MetaFilter posts tagged with disease and medicine

The girl who turned to bone.

dmd — Fri, 24 May 2013 07:01:02 -0800

A rare disease is defined as any condition affecting fewer than 200,000 patients in the United States. More than 7,000 such diseases exist, afflicting a total of 25 million to 30 million Americans.. One of them, fibrodysplasia ossificans progressiva (FOP), might be approaching a cure. Previously, also from The Atlantic.

291 diseases and injuries + 67 risk factors + 1,160 non-fatal complications = 650 million estimates of how we age, sicken, and die

hat — Fri, 14 Dec 2012 11:08:08 -0800

As humans live longer, what ails us isn't necessarily what kills us: five data visualizations of how we age, sicken, and die. Causes of death by age, sex, region, and year. Heat map of leading causes and risks by region. Changes in leading causes and risks between 1990 and 2010. Healthy years lost to disability vs. life expectancy in 1990 and 2010. Uncertainties of causes and risks. From the team for the massive Institute for Health Metrics and Evaluation Global Burden of Diseases, Injuries, and Risk Factors Study 2010. The data visualizations page also includes a large number of static figures from the GBD 2010 study. The GBD 2010 team at the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, "spent almost 5 years building [the database of causes of death]; we have included almost 800 million deaths from 1950 to 2010, and the data come from different sources," resulting in "the biggest database for cause of death analysis in the world," according to Rafael Lozano at the University of Washington. The GBD 2010 includes:

291 diseases and injuries
67 risk factors
1,160 sequelae (nonfatal health consequences)
Estimates for 21 regions
Estimates for 20 age groups

Takeaway points from the press release (emphasis mine):

Child mortality has dropped by more than 60%, falling "so quickly that it has beaten every published prediction," though diarrhea and other infectious diseases still kill well over a million children under the age of 5 every year.
Deaths among adults aged 15 to 49 increased by 44% between 1970 and 2010, "in part because of increases in violence and the ongoing challenge of HIV/AIDS."
Undernutrition has "successfully been cut by two-thirds," and now physical inactivity and macronutrient overnutrition contribute to a 10%-and-rising fraction of the disease burden.

However,

The trends identified in GBD 2010 occur across regions with one notable exception: sub-Saharan Africa, where infectious diseases, childhood illnesses, and maternal causes of death account for as much as 70% of the burden of disease. By comparison, these conditions account for only one-third of the burden in south Asia and Oceania, and less than 20% in all other regions.

Research findings from the main publication summary (emphasis mine):

In 2010, the three leading risk factors for global disease burden were high blood pressure [...]; followed by tobacco smoking, including secondhand smoke [...]; and alcohol use [...] This reflects a substantial change from 1990 when the leading risk factors were childhood underweight [...]; followed by household air pollution from use of solid fuels [...]; and tobacco smoking, including secondhand smoke [...].
Regional differences are significant. While much of the world is burdened by obesity and high body mass index, underweight is still the leading risk factor in sub‐Saharan Africa. Other prevalent risk factors in the region include household air pollution and nonexclusive and discontinued breastfeeding.
Although child undernutrition has fallen significantly as a risk factor for all ages, it remained the leading risk factor worldwide in 2010 for children under 5, accounting for 12.4% of global DALYs [disability‐adjusted life years], followed by nonexclusive or discontinued breastfeeding at 7.6%.
A number of risks that primarily affect childhood communicable diseases, including unsafe water and sanitation and micronutrient deficiencies, declined in significance in the past 20 years, with unsafe water and sanitation accounting for only 0.9% of global DALYs in 2010.
At the same time, GBD 2010 findings show the importance of household air pollution from solid fuels and ambient particulate matter pollution as major risk factors. One or both rank in the top 10 as causes of disease burden in 13 of the 21 regions. In south Asia, they are the leading cause of burden.

From the Guardian's reporting (more: 1, 2, 3):

Since 1970 the largest gains in life expectancy have taken place in the Maldives (27.3 years for men and 29.4 years for women) and improvements in life expectancy at birth in excess of 20 years were recorded in Bangladesh, Bhutan, Iran, and Peru. But life expectancy fell by one to seven years in Zimbabwe and Lesotho, where populations were severely affected by HIV/Aids, and for men in Ukraine and Belarus, where an alcohol crisis took hold.

If you'd like to read the papers themselves, the full text is currently available for free (but registration required) at The Lancet. In addition to the data visualizations, the IHME provides GBD 2010 publication summaries: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Age‐specific and sex‐specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010

Years lived with disability (YLDs) for 1,160 sequelae of 289 diseases and injuries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Disability‐adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010
Each of the data visualizations again:

Causes of death by age, sex, region, and year
Heat map of leading causes and risks by region
Changes in leading causes and risks between 1990 and 2010
Healthy years lost to disability vs. life expectancy in 1990 and 2010
Uncertainties of causes and risks

The Institute for Health Metrics and Evaluation adds,

The findings are being announced at the Royal Society in London on Dec. 14 and published in The Lancet, the first time the journal has dedicated an entire triple issue to one study.

The Lancet includes The story of GBD 2010: a “super-human” effort:

“Running the programs to map the data to our cause list of 291 causes and correcting the bias can take days, even using a powerful cluster of more than 100 computers. The data that we have to store after the modelling process can take 3 terabytes.” [Rafael] Lozano estimates that the storage needed for the causes of death data was 400 times bigger than that for GBD 1990 [...] Majid Ezzati, chair in global and environmental health at the School of Public Health, Imperial College London, UK, told The Lancet, As researchers, we tend to believe that more ‘data’ are better than less. I still believe so. But more data, but not all the perfect data we could wish for, means that we need to fundamentally think differently about when to stop searching for more and how to use it [...] The study brought out the well-known but far too frequently overlooked issue that people of different scientific traditions—clinicians, basic scientists, epidemiologists, and quantitative scientists—think and speak differently about the same problem. This can of course be a very powerful resource for bringing together different ways of looking at a problem and solving in the most comprehensive and interesting way—a true systems approach. It can also be a challenge, and at times a source of tension.

(Previously on the Institute for Health Metrics and Evaluation: Is there a market for years?)

Pyridomycin: nature's isoniazid

Blazecock Pileon — Fri, 21 Sep 2012 02:52:35 -0800

Drug-resistant and "extensively" resistant strains make containment and treatment of tuberculosis ever more difficult. Fortunately, researchers based in Switzerland have (re-)discovered a naturally-made antibiotic called pyridomycin, which will kill isoniazid-resistant M. tuberculosis bacteria.

Biting back at Malaria...

BobbyVan — Tue, 18 Oct 2011 12:24:40 -0800

A new malaria vaccine has been shown effective in large-scale field trials. After decades of disappointment, researchers think they're finally on track to unleash the first practical vaccine against malaria, one of mankind's ancient scourges. In the world's first large field trial of an experimental malaria vaccine, several thousand young children who got three doses had about 55 percent less risk of getting the disease over a year than those who got a control vaccine against rabies or meningitis. The vaccine was developed by British pharmaceutical company GlaxoSmithKline and the PATH Malaria Vaccine Initiative (MVI), a non-profit.

Surviving Survival

zarq — Sat, 16 Jul 2011 11:42:16 -0800

The Summer 2011 issue of Stanford Medicine Magazine is about "Surviving Survival": The Woman Who Fell To Earth / Khmer Rouge on Trial / A Kid Again / Her Stroke of Insight / RxErcise Download a pdf here.

Photographic Immortality

zarq — Tue, 26 Apr 2011 09:35:00 -0800

The Burns Archive is a collection of over 700,000 historical photographs that document disturbing subject matter: obsolete medical practices and experiments, death, disease, disasters, crime, revolutions, riots and war. Newsweek posted a select gallery this past October, as well as a video interview and walk-through with curator and collector Dr. Stanley B. Burns, a New York opthalmologist. (Via) (Content at links may be disturbing to some.) Blog, which notes that an exhibition of photos, "Sleeping Beauties" is currently being shown at the Albin O. Kuhn Library & Gallery in Baltimore. Books with photos from the collection: * Sleeping Beauty II: Grief, Bereavement in Memorial Photography American and European Traditions * News Art: Manipulated Photographs from the Burns Archive * Deadly Intent: Crime & Punishment Photographs from the Burns Archive * Geisha: A Photographic History, 1872-1912

master of information

kliuless — Sat, 09 Apr 2011 11:00:18 -0800

The New Biology - Eric Schadt's quest to upend molecular biology and open source it. (via)

Happy 65th birthday to the MRC birth cohort of 1946

zarq — Mon, 21 Mar 2011 10:14:39 -0800

Epidemiology: Study of a lifetime. "In 1946, scientists started tracking thousands of British children born during one cold March week. On their 65th birthday, the study members find themselves more scientifically valuable than ever before." The article as it appeared in the magazine can be downloaded as a pdf. How did they keep 80% of the birth cohort involved in the study? Cards and Calls.

More Americans are Surviving Cancer

zarq — Fri, 11 Mar 2011 07:43:04 -0800

According to new data released by the CDC yesterday, more Americans are surviving cancer thanks to advances in increased early detection and treatment. CDC analysis shows an unprecedented 20% increase in survival rates between 2001 and 2007, which is nearly a quadruple increase since 1971. * One in 20 US citizens (approximately 11.7 million people) is a cancer survivor. * One in five of them are over the age of 65. * Survivors are more likely to be female than male (54% vs. 46%). * "22% of cancer survivors had been diagnosed with breast cancer; 19% with prostate cancer; and 10% with colorectal cancer. Those three cancers accounted for slightly more than half of all cancer diagnoses." From the CDC link: Similar to previous reports, this analysis found that the majority of cancer survivors are females and persons aged ≥65 years. Women are more likely to be survivors because cancers among women (e.g., breast or cervical cancer) usually occur at a younger age and can be detected early and treated successfully; in addition, women have a longer life expectancy than men. Among men, a substantial number of cancer survivors had prostate cancer, which is diagnosed more commonly among older men. The large proportion of cancer survivors aged ≥65 years reflects the increase in cancer risk with age and the fact that more persons with diagnoses of cancer are surviving ≥5 years.

Coach Walt

zarq — Sun, 13 Feb 2011 11:23:03 -0800

Wake Forest University's slogan for their baseball team in 2011 is 'What are you willing to sacrifice to help make this team better?' "Head coach Tom Walter's intent was to have his players thinking about sacrifice bunts, moving runners over, and giving up personal glory to help the Demon Deacons improve as a team. But what Walter chose to sacrifice is greater than simply hanging in on a curve ball and taking one for the team. Walter gave up a kidney." "The story... is a reminder not only of the depth of some people's generosity but also of the need for more tissue donation to serve African Americans and other under-represented minority groups." Further coverage: USA Today, ABC, ESPN: 1, 2.

"A Minute With Venus... A Year With Mercury!"

zarq — Tue, 01 Jun 2010 16:48:09 -0800

"During World War I, the [US] Army lost 7 million person-days and discharged more than 10,000 men because they were ailing from STDs. Once Penicillin kicked in in the mid-1940s, such infections were treatable. But as a matter of national security, the military started distributing condoms and aggressively marketing prophylactics to the troops in the early 20th century." Additional Background From the NIH: Visual Culture and Public Health Posters. (Previously on MeFi.) They have a section on Venereal Disease. Medical History: Venereal Disease and Treatment During WWII

The Ban on Blood Donation

zarq — Wed, 26 May 2010 11:35:07 -0800

Are the Rules That Determine Who Can Donate Blood Discriminatory? Canadian AIDS researchers Dr. Mark Wainberg and Dr. Norbert Gilmore say that while the ban on blood donation from men who have sex with other men may have been ethically and scientifically justified in the 1980's, it no longer makes sense. (CMAJ.) Even though the US FDA reaffirmed their long-standing ban in 2007, they plan to revisit the policy in June. Background Currently gay and other men who have sex with men in Canada and the US, as well as the UK and a number of other countries, are permanently banned from giving blood. The prohibition in North America was introduced in 1983. Thousands of individuals were infected with HIV after receiving blood products infected with the virus before effective screening was developed.
Also: Before giving blood, all men are asked if they have had sex, even once, with another man since 1977. Those who say they have are permanently banned from donating. The FDA said those men are at increased risk of infection by HIV that can be transmitted to others by blood transfusion. In March 2006, the Red Cross, the international blood association AABB and America’s Blood Centers proposed replacing the lifetime ban with a one-year deferral following male-to-male sexual contact. New and improved tests, which can detect HIV-positive donors within just 10 to 21 days of infection, make the lifetime ban unnecessary, the blood groups told the FDA.
And: In the CMAJ article, Wainberg and colleagues noted that several industrialized countries, including Argentina, Australia, Japan, and Sweden, have implemented a shorter one-year period of deferral.
More on the study from the Globe and Mail, National Post and Toronto Sun From 2000: Should Gay Men be Allowed to Donate Blood?

Defying the FDA, Doctors in Colorado Offer Stem Cell Therapies for Joint Diseases

zarq — Wed, 17 Mar 2010 11:25:56 -0800

The FDA has yet to approve stem cell therapies for general use in medicine, but that hasn’t stopped doctors in Colorado from providing them anyway. Background In 2007, Colorado-based Regenerative Sciences Inc., (RSI) began offering "Regenexx", to the public: an adult stem cell transplant that uses injected autologous mesenchymal stem cells to treat joint injuries and bone damage, as an alternative to traditional surgical techniques. Since then, they claim to have treated 348+ patients with 800+ injections and are reporting high success rates: 89% of their knee patients and 75% of their hip patients showed marked improvement. (Scroll to: "What is the success rate? How many people respond? What is the cure rate?") Drug, or Surgical Procedure? In 2008, the FDA sent RSI an untitled warning letter, which said the company could not use mesenchymal stem cells as an injectible on humans without a biologics license (BLA) or an investigational new drug application (IND). (See: "Will the FDA kill adult stem cell medicine?") More here (followup in first graph of this post) and here. The company responded, claiming Regenexx is a surgical procedure, (even though the cells are lab-cultured and used to treat disease conditions,) and thus not subject to FDA regulation. A response from the FDA is still pending.

Third-world (and first) diagnosis under $0.01

swimming naked when the tide goes out — Sat, 06 Mar 2010 21:36:55 -0800

Detecting a handful of diseases with comic book ink and a postage stamp (well, not quite, but the technology is related to the ink and it's on a postage stamp sized piece of paper). What's best is that the result is a simple visual that can be sent to doctors far away for recognition.

Are We About to Eliminate AIDS?

andoatnp — Sat, 21 Feb 2009 23:40:53 -0800

New Scientist:

What if we could rid the world of AIDS? The notion might sound like fantasy: HIV infection has no cure and no vaccine, after all. Yet there is a way to completely wipe it out - at least in theory. What's more, it would take only existing medical technology to do the job.

Here's how it works. If someone who is HIV positive takes antiretroviral-drug therapy they can live a long life and almost never pass on the virus, even through unprotected sex. So if everyone with HIV were on therapy, there would be little or no transmission. Once all these people had died, of whatever cause, the virus would be gone for good. It's a simple idea, but the obstacles to implementing it worldwide are enormous. Persuading everyone with HIV to start therapy purely for public health reasons could be ethically dubious. To identify everyone who is HIV positive would require such widespread testing that some may feel it breached their civil liberties. Then there is the question of who would fund such a massive undertaking.

Much much more in the article.

retrovirally transforming pancreatic cells from adult mice into insulin-producing beta cells

kliuless — Wed, 27 Aug 2008 19:51:39 -0800

Scientists Repurpose Adult Cells - "Scientists have transformed one type of fully developed adult cell directly into another inside a living animal, a startling advance that could lead to cures for a variety of illnesses and sidestep the political and ethical quagmires associated with embryonic stem cell research." [nature abstract, nature writeup, audio announcement]

Superbugs

homunculus — Sat, 09 Aug 2008 22:16:02 -0800

Superbugs. "The new generation of resistant infections is almost impossible to treat."

Rachel Carson

homunculus — Mon, 02 Jun 2008 23:20:21 -0800

Rehabilitating Carson: "Why do some people continue to hold Rachel Carson responsible for millions of malaria deaths?" A reply: Contra John Quiggin and Tim Lambert, DDT is usually the most cost-effective anti-malaria treatment, and remains scandalously underused More on the debate, including links to the authors' replies to Bate: Big Tobacco and the war on science

Mental Illness Might Be Caused By Microbes

amyms — Sat, 19 Apr 2008 23:05:11 -0800

Are you batshitinsane? Viruses and/or bacteria may be the cause.

Retrospectacle on the Plague

McLir — Fri, 18 Jan 2008 13:46:24 -0800

Retrospectacle on the Plague. Shelley Batts is a neuroscience PhD candidate who writes the great blog Retrospectacle [Prev]. She's recently posted a series on the bubonic plague: It's real and perceived causes (1 2), the bizarre medical garb doctors used, and modern cases of Yersinia pestis* infection in the U.S. and the world.

Anti-depressants, Serotonin and Depression

OmieWise — Thu, 17 Jan 2008 08:12:07 -0800

"Researchers found that failing to publish negative findings inflated the reported effectiveness of all 12 of the antidepressants studied." See also: Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. NEJM paper referenced. (Subscription required) Older: Antidepressants Versus Placebos: Meaningful Advantages Are Lacking,
but, Small Effects Are Not Trivial From a Public Health Perspective.

RIP Robin Prosser

homunculus — Mon, 29 Oct 2007 12:03:14 -0800

Robin Prosser was a former concert pianist and systems analyst who suffered from an autoimmune disease similar to lupus for over 20 years. The disease left her in constant pain and made her allergic to most pharmaceutical painkillers. Only medical marijuana brought her relief, but last spring the DEA seized her medicine. Unable to cope with the chronic pain any longer, she committed suicide on October 18th. [Via Andrew Sullivan.]

Bacterial marketing: the other Oskar Schindler

goodnewsfortheinsane — Fri, 19 Oct 2007 18:20:23 -0800

Upon the Nazi invasion of Poland, pediatrician Eugeniusz Łazowski and his friend Stanisław Matulewicz fabricated a fake typhus epidemic to save Polish Jews from the Nazis. Knowing that typhus-infected Jews would be summarily executed, non-Jews were injected with the harmless Proteus OX19, which would generate false positives for typhus. Anglicising his name to "Eugene Lazowski", the doctor moved to the United States after the war. He lived and worked in Chicago from 1958, and passed away in late 2006 at the vernerable age of 92, in Eugene (!), Oregon. Oddly little is written about Lazowski and Matulewicz on the web; although apparently there has been work on a documentary titled "A Private War" by a filmmaker named Ryan Bank. So feel free to add supporting links if you are aware of any.

Many of World’s Poor Suffer in Pain

homunculus — Mon, 10 Sep 2007 13:15:36 -0800

Drugs Banned, Many of World’s Poor Suffer in Pain "Millions of people die in pain because they cannot get morphine, which is legal for medical use in most nations." [Via TalkLeft.]

Diseases of the Skin

youngergirl44 — Wed, 03 Jan 2007 21:57:55 -0800

Diseases of the Skin by Gary M. White & Neil H. Cox. All you ever wanted to know about how bad your skin could be - full of images. Possibly NSFW, as some groin photos are included.