Protein- and fiber-packed meal

 

Another experiment today resulted in a pretty edible lunch. It was all done in a pan, in less than 20 minutes. The meal has egg whites that supply the protein, and plenty of fiber coming from an onion, peppers and beans.

Ingredients:
1 carton egg whites, 16 oz
1 can black beans (drained), 15 oz
2-3 peppers (any color), cut into small pieces
1 big sweet onion, peeled, cut thinly  
a few garlic cloves, crushed
hot pepper flakes
black pepper
paprika
salt
2 Tbsp olive oil

How to cook:
Pour the oil in a pan and soften the onion in it. Mix from time to time to prevent burning. I use a cover to keep the moisture in the veggies, so that they are steamed rather than fried. Add the peppers, cover and continue cooking until desired softness. Continue mixing occasionally.  

Add the crushed garlic and the beans. After a minute or less, add the carton of egg whites, salt and all other spices (i.e., the listed in the Ingredients section or any other spices you may prefer). Heat through and mix until the egg whites are cooked. Serve with a salad (cucumbers with garlic, olive oil and vinegar go well).

I dramatically reduced my cheese consumption these days. In old times, I would have sprinkled some feta cheese on the egg whites.  Now, to compensate for my salt craving, I simply use salt. Is salt that bad for you, watch the new video on my favorite YouTube Channel What I've learned.  Be careful, however: there is an association between high consumption of salt/salt-preserved foods and stomach cancer!

Gene Expression And veteran Suicide Attempts

Here is a study showing suicide attempts by veterans is linked to altered gene expression associated with several cell signaling pathways, including mTOR and Wnt (which, by the way, are strongly linked to cancer and other diseases) that can in some cases be (potentially) “druggable” or amenable to other future therapies.  These findings have potential implications for civilians as well.  Abstract:

According to a recent report from the Office of Suicide Prevention in the US Department of Veterans Affairs, veterans represent 8.5% of the US population, but account for 18% of all deaths from suicide. The aim of this study of psychiatric patients (n=39; 87% male) was to compare blood gene expression data from veterans with a history of one or more suicide attempts to veterans who had never attempted suicide. The attempter and non-attempter groups were matched for age and race/ethnicity, and both groups included veterans with a diverse psychiatric history that included posttraumatic stress disorder (PTSD) and substance-use disorders. Veterans were interviewed for lifetime psychiatric history, including a detailed assessment of prior suicide attempts and provided a blood sample. Results of Ingenuity Pathway Analysis (IPA) identified several pathways associated with suicide attempts, including the mammalian target of rapamycin (mTOR) and WNT signaling pathways. These pathways are of particular interest, given their role in explaining pharmacological treatments for suicidal behavior, including the use of ketamine and lithium. These results suggest that findings observed in civilians are also relevant for veterans and provide a context for interpreting results observed in post-mortem samples. In conclusion, an emerging body of work that shows consistency in findings across blood and brain samples suggests that it might be possible to identify molecular predictors of suicide attempts.

Nivolumab Vs. Ipilimumab For Melanoma

Nivolumab and ipilimumab are monoclonal antibodies useful in the treatment of advanced melanoma; these target "immune checkpoints" - the activity that suppresses immune system recognition of cancer.  Thus, these antibodies inhibit the checkpoints and allow the patient's immune system to better fight the cancer.  It seems that nivolumab is superior to ipilimumab in at least this study. Abstract:

Background Nivolumab and ipilimumab are immune checkpoint inhibitors that have been approved for the treatment of advanced melanoma. In the United States, ipilimumab has also been approved as adjuvant therapy for melanoma on the basis of recurrence-free and overall survival rates that were higher than those with placebo in a phase 3 trial. We wanted to determine the efficacy of nivolumab versus ipilimumab for adjuvant therapy in patients with resected advanced melanoma. Methods In this randomized, double-blind, phase 3 trial, we randomly assigned 906 patients (≥15 years of age) who were undergoing complete resection of stage IIIB, IIIC, or IV melanoma to receive an intravenous infusion of either nivolumab at a dose of 3 mg per kilogram of body weight every 2 weeks (453 patients) or ipilimumab at a dose of 10 mg per kilogram every 3 weeks for four doses and then every 12 weeks (453 patients). The patients were treated for a period of up to 1 year or until disease recurrence, a report of unacceptable toxic effects, or withdrawal of consent. The primary end point was recurrence-free survival in the intention-to-treat population. Results At a minimum follow-up of 18 months, the 12-month rate of recurrence-free survival was 70.5% (95% confidence interval [CI], 66.1 to 74.5) in the nivolumab group and 60.8% (95% CI, 56.0 to 65.2) in the ipilimumab group (hazard ratio for disease recurrence or death, 0.65; 97.56% CI, 0.51 to 0.83; P<0.001). Treatment-related grade 3 or 4 adverse events were reported in 14.4% of the patients in the nivolumab group and in 45.9% of those in the ipilimumab group; treatment was discontinued because of any adverse event in 9.7% and 42.6% of the patients, respectively. Two deaths (0.4%) related to toxic effects were reported in the ipilimumab group more than 100 days after treatment. Conclusions Among patients undergoing resection of stage IIIB, IIIC, or IV melanoma, adjuvant therapy with nivolumab resulted in significantly longer recurrence-free survival and a lower rate of grade 3 or 4 adverse events than adjuvant therapy with ipilimumab. (Funded by Bristol-Myers Squibb and Ono Pharmaceutical; CheckMate 238 ClinicalTrials.gov number, NCT02388906 ; Eudra-CT number, 2014-002351-26 .).

Why not combine them?  Someone has thought of that, and it works well.

More on checkpoints here.

Strength Training Improves Cognitive Performance In Elderly Women

By Jonik - Own work, CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=528985

Strength training in elderly women can not only enhance strength (and, hence, bodily function) but also increases “cognitive capabilities” (brain function).  This emphasizes brain-body connections and the utility of physical activity in maintaining mental as well as physical fitness.  Of course, given the possibility of injury or other negative effects, particularly in the elderly, interested individuals would need to consult their physician for the go-ahead, and get at least some sort of instruction in technique from a trainer or therapist.  Abstract:

Aging is a degenerative process marked by recognized functional, physiological, and metabolic impairments, such as dynapenia and diminished cognitive capacity. Therefore, the search for innovative strategies to prevent/delay these physiological and cognitive disorders is essential to guarantee the independence and life quality of an elderly population. The aim of this work is to verify the effect of a 12-week resistance exercise program on the general physical aptitude and cognitive capacities of elderly and sedentary women. Twenty-nine women (65.87±5.69 years) were divided into two groups. The control group was composed of eight elderly women who met the same inclusion criteria of the study and the strength training group was composed of 29 elderly women who were subjected to a resistance exercise program defined by 12 upper and lower limb exercises combined in 3×10 repetitions with 1-minute interval between repetitions and two resting minutes between exercises (three times/week). Weight loads were fixed between 60% and 75% of the apparent 1 repetition maximum, which was estimated by the test of 10 maximum repetitions. The direct curl was performed for upper body strength evaluation with 2.3 kg dumbbells for 30 seconds, whereas the chair test was used for lower body evaluation (total sit-stand movements in 30 seconds). The cognitive capacities of subjects were evaluated by "The Montreal Cognitive Assessment" questionnaire. After 12 weeks, the elderly group showed significant increases in the average upper body strength (58%), lower body strength (68%), and cognitive capacity (19%). The present study demonstrated that regular resistance exercises could provide significant gains on the upper and lower body strength concomitant to positive improvements on cognitive capacities of elderly women, bringing enhanced life quality.

Breakfast And Adolescent Girls

The study linked here suggests that eating breakfast doesn’t really help with respect to energy balance and physical activity during the day; however, it is restricted to adolescent girls and, also, apparently doesn’t look at how eating breakfast may affect school performance (should one take an exam on an empty stomach?).  So take it for what it is worth, an interesting data point, but limited   Abstract:

It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised cross-over design, forty girls (age 13·3 (sd 0·8) years, BMI 21·5 (sd 5·0) kg/m2) completed two, 3-d conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (approximately 1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated-measures ANOVA. Post-breakfast EI was 483 (sd 1309) kJ/d higher in NB v. SB (P=0·025), but total daily EI was 1479 (sd 11311) kJ/d higher in SB v. NB (P<0·0005). Daily carbohydrate, fibre and protein intakes were higher in SB v. NB (P<0·0005), whereas daily fat intake was not different (P=0·405). Effect sizes met the minimum important difference of ≥0·20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0·451) or time spent sedentary or in PA (P≥0·657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a SB was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people.

Facial anti-inflammatory mask

Hello dear readers, 

This recipe for an anti-inflammatory mask has way too many ingredients; however, I do not want to subtract any of them since they all have proven inflammation-quenching qualities. 

If you a missing an ingredient or two, you can still go ahead and try it.

Here it is:
1 tsp of plain yogurt (any type, any fat content)
1/2 tsp raw honey
1 tsp or less of apple cider vinegar (with the mother)
3 drops of tea tree oil
3 crushed aspirin pills (uncoated)
a pinch of turmeric powder

Mix all in a plastic cup. Be careful to apply only on your face (turmeric stains everything). I keep the mask on my face until the mixture dries out and tightens the skin. Wash with water. If you are afraid that your skin will acquire yellow glow from the turmeric powder, then shorten the treatment. 

I routinely leave the mask for an hour on my face and if there is any residual color, I wipe off the skin with my recipe cleanser.

KarlieKloss-obsessed

Hello there!

These days, I have very little time to relax or do any of the four Cs of happiness as described by Dr. Lustig (i.e., connect, contribute, cope, and cook). 

The only niche I have chiseled as "my time" are the morning breakfasts, and this week I have been "KarlieKloss-obsessed". I have watched probably more than 20 of her short videos during my breakfast time. Some of these videos are dedicated to cooking, and I would like to share three of the recipes:

•  vegan ice cream

• pancakes*

• egg sandwich

* About the pancakes: I tried the recipe myself and added a heaping Tbsp of Cream of Wheat per each banana/egg. I am anemic and this addition adds iron to my dietary intake in yet another form. Also, these pancakes do not break into pieces only if one makes them exceedingly small (as shown by Karlie). 

Bon appetit!

iPS Cells Against Parkinson's Disease

By Y tambe - Y_tambe's file, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3210604

Induced pluripotent stem (iPS) cells have the potential to help with many human disorders, and bypass the ethical problems of embyronic stem cells, since the iPS cells are derived from adult cells. A study has shown promise in using iPS cells against Parkinson's disease in a macaque primate model of the disease.  Abstract:

Induced pluripotent stem cells (iPS cells) are a promising source for a cell-based therapy to treat Parkinson's disease (PD), in which midbrain dopaminergic neurons progressively degenerate. However, long-term analysis of human iPS cell-derived dopaminergic neurons in primate PD models has never been performed to our knowledge. Here we show that human iPS cell-derived dopaminergic progenitor cells survived and functioned as midbrain dopaminergic neurons in a primate model of PD (Macaca fascicularis) treated with the neurotoxin MPTP. Score-based and video-recording analyses revealed an increase in spontaneous movement of the monkeys after transplantation. Histological studies showed that the mature dopaminergic neurons extended dense neurites into the host striatum; this effect was consistent regardless of whether the cells were derived from patients with PD or from healthy individuals. Cells sorted by the floor plate marker CORIN did not form any tumours in the brains for at least two years. Finally, magnetic resonance imaging and positron emission tomography were used to monitor the survival, expansion and function of the grafted cells as well as the immune response in the host brain. Thus, this preclinical study using a primate model indicates that human iPS cell-derived dopaminergic progenitors are clinically applicable for the treatment of patients with PD.

It is 10:10, Do You Know Where Your Credit Card Is?

Here is a study that demonstrates how clever advertisers are, and how they manipulate images to increase the probability that you will buy their product.  Watch advertisements tend to have the time set at 10:10, as this image resembles a smiling face, and increases feelings of pleasure and intention to buy, particularly among women.  Caveat emptor.  Abstract:

Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10) would enhance emotional valence and intention to buy compared to a neutral time setting (11:30), whereas a time setting resembling a sad face (8:20) would have the opposite effect. Moreover, we investigated a possible interaction effect with the gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10) can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed.

Another Drug For Cardiovascular Disease

A report on the effectiveness of another drug for cardiovascular disease is found here.  I would like to see more on lifestyle (e.g., diet and exercise) however.  Abstract:

Background Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. Methods We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. Results During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. Conclusions Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .).

Does Maternal Gut Microbiota Affect Autism Risk?

This paper linked here shows that certain gut microbiota can trigger inflammatory responses in female mice that increases the chances of offspring with abnormalities associated with maternal immune activation; in humans, such abnormalities include autism.  Thus, if these findings also apply to humans, a possible link between the gut microbiota of the mother and risk of autism in the child.  Abstract:

Maternal immune activation (MIA) contributes to behavioural abnormalities associated with neurodevelopmental disorders in both primate and rodent offspring. In humans, epidemiological studies suggest that exposure of fetuses to maternal inflammation increases the likelihood of developing autism spectrum disorder. In pregnant mice, interleukin-17a (IL-17a) produced by T helper 17 (TH17) cells (CD4+ T helper effector cells involved in multiple inflammatory conditions) induces behavioural and cortical abnormalities in the offspring exposed to MIA. However, it is unclear whether other maternal factors are required to promote MIA-associated phenotypes. Moreover, the underlying mechanisms by which MIA leads to T cell activation with increased IL-17a in the maternal circulation are not well understood. Here we show that MIA phenotypes in offspring require maternal intestinal bacteria that promote TH17 cell differentiation. Pregnant mice that had been colonized with mouse commensal segmented filamentous bacteria or human commensal bacteria that induce intestinal TH17 cells were more likely to produce offspring with MIA-associated abnormalities. We also show that small intestine dendritic cells from pregnant, but not from non-pregnant, females secrete IL-1β, IL-23 and IL-6 and stimulate T cells to produce IL-17a upon exposure to MIA. Overall, our data suggest that defined gut commensal bacteria with a propensity to induce TH17 cells may increase the risk of neurodevelopmental disorders in the offspring of pregnant mothers undergoing immune system activation owing to infections or autoinflammatory syndromes.

September 2017 Garden

Somewhere in Northeast America

STOP THE ACNE

 
More than three years ago, my teenage daughter developed acne, and we have been going to our local dermatology clinic for the past 2+ years. My girl went through an oral antibiotic and Epiduo, as well as topical antibiotics. Through these treatments, the skin condition has been fluctuating; however, a few months ago, the acne exploded into the worst inflammation I have ever seen. The U.S. dermatologists recommended a new topical antibiotic. Our insurance refused to cover it, and in the middle of the bargaining process, we went to visit my family abroad. This is how my daughter and I ended up in a dermatology office outside the U.S. 

The foreign doctor gave us an one-hour speech on the ramifications of having acne, on all likely reasons for acne, and all preconceptions of the condition, the approaches that could or could not help (in this category were the antibiotics). He even handed me as a gift a booklet he had written.

Finally, he got from his chair, opened one of his cabinets and extracted a few bottles and tubes of ISISPHARMA. This French company is offering a series of products called Teen-derm K.  We bought a bottle of lotion to clean the face and a tube of concentrate to treat the face with. 

The most novel active ingredient in this treatment is the 5-alpha avocuta, a 5-alpha reductase inhibitor extracted from avocado. The inhibitors of the enzyme 5-alpha reductase do not allow for the formation of dihydrotestosterone from testosterone. Dihydrotestosterone is a potent hormone that supports inflammation. In fact, it seems to stimulate not only acne, but also cerebrovascular inflammation through the activation of NF-kappaB.

According to the website of ISISPHARMA, the concentrate also contains Boswellia extract, salycilic acid, glucose and Xylitol.

According to this website, “Boswellia Serrata is a gum resin extracted from a tree, which is sometimes burnt (the entire species of Boswellia is commonly known as Frankinsence) as an aromatic, or otherwise administered as medicine.” Boswellia extract has anti-inflammatory activity.

It has been almost a month now and we have seen really good results. After so many frustrations, at least these products worked for us. However, the products of ISISPHARMA are not easy to buy in the U.S.  We brought a limited stash of the products home for personal use. The continuous use of Teen-derm K will require Amazon orders (the products are shipped from Europe).

If you would like to learn more, through online forums I found this link to a clinical study on avocuta. It seems that the effects of the reductase inhibitor are at least equivalent to these of retinoids used for acne; however, the side effects are less pronounced.

Of course, personal discipline and some other home-cooked approaches could supplement the Teen-derm K effects.  Below are the recipes of two anti-inflammatory masks that one can mix in the kitchen. By the way, Teen-derm K also offers a mask, which we are currently trying since it came in the package of our first Amazon offer.
 
Aspirin-curcumin mask
Mix a teaspoon of plain yogurt, a few drops of apple cider vinegar (with the mother), two drops of tea tree oil, a dash of curcumin, three uncoated aspirin pills (crushed into powder), ½ tsp raw honey.

Avocado mask
Meshed avocado, a few drops of avocado oil, two drops of tea tree oil, yogurt to connect the ingredients.

Here is a good video for acne-spot treatment:

Gut Microbiota As Effectors Of Cell Physiology And As Potential Therapeutic Vectors

By Darryl Leja, NHGRI - http://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=85320, Public Domain, https://commons.wikimedia.org/w/index.php?curid=29534265

It is known that microbiota, particularly gastrointestinal bacteria, can have a profound effect on human health.  This study (linked here) shows another mechanism by which this occurs – the bacteria can produce compounds that affect signaling pathways in human cells, potentially regulating metabolic hormones and glucose levels. Thus, bacteria can produce factors that mimic human equivalents, affecting human cell physiology, and thus influencing human health. The authors propose “microbiome-biosynthetic gene therapy” – leveraging this ability of microbes to have them produce factors that can promote therapeutic changes in the human system.  Abstract:

Commensal bacteria are believed to have important roles in human health. The mechanisms by which they affect mammalian physiology remain poorly understood, but bacterial metabolites are likely to be key components of host interactions. Here we use bioinformatics and synthetic biology to mine the human microbiota for N-acyl amides that interact with G-protein-coupled receptors (GPCRs). We found that N-acyl amide synthase genes are enriched in gastrointestinal bacteria and the lipids that they encode interact with GPCRs that regulate gastrointestinal tract physiology. Mouse and cell-based models demonstrate that commensal GPR119 agonists regulate metabolic hormones and glucose homeostasis as efficiently as human ligands, although future studies are needed to define their potential physiological role in humans. Our results suggest that chemical mimicry of eukaryotic signalling molecules may be common among commensal bacteria and that manipulation of microbiota genes encoding metabolites that elicit host cellular responses represents a possible small-molecule therapeutic modality (microbiome-biosynthetic gene therapy).

Detection Of Early Stage Cancers Using Circulating Tumor DNA.

One "holy grail" of cancer diagnostics is the development of a non-invasive (e.g., blood) test that can detect early stage cancers.  Some progress has been made; from the abstract

Evaluation of 200 patients with colorectal, breast, lung, or ovarian cancer detected somatic mutations in the plasma of 71, 59, 59, and 68%, respectively, of patients with stage I or II disease…These analyses provide a broadly applicable approach for noninvasive detection of early-stage tumors that may be useful for screening and management of patients with cancer.

Therefore, tumor DNA. and its diagnostic mutations, can be found in the plasma of a majority of patients with early stage cancers.  That is good news, and we await further refinement of this approach.

Can a hot dog kill you

"...twice as many Americans are estimated to die each year from eating hot dogs and other processed meats (~58,000 deaths/year) than from car accidents (~35,000 deaths/year)"

Read this and more revelations about our diet in Want to fix America's health care? First, focus on food.
 
As mentioned before by other medical professionals, 75% of our diseases are due to our diet. And yet, the fad tells us that we need to build "precision medicine", based upon our genetic makeup.

Guess what, our grandparents with the same "genetic makeup" did not suffer the diseases we have today simply because they did not indulge on fast food and sugar-laden goodies. 

"Precision medicine" feeds the ego of a limited number of "elite" researchers and medical professionals, and pads their pockets. Developing this type of health care and research will have no effect on the health status of the nation.

 

Chronic Back Pain: Surgery Or Conservative Treatment?

By http://en.wikipedia.org/wiki/user:Vsion - Originally Vsion's work, CC0, https://commons.wikimedia.org/w/index.php?curid=16090144

Should you have surgery or nonsurgical treatment for chronic lower back pain? This paper suggests nonsurgical treatment can be “effective, feasible, and safe” although more studies, properly conducted, are required to give more definitive results (a caveat one often reads with respect to such studies and reviews). Conclusions from the abstract:

CONCLUSIONS: For chronic low back pain, nonsurgical treatment was shown to be effective, feasible, and safe during the follow-up period. More randomized controlled trials are needed to compare surgical and nonsurgical treatment of chronic low back pain.

Here is a paper on lumbar spinal stenosis treatment, conclusions of the abstract:

AUTHORS' CONCLUSIONS: We have very little confidence to conclude whether surgical treatment or a conservative approach is better for lumbar spinal stenosis, and we can provide no new recommendations to guide clinical practice. However, it should be noted that the rate of side effects ranged from 10% to 24% in surgical cases, and no side effects were reported for any conservative treatment. No clear benefits were observed with surgery versus non-surgical treatment. These findings suggest that clinicians should be very careful in informing patients about possible treatment options, especially given that conservative treatment options have resulted in no reported side effects. High-quality research is needed to compare surgical versus conservative care for individuals with lumbar spinal stenosis.

Essentially, these authors state that there is no clear evidence of whether surgery or more conservative treatment is best for lumbar spinal stenosis; however, given that there is a significant risk of side effects for surgery and no side effects reported for conservative treatments, clinicians need to take care in how they inform patients of treatment options. Everyone must make their own decisions on these matters with the consultation of their physician. Speaking strictly for myself (as someone who has had some moderate flare-ups of lower back pain), I would always first choose the conservative treatments and have surgery as a “last resort’ back-up plan. But, that’s me. Others may be in a condition where conservative treatment does not help and then they and their physician need to review more aggressive treatment options.

Reducing Inflammation To Combat Cardiovascular Disease

By Transferred from en.wikipedia to Commons., CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2816579

Typically, cardiovascular disease is approached by reducing lipid levels (doctors usually prescribe medication, although dietary changes, and exercise, in our opinion should be focused more on). However, reducing inflammation can reduce the risk of cardiovascular disease independent of lowering lipid levels.  This is an important approach that expands the therapeutic toolkit against cardiovascular disease and underscores the importance of inflammation for cardiovascular problems (and many other diseases as well). The full paper is here; read the abstract below:

Background Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. Results At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). Conclusions Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846 .).