Yo Doctors

Doctors less likely to bond with overweight patients

In a small study of 39 primary care doctors and 208 of their patients, Johns Hopkins researchers found that patient weight played no role in the quantity of physicians' medical questions, medical advice, counseling, or treatment regimen discussions. But when it came to things like showing empathy, concern and understanding, the doctors were significantly more likely to express those behaviors in interactions with patients of normal weight than with overweight and obese patients, regardless of the medical topic being discussed.
Obese patients may be particularly vulnerable to poorer physician-patient communications, Gudzune says, because studies show that physicians may hold negative attitudes toward these patients. Some physicians have less respect for their obese patients, which may come across during patient encounters.

Gosh golly, say it ain't so.
This is the part that gets me though-

"If patients see their primary care doctors as allies, I think they will be more successful in complying with our advice," says Gudzune, whose practice focuses on weight-loss issues.

What makes you believe we aren't complying with your advice?
The fact that we do not succeed in losing weight?
Your disrespect seems to be based on the assumption we are insincere or incompetent.
You might want to think about that.  What if we aren't?

Brain Eating Zombies of the Day

Kenneth Mackie et al.

Key Shift in Brain That Creates Drive to Overeat Identified

The switch involves receptors that trigger or inhibit the release of the orexin A peptide, which stimulates the appetite, among other behaviors. In normal-weight mice, activation of this receptor decreases orexin A release. In obese mice, activation of this receptor stimulates orexin A release.
Using mice, this study found that in obesity, CB1 cannabinoid receptors become enriched on the nerve terminals that normally inhibit orexin neuron activity, and the orexin neurons produce more of the endocannabinoids to activate these receptors. Activating these CB1 receptors decreases inhibition of the orexin neurons, increasing orexin A release and food consumption.

Well that explains the effects of medical marijuana.  In mice.  Maybe.  But more orexin production does NOT explain obesity in humans, as evidenced by the fact that Narcoleptics - who have no orexin- have an extremely high incidence of binge eating and obesity.   Geez louise, do your homework...

An emerging idea, Mackie said, is that this network is reset during obesity so that food consumption matches maintenance of current weight, not a person's ideal weight. Thus, an obese individual who loses weight finds it difficult to keep the weight off, as the brain signals the body to eat more in an attempt to return to the heavier weight.

Yes, well I will have to tell him he's wrong about that.
There is no frakkin set point.  We just get fatter, period.

For the Record

I am half Scottish/English and half German.

Miserable and Annoying.

Ha.

Cause and Effect

Austerity is hurting our health, say researchers

Austerity is having a devastating effect on health in Europe and North America, driving suicide, depression and infectious diseases and reducing access to medicines and care, researchers said on Monday.

Yes, well, go figure. 
This is really only remarkable because  it doesn't seem to be hurting the health industries much.
Go figure.

Through the Looking Glass

Very long.  Better than ever.  My heart belongs to Matty.

Everything Is Rigged: The Biggest Price-Fixing Scandal Ever

All of these stories collectively pointed to the same thing: These banks, which already possess enormous power just by virtue of their financial holdings – in the United States, the top six banks, many of them the same names you see on the Libor and ISDAfix panels, own assets equivalent to 60 percent of the nation's GDP – are beginning to realize the awesome possibilities for increased profit and political might that would come with colluding instead of competing. Moreover, it's increasingly clear that both the criminal justice system and the civil courts may be impotent to stop them, even when they do get caught working together to game the system...

The banks found a loophole, a basic flaw in the machine. Across the financial system, there are places where prices or official indices are set based upon unverified data sent in by private banks and financial companies. In other words, we gave the players with incentives to game the system institutional roles in the economic infrastructure. Libor, which measures the prices banks charge one another to borrow money, is a perfect example, not only of this basic flaw in the price-setting system but of the weakness in the regulatory framework supposedly policing it. Couple a voluntary reporting scheme with too-big-to-fail status and a revolving-door legal system, and what you get is unstoppable corruption.

You think banking has subjective opinions, arbitrary definitions and self serving financial incentives underlying the system?

Try Psychiatry. 

Liars and Criminals

US sues Novartis in NY again

The U.S. government sued Novartis Pharmaceuticals Corp. again on Friday, saying it paid kickbacks for a decade to doctors to steer patients toward its drugs, sometimes disguising fishing trips off the Florida coast and trips to Hooters restaurants as speaking engagements for the doctors.
The lawsuit in U.S. District Court in Manhattan came two days after the government brought a similar lawsuit against Novartis, which is based in East Hanover, N.J. The first lawsuit said the company paid kickbacks to pharmacies to switch kidney transplant patients from competitors' drugs to its own. In the second lawsuit, the government accused the company of using from 2001 through 2011 multimillion-dollar "incentive programs" that targeted doctors willing to accept illegal kickbacks to urge patients to use the company's drugs.
"And for its investment, Novartis reaped dramatically increased profits on these drugs, and Medicare, Medicaid and other federal health care programs were left holding the bag," U.S. Attorney Preet Bharara said in a statement.

And We Have a Winner

The circle of insanity is now complete.

Scientist thinks eating boogers may actually be good for your health 

The bacteria are now running experiments on themselves.

Save the Date

Even though it's vague.

Narcolepsy selected for FDA’s Patient-Focused Drug Development Initiative

Patient-Focused Drug Development: Disease Area Meetings Planned for Fiscal Years 2013-2015
Narcolepsy: TBD, approximately September 2013

Looks like I'm going to Silver Spring, Maryland in the fall.

Good Stuff

Newfound hormone holds hope for diabetes treatment

The hormone, called betatrophin, triggers the growth of pancreatic "beta" cells lost or ineffective in diabetes. Insulin is produced by beta cells in the pancreas.
...
In the journal Cell, a team led by Harvard's Peng Yi reports that betatrophin can produce a roughly seventeenfold increase in these cells, and its increase may partly explain the rapid growth of these cells seen during pregnancy to feed developing fetuses in mammals, including people.

My husband wants some right now.

(And an increase in insulin production explains the onset of Narcolepsy in some pregnant women.  Huh.)

Tick Tock

Doctors Denounce Cancer Drug Prices of $100,000 a Year

Prices for cancer drugs have been part of the debate over health care costs for several years — and recently led to a public protest from doctors at a major cancer center in New York. But the decision by so many specialists, from more than 15 countries on five continents, to join the effort is a sign that doctors, who are on the front lines of caring for patients, are now taking a more active role in resisting high prices. In this case, some of the specialists even include researchers with close ties to the pharmaceutical industry. The doctors and researchers, who specialize in the potentially deadly blood cancer known as chronic myeloid leukemia, contend in a commentary published online by a medical journal Thursday that the prices of drugs used to treat that disease are astronomical, unsustainable and perhaps even immoral. They suggested that charging high prices for a medicine needed to keep someone alive is profiteering, akin to jacking up the prices of essential goods after a natural disaster.

It's currently about $75,000 dollars a year for Xyrem.
A generic chemical they prescribe to chronically sick children.  Not a designer drug.  Not terminal illness.

The clock starts now.   I'm waiting for Narcolepsy Network to Raise some freakin Awareness of this.

After it is Approved

Is when they find out how it really works.

Diet As Effective As Surgery For Diabetes Patients

"For years, the question has been whether it is the bariatric surgery or a change in diet that causes the diabetes to improve so rapidly after surgery. We found that the reduction of patients' caloric intake following bariatric surgery is what leads to the major improvements in diabetes, not the surgery itself."

Just thinking

Xyrem now costs over $5000/ month.
I never, ever got anywhere close to making $5000 a month.   And then I was unemployable.

Speechless

Read the comments

Their Vision of Your Future

Binge Eating Curbed by Deep Brain Stimulation in Animal Model

Deep brain stimulation (DBS) in a precise region of the brain appears to reduce caloric intake and prompt weight loss in obese animal models, according to a new study led by researchers at the University of Pennsylvania. The study, reported in the Journal of Neuroscience, reinforces the involvement of dopamine deficits in increasing obesity-related behaviors such as binge eating, and demonstrates that DBS can reverse this response via activation of the dopamine type-2 receptor.

Ooh, brain surgery will make doctors even more money than stomach surgery. 

Funny thing though-  amphetamines-  which depressed and fat people seem to find very effective in easing their symptoms-  actually reduce D2 receptor activity.

Fun with Obsession

PBS is airing a three-part mini series called "The Blechley Circle".

Four former Blechley Park codebreakers attempt to solve a murder mystery.   It's a rainbow spectrum of OCD.   Ha.

The first one aired a couple days ago, maybe you can pick up a repeat before the next one...

Nobody could have predicted

Study Links Autism With Antidepressant Use During Pregnancy

A cautiously worded study based on data collected in Sweden has found that “in utero exposure to both selective serotonin reuptake inhibitors (S.S.R.I.’s) and nonselective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability.”
...
This is the second study in two years to associate antidepressant use during pregnancy with an increased incidence of autism in exposed children. An earlier, smaller study in California also found a modest increase in risk. The Sweden-based study could not (and did not) exclude the possibility that it was the severe depression, rather than the use of antidepressants, that created the association, but the smaller California study (which considered only S.S.R.I.’s) found “no increase in risk” for mothers with a history of mental health treatment in the absence of prenatal exposure to S.S.R.I.’s.

Quote of the Day

"I wanted the pain to stop."

Sgt. John Russell, who killed five of his fellow soldiers at a mental health clinic in Iraq.

Yo Doctors

Blame Yourselves.
This is ALL Your Fault.
This is what happens when we follow your advice.

(gosh I love weeping before 7am.)

Yo Obesity Doctors

Impact of Obesity in Children with Narcolepsy.

AIMS:
To evaluate the impact of obesity on clinical and sleep characteristics in a population of narcoleptic children.
METHODS:
Data from the children diagnosed with idiopathic narcolepsy in the National Reference Centers for Narcolepsy were collected between 2008 and 2011. Clinical and electrophysiological characteristics were compared between obese (body mass index [BMI] greater than P97) and nonobese children.
RESULTS:
The 117 children (65 boys, 59 de novo patients) had a mean age of 11.6 ± 3.1 years on diagnosis. Cataplexy was present in 81%, DQB1*0602 in 91%. Mean BMI was 23.2 ± 5.2 kg/m2 and BMI z-score was 2.9 ± 2.6. Obesity was found in 60% with a similar prevalence in treated versus de novo patients and in patients with and without cataplexy. Sleepiness and cataplexy started earlier in obese children. Obese narcoleptic children had lower sleep efficiency, higher apnea hypopnea index and respiratory arousals index (RAI) than nonobese children. BMI z-score was positively correlated with RAI. Obese children were more tired and missed more often school than nonobese children.
CONCLUSION:
Obesity affects more than 50% of narcoleptic children, mostly younger at disease onset, and has a deleterious impact on sleep quality as well as on school attendance.

The obesity rate among narcoleptics is TWICE the normal population.  And it would be higher if you found and removed all the narcoleptics...
You think you might want to research that???

Here's some more evidence of dose dependent glucose effects-
Narcolepsy and pregnancy: a retrospective European evaluation of 249 pregnancies.

Weight gain during pregnancy was higher in narcoleptic patients with cataplexy. More patients with narcolepsy-cataplexy during pregnancy had impaired glucose metabolism and anaemia. 

The Guinea Pig Generation

Tons of good research in this article but it boils down to this:

Who Needs Antioxidants? No One.

Perhaps the most damning evidence against the Free Radical/Oxidative Stress Theory of Aging is that after 60 years of intensive research into antioxidants, with billions of dollars spent looking for nutrients that can retard cell aging, not a single antioxidant compound has been found that can extend human life. In fact, in a shocking number of human trials, antioxidants (beta carotene, Vitamin E, Vitamin A) have actually increased all-cause mortality.

ht Andrew Sullivan

This is Why

The world we have created.

Something I have been thinking about lately

Snot nosed kids

I always slept in the shopping cart.

Are you effing kidding me?

Texas fertilizer company didn't heed disclosure rules before blast

The fertilizer plant that exploded on Wednesday, obliterating part of a small Texas town and killing at least 14 people, had last year been storing 1,350 times the amount of ammonium nitrate that would normally trigger safety oversight by the U.S. Department of Homeland Security (DHS). Yet a person familiar with DHS operations said the company that owns the plant, West Fertilizer, did not tell the agency about the potentially explosive fertilizer as it is required to do, leaving one of the principal regulators of ammonium nitrate - which can also be used in bomb making - unaware of any danger there.

Nobody tracks where that stuff goes?   And I have to limit myself to 3 ounces of mouth rinse to get on an airplane?  And show picture ID to buy Sudafed?   Where the hell is all that Homeland Security money going?

Shit is fucked up and bullshit.

Quickie Correlation

Growing Number of People Get Too Much Sleep

Most people you know probably talk about not getting enough sleep, but the percentage of U.S. adults who sleep for more than nine hours a night is actually on the rise, a new study suggests. Between 1970 and 2007, the percentage of survey participants who reported sleeping for more than nine hours over a 24-hour period increased from 28 percent in 1985 to 37 percent in 2007, the study found. The trend was seen in participants' reports of both their weekday and weekend sleep habits. What's more, the percentage of people who slept for less than six hours a night decreased, from about 11 percent in 1985 to 9 percent in 2007, the researchers said.

U.S. Sugar Consumption On The Rise

Daily consumption of added sugars in the U.S. averages 3.2 ounces (15.8 percent of daily caloric intake) and has increased substantially since 1977-1978, when added sugars contributed only 10.6 percent of the calories consumed by adults, according to a new study in JAMA.
(The study also points out that consuming higher amounts of added sugars is associated with lower levels of high-density lipoprotein cholesterol and higher levels of triglycerides, which are important risk factors for cardiovascular disease.)

Brain Eating Zombies of the Day

Gerald Haeffel and Jennifer Hames

Risk Factor for Depression Can Be 'Contagious'

Within one month of arriving on campus, the roommates completed an online questionnaire that included measures of cognitive vulnerability and depressive symptoms. They completed the same measures again 3 months and 6 months later; they also completed a measure of stressful life events at the two time points.
The results revealed that freshmen who were randomly assigned to a roommate with high levels of cognitive vulnerability were likely to "catch" their roommate's cognitive style and develop higher levels of cognitive vulnerability; those assigned to roommates who had low initial levels of cognitive vulnerability experienced decreases in their own levels. The contagion effect was evident at both the 3-month and 6-month assessments.
Most importantly, changes in cognitive vulnerability affected risk for future depressive symptoms: Students who showed an increase in cognitive vulnerability in the first 3 months of college had nearly twice the level of depressive symptoms at 6 months than those who didn't show such an increase.

Their hypothesis is "negative thinking" is "contagious" during major life transitions, when "social environments are in flux".   And they believe this data supports that flying ass monkey.

How about a little Occam's Razor:   Depression is caused by an infection and living with someone who has it is a good way to catch it.
Not to mention- people often change their diet, exercise and hygiene when their "social environments are in flux".

This is basic epidemiology.  Just because you don't know what it is- doesn't require you to make stuff up to explain it.