Bacterium ‘to blame for Crohn’s’

From the BBC:

Crohn’s can affect the intesti

Researchers believe the lack of a specific bacterium in the gut may be a cause of Crohn’s disease.

A shortage of naturally-occurring bacteria is thought to trigger the inflammatory gastrointestinal disorder by over-stimulating the immune system.

Now a French team has highlighted the bug, Faecalibacterium prausnitzii, which they show secretes biochemicals that reduce inflammation.

Medical Student Suicide more ‘burnout’ than depression

It’s probably no surprise to those of us currently undergoing medical studies, but we still need some proof and this comprehensive study from the US offers some interesting insights into the reality of depression in medical students.

The study in the Sept. 2 Annals of Internal Medicine found that 50% of approximately 2,200 medical students surveyed at seven medical schools reported burnout, while 11% said they considered suicide in the past year. This is despite them beginning medical school with mental health profiles similar to their non-medical peers.

While previous studies understandably tied such ideations to depression, these findings link medical student burnout — depersonalization, emotional exhaustion and low personal accomplishment — to the thoughts of suicide.

What is universally true is that the majority of my friends in medical school, like myself, come to medical school having previously been at the top of the academic pile. Suddenly they are barely passing and might even feel like they are not learning anything because they are so inundated with information. It is a unique and challenging place to be.

There is also a constant need to excel that is stretched to it’s limits as one tries to cram early adulthood, studies and other responsibilities into a few short years. Just this morning, walking to hospital, I was talking with two classmates that have been trying to write up PhD’s throughout the last three years of medical studies.

Prostate protein better than Morphine

A soon to be published study says that PAP, a protein used to help detect prostate cancer, is better than morphine at reducing pain.

The researchers from the University of North Carolina found that PAP works by stripping away phosphate groups, the chemical tags that serve to activate or inactivate chemical messengers. In particular, it removes adenosine triphosphate, or ATP, which normally initiates the activities that invoke a painful sensation in a neuron.

This is another victory for biologics in the new world of drug discovery.

Make stem cells in your home kitchen

Long gone are the debates between the embryonic and adult stem cell camps. With the news that virtually any adult stem cell can be made pluripotent with the addition of 4 genes, embryonic stem cells have surely been consigned to the dustbin (except in places like California where Arnie had committed a billion to their study and no one wants to look bad).

Researchers at the Harvard Stem cell institute are now able to make cells pluripotent using a relatively harmless adenovirus.

When one considers that only a few years ago these cells were the holy grail of scientists, I feel that useful treatments may come sooner than we expect.

E-health and Ginseng

Yet another one of my friends came up to me last week and said – Hey, this whole PHR thing is making sense to me now!!

‘Awesome!’, I said. ‘So you, who work in IT, and have listened to me rave on about the need for PHR’s for some years now, have finally got it?’

I’m just hoping not everyone takes this long to cotton on!

The friend in question – who is a great bloke mind you – had recently moved and was seeing a whole new bunch of doctors including specialists. The effort to get all his records, referrals and scans to his new doctors was proving more than cumbersome.

Enough said about PHR’s – I’m always talking about them – to something different…

I love Chinese medicine, in fact, I love alternative or non-western medicine in general. In part because it reminds me of my lovable mother that falls for every quackery offered in Sydney to cope with the aches and strains of aging and being the mother of 10 (adorable) children. I also love it because it offers insight into what the world would be like without a regulated pharmaceutical industry.

So I was amused to read that in China, authorities have had to crack down on a company that sells Ginseng for injection that has been killing people. I mean, I know of Ginseng cream, and Ginseng tea, but Ginseng for injection? IV? What else do they inject over there? English breakfast tea?

Our patent system is stuffed

It pretty much ruined my masters of science research experience. And I know it has caused no end of dramas for most other scientists I know. Yet it lives on as a necessary evil. When will we finally change it?

More evidence that the patent system stifles innovation has come out of a ‘landmark’ Canadian study. They say that in comparison to IT, biosciences have really failed to deliver over recent decades. Few major problems have been solved. Indeed, the IT patent system is quite different from that used in biotech/pharma.

The study backed the idea of more public-private partnerships to share risks during early stages of research, and more patent pooling during the later stages of development and commercialisation. A summary of other recommendations are as follows:

Governments should:

• Seek other ways to encourage innovation—not just through IP, but through health and environmental regulations, the judicial system and tax rules; for instance.
• Work with industry to help create respected and trusted entities whose members that can be counted on to mediate disputes fairly and encourage indigenous and local communities in policy development
• Develop Public-Private Partnerships to conduct early stage research including through the sharing of health related data to allow the sharing of risk across industry.

Patent offices should:

• Collect standardized patent-related information, including license data as they are doing in Japan
• Assist developing countries and NGOs in finding out which patents exist in order to enable licensing

Industry should:

• Establish an independent, non-profit technology assessment organization to evaluate new biotechnology products from developing countries
• Participate actively in the creation of Public-Private Partnerships and other collaborative mechanisms
• Be transparent about patent holdings
• Develop new business models that promote partnerships and collaborations

Universities should:

• Develop clear principles relating to the use and dissemination of intellectual property and promote greater access and broad licensing
• Develop measures of the success of transfer of technology based on social returns rather than on the number of patents hold
• Enter into collaborations between developed and developing countries to ensure that developing country doctoral and post-doctoral students have opportunities to study and work at home.

This article offers a nice outline of bioscience patents and some of the problems we face.

Why do people hate Pharma?

Having done a little drug development work it has always mystified my why so many of my student friends have a high level of distrust for pharma. After all, if they didn’t provide new therapies, where would we be?

Yes, there are many aspects of their business model that are questionable, but the truth is that most pharma companies aren’t doing as well as we might think. It seems the answer probably lies much deeper and in this Adweek article a number of studies are outlined that try to answer this question.

One of the big reasons researchers have discovered is the fact that people don’t want to be sick enough to need drugs. The article also concludes that safety scares undermine people’s faith in the drugs themselves. And the public doesn’t trust pharma to share adverse info on their meds, further undermining that faith–and hurting pharma’s rep.

I have my own theory that is based on more abstract philosophical reasoning (i.e. I have little proof for this). It derives from the fairly obvious fact that people innately believe that healthcare, like education, should be free, or at least provided as cheaply as possible. But big pharma, like the American private health providers, are an antithesis of this sentiment. Anything you have to pay for when you are desperately sick comes from someone that cannot have a heart.

Whatever the reasons for peoples feelings, it would be great to see a poll on how misguided many of my young colleagues are on this matter. Nevertheless, there is also a lot of work to be done in examining the pharma business model. Surely there are ways that drugs can be produced more cheaply.

Simple tracking tools can prevent superbugs

While we all live in fear of antibiotic resistant superbugs and pray that drug companies find the next generation of microbicides, simple tools such as database tracking and susceptibility testing are being overlooked.

Now antimicrobial stewardship programs are being introduced to combat this oversight. Here, teams of pharmacists, infectious-disease specialists and microbiologists monitor the use of a hospital’s antibiotics and restrict prescriptions of specific drugs when they become less effective at fighting infections.

As an example of just how effective this simple program can be, a 178-bed community hospital named the Hunterdon Medical Center in Flemington, N.J., developed guidelines for the most commonly overused antibiotics, and routinely tested bacteria from its facility to determine their susceptibility to drugs in its formulary. In a 2007 test, they found that 51% of cultures of Klebsiella pneumoniae were susceptible to ciprofloxacin, up from 27% a year earlier. Over the period the susceptibility to antibiotics of Pseudomonas aeruginosa rose to 79% from 54%.

Imagine if all our hospitals were that well organised!!

Healthcare on a mobile phone

Those of you that have worked in the developing world will know the difficulty a lack of technology can pose. Basic measurements such as a full blood count, blood type, electrolytes etc cannot be measured in the field.

While the mobile already had many promising telemedicine applications, we are beginning to see developments such as this LUCAS microfluidic cell counter that will eventually allow blood counts to be carried out using a chip in a mobile phone.