Tuesday, October 18, 2011
The key protein is called Vascular Endothelial Growth Factor, VEGF. It is known to stimulate the growth of healthy blood-vessel linings. We know for a fact that healthy blood vessels are important to maintaining healthy brains! Without them, we get strokes, not to mention this type of ataxia.
The funding-hungry researcher's first thought is, "How do we turn this into a drug?"
The smart clinician's first thought is, "How do we improve vasculation, oxygenation and circulation in safe, endogenous, sustainable ways from youth onwards?"
Don't need FDA approval for that. Just takes fresh food, fresh air, clean water, and safe activity.
Clinicians, if you're puzzled about how to get all that for your patients, call your legislators (use the link on the right to find them) and share your concerns. Those letters after your name are worth more than you might think.
(This is where I give myself points for not being violently and irrationally opposed to the class of drugs that did me, personally, so much harm. It's important not to throw the baby out with the bathwater.)
129 patients were divided into roughly 3 groups, one of which got 5-10 mg Lexapro daily, another got placebo, and the third were assigned to "a problem-solving therapy program developed for treating patients with depression." (No idea what program that is and they weren't specific about it.)
The Lexapro group had the best neurocognitive scores after 12 weeks, though the author doesn't say by how much, or how they processed the data. These are both important issues in scientific studies, since some differences are significant and others are just curious, and how you arrived at those figures can have a considerable effect on how seriously your readers should take them.
"...reported changes in neuropsychological performance resulted in an improvement in related activities of daily living" -- which makes perfect sense. When all is said and done, healing of any kind is about what more you can DO afterwards! Doctors, patients, and significant others tend to lose sight of that, getting lost in the compelling drama of symptomatology, misery, and pain. It's not that that isn't important, but being able to take care of yourself -- or making it so your patient can do so -- is absolutely primal.
This study used low doses, which I suspect is key to unimpaired cognitive function -- not to mention avoiding the usual side effects of this class of drugs, as they did.
Lasting damage to memory and thinking, more bad choices, and increased likelihood of developing chronic conditions later in life, are far more likely because the damage from each form of fashionable self-abuse compounds the other.
This idea is certainly high on the head-desk quotient, but the article is mostly clear and sensible:
They mention that the risks to women are higher ounce per ounce, but don't say why; that vagueness is annoying and wrong, and science is far enough along to know better.
The idea that real food might be good for you is kind of a shocking idea, to some. Encourage them to get used to it. Fresh salad, berries, roast chicken, apples, baked potatoes, butternut squash ... There are worse things. Like brain damage, cirrhosis, kidney failure, strokes, chronic fatigue, and HIV.
And looking really bad by 30.
Sunday, October 9, 2011
This study -- finally, and despite the facile title -- gets more specific about what happens with HIV in the CSF (cerebrospinal fluid):
"Distinct AIDS viruses found in cerebrospinal fluid of people with HIV dementia"
By and large it's excellent work: the info on HIV in the macrophage is intriguing, as is the implied interplay between the seroactive HIV and the CSF-inhabiting HIV.
The implied determination to get more people on the horrifically aggressive HAART pharmaceutical regime is disappointing, for 2 important logical reasons:
1. This intensive regime, itself, has powerful and often irreversible effects on the following: mitochondrial survival, bone mineralization, memory & cognition, and digestion & absorption. That means teeth crumble and bones turn chalky, nutrition in food becomes unavailable so it's harder to maintain, and most of all, those of you who've read my work on mitochondria and on iatrogenic brain damage know how horrifying I find it to cavalierly trash those vital systems, most notably in the absence of any real efforts to support them in the face of iatrogenic -- let alone pathologic -- assaults.
2. The lack of any indication that the HAART drugs are any better at crossing the meninges (the covering over your spine & brain that forms the "blood-brain barrier") after this study, than they were before this study. That's an oversight that invokes a sardonic laugh. Heaven forbid the provider should actually pay attention to the patient and start the meds when needed, rather than assaulting the system maybe years before it's necessary in the hope of staying one month ahead of one strain's breakout. Bad math, you see?
It would be good to move away from the meme that drugs are the best, first, last, and finest answer. They're one part of it and they're easy to monitor, but we have to get a lot better at much more basic human care.
Good science. Stupid clinical take-away. But good science.