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Letters to the Editor Issue 254

by Letters(more info)

listed in letters to the editor, originally published in issue 254 - May 2019

Measles, Measles, Everywhere!

by Celeste McGovern

 

Republished from ghostshipmedia.com

http://www.ghostshipmedia.com/2019/03/31/measles-measles-everywhere/

 

While government and media are turning on “anti-vaxxers” for the latest outbreak, Ghost Ship Media looks at the thousands of documented ER visits of children with fevers, seizures and rashes from measles vaccine virus. Public health erases cases of “vaccine-associated measles” from outbreak data. And did you know that vaccine measles virus is in urine after a shot?

2019 is proving to be the year of the reign of measles terror. In January, it was reported that infected children were milling about the international airport in Portland, Oregon. Neighbouring Washington declared a state of emergency a mere 10 days later when 31 cases of measles had been reported in the state. This week, five states were dealing with outbreaks and the Centers for Disease Control and Prevention confirmed 314 cases across the nation – almost half the high of 667 cases in 2014.

Clearly, according to the united mainstream media, “anti-vaxxers” are responsible for returning this measly plague from “near extinction.” As one commentator said,  parents who do not ensure that their children get the bare minimum of 23 needles by age five are the moral equivalent of  “drunk drivers” –  a menace to everyone on the public highway who should “opt out of society.” Following this vein, one New York county took the extraordinary measure this week of instituting a ban on unvaccinated children in public spaces. Violators will be fined $500 and face up to six months in prison if they dare let an unvaccinated child step outside her home in Rockland County, a mostly Orthodox Jewish community north of New York City where 153 cases of measles were reported.

“We will not sit idly by while children in our community are at risk,” Rockland County Executive Ed Day said, launching something eerily akin to marking Jews in Berlin in 1939.  He didn’t say how this would work – are children to show papers before entering shops or synagogues? Or are they to wear stars on their jackets to identify them?  They must have a way.  And they have justified it. “This is a public health crisis and it is time to sound the alarm.”

Vaccine-Induced vs. Vaccine-Preventable

While the measles five-alarm is ringing, it is worth looking into the peer-reviewed, published medical literature about recent infections. The funny thing is that there are hundreds of documented cases – maybe thousands undocumented — of measles going unreported to the CDC every year. Not secret cases of feverish children with mottled rashes, hidden away in the houses of Orthodox Jews or anti-vaxxer wellness types. No. Thousands of kids, show up in emergency rooms and clinics across the nation annually with spiking fevers, rashes and seizures caused by measles virus. The medical literature describes their illness as “clinically indistinguishable” from wild-type measles but it is caused by a vaccine virus.

“Vaccine- Associated Rash Illness”  looks so much like wild measles that parents go in droves to emergency rooms, usually seven to 12 days after a shot.  Even doctors have to be educated to distinguish  “vaccine-associated measles” from “vaccine-preventable” measles. The only accurate way to do this is by genotyping the virus using polymerase chain reaction (PCR) testing. Good thing we can do that, right? Except that doctors are told not to do PCR tests on children with measles who were recently vaccinated. Public health agencies tell doctors that they must report every case of measles – unless it is in children (or adults) who were recently vaccinated.

ER Visits

It’s true, public health agencies tell parents to expect loss of appetite, mild fever and rash  –  “a mild form of measles” –  seven to 12 days after a measles injection. But for many, many children the reaction is not mild.   One study, published in 2017 in  Vaccine  (the journal of the vaccine industry) found that 7,480 (0.8 percent) of 946,806 American babies – that’s approaching one in 100 – who had recently received a first shot of MMR or MMRV between 2000 and 2012 were taken to an emergency room or clinic and had a “medically-attended” fever 7 to 10 days later.  The study excluded children in hospital earlier than day 7 as well as children who spiked fevers beyond day 10, so actual hospital visits for vaccine fevers is under-reported. This was not an expected vaccine reaction, the researchers said, but “considered an adverse event” to immunization and the study was trying to distinguish those children, clumped in certain genetic families it turns out, who are vulnerable to the reaction so that vaccines could one day be “personalized.” So, if vaccine researchers have found that some kids react differently to vaccines in a bad way than others, should county executives be issuing mandates that all children must be vaccinated?  One shot clearly does not fit all.

An earlier study from Canada also found that one in every 168 babies end up at an ER within two weeks of a measles shot. That’s a lot higher than the one-in-a-million vaccine risk that parents are told about, isn’t it?  The study said the babies were seen mostly for spiking fevers, rashes and seizures. The CDC recognizes an increased risk of seizures after vaccines, including the MMR. Parents take seizures seriously. Maybe they’d be inclined to join the growing ranks of “anti-vaxxers” who don’t want to take any risk – no matter how small the CDC thinks it is – of seizures in their healthy baby.

Erasing Cases

In the midst of measles outbreaks we hear so much about, epidemiologists exclude vaccine-associated measles from the public picture. In one study of a measles outbreak in Ontario, Canada in 2015, health officials found that only 17 of 36 confirmed measles-positive cases were “wild type”– likely imported from abroad. Gene sequencing revealed that sixteen of the rest of the confirmed cases were from vaccine measles strain. Another two cases were thrown out before gene sequencing because they were from recently vaccinated individuals and assumed to be “vaccine-associated.” This means that half of the measles cases in the study (18 out of 36) were in people who were infected with vaccine measles, but the public health authorities only recognized 17 cases and could conclude that “most cases occurred in unimmunized individuals.’  In truth, most of the cases occurred in vaccinated people – and they were caused by the vaccine. But public health concluded, of course, that everyone should get vaccinated.

Apart from their staggering omission of cases, why didn’t the health authorities exclude the other 16 cases of vaccine-associated measles before PCR analysis? Perhaps they couldn’t identify them because they were not recently vaccinated. How long ago were they vaccinated? Or were they infected by another recently vaccinated person? What’s remarkable, is these measles cases didn’t interest the Ontario public health officials. These patients, sick with confirmed measles from vaccines, were thrown out of the data pool and, apparently, not further investigated.

In the midst of another measles outbreak,  public health people in British Columbia, Canada were surprised in 2013 when they tested a two-year-old baby girl who had a hot case of measles 37 days after her vaccine shot. The researchers said they “presumed” her illness must have been wild because 37 days is way beyond the expected seven to 21-day window of illness after immunization described by the Canadian adverse event following immunization (AEFI) surveillance system.  What’s scary about this is that our state-of-the-art surveillance systems have huge, gaping holes in their data collection because 1) they don’t understand the virus; 2) they don’t understand their vaccines; 3) they are hiding information. or 4) all of the above.

Vaccine Virus Shedding

Scarier still is the researchers’ conclusion that “Further investigation is needed on the upper limit of measles vaccine virus shedding.” In other words, they know that people shed the live vaccine virus after they are immunized, but they don’t know for how long. Or how infectious it is. We could only find one case of transmission of vaccine virus (brother to sister) –  a vaccinated child infecting an unvaccinated child  –  in the literature. Are we supposed to believe that this has only happened once since 1989 after millions of vaccinations? Or should we be worried that public health has stopped looking for what it doesn’t want to find?

There are horrific anecdotes of people who got measles from their children after they were vaccinated. That’s not hard to believe when studies show that the vaccine measles virus is readily detected in the urine of most children throughout a two-week testing period after vaccination.  Watch out changing diapers of vaccinated children.

Some of those most vulnerable to full-blown vaccination-induced measles are those with compromised immune systems. (e.g. here, here, and here.) Aren’t we told that we’re all supposed to be vaccinated to protect those with weak immune systems? The truth, from the medical literature, is that it is immunocompromised immune systems may not mount a full defence against the live virus in the vaccine. It is these individuals who have also been found to be shedding measles virus long after infection so it would not be surprising to find they shed vaccine virus long afterwards too.

Vaccine measles virus could be airborne like natural disease, as well. This study describes a three-year-old boy who was diagnosed with bronchitis  –  not measles  –  after an MMR vaccine. He had no measles rash but genotyping of the virus that he was excreting from his infected throat proved that it was an “attenuated” measles strain.

See no Evil

It’s clear that doctors don’t usually test the children who show up at a hospital with measles rashes when they know it must be a vaccine reaction. In fact, they are told not to. “Testing for measles should only be considered in specific circumstances for which there is a possible exposure history to wild-type virus,” public health agencies say. In other words, don’t order the tests if it is going to confirm a vaccine strain.

It’s also clear that public health definitions of measles effectively omit the vaccine-induced disease. If it’s not included, it’s not recorded.  “Given that the standard provincial case definition excludes those who have been recently vaccinated, it was initially not clear that case management and contact tracing should be pursued,” some Canadian public health researchers wrote in one measles case study. In other words, they weren’t sure whether or not to investigate a kid who showed up covered head to toe in measles rash with fever and conjunctivitis. It was in the midst of an outbreak, so they decided to pursue it, against the public health guidelines. Swabs from his nose, throat and urine proved it was the vaccine.

This recent paper describes a 14–month-old Dutch boy admitted to hospital with an “impressive rash” 13 days after MMR-vaccination. Diagnostic tests confirmed measles infection and this “caused the mother to doubt further vaccination” according to the paper. Skip the testing, advised the health authorities. “Elaborate diagnostic procedures may cause the parents a lot of stress and therefore offering reassurance to parents may be more appropriate.”

Public health does not understand why most parents are not reassured if their child’s measles infection came from a vaccine vial. Are they not human?  Public health lackeys don’t understand the grassroots beneath “vaccine-hesitancy,” which they target as a leading threat to global security now, because they are out of touch with reality. People, like those in Rockland County, don’t avoid vaccines because they are misled by “fake” news and Facebook  –  but because of the real stories of corporate greed and political cover-up and vaccine-injured children that are shared on those platforms. The data bears them out. There are millions of them. They can’t be censored out of existence and vaccine-associated measles will not be eradicated if every last one of them is force vaccinated or banished.

Acknowledgement Citation

Republished from ghostshipmedia.com

http://www.ghostshipmedia.com/2019/03/31/measles-measles-everywhere/

 

 

‘Game-Changing’ Leukaemia Treatment Test

The first test to quickly and accurately predict how people will respond to standard treatment for the most common type of leukaemia has been developed by a researcher at Brighton and Sussex Medical School (BSMS), run by the universities of Brighton and Sussex.

The technology could guide doctors’ decisions on which drugs to give to patients.

Experts say the test could now be a ‘game changer’ in the treatment of chronic lymphocytic leukaemia (CLL). It also has the potential to change how other cancers, including myeloma and breast cancer, are treated. While previous versions of the test had taken a week to process, results can now be ready in a day. The research, which was funded by the blood cancer research charity Bloodwise, is published in the journal Leukemia.[1]

CLL is a slowly developing blood cancer in which patients produce mutated versions of white blood cells that build up in the blood, bone marrow and lymph nodes and crowd out healthy blood cells. CLL progresses at different rates in different people and never progresses at all in a third of patients.  Until now there has been no accurate test that can be used to indicate whether and how fast individual patients’ cancer will develop.

The high-throughput ‘STELA’ test measures the length of sections of DNA in cancer cells called telomeres, which are found at the end of chromosomes. Telomeres act in the same way as protective plastic tips on the end of shoelaces, preventing chromosomes ends from ‘fraying’.  Telomeres shorten every time a cell divides to create a new cell and eventually the chromosome ends are left exposed – leading to extensive DNA damage that speeds up cancer progression.

The researchers have shown that people who have very short telomeres when they are diagnosed are much more likely to have fast-progressing cancer. 

The improved STELA test was used to analyse samples from 260 patients to see if it could predict how patients would respond to intensive chemotherapy combined with immunotherapy.  The test showed that people with short telomeres relapsed much sooner after treatment than patients with long telomeres – on average 3.7 years after treatment compared to 5.5 years.  

Patients with cancer cells containing mutations to the IGHV gene are known to have a better outcome than patients without this genetic mutation. The STELA test was found to be a more accurate predictor of relapse than testing for the IGHV mutation or any other current prognostic or predictive test.

Professor Chris Pepper, from BSMS, who developed the test while at Cardiff University with Professors Duncan Baird and Chris Fegan, said: “Our study shows that some patients have a very long duration of response to chemo immunotherapy, and may even be cured. These patients all have long telomeres.  In contrast, patients with short telomeres invariably showed an inferior response and should be considered for alternative treatments.”

Professor Pepper has now been awarded nearly £300,000 by Bloodwise to lead research at BSMS finding new targeted drugs for treatment-resistant CLL. 

Dr Alasdair Rankin, Director of Research at Bloodwise, said: “People with CLL can experience great anxiety and uncertainty about how their cancer will progress. This test could give people the peace of mind that they will receive the most effective treatment possible if it does. It may even allow some people to be told that their cancer is unlikely to progress.”

The paper can be read at https://www.nature.com/articles/s41375-019-0389-9

Reference

Kevin Norris, Peter Hillmen, Andrew Rawstron, Robert Hills, Duncan M. Baird, Christopher D. Fegan & Chris Pepper. Telomere length predicts for outcome to FCR chemotherapy in CLL. Leukemia 2019. https://doi.org/10.1038/s41375-019-0389-9 . https://www.nature.com/articles/s41375-019-0389-9

Source: Ken Young <precise@precise.uk>

 

Genetically Encoded Sensor Isolates Hidden Leukemic Stem Cells

Cells express surface markers that help them escape most targeted therapies, TAU researchers say. All stem cells can multiply, proliferate and differentiate. Because of these qualities, leukemic stem cells are the most malignant of all leukemic cells. Understanding how leukemic stem cells are regulated has become an important area of cancer research.

A team of Tel Aviv University researchers have now devised a novel biosensor that can isolate and target leukemic stem cells. The research team, led by Dr Michael Milyavsky of the Department of Pathology at TAU's Sackler School of Medicine, discuss their unique genetically encoded sensor and its ability to identify, isolate and characterize leukemic stem cells in a study published on January 31 in Leukemia.

"The major reason for the dismal survival rate in blood cancers is the inherent resistance of leukemic stem cells to therapy," Dr Milyavsky says. "But only a minor fraction of leukemic cells have high regenerative potential, and it is this regeneration that results in disease relapse. A lack of tools to specifically isolate leukemic stem cells has precluded the comprehensive study and specific targeting of these stem cells until now."

Until recently, cancer researchers used markers on the surface of the cell to distinguish leukemic stem cells from the bulk of cancer cells, with only limited success. "There are hidden cancer stem cells that express differentiated surface markers despite their stem cell function. This permits those cells to escape targeted therapies," Dr Milyavsky explains. "By labelling leukemia cells on the basis of their stem character alone, our sensor manages to overcome surface marker-based issues.

"We believe that our biosensor can provide a prototype for precision oncology efforts to target patient-specific leukemic stem cells to fight this deadly disease."

The scientists searched genomic databases for "enhancers," the specific regulatory regions of the genome that are particularly active in stem cells. Then they harnessed genome engineering to develop a sensor composed of a stem cell active enhancer fused with a fluorescence gene that labels the cells in which the enhancer is active.

The scientists were also able to demonstrate that sensor-positive leukemia stem cells are sensitive to a known and inexpensive cancer drug called 4-HPR (fenretinide), providing a novel biomarker for patients who can potentially benefit from this drug.

"Using this sensor, we can perform personalized medicine oriented to drug screens by barcoding a patient's own leukemia cells to find the best combination of drugs that will be able to target both leukemia in bulk as well as leukemia stem cells inside it," Dr Milyavsky concludes. "We're also interested in developing killer genes that will eradicate specific leukemia stem cells in which our sensor is active."

The researchers are now investigating those genes that are active in leukemic stem cells in the hope finding druggable targets.

Further Information

https://www.aftau.org/weblog-medicine--health?=&storyid4704=2442&ncs4704=3&erid=7786081

Source

George Hunka, American Friends of Tel Aviv University" ghunka@aftau.org

 

TMJ Dysfunction Blog: Autism/Learning Difficulties/OCD Testimony

Republished from dramir.com

http://dramir.com/blog/archives/1767-Autism-From-Oblivion-to-Resurrection.html

 

“…in a world of constant change, you need to try to connect with the environment around you any way you can; by sweeping your eyes, by opening your mind to uncomfortable ideas, even by trying to sympathize with historically noxious figures. Only then could you improve your chances of not missing the signs that something, something important, was about to change.

Joshua Cooper Ramo

I’m here to talk about learning difficulties and Autism. During my lengthy treatment, I spent many an hour on Dr Amir’s website and was fascinated by the possibilities and what else his treatment could achieve. One testimonial, in particular, stood out, it was about an Autistic guy who had learning difficulties. He’d finished Dr Amir’s treatment and had come out the other side of it; more sociable, more empathic and a fully functioning adult able to run his own business. This testimonial really shocked and resonated with me because I, myself, have an autistic sibling.

My brother was in a terrible way circa 2016/17, he had NUMEROUS problems and numerous strange rituals too. He was unable to get dressed by himself; that job was left to my mother. If his pyjama trousers rubbed against his leg the ‘wrong’ way he demanded she start all over again. He’d scream whenever he was in the toilet claiming he was uncomfortable, he was insistent that he had to be sat ‘perfectly’. In fact, everything had to be ‘perfect’. He went through phases, one month nobody could sit next to him and the next month he was too afraid to sit down full stop. My mum would often cry and to make matters even worse every time she would approach him to talk to him about his problems he wouldn’t talk. Hassan was very hard to get a conversation out of so it was often hard to tell what exactly was wrong with him.

I brought him to Dr Amir in July 2017 a month before he was due to start sixth-form at Bromley college and he was really in a bad way. Dr Amir would often observe his strange stance whereby he would walk around holding his two hands out above his head. When asked why he stood and walked in this peculiar fashion Hassan said “to keep the germs away”. Hassan’s venture into college was an exercise in futility and by October 2017 he’d completely dropped out, his teachers were convinced he would need care for the rest of his life. Nevertheless, we kept persevering with Dr Amir’s treatment and his advice. In time the eye bags under his eyes went, his skin began to look a healthier shade of pink, the rituals went away one by one and finally, he was able to go back to school. I was amazed at the results.

Dr Amir had told me from the start of my treatment way back in 2015 that a healthy mind was all about oxygen intake. It’s been 19 or so months since Hassan began his treatment and I was both a keen observer but also sceptical from the start. I always bore in mind EXACTLY how Hassan was at the very BEGINNING of the treatment so I could compare and contrast it to what he is now. And I can definitely say that he’s far more sociable, his vocabulary has increased tenfold, he’s far more empathic then he ever was and he’s definitely a lot smarter too. In fact, contrary to what his teachers believed was possible, he’s now an aspiring chef and will be looking for full-time employment, instead of being a burden on society once his sixth-form is complete. He’s already made major strides by completing work experience at the Green Man community hub as a budding chef.

Andrew B. February 2019

Acknowledgement Citation

Republished from dramir.com

http://dramir.com/blog/archives/1767-Autism-From-Oblivion-to-Resurrection.html

 

Ground Breaking Pancreatic Cancer Trial Reaches Patient Milestone

A ground breaking pancreatic cancer trial, which aims to match patients with more targeted and effective treatment for their tumours, has successfully recruited its 100th patient.

Run by Precision-Panc, a research programme and clinical trials project led by the University of Glasgow with major funding from Cancer Research UK, the trial brings a precision medicine approach to pancreatic cancer treatment for the first time in the UK.

Pancreatic cancer is the fifth most common cause of cancer death in the UK with a 5-year survival rate of less than 3%. Around 9,800 people are diagnosed with pancreatic cancer per year in the UK and around 9,000 people die.

In December 2017 Precision-Panc began working alongside colleagues in NHS Greater Glasgow and Clyde Health Board to recruit suitable pancreatic cancer patients to the Precision-Panc Master Protocol* at Glasgow Royal Infirmary.

The Glasgow-born project has been so successful in the last year, it has now been rolled out to 16 sites across the UK, offering potential treatment hope for pancreatic cancer patients nationwide. As part of the protocol, each patient undergoes tumour biopsy to obtain material that is then used for molecular profiling at the Glasgow Precision Oncology Laboratory  (GPOL) within the University of Glasgow.  The results may then be used to help match patients to the most appropriate, currently available clinical trial.

This ability to link clinical data with the patient’s unique molecular profiling data enables rapid new discoveries, and enhances the delivery of precision medicine to current and future patients. Professor Andrew Biankin, Chief Investigator of Precision Panc and Regius Chair of Surgery and Director of the University of Glasgow Wolfson Wohl Cancer Research Centre, said: “I am extremely proud of what we have been able to achieve so far with Precision Panc. Recruiting the 100th patient is a milestone for us and signals our ability to make real changes to the lives and survival rates of patients with pancreatic cancer.

“The success we have achieved so far – including opening 17 sites across the country – is testament to what we are able to achieve and deliver for patients as a team.”

The overall aim of PRECISION Panc is to make precision medicine a reality for more people with pancreatic cancer through building up knowledge that will ultimately allow clinicians to match patients with the most suitable treatment or clinical trial for them.  The project aims to facilitate drug development, and ultimately new drug approval, allowing access and improving survival in patients with pancreatic cancer.

Dr Ian Walker, Director of Clinical Research at Cancer Research UK, said: “To make real progress in improving survival for people with pancreatic cancer, we need to understand which drugs will be most likely to provide benefit for individual patients. Through Precision-Panc, we are looking to do just that, and recruiting 100 patients is a huge landmark for this ambitious study.

“While overall survival from cancer has doubled over the last 40 years, pancreatic cancer has only seen little improvement, and too many people die from the disease each year. Innovative studies like Precision-Panc are vital to changing the outlook for these patients and we look forward to seeing how it continues to progress.”

About Precision-Panc and the PRIMUS Trials 

*The Master Protocol serves as the entry point to Precision-Panc and is the first step for patients to be recruited before enrolling onto a suitable clinical trial. Three clinical trials, funded in part by Cancer Research UK, will recruit a total of 658 pancreatic cancer patients under the Precision-Panc umbrella, with scope to add more trials in the future. Each clinical trial will test new drugs and combinations of drugs tailored to match specific patients.

Precision-Panc is an ambitious programme of research that seeks to uncover the molecular profile of individual patients with pancreatic cancer, to learn more about the disease and to pave the way for patients entering clinical trials in a way that matches their tumour biology to the type of treatment. It is composed of a network of clinical trials aimed to find the right trial for the right patient matching patients to treatments most likely to work for their type of pancreatic cancer. It is designed to be comprehensive with a faster turnaround time than traditional clinical trials while advancing discovery through science and ultimately changing patient outcomes in this disease.

Precision-Panc is a collaborative effort between clinicians, scientists and various other experts with key partnerships between the NHS GGC Biorepository, Molecular Genetics West of Scotland Genetic Services based at the Queen Elizabeth University Hospital, the Glasgow Precision Oncology Laboratory at the Wolfson Wohl Cancer Research Center, University of Glasgow, Beatson Institute for Cancer Research, and the CRUK Clinical Trials Unit formed to carry out tissue acquisition, storage, processing, testing and analysis.

In 2017 Cancer Research UK committed £10 million investment to support Precision Panc. Other support and funding has been received from the University of Glasgow, Celgene, Wellcome Trust, Chief Scientist’s Office, Scottish Genomes Partnership, MRC/ESPRC Glasgow Molecular Pathology Node, NHS Scotland, The Howat Foundation, Pancreatic Cancer UK, The Scottish Precision Medicine Ecosystem/Stratified Medicine Scotland Innovation Centre, AstraZeneca/MedImmune, NCRI and ECMC. 

Pancreatic Cancer UK (and Pancreatic Cancer Scotland) provide further critical support to the Precision-Panc network and generally to those affected by pancreatic cancer.

PRIMUS-001 (Pancreatic Cancer Individualized Multi-arm Umbrella Study) is an adaptive Phase II/III study with an integrated biomarker evaluation in patients with metastatic disease and is currently open at 11 sites around the UK. PRIMUS-002 will aim to define biomarkers of therapeutic responsiveness in the neoadjuvant setting and opened in Glasgow in March 2019.  Celgene International supports both of these studies.

Additionally, PRIMUS-003, supported by AstraZeneca, is using an immunotherapy approach and is also currently recruiting patients in the metastatic setting. If appropriate, as part of the Precision-Panc Master Protocol, patients may also be helped onto other suitable clinical trials that are already up and running across the UK.

Further Information

Please contact Elizabeth McMeekin or Ali Howard in the University of Glasgow Communications and Public Affairs Office on Tel: 0141 330 4831 or Tel; 0141 330 6557;  Elizabeth.mcmeekin@glasgow.ac.uk  or ali.howard@glasgow.ac.uk  

 

Promising New Treatment could Regenerate Gum Tissue

Gum disease is one of the most widespread diseases in the United Kingdom. When left untreated, the consequences can become irreversible. Now, a new procedure could treat the problem. In an exciting new study, scientists have been able to combine biological and mechanical techniques to repair and regenerate bone and gum tissue.[1]

Long-standing gum disease often turns into periodontal disease, affecting the tissues supporting the teeth. As the disease gets worse, the bone anchoring the teeth in the jaw wears away and tooth loss occurs.

To treat the condition, researchers surgically implanted a thin, film-like membrane between the inflamed gum and tooth. This membrane blocks the infection from the gums and delivers antibiotics, medication and growth factors to the gum tissue.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, describes the impact of tooth loss and believes the research could be extremely promising. Dr Carter says: “Millions of people across the world lose teeth from periodontitis and it can have severe bearing on everyday life.  Missing teeth can make eating, smiling and speaking more difficult.  It can also have an impact on our confidence and mental well-being, as well as increase the risk of developing general health problems.

“Scientific breakthroughs in similar fields have already led to developments in many other areas of healthcare, such as prosthetics and tissue regeneration. These have helped millions of people gain a better quality of life and this cutting-edge research has the potential to do the same in the future. This study has significant potential and we shall look forward to human trials.”

Most adults suffer from gum disease during their lifetime, and the majority will experience it more than once.

In recent years, gum disease has been linked with general health conditions such as diabetes, strokes, cardiovascular disease, poor pregnancy outcomes and even dementia.

As part of the study, researchers created a membrane which was coated with a special material that has been found to speed up bone regeneration.  They then tested this against human stem cells from the gums which had been exposed to erosion for eight weeks.

Co-author of the study, Alireza Moshaverinia says: "We've determined that our membranes were able to slow down periodontal infection, promote bone and tissue regeneration.

“We've also figured out a way to prolong the drug delivery timeline, which is key for effective wound healing. We see this application expanding beyond periodontitis treatment to other areas needing expedited wound healing and prolonged drug delivery therapeutics."

The study was published last week in ACS Nano, a journal published by the American Chemical Society.

At present, there is no cure for periodontal disease, but it can be controlled with good home care and regular visits to the dentist.  By doing these, any further loss of bone will be very slow, and it may stop altogether. “All gum disease is caused by plaque – a film of bacteria which forms on the surface of the teeth,” adds Dr Carter.

“Catching gum disease early, before it escalates into periodontitis is vital. To prevent and treat gum disease, make sure to remove all the plaque from the teeth every day.  This is done by brushing and cleaning in between the teeth with ‘interdental' brushes or floss.

“The first sign of gum disease is blood on your toothbrush or in the toothpaste you spit out after cleaning your teeth.  Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.”

References

1. Mohammad Mahdi Hasani-Sadrabadi, Patricia Sarrion, Nako Nakatsuka, Thomas D. Young, Nika Taghdiri, Sahar Ansari, Tara Aghaloo, Song Li, Ali Khademhosseini, Paul S. Weiss, and Alireza Moshaverinia. Hierarchically Patterned Polydopamine-Containing Membranes for Periodontal Tissue Engineering. ACS Nano Article ASAP,
DOI: 10.1021/acsnano.8b09623. 2019. https://pubs.acs.org/doi/10.1021/acsnano.8b09623  

Further Information

To learn more about gum disease and your oral health, visit the Oral Health Foundation’s website at www.dentalhealth.org The charity also runs a Dental Helpline that offers free, impartial and confidential advice. The Dental Helpline can be contacted by telephone on Tel: 01788 539 780;  helpline@dentalhealth.org   www.dentalhealth.org

 

Is your Medical Consent Properly Informed?

by Robert Verkerk PhD Founder, Executive and Scientific Director ANH

 

Republished from anhinternational.org

https://www.anhinternational.org/news/is-your-medical-consent-properly-informed

 

Patients, understandably, expect their doctors to have their best interests at heart. They must be able to trust them not only with their health, but ultimately, with their lives. Along with this trust comes the assumption that their doctors have at their disposal all the information necessary to ensure the best possible advice on treatments, including about all the options, and their respective risks and benefits. Armed with this information, along with understanding a patient’s needs and life demands, comes the notion of shared clinician-patient decision making – now widely viewed as a worthy substitute for more paternalistic, doctor ‘as God’ rather than ‘as Guide’ approaches.

To get to this place, the doctor needs to help create the right environment to allow discussion of all available treatment options, along with their respective risks and benefits so that shared decision-making can occur in the best interests of the patient. Nice in theory, but we hear almost daily of cases that fall short – sometimes very short – of this medical ethic.

When you have an operation, signed consent is required to acknowledge acceptance of potential risks, yet starting a lifelong drug-based treatment is often treated as being much less important.

All too often, patients are prescribed drug treatments with little or no discussion of their potential negative effects on their health. A case in point is the almost ubiquitous prescription of statins among over-50-year-olds with mildly ‘raised’ cholesterol levels, often without due account being taken of more subtle markers of heart disease risk such as small, dense LDL and oxidised or glycated LDL. Most doctors’ decisions to prescribe statins are made using cholesterol (LDL and HDL) and triglycerides as the only markers, ignoring how well or otherwise their patient is controlling blood sugar with insulin. In short, high LDL levels in those who are not insulin resistant – i.e. those who have good blood sugar control – is not associated with increased heart attack risk.

When patients are offered statins which they might be on for the rest of their lives, very rarely are they told their risk of contracting type 2 diabetes might be increased significantly. A recently published study suggests a nearly 40% increased risk. Nor are they often told what a a thorough analysis of clinical trials has found, as published in BMJ Open in 2015, that their average increase in life expectancy might be just 5.2 days if they’ve had a history of heart disease, or just 3.1 days if they haven’t.

Most mainstream doctors don’t have enough information from standard blood tests to make decisions to offer the best available advice to patients. On top of this, information on possible harms or side-effects are often withheld or under-emphasised, whilst benefits are overstated. The net result is that patients are unable to make a properly informed choices.

What is Informed Consent?

Seeking informed consent to medical treatments from patients is a fundamental principle of medicine. It’s the process by which a patient agrees to a particular medical treatment be it drug-based, surgical or investigative tests, after considering known risks and benefits of the treatment.

Informed consent should also mean that a patient is provided information on available alternatives. Furnishing patients with information about risks of treatments prior to consent being given as well as being offered information about alternative options are two things that are often omitted within the narrow confines of 10-minute general practitioner consultations.

For informed consent to be valid, there are four basic pre-requisites:

  • Consent must be given voluntarily, without coercion or duress;
  • The patient giving consent must be deemed to have the mental capacity/ability to make the decision;
  • The clinician must disclose the expected benefits and risks of a given treatment, test or procedure along with the likelihood of those risks/benefits happening;
  • The patient needs to understand the information they are given.

Legal precedent has refined the definition of informed consent in the UK to ensure that “…doctors must ensure their patients are aware of the risks of any treatments they offer and of the availability of any reasonable alternatives.”

Elsewhere, the definition is similar, such as in the US, the European Union, Australia and South Africa.

Misleading Information?

Misinformation is rife with biased reporting of risks and benefits of treatments in medical journals and the media fuelled by commercial conflicts of interest. It’s often easier for time-pressed clinicians to turn to information and training from pharma than scour the journals and make educated decisions about actual benefits and risks. This is a reason why independent assessors of clinical data such as Cochrane have been so valued by clinicians – but that independence is now in doubt. Added to this there can be a reluctance to go against mainstream dogma.

But how much info is enough? We’re told repeatedly some patients just don’t want to know, others want to walk out of primary care with a pill of some kind, and some just want to be told what to do. This doesn’t give clinicians a ‘get out of jail free’ card to withhold information or offer limited choices. In fact, research has found that many patients want to be given all available, relevant information and don’t want clinicians to pick and choose what they think the patient should hear.

It’s often difficult for patients to assess risk of harm or potential benefits of a treatment because of the way scientific findings are presented in the public domain. The media and pharma spin doctors typically cite the ‘relative risk’ of a particular intervention or dietary habit. But on its own, without the context of ‘absolute risk’, and without relevant comparisons of relative risk, it’s actually meaningless and can be very misleading! This is well illustrated by the European Food Information Council’s comparison of data about relative and absolute risk in relation to bowel cancer risk and processed meats.

A Breach of the Hippocratic Oath?

Imagine a scenario where a morbidly obese patient visits her doctor with chronic knee pain. The doctor prescribes painkillers and anti-inflammatories, which the patient gratefully accepts. The doctor doesn’t discuss other science-based options such as weight loss to relieve pressure on the knee and an anti-inflammatory diet that helps reduce overall levels of systemic, low-grade inflammation. Although the patient has consented to the prescribed treatment, has the doctor failed in his duty to obtain fully informed consent by not discussing alternative options, including science-based non-drug approaches? More than this, has the doctor been negligent in not considering what other health challenges may be faced by the morbidly obese patient, including her increased risk of cancer, heart disease and type 2 diabetes?

Herein lies a systemic failing of primary care – the difficulty of handling comorbidities (multiple conditions or diseases) within the narrow time frames of a primary care consultation window that averages around 10 minutes in most countries and is seen as “a key constraint to delivering expert generalist care.”

Stuck in the Evidence Mire

Current healthcare systems focus largely on the relief of symptoms as opposed to the creation of health. That’s at odds with an altogether different model that we’ve been developing with our ‘blueprint for health system sustainability’. Treatment recommendations being based on clinical guidelines rely on incomplete and frequently biased evidence that aims primarily to simplify prescribing decisions. Woe betide any medic who dares challenge the status quo!

Become an Empowered Citizen

You can take an active part in your health care by asking your clinician six simple questions below, before agreeing to recommended treatment(s). Crucially, if you’re not sure, ask for time to consider the recommendations, do some research and don’t be afraid to say no or ask for a second (or third!) opinion. Your health depends on it.

  • What benefits do you think the treatment(s) you are recommending will give me?
  • Do you know the risks or harms of the various treatment options and how these compare with doing nothing?
  • Have you discussed with me the full range of alternatives that are relevant to my condition(s)?
  • Do you feel that you have taken into account my needs sufficiently and do you think we have shared the clinical decisions?
  • What might happen if I don’t follow the advice you’ve offered?
  • Are there any dietary and lifestyle changes, or any other non-drug treatments or approaches, I can use that you think will make a difference?

And finally, we’ve just released a 4-minute video that gives the ‘health creators’ among you an introduction to our health system sustainability blueprint. It explains just how important it is to have a universal language that allows citizens, health and fitness professionals to engage in informed, two-way communications to allow informed choices and, where appropriate, shared decision making.

Acknowledgement Citation

Republished from anhinternational.org

https://www.anhinternational.org/news/is-your-medical-consent-properly-informed

Source: Robert Verkerk PhD | ANH-Intl <info@anhinternational.org>

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