Tag: medicine

Evidence-based medicine has been hijacked

RW: You also write that evidence-based medicine “still remains an unmet goal, worthy to be attained.” Can you explain further?

JI: The commentary that I wrote gives a personal confession perspective on whether evidence-based medicine currently fulfills the wonderful definition that David Sackett came up with: “integrating individual clinical expertise with the best external evidence”. This is a goal that is clearly worthy to be attained, but, in my view, I don’t see that this has happened yet. Each of us may ponder whether the goal has been attained. I suspect that many/most will agree that we still have a lot of work to do.

Gene Expression Modeling

ML uncovers unknown features of multi-drug-resistant pathogen

Even though the model built with ADAGE was relatively simple, it had no trouble learning which sets of P. aeruginosa genes tend to work together or in opposition. To the researchers’ surprise, the ADAGE system also detected differences between the main laboratory strain of P. aeruginosa and strains isolated from infected patients. “That turned out to be one of the strongest features of the data”.

“We expect that this approach will be particularly useful to microbiologists researching bacterial species that lack a decades-long history of study in the lab. Microbiologists can use these models to identify where the data agree with their own knowledge and where the data seem to be pointing in a different direction … and to find completely new things in biology that we didn’t even know to look for.”

An Epidemic of Absence

This groundbreaking book explores the promising but controversial “worm therapy”—deliberate infection with parasitic worms—in development to treat autoimmune disease. It explains why farmers’ children so rarely get hay fever, why allergy is less prevalent in former Eastern Bloc countries, and how one cancer-causing bacterium may be good for us. It probes the link between autism and a dysfunctional immune system. It investigates the newly apparent fetal origins of allergic disease—that a mother’s inflammatory response imprints on her unborn child, tipping the scales toward allergy. In the future, preventive treatment—something as simple as a probiotic—will necessarily begin before birth.

our immune system is tuned for the presence of parasites. remove those, and it overshoots, creating allergies.

Gout returns

These dietary problems are translating to a resurgence of a handful of preventable diseases. In the U.K., 3m people are malnourished, and malnutrition-related hospitalizations spiked by 50%. 100k patients were hospitalized with gout. Gout—typically related to a buildup of uric acid due to over-consuming alcohol and rich foods—is a problem in the US, as well. The prevalence of gout in the US has steadily risen over the past 20 years, affecting more than 8m Americans in 2011.

Bioreactor protein synthesis

The key to the cell-free reactions in the new bioreactor is a permeable nanoporous membrane and serpentine (snake-like) design, made using a combination of electron-beam lithography and advanced material-deposition processes. The long serpentine channels allow for exchange of materials between parallel reactor and feeder channels. With this approach, the team can control the exchange of metabolites, energy, and species that inhibit production of the desired protein. The design also extends reaction times and improves yields. Lives of soldiers and others injured in remote locations could be saved with a cell-free protein synthesis device; could also produce custom orphan drugs and personalized medicines at low cost

Cambodian iron fish hack

interventions like these are crucial to make the world smarter.

In 2008, Christopher Charles was thinking about anemia. Anemia is often caused by an iron deficiency. It makes you tired and weak. It makes you have trouble thinking clearly. Almost 50% of Cambodia’s population suffers from this disease! Over 3.5b people on our planet have anemia, a $50b drain on global GDP. You can cure anemia with iron supplements – but they taste bad, and they often cause stomach pains, constipation, and even more disgusting problems. So Charles had another idea: give villagers little blocks of iron to drop into their cooking pots. The iron gets released slowly as the water boils. But at first, people hated them. They thought the iron blocks where ugly. They thought the iron blocks would scratch their pots. So they turned them into doorstops. He kept trying. Eventually he came up with a second idea, that could make the first idea work.

He realized that in rural Cambodia almost everything revolves around fish. People earn money fishing, they’re a big part of the Khmer diet and their folklore. So, he made iron into “lucky fish”. And people are now happy to put one into the pot when cooking.

1 of those who has been using the fish is Sot Mot, a 60-year-old grandmother who lives just outside Phnom Penh. She drops the fish into boiling water as she chops up garlic, ginger and lemongrass for Khmer chicken soup. “Before, I felt tired and lazy and my chest shook when I was tired. But after I use the fish, I have strength and energy to work and I sleep well, too.”

1 of her granddaughters seems to be improving, too. “Before, when I went to school I felt tired, and I didn’t do well at math, maybe the 6th in the class. Now, I’m No. 1.”

2023-09-13: And sometimes you have to take something out, like lead

Last year in Get the Lead Out of Turmeric! I reported that adulteration of turmeric was a major source of lead exposure among residents of rural Bangladesh. Well there is good news: the lead is gone! Wudan Yan at UnDark reports the remarkable story of academic research quickly being translated into political action that improves lives.

Biofilms

Biofilms are extremely tough to get rid of, so this is very welcome news.

A solution for biofilms — a scourge of infections in hospitals and kitchens formed by bacteria that stick to each other on living tissue and medical instruments — has been developed: Injecting iron oxide nanoparticles into the biofilms, and using an applied magnetic field to heat them, triggering them into dispersing.

2017-09-15: Physics of biofilms

Bacteria are extremely adept at building biofilm cities, often in places humans don’t want them: catheters, sewer lines, and our teeth, to name a few. Now scientists are working to unlock the structural mysteries in order to eradicate unwanted bacterial buildup. The first biofilm researchers focused more on the chemical environments of these microbial communities rather than the physical forces that also governed their existence. In the past 10 years, advances in microscale engineering and high-resolution microscopy have allowed scientists to measure physical forces acting on individual cells and replicate a range of environmental conditions in the lab that have enabled scientists to begin to track the formation of a biofilm, cell by cell.

An End to Down Syndrome?

things are going to get very complicated, soon.

Diana Bianchi is now trying to fix the developmental abnormalities, often triggered by the non-wild type karyotype, of individuals with Down Syndrome. But the reporting in this piece suggests many in the Down Syndrome community are ambivalent about a cure, though some are supportive. After all, a “fix” implies a problem, which many will not admit. My own question is why pro-life organizations and individuals don’t fund Bianchi’s research to the hilt?

Gene Therapy

This is the first time human cells, engineered in this particular way, have been given back to a patient. The technology has got enormous potential to correct other conditions

2019-06-30: Germline Gene Therapy

means of correcting disease-causing nuclear and mitochondrial DNA mutations in gametes or preimplantation embryos have now been developed and are commonly referred to as germline gene therapy (GGT). We will discuss these novel strategies and provide a path forward for safe, high-efficiency GGT that may provide a promising new paradigm for preventing the passage of deleterious genes from parent to child.

2020-12-07: Cures

Both the Vertex/CRISPR and Bluebird techniques seem to work – and in fact, to work very well. There are now people walking around, many months after these treatments, who were severely ill but now appear to be cured. That’s not a word we get to use very often.