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Archive for December, 2012

Your other brain?

You probably imagine that you do all your mental work – perceiving, analysing, thinking, feeling and so on – with your brain – that organ inside your skull. However, we’ve known for some time that there are networks of neurones around the hollow organs of the body, especially around the heart and the intestines. We’ve also discovered “neurotransmitters” originating from those parts of the body. So, at very least, we are aware that there are two way connections between the heart and the brain, and the gut and the brain.

A recent article in New Scientist magazine described the network around the gut and named it the “Enteric Nervous System” (ENS). There are around 500,000 neurones around the gut (where there are about 85 billion in the brain). Most surprisingly, alongside the 40 or so neurotransmitters in this network, two chemicals known to affect mood and mental functions, dopamine and serotonin, are also present. In fact, it is now thought that 50% of all dopamine is produced in the brain, and 50% in the ENS. Only 5% of serotonin is produced by the brain, and 95% of it in the ENS. This is quite astonishing when you consider the roles these hormones can play in our behaviour.

The other fascinating fact the author of the New Scientist article highlights is the presence of Lewy bodies in the ENS (these are the pathological lesions seen in the brains of patients with Parkinsons Disease), and patients with Alzheimer’s have characteristic lesions on both their brain and ENS neurones. Do those “neurological” diseases begin in the brain, or in the gut?

It’s good to see scientists discovering how interlinked our bodily systems are, and how difficult it is to reduce a person to parts – even the two parts of Mind and Body. Are those parts really such separate parts of they are so connected and inter-related?

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An ad on STV caught my eye the other day. It was a public service ad from NHS Scotland and was exhorting people to be prepared for the Christmas and New Year holidays as their GP surgeries would be closed Tuesday and Wednesday on each of the next two weeks. So, “don’t run out of your repeat prescriptions”!

And I thought, this is the big idea in health care? Make sure patients realise their doctors won’t be working for two days in a row so DON’T RUN OUT OF YOUR DRUGS.

I thought I’d pop across and see what NHS24 were saying. They have a whole section called “Be Ready for Winter”. It’s got three pieces of advice –

1. Restock your medicine cabinet

2. Order repeat prescriptions

3. Note when your GP’s surgery closes

Then, on Friday, I read an article in New Scientist, entitled “A humane solution” which was advocating more human drug trials instead of animal ones, as the animal ones don’t show the potential problems when drugs are taken by humans. But here’s the bit in the article that whacked me between the eyes….the first sentence….

Adverse drug reactions are a major cause of death, killing 197,000 people annually in the European Union and upwards of 100,000 in the US

Why do we tolerate this?

How did a “Health Service” become a “Drug Service”?

 

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Everything we see is influenced by what’s already in our memories and our imagination……what do you see here?

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Reducing risks

If you suffered from a heart attack or a stroke you’d probably be interested in trying to reduce your chances of a second one. So here is something which apparently achieves the following results –

35 per cent reduction in risk for cardiovascular death
14 per cent reduction in risk for new heart attacks
28 per cent reduction in risk for congestive heart failure
19 per cent reduction in risk for stroke

Pretty impressive huh?
So what is this wonderful treatment?

“A heart-healthy diet rich in fruits, vegetables and fish” , according to a big study conducted by researchers at McMaster University.

In the report about the study was a little passing comment – “At times, patients don’t think they need to follow a healthy diet since their medications have already lowered their blood pressure and cholesterol — that is wrong,” said Mahshid Dehghan, the study’s lead author and nutritionist at McMaster University’s Population Health Research Institute”
That is actually such an important point. How many people are suckered into the belief that as long as they take drugs they can forget about trying to live a healthier life?

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Flu

At this time of year there are queues of patients in the GPs’ surgeries standing in line waiting for flu jabs. I routinely receive emails from my employer (the NHS) exhorting me to have the flu vaccine.
I’m not joining in.
An elderly patient told me recently she attended her GP for a routine BP check from the nurse who asked her if she had been vaccinated for the flu yet. She said no, and as last year she had felt unwell for a few days afterwards, she said she would come back for it after a planned weekend break. The nurse said, nonsense, the flu jag doesn’t make you feel unwell, picked up a syringe in injected it into the patient’s arm. She was furious, and said she wasn’t well enough to enjoy her weekend away afterwards. I’m sorry, but this is no way to deliver health care.
Here’s where the story gets worse.
The Center for Infectious Disease Research and Policy in Minnesota has reviewed the evidence for the claims made about flu vaccination. What did they find?
Based on a comprehensive review of data published from 1967 to 2012, they found evidence for “consistent high-level protection is elusive,” the researchers concluded. Although vaccination was found to provide modest protection from infection in young healthy adults who rarely have complications of flu, the authors found that “evidence for protection in adults 65 years of age and older [who represent over 90% of deaths from flu] . . . is lacking.” Apparently in otherwise fit, healthy young adults flu immunisation can reduce their experience of illness by half a working day. In the elderly there is no evidence is protects them. (This study was reported in the BMJ with the headline “Belief not science is behind flu jab promotion, new report says”)
Yet, the NHS heavily pushes this immunisation.
On a related subject let’s think about Tamiflu which Roche persuaded governments around the world, including the UK, to stockpile supplies costing billions of dollars, on the basis of an evidence base which they continue to refuse to publish. In 2005, the UK agreed to buy £200 million of Tamiflu.
However, the evidence that Tamiflu would actually significantly prevent either the spread of flu, or the incidence of complications has all been based on studies carried out by Roche itself. The BMJ and the Cochrane Collaboration are leading a campaign to get Roche to release the data from their 8 out of 10 unpublished trials. In fact, the BMJ has set up a website.
When it comes to flu, the government seem prepared to promote and purchase, at huge cost, treatments with very, very sparse evidence bases.

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Global brain

Howard Bloom’s “Global Brain” [ISBN 0471419192] is a great and stimulating read. He describes “complex adaptive systems” as having five characteristics –

Diversity generators, conformity enforcers, inner judges, resource shifters and intergroup tournaments.

These are an interesting five characteristics to highlight (there are, of course, other characteristics of “complex adaptive systems”) and Bloom takes his time to describe in gripping and convincing detail how each of these characteristics has contributed to the evolution of life on this planet.

You could read this book as a critique of orthodox Darwinism – the selfish gene, individualised kind of Darwinism – with a very convincing case being made for group selection as a key part of the engine of evolution. He really does make a good clear case for group as opposed to individualised “survival of the fittest” evolution.

I especially like his first two characteristics – diversity generators and conformity enforcers.

All human beings create a sense of self out of the need to be an individual, to be unique, to be different, and the need to belong, to share, to connect and to fit in with others. Diversity generation creates difference, whilst conformity enforcement creates connections and rules.

Diversity generators and conformity enforcers also remind me of Thomas Berry’s lovely idea of wildness and discipline

However…….I ended up not satisfied with the relentlessly competitive theme. His other three characteristics all contribute to a series of survival of the fittest battles. I think there is truth in this but think for a moment about the human body. Our heart and our liver don’t fight each other for resources with the winner taking all. Something else happens – mutually beneficial relationships are established.

Mutually beneficial relationships are the key characteristic of integration, and integration strikes me as a key way in which Life evolves. Through increasing amounts of mutually beneficial connections, complex adaptive systems become both more complex and more adaptive.

It’s not all about competition.

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