like those seen by Fluegel can reduce cardiovascular disease and bring a 35 to 40 percent reduction in fatal strokes.

Health benefits aside, researchers are excited about the prospect of improving the market for whey, a cheese byproduct that often has to be disposed of at some expense. Its potential economic impact is unclear, says Shannon Neibergs, a WSU extension economist, "but any positive use of that product is going to be beneficial."

I'm not going blind. I just have bad eyesight.

Back in 1994 I got a blurry spot in my vision and went in to get it checked. The doctor told me the name of the condition and off I went. I had a followup a few years later without anything getting worse. The doctor told me the name of it.

At some point it came up in conversation and someone asked me if it was macular degeneration and that sounded familiar.

So for the last decade I've been walking around thinking I had macular degeneration. Which is not good and which can lead to blindness. Well, I recently got a new prescription through my health plan, and the eye doctor arranged for another test to see how my eyeballs' health were.

Guess what? I don't have macular degeneration. I had central serous retinopathy. It turns out that it's a lot less serious than that other thing. There's a wikipedia entry on it here. One of the suspected causes of CSR is stress, and back in '94 I had a lot of stress. I was up to my eyeballs in stress, from my work in the union and my marriage. Amazing how you can deal with stress but eventually something pops, which apparently was the back of an eyeball.

In any case, these days I'm retired, I'm divorced and living with a girlfriend who is a lot less stressful than my ex. I only feel stress when I'm dealing with computer things.

I still have crappy vision. But, hey, I'm not going blind. At least not that fast.

Ritalin and cocaine

No, this isn't a really bad idea for party treats. Apparently, Ritalin has some value in treating cocaine abusers.

 A brain-scanning study at the U.S. Department of Energy's (DOE) Brookhaven National Laboratory, conducted with collaborators from Stony Brook University, reveals that an oral dose of methylphenidate, commonly known as Ritalin, improves impaired brain function and enhances cognitive performance in people who are addicted to cocaine.

The study -- to be published in the Proceedings of the National Academy of Sciences -- suggests that methylphenidate, combined with cognitive interventions, may have a role in facilitating recovery from drug addiction.

"Previous studies have shown that methylphenidate does not decrease cocaine use or prevent relapse in addicted individuals, so it wouldn't work to treat cocaine addiction directly, the way methadone works to treat heroin abuse," said Rita Z. Goldstein, a psychologist who leads the neuropsychoimaging group at Brookhaven Lab. "But other studies show that methylphenidate does decrease behaviors such as risk taking and impulsivity and improves brain function and cognitive performance in a range of other conditions that also affect the brain's prefrontal cortex, including attention deficit hyperactivity disorder (ADHD), some forms of dementia, and certain kinds of brain injury. If it also has these positive effects in cocaine-addicted individuals, then it could be a useful component of a treatment strategy that helps increase recovering addicts' impulse control."

To find out, Goldstein's group performed functional magnetic resonance imaging (fMRI) on 13 cocaine users and 14 healthy control subjects who were asked to perform a cognitive task after being given either a low oral dose of methylphenidate (20 milligrams) or a placebo. The task involved pushing a button to correctly identify the color of a printed word; some words had to do with drug use, others were "neutral." Subjects received monetary rewards for correct answers.

The scientists were particularly interested in two parts of the prefrontal cortex previously shown to be impaired during this cognitive activity in cocaine-addicted individuals. "These regions help to regulate emotion, cognition, and behavior in response to salient stimuli -- the things we find particularly interesting or relevant," Goldstein said. "Because drug users have deficits in these regions, they may have less ability to regulate their emotions and exert cognitive control over certain behaviors."

And researchers are finding Ecstacy is good for sufferers of post-traumatic stress disorder. Really.

A way to measure chronic stress leading up to heart attacks

Humans release cortisol when stressed. And everyone presumes that stress is a big contributor to heart attacks. Here's how they can measure it:

Stressors such as job, marital and financial problems have been linked to the increased risk for developing cardiovascular disease including heart attack. But there hasn't been a biological marker to measure chronic stress. Drs. Gideon Koren and Stan Van Uum developed a method to measure cortisol levels in hair providing an accurate assessment of stress levels in the months prior to an acute event such as a heart attack.

The research is published on-line in the journal Stress.

Cortisol is considered to be a stress hormone. Its secretion is increased during times of stress. Traditionally it's been measured in serum, urine and saliva, but that only shows stress at the time of measurement, not over longer periods of time. Cortisol is also captured in the hair shaft.

"Intuitively we know stress is not good for you, but it's not easy to measure," explains Dr. Koren, who holds the Ivey Chair in Molecular Toxicology at Western's Schulich School of Medicine & Dentistry. "We know that on average, hair grows one centimetre (cm) a month, and so if we take a hair sample six cm long, we can determine stress levels for six months by measuring the cortisol level in the hair."

Antarctic octopus venom

As I recall, awhile back scientists isolated a compound in scorpion venom that might be able to create a painkiller without the euphoria or addictive aspects.

Now scientists are isolating venom from octopuses and other cephalopods in the waters around Antarctica. Who knows what medicines they may be able to develop from them.

Venom has long been recognised as a potentially valuable resource for drug development. However, scientists have only recently discovered the largely untapped resource cephalopods such as octopuses, cuttlefish and squid, possess in their unique venom properties -- especially the species that live in sub-zero temperatures.

Team Leader, Dr Bryan Fry from the Bio21 Institute says it was a mystery how venomous animals have adapted their venom to have an effect even in sub-zero temperatures, where most venoms would normally lose their function.

"This is the first study that has collected Antarctic octopus venom and confirmed that these creatures have adapted it to work in sub zero temperatures -- the next step is to work out what biochemical tricks they have used," he says.

Dr Fry says the venom analysis revealed that Antarctic octopus venom harbours a range of toxins, two of which had not previously been described.

"We have discovered new small proteins in the venom with very intriguing activities -- these are potentially useful in drug design, but more will be revealed as the study continues," he says.

The study follows from Dr Fry's revelation last year that all octopuses are venomous. The team of scientists then embarked on a huge task to collect and study completely novel venoms to gain a greater understanding of how they work.

"An understanding of the structure and mode of action of venom found in all octopuses may help design drugs for conditions like pain management, allergies and cancer."

 

Ugly cusses, eh?

Now doctors are worried

About texting and talking while driving.

Writing in the June 10 issue of the New England Journal of Medicine, Ship notes physicians routinely ask patients about habits associated with potential harm like the use of helmets, seatbelts, cigarettes, condoms, drugs and alcohol. And with data showing 28 percent of all accidents in the United States are caused by drivers talking on cell phones or texting, it's time to step into this issue too.

"When a doctor raises an issue while providing overall preventive care, the message is different from that conveyed by a public service announcement nestled between ads for chips and beer or a printed warning on a product box," she writes. "It's time for us to ask patients about driving and distraction."

While the absolute increase in the risk of collision attributable to distracted drivers is hard to assess, Ship says one study showed talking and driving posed a four time greater risk than undistracted driving. A second study suggested texting raised the risk of collision by a factor of 23.

"More than 275 million Americans own cell phones and 81 percent of them talk on those phones while driving. The adverse consequences have reached epidemic proportions."