Exciting Reading...


Addition of thalidomide to melphalan and prednisone treatment prolongs survival in multiple myeloma - a retrospective population based study of 1162 patientsLund J, Uttervall K, Liwing J, Gahrton G, Alici E, Aschan J, Holmberg E, Nahi H; European Journal of Haematology (Oct 2013)

The combination of melphalan and prednisone (MP) has been the standard treatment of multiple myeloma (MM). Since the introduction of novel agents, the clinical outcome in MM has improved. Several prospective studies with thalidomide combined with MP (MPT) compared to MP have been performed, most of them showing that MPT gives a better response rate and median overall survival (OS). Among 1843 MM patients admitted to 15 Swedish centres, we selected all patients treated with MP and MPT in 1(st) , 2(nd) , 3(rd) or 4(th) line of therapy, in total 888 patients treated with MP and 274 with MPT. Patients were evaluated for response rate, OS and TTNT. Multivariate Cox model analysis was made to adjust for different criteria at time for MM-diagnosis. The median OS from beginning of 1(st) line of treatment was 2.2/4.2 years after MP/MPT respectively, and in 2(nd) , 3(rd) and 4(th) line of treatment 1.8/2.9, 1.4/1.6 and 1.1/1.9 years (P<0 .0001="" 0.003="" 0.235="" 0.45-0.84="" 0.55="" 0.61="" 0.74="" 1="" 2="" a="" after="" all="" and="" article="" better="" both="" by="" ci:="" compared="" copyright.="" death="" for="" gave="" group="" in="" is="" line.="" line="" mp="" mpt="" nd="" of="" only.="" overall="" p="" protected="" rate="" relative="" reserved.="" rights="" risk="" significantly="" st="" survival="" the="" therapy="" this="" to="" treatment="" vs.="" was="" with="">

Hat tip to DocGuide.com and thier e-mails...


I'm not crazy - it's my belly!


Now I have an excuse for whatever I want...

How bacteria in your gut affect your mental health

Bacteria in yogurt produce a happy signal

Scientists searching for the underlying causes of mental illness have discovered a surprising contributor — it appears the bacteria that live in your gut may play a major role in your mental health and well-being.
CBC Radio science columnist Torah Kachur spoke to researchers such as Karen Madsen at the University of Alberta who are studying the types of bacteria that live in your gut and how they affect your behaviour, via a nerve that travels between the gut and the brain.
"You know the whole term, 'listen to your gut'? It’s kind of taking on a whole new meaning," Kachur told Rebecca Zandbergen, host of CBC's Radio West.
Kachur explained that there are "good" bacteria, like Bifidiobacterium and Lactobacillus, that are present in yogurt. They produce a happy signal called GABA, which acts on the nervous system to curb depressive symptoms and anxiety. 
Meanwhile, "bad" bacteria like the Clostridium family, of botulism fame, live in our guts and dine on our Western diets of high fat, high sugar and processed foods, Kachur said. She added that these bacteria can produce toxins that are released into the bloodstream and could affect the  brain.
CBC Radio science columnist Torah Kachur
Kachur recommends eating food high inprobiotics, such as yogurt, sauerkraut,kimchi and miso soup; and avoiding high fat and high sugar diets, in order to promote the growth of bacteria that are good for your mental health.
"We've got to nurture and take care of our microbes.

Why are they criminalising Bone Marrow reimbursements?


Wrong, wrong, wrong!

Sorry, but this is what happens when anonymous paper pushing robotic bureaucrats make decisions via wikipedia page insights.

Outlawing a process because it didn't exist when some law was passed in the '80s proves that government only HINDERS medical science, and can not possibly help.

I will just give it to you full bore...


HHS Proposes Rule to Amend NOTA, Nullify Flynn v. Holder

Section 301 of the National Organ Transplant Act (NOTA) of 1984 criminalizes the transfer of “human organs” for “valuable consideration.” Reimbursement of reasonable out-of-pocket expenses associated with travel and lost wages are okay—as are, since the 2008 amendment of NOTA, paired living donor chains—but any other “valuable consideration” that might incentivize sources of organs is not. Under NOTA, as amended,
‘human organ’ means the human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof and any other human organ (or any subpart thereof, including that derived from a fetus) specified by the Secretary of Health and Human Services by regulation
(emphases added). HHS has since added to this list “intestine, including the esophagus, stomach, small and/or large intestine, or any portion of the gastrointestinal tract.”
So-called “bone marrow transplants”—in reality, infusions of hematopoietic (blood) stem cells (HSCs)—are often life-saving procedures for those with, for example, leukemia or aplastic anemia. (See these sobering statistics compiled by the Institute for Justice, which represented the plaintiffs in Flynn.) When NOTA was passed, the only way to obtain HSCs was through bone marrow aspiration using a long needle thick enough to suck liquid marrow directly from the donor’s pelvic bone. HSCs are then harvested from the marrow. The procedure is done under general anesthesia and so the donor is subject to the usual risks of anesthesia. Although the donor can return to usual activities in two to seven days, discomfort may linger for up to two weeks..During the past twenty years or so, however, a new method of obtaining HSCs has emerged—apheresis—that avoids the need to invade the bone for marrow. (Kim Krawiec had a helpful post a while back with short videos thatexplain the differences between the two methods.) Today, something like two-thirds of HSC donation occurs through apheresis (traditional aspiration is medically indicated in some cases). Using this method, the donor receives five daily injections of a drug that accelerates blood stem cell production and coaxes the stem cells to move from the bone marrow into the bloodstream, where they are called peripheral blood stem cells (PBSCs). On the fifth day, the donor sits in a recliner for up to eight hours while blood is drawn from one of her arms, recycled through an apheresis machine that harvests the stem cells, and returns the remaining blood to the donor in her other arm. Possible side effects of the drug in the five-day run-up to the procedure include headaches and bone or muscle aches. After harvesting, the donor can return to her normal routine in one or two days, and complications are, according to the 9th Circuit, “exceedingly rare.”
Still, insufficient numbers of willing, compatible donors (there are just four blood types but millions of marrow cell types) exist. Those in need of transplants who have diverse genetic backgrounds, such as African Americans and those of multiple races/ethnicities, are especially difficult to match.
In Flynn v. Holder, a group of plaintiffs challenged the ban on compensating bone marrow donors. Plaintiffs included parents of children with leukemia and aplastic anemia; a parent of mixed-race children; and MoreMarrowDonor.org, a California nonprofit that wanted to test a pilot program in which it would offer bone marrow providers $3,000 awards in the form of scholarships, housing allowances, or gifts to a charity of their choice. They pressed two arguments before the Ninth Circuit—one based on the Equal Protection Clause, and one based on statutory interpretation. (A third argument, that the ban violates substantive due process, was rejected by the district court by fairly dubious analogy toAbigail Alliance, and plaintiffs did not raise it on appeal.)
Plaintiffs’ first argument was that NOTA, as applied to MoreMarrowDonor.org’s pilot program, violates the Equal Protection Clause by distinguishing, without rational basis, blood, sperm, and eggs (which do not come within NOTA’s definition of “human organ,” and donors of which may be compensated) and HSCs (donors of which may not be compensated under HHS’s interpretation of NOTA, regardless of the method of procurement). Plaintiffs argued that HSC donors—like blood and gamete donors, but unlike solid organ donors—are exposed to little risk and quickly regenerate what they have donated.
As applied to HSCs donated through aspiration, the court held that NOTA’s compensation ban might have any number of rational (if imperfect) bases and, therefore, does not violate the Equal Protection Clause. However, the court avoided the constitutional question as applied to HSCs donated through apheresis, holding that “the statute contains no prohibition.” According to the court, Congress could not have intended for NOTA’s reference to “bone marrow” to encompass the harvesting of HSCs through apheresis (that is, PBSCs), because that procedure did not exist in 1984.
As for what the statute implies about apheresis-derived PBSCs, the question came down to whether PBSCs should (as the government argued) be considered “bone marrow” or a “subpart thereof,” both of which are covered by NOTA’s ban, or (as plaintiffs argued) “blood,” which is not. The court sided with plaintiffs, finding among other defects in the government’s argument that it “proved too much”; after all, if HSCs are “part of” bone marrow because they are formed there, then so are the white and red blood cells that the government concedes fall outside of NOTA’s scope. In short, the court found,
All that differentiates the blood drawn in peripheral blood stem cell apheresis from the blood drawn from a compensated blood donor, other than the filtration process, is the medicine given to donors in the days before the blood draw to increase hematopoietic stem cell secretion.
In its petition for rehearing (here’s Kim again), the government raised a fairly weak new argument (Kim again) based on the fact that Congress—in an entirely different Title of the U.S. Code, pertaining to entirely different issues—defined “bone marrow” to include PBSCs. The court rejected the government’s petition for rehearing but did amend its opinion to reflect its rejection of the state’s new argument. The court concluded:
We construe “bone marrow” to mean the soft, fatty substance in bone cavities, as opposed to blood, which means the red liquid that flows through the blood vessels. The statute does not prohibit compensation for donations of blood and the substances in it, which include peripheral blood stem cells. The Secretary of Health and Human Services has not exercised regulatory authority to define blood or peripheral blood stem cells as organs. We therefore need not decide whether prohibiting compensation for such donations would be unconstitutional.
In its notice of proposed rulemaking this week, of course, HHS seeks to use just this regulatory authority. (Comments, by the way, are due by December 2, 2013.) The agency proposes to “explicitly incorporate hematopoietic stem cells (HSCs) within peripheral blood in the definition of ‘’bone marrow,’ so that the prohibition on transfers of human organs for valuable consideration applies to HSCs regardless of whether they were recovered directly from bone marrow (by aspiration) or from peripheral blood (by apheresis).”
As I said, in my next post, I’ll talk about the policy arguments for underlying HHS’s use of its regulatory authority. They include the usual suspects—commodification, coercion of PBSC vendors, exploitation of the sick, and concerns about compensation crowding out altruism and incentivizing vendors to conceal infectious diseases.

As part of the Cancer Community...

just doing my part!

Hi again, thanks for getting back to me! I work as the Community Outreach Director for the Mesothelioma Cancer Alliance. Mesothelioma Awareness Day just passed last Thursday and our campaign was a huge success! I am contacting bloggers like you in the cancer community to ask for help in continuing to spread awareness. Fortunately, because mesothelioma is a completely preventable cancer (caused only by asbestos exposure), knowing more about the disease and it's risk factors truly does make a difference.

I've attached the mesothelioma facts sheet that I used for the campaign this year. I would love it if you'd be willing to share it on your blog for your community. With more awareness, hopefully one day we can get asbestos banned once and for all.

Hoping to hear from you soon : )

 "How we spend our days is, of course, how we spend our lives."  -Annie Dillard

Wouldn't want it, and thankfully, it will get rarer...