Archive for the ‘Medicine’ Category

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A new protein (FGF1) which could eliminate diabetes

July 17, 2014

This is more than just interesting.

It may come too late for me but I suspect that by 2050, the great fear of diabetes Type 2 and the real damage it causes, will long have been forgotten. But there will still be a challenge in not allowing the solution to excuse and encourage a life-style which is essentially unhealthy. It should not become like a glutton inducing vomiting so that he can eat some more!!

A new paper in Nature

Jae Myoung Suh, Johan W. Jonker, Maryam Ahmadian, Regina Goetz, Denise Lackey, Olivia Osborn, Zhifeng Huang, Weilin Liu, Eiji Yoshihara, Theo H. van Dijk, Rick Havinga, Weiwei Fan, Yun-Qiang Yin, Ruth T. Yu, Christopher Liddle, Annette R. Atkins, Jerrold M. Olefsky, Moosa Mohammadi, Michael Downes, Ronald M. Evans. Endocrinization of FGF1 produces a neomorphic and potent insulin sensitizer. Nature, 2014; DOI: 10.1038/nature13540

From the Press Release:

One injection stops diabetes in its tracks

In mice with diet-induced diabetes—the equivalent of type 2 diabetes in humans—a single injection of the protein FGF1 is enough to restore blood sugar levels to a healthy range for more than two days. The discovery by Salk scientists, published today in the journal Nature, could lead to a new generation of safer, more effective diabetes drugs.

The team found that sustained treatment with the protein doesn’t merely keep blood sugar under control, but also reverses insulin insensitivity, the underlying physiological cause of diabetes. Equally exciting, the newly developed treatment doesn’t result in side effects common to most current diabetes treatments. ……. 

Diabetes drugs currently on the market aim to boost insulin levels and reverse insulin resistance by changing expression levels of genes to lower glucose levels in the blood. But drugs, such as Byetta, which increase the body’s production of insulin, can cause glucose levels to dip too low and lead to life-threatening hypoglycemia, as well as other side effects.

In 2012, Evans and his colleagues discovered that a long-ignored growth factor had a hidden function: it helps the body respond to insulin. Unexpectedly, mice lacking the growth factor, called FGF1, quickly develop diabetes when placed on a high-fat diet, a finding suggesting that FGF1 played a key role in managing blood glucose levels. This led the researchers to wonder whether providing extra FGF1 to diabetic mice could affect symptoms of the disease.

Evans’ team injected doses of FGF1 into obese mice with diabetes to assess the protein’s potential impact on metabolism. Researchers were stunned by what happened: they found that with a single dose, blood sugar levels quickly dropped to normal levels in all the diabetic mice.

“Many previous studies that injected FGF1 showed no effect on healthy mice,” says Michael Downes, a senior staff scientist and co-corresponding author of the new work. “However, when we injected it into a diabetic mouse, we saw a dramatic improvement in glucose.”

The researchers found that the FGF1 treatment had a number of advantages over the diabetes drug Actos, which is associated with side effects ranging from unwanted weight gain to dangerous heart and liver problems. Importantly, FGF1—even at high doses—did not trigger these side effects or cause glucose levels to drop to dangerously low levels, a risk factor associated with many glucose-lowering agents. Instead, the injections restored the body’s own ability to naturally regulate insulin and blood sugar levels, keeping glucose amounts within a safe range—effectively reversing the core symptoms of diabetes. ……… 

I suspect a golden age of medical science is underway and it will be unrecognisable – for us – by 2050.

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Fat pigs are happy pigs

June 7, 2014

Caesar: Let me have men about me that are fat ..

A truth known already in Shakespeare’s day and a new paper seems to confirm the adage – even if only for pigs.

Annika Maria Juul Haagensen et al, High Fat, Low Carbohydrate Diet Limit Fear and Aggression in Göttingen Minipigs, PLOS One, DOI: 10.1371/journal.pone.0093821

Nordic Science:Most of us associate the words ‘fat’ and ‘cholesterol’ with overweight, cardiovascular disease and unhealthy lifestyles but we could all be wrong, according to researchers who argue that not even the infamous saturated fats are as bad as we think they are. 

A new Danish study reveals that a diet high in fat and cholesterol makes pigs more social, less aggressive and less fearful. According to the researchers behind the study, such behaviour is associated with good health. …….. 

Even though the study was done on pigs the results would most likely be applicable to humans as well, says Annika Maria Juul Haagensen, PhD in Veterinary Disease Biology at the University of Copenhagen, who authored the study.

“It’s definitely something we should consider,” she says. “The next step is to determine how much fat is optimal for our physical and psychological health.”

Associate professor Lotte Lauritzen from the Department of Nutrition, Exercise and Sports at the University of Copenhagen says that’s a reasonable assumption.

“Previous studies on monkeys and rodents support these findings,” she says. “We know that our brain cells need fat to make new connections and function optimally.”

For instance, she says, too little omega 3 fat affects the serotonin system which regulates our mood. …….. 

“There are several possible explanations to the changes in behaviour we observed in the pigs that were fed more fat,” she says.

One could be that the fat and cholesterol cause an increased release of serotonin. The higher levels of serotonin could’ve changed how aggressive, depressive and anxious the pigs were.

“At the same time a study shows that cholesterol increases the permeability between brain cells and blood. This means that more nutrients are transferred from the blood to the cells,” says Haagensen.

Fat and sugar and cholestorol are not all bad and don’t quite deserve the demonisation they have been subject to.

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Overprotection of babies may increase the risk for allergies

June 7, 2014

It is often said that one in 3 in developed countries suffer from some of allergy. By the time they are 3 years old half the children in the US suffer from wheezing or asthma. It is often claimed that this is because of the various chemical compounds that modern humans have put into the atmosphere. But I am not so sure that this is the sole cause or even a significant cause. It could be that we are seeing the downside of having an obsession about dirt and being obsessively “antiseptic”  with our children.

Our immune systems need to be triggered and challenged if they are to develop. That is well enough known and is the basic fact exploited by the advances in vaccination science. But the corollary is that when we are overprotective with babies – and especially in the first year of life – a lack of exposure to these triggers prevents the immune system from developing some basic resistances and this may lead to the greater incidence of allergies later on.

It could well be that it is the obsessive cleanliness around our infants which is itself the cause of an underdeveloped immune system and the greater prevalence of allergies.

A new paper finds that some exposure to “dirt” early in life is probably a very good thing.

Susan V. Lynch et al,  Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children. Journal of Allergy and Clinical Immunology, 2014; DOI:10.1016/j.jaci.2014.04.018

Abstract: 

Wheezing illnesses cause major morbidity in infants and are frequent precursors to asthma. We sought to examine environmental factors associated with recurrent wheezing in inner-city environments. …….. 

Cumulative allergen exposure over the first 3 years was associated with allergic sensitization, and sensitization at age 3 years was related to recurrent wheeze. In contrast, first-year exposure to cockroach, mouse, and cat allergens was negatively associated with recurrent wheeze (odds ratio, 0.60, 0.65, and 0.75, respectively; P ≤ .01). Differences in house dust bacterial content in the first year, especially reduced exposure to specific Firmicutes and Bacteriodetes, was associated with atopy and atopic wheeze. Exposure to high levels of both allergens and this subset of bacteria in the first year of life was most common among children without atopy or wheeze.

In inner-city environments children with the highest exposure to specific allergens and bacteria during their first year were least likely to have recurrent wheeze and allergic sensitization. These findings suggest that concomitant exposure to high levels of certain allergens and bacteria in early life might be beneficial and suggest new preventive strategies for wheezing and allergic diseases.

From the John Hopkins Press Release :

Infants who grew up in homes with mouse and cat dander and cockroach droppings in the first year of life had lower rates of wheezing at age 3, compared with children not exposed to these allergens soon after birth. The protective effect, moreover, was additive, the researchers found, with infants exposed to all three allergens having lower risk than those exposed to one, two or none of the allergens. Specifically, wheezing was three times as common among children who grew up without exposure to such allergens (51 percent), compared with children who spent their first year of life in houses where all three allergens were present (17 percent).

In addition, infants in homes with a greater variety of bacteria were less likely to develop environmental allergies and wheezing at age 3.
 
When researchers studied the effects of cumulative exposure to both bacteria and mouse, cockroach and cat allergens, they noticed another striking difference. Children free of wheezing and allergies at age 3 had grown up with the highest levels of household allergens and were the most likely to live in houses with the richest array of bacterial species. Some 41 percent of allergy-free and wheeze-free children had grown up in such allergen and bacteria-rich homes. By contrast, only 8 percent of children who suffered from both allergy and wheezing had been exposed to these substances in their first year of life.

Not all dirt is bad.

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Excellence in illustrations

June 4, 2014

A picture is worth ten thousand words — but only when the picture is the right one. Having been involved with presentations and teaching and lectures I can vouch for that.

With the ubiquitous PowerPoint slides, it is quality and certainly not quantity that counts. Using the “right” illustration is extremely powerful and – above all – enables the speaker/presenter to stay on topic and get the message across. When I first started giving lectures I tended – as most beginners do – to have far too many slides to illustrate my talks. I used to try and have almost as many slides as I had minutes to speak. I tried- as beginners are wont to do – to try and get everything I wanted to say onto my slides. I forgot to focus on the message(s) I wanted to leave in the listener’s head.

But that temptation to broadcast rather than to communicate soon changed and the number of slides quickly reduced. I think I really learned the lesson on a trip to Japan when my baggage didn’t arrive and I was forced to make about 5 presentations – each about an hour long – with no PowerPoint slides and only 2 overhead projector illustrations available to me. Nowadays I tend to have at most one illustration for about 5 – 8 minutes of lecture/presentation time. That puts much greater pressure on selection of the right illustration. Paradoxically the “right” illustration is nearly always simpler, less cluttered and more focused.

There is also a downside. Images are so powerful that even one “wrong” illustration out of very many can completely destroy a lecture or a presentation.

John Hopkins celebrated 100 years of medical illustration a few years ago .

The exhibition will make you marvel at the amazing intricacy of the human body, the enormous talent of medical illustrators, and the trajectory the profession has taken over the past 100 years to produce art for medical science. The collection includes an array of subjects — anatomy, pathologic specimens, surgical techniques, textbook illustrations, magazine covers, and more — created with pen and ink, carbon dust, watercolor, photography, and digitized media.

Dr. Levent Efe specialises in medical illustrations and this pregnant elephant is one of their many fascinating works:

"Pregnant

Pregnant Elephant Image Credit Dr. Levant Efe

h/t: Science is Beauty

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Vegetarians more susceptible to allergies, cancer, heart disease and depression

March 31, 2014

A new study from the University of Graz contradicts the politically correct advantages usually attributed to vegetarianism. “… our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life”. 

It would seem that vegetarianism is “more about an ideological message that suggests false promises”.

Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study by Nathalie T. Burkert, Johanna Muckenhuber, Franziska Großschädl, Eva Rasky, Wolfgang Freidl, PLOS One, February 2014, Volume9, Issue 2.

DOI: 10.1371/journal.pone.0088278

Abstract: Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N = 330 for each form of diet – vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors.

Press Release (in German)

NoTricksZone summarises the findings:

The scientists examined a total of 1320 persons who were divided up into 4 groups of 330 persons each. All groups were comparable with respect to gender, age, and socio-economic status. The study also accounted for smoking and physical activity. Also the BMI was within the normal range for all four groups (22.9 – 24.9). The only thing that really was different among the four groups was the diet. The four groups were: 1) vegetarians, 2) meat-eaters with lots of fruit and veggies, 3) little meat-eaters and 4) big meat-eaters. More than three quarters of the participants were women (76.4%).

..the results contradict the common cliché that meat-free diets are healthier. Vegetarians have twice as many allergies as big meat-eaters do (30.6% to 16.7%) and they showed 166% higher cancer rates (4.8% to 1.8%). Moreover the scientists found that vegans had a 150% higher rate of heart attacks (1.5% to 0.6%). In total the scientists looked at 18 different chronic illnesses. Compared to the big meat-eaters, vegetarians were hit harder in 14 of the 18 illnesses (78%) which included asthma, diabetes, migraines and osteoporosis .

The Medical University of Graz confirms findings by the University of Hildesheim: More frequent psychological disorders among vegetarians, the press release writes.

…. the University of Graz found that vegetarians were also twice as likely to suffer for anxiety or depressions than big meat eaters (9.4% to 4.5%). That result was confirmed by the University of Hildesheim, which found that vegetarians suffered significantly more from depressions, anxiety, psychosomatic complaints and eating disorders [2]. The U of Graz scientists also found that vegetarians are impacted more by ilnessses and visit the doctor more frequently …….

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Older fathers becoming a threat to their children

March 27, 2014

Back in 2009 there was a rash of articles about the dangers to children of advanced paternal age.

Children born to fathers 40 or older have nearly a six-fold increase in the risk of autism as compared with kids whose fathers were younger than 30. Children of fathers older than 50 have a nine-fold risk of autism. And advanced paternal age, as it’s called, has also been linked to “an increased risk of birth defects, cleft lip and palate, water on the brain, dwarfism, miscarriage and ‘decreased intellectual capacity.'” 

And to an increased risk of schizophrenia. This risk rises for fathers with each passing year. The child of a 40-year-old father has a 2 percent chance of having schizophrenia-double the risk of a child whose father is younger than 30. And the kicker: A 40-year-old man’s risk of having a child with schizophrenia is the same as a 40-year-old woman’s risk of having a child with Down syndrome. More recent studies have linked fathers’ age to prostate and other cancers in their children. In September 2008, researchers linked older fathers to an increased risk of bipolar disorder in their children. Add to that the new finding, that the kids of older fathers score lower on IQ and other cognitive tests. 

Now 5 years later there is yet again a splurge of articles about the dangers of older fathers. These headlines are just in 2014.

  1. The Guardian: Children of older men at greater risk of mental illness. 
  2. Daily Mail: Children born to older fathers ‘are more likely to be ugly’… but may also live longer
  3. Daily Mail: Number of older fathers rises 58% in 14 years: 26 children every day are born to dads who are aged over 50

Of course it must also then follow that younger siblings (born inevitably to older fathers than their elder siblings) have a greater risk of autism, schizophrenia, prostate cancer, lower IQ, cleft palate, water on the brain, of being uglier and suffering from dwarfism!

Perhaps the EU should introduce some legislation to limit the age at which children can be fathered.

After all these aged (but usually richer) fathers are threatening the fundamental genetic structure of humans and perhaps threatening future evolution!!

 

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More stem cell fakery as a quick way to publication and fame?

March 11, 2014

Dr Haruko Obokata shot to fame with her stem cell papers photo BBC

Another young researcher, Dr Haruko Obokata has apparently made sensational claims about her stem cell research, shot to fame as lead author in two papers published in Nature and is now in the dock for dodgy images and irreproducible results (perhaps faked).

WSJ: Her co-author, Teruhiko Wakayama of Yamanashi University in Japan, called Monday for the retraction of the findings, published in late January in a pair of papers in the journal Nature.

The papers drew international attention because they held out a safer, easier and more ethical technique for creating master stem cells. These cells, which can be turned into all other body tissues, promise one day to transform the treatment of various ailments, from heart disease to Alzheimer’s. 

But shortly after the papers appeared, Japan’s Riken Center for Developmental Biology, where the work took place, began to investigate alleged irregularities in images used in the papers. Separately, many labs said they couldn’t replicate the results.

A spokesman for Riken said Tuesday that the institution was considering a retraction and that the article’s authors were discussing what to do.

Dr. Wakayama said he has asked the lead author, Haruko Obokata, to retract the studies. “There is no more credibility when there are such crucial mistakes,” he said in an email to The Wall Street Journal.

Dr. Wakayama said he learned Sunday that an image used in Dr. Obokata’s 2011 doctoral thesis had also been used in the Nature papers. “It’s unlikely that it was a careless mistake since it’s from a different experiment from a different time,” he said.

Like several other researchers, Dr. Wakayama said he hasn’t yet been able to reproduce the results. “There is no value in it if the technique cannot be replicated,” he said. 

But another co-author of the papers, Charles Vacanti, a tissue engineer at Harvard Medical School and Brigham and Women’s Hospital in Boston, defended the work. “Some mistakes were made, but they don’t affect the conclusions,” he said in an interview Monday. “Based on the information I have, I see no reason why these papers should be retracted.”

Dr. Vacanti—whose early work some 15 years ago spurred the novel experiments—said he was surprised to hear that one of his co-authors asked for the retraction.

Dr. Vacanti said he had spoken to Dr. Obokata on Monday and that she also stood by the research. “It would be very sad to have such an important paper retracted as a result of peer pressure, when indeed the data and conclusions are honest and valid,” said Dr. Vacanti. …..

The papers created a stir because they reported a process by which mouse cells could be returned to an embryonic-like state simply by dipping them in a mild acid solution, creating what they called STAP cells, for stimulus-triggered acquisition of pluripotency. ….

There seems to be a hint of some “academic rivalry” here as well.

Retraction Watch has more:

Nature told the WSJ that it was still investigating the matter. As Nature‘s news section reported last month, lead author

…biologist Haruko Obokata, who is based at the institution…shot to fame as the lead author of two papers1, 2 published in Nature last month that demonstrated a way to reprogram mature mouse cells into an embryonic state by simply applying stress, such as exposure to acid conditions or physical pressure on cell membranes.

But the studies, published online on January 29, soon came under fire. Paul Knoepfler has had a number of detailed posts on the matter, as hasPubPeer.

Stem cell research seems to have more than its fair share of dodgy papers – presumably because sensational results are easier to come by and very much easier to get published.

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Eugenics by default: Abortion is of greater significance now than infant mortality ever was

March 6, 2014

We determine the demographic future – almost unthinkingly – by the patterns of child-bearing and child-rearing that we practise today. Population and its composition for the next 100 years or so has already been determined. The Chinese population has started declining and will continue to do so till at least 2100. The Indian population will reach its peak around 2050 and will then decline. The “aging” of populations and the increase of longevity has also been fixed. Demographic “robustness” is critically dependent on maintaining the ratio of the “working” population to the “supported” population (the young and the old). The US is maintaining its demographic sustainability by means of immigration in the face of declining fertility rates. Some countries in Europe are doing the same. Many do not since maintaining  some form of “racial purity” is an undercurrent in many societies and fuels the resistance to immigration – even with dangerous declines in fertility rates. Japan is facing an aging crisis as immigration is resisted. The numbers are inexorable.

Fitness to survive after birth is no longer of significance in the survival stakes. All around the world societies see to it that those with disabilities – once born – are protected. The further evolution of humans will now increasingly be the result of

  1. artificial selection for particular genetic traits, and
  2. the deselection of individuals who have been conceived but are not allowed to be born or to survive and reproduce.

It is my contention that we are in fact – directly and indirectly –  exercising an increasing amount of genetic control in the selection and deselection of our offspring. So much so that we already have “eugenics by default” being applied to a significant degree in the children being born today.

The numbers tell the tale.

One of the key measures of the advances of medical science has been the drastic reduction of infant mortality rates (defined here as deaths after birth but before the age of one year). In the 16th and 17th century this was about 30% of all births (an estimate based on a dearth of data). Since 1950 this rate has dropped from about 15% of all births to around 4% today. The variation is still very high with the current rate being as high as 12% in Afghanistan and 11% in Niger but less than 0.2% in Monaco. By 2050, as development in Africa proceeds, this global rate is expected to have dropped to about 2% (20 per 1000 live births).

It is more difficult to define miscarriages. After fertilisation of an egg it seems that perhaps 50 – 70% fail to attach themselves to the uterus wall and these would not even be considered – or even show up – as a pregnancy. I take such “miscarriages” to be failures of conception. Taking attachment to the uterine wall and the establishment of a fetal heartbeat as being a successful conception, around 10% still result in a miscarriage today.

In 2012 about 135 million babies were born (7 billion population and crude birth rate of 19.15 per 1000 of total population). Worldwide induced abortions numbered about 45 million (estimate). One third of all successful conceptions were not allowed to reach birth.

Economist:  It fell precipitously in the 1990s, but recently the rate has not budged, barely dipping from 29 abortions per 1,000 women (aged 15 to 44) in 2003 to 28 abortions per 1,000 women in 2008. Eastern Europe has the highest abortion rate in the world, at 43 per 1,000. The geography of abortions has also shifted. In 2008, 86% of abortions were in the developing world, up from 78% in 1995.

(Note! the number per 1000 women of child bearing age is different to the number per 1000 live births).

The current status then is:

  • Of 1000 successful conceptions (fetal heartbeat established)
  • less than 20 are by IVF
  • 100 are miscarried before birth
  • 330 are aborted before birth
  • 570 live births result
  • 22 do not survive beyond one year
  • 548 survive beyond 12 months
  • 3 do not survive beyond 5 years
  • About 540 – 545 live to child bearing age

Four hundred years ago miscarriage rates (after successful conception) were probably around 20% of live births and infant mortality rates were about 30%, such that only 50% of all successful conceptions led to children surviving up to their first birthdays.

The picture today is not so different. About 55% of all successful conceptions lead to children surviving beyond one year.

Without moralising about abortion – which I am not qualified to do – as far as the numbers are concerned, infant mortality of 400 years ago has effectively been replaced by abortion today. Deselection which took place in the first year after birth has been shifted to the period after conception but before birth. From a genetic perspective and since there is an element of “selection” in every abortion, abortions today are of greater evolutionary and demographic significance than infant mortality ever was.

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Has Psychiatry just become a marketing tool for pills?

March 2, 2014

I have always been uncomfortable with the readiness to “medicalise” all behavioural issues. Where parents or teachers or social workers and others charged with teaching behavioural skills can easily find an excuse for their failures. Because a behavioural problem has been classified as a medical problem. Nearly always leading to the use of medication.  There seems to be an unholy alliance between the psychiatry industry and the pharmaceutical industry.

The Psychiatry Bible (DSM 5) has seemed to me to be nothing but a Marketing Brochure for the pharmaceutical companies where

The drug companies pay eminent professors, university officials and teaching hospital chairmen millions ‘in personal income’ to concoct more and more abnormalities so that more and more pills can be dished out by GPs and specialists. 

They pocket consultancy fees to attend conferences, give marketing lectures and endorse useless tablets. They are bribed, in essence, not to openly criticise the pharmaceutical industry.

.. people are led to believe they have ‘a problem in their brain’ if they drink too much coffee (‘caffeine-related disorders’), stutter or swear (‘language disorders’), are shy or reserved (‘social phobias’), suffer period pains, are too fat or too thin, feel irritable, sexy, unsexy, sleepless, tired, or experience grief for more than two weeks after the death of a loved one. By these means, 26.2  per cent of all American adults suffer from a disorder of some sort, requiring that it be ‘pharmacologically treated’. Though psychiatric research is by all accounts ‘a hodgepodge, scattered, inconsistent and ambiguous’, one thing has definitely emerged – that anti-depressants don’t work. Extensive trials have shown that placebos induce as much of a degree of uplift as Prozac, Seroxet or any of the other wonder drugs, which simply make patients feel numb, glassy and emotionally disengaged.

Now it seems Dyslexia does not really exist. 

Now comes The Dyslexia Debate, published yesterday, a rigorous study of this alleged ailment by two distinguished academics – Professor Julian  Elliott of Durham University, and Professor Elena Grigorenko of Yale University.

Their book makes several points. There is no clear definition of what ‘dyslexia’ is. There is no objective diagnosis of it. Nobody can agree on how many people suffer from it. The widespread belief that it is linked with high intelligence does not stand up to analysis.

And, as Parliament’s Select Committee on Science and Technology said in 2009: ‘There is no convincing evidence  that if a child with dyslexia is not labelled as dyslexic, but receives full support for his or her reading difficulty, that the child will do any worse than a child who is labelled dyslexic and then receives special help.’

 This is because both are given exactly the same treatment. But as the book’s authors say: ‘Being labelled dyslexic can be perceived as desirable for many reasons.’ These include extra resources and extra time in exams. And then there’s the hope that it will ‘reduce the shame and embarrassment that are often the consequence of literacy difficulties. It may help exculpate the child, parents and teachers from any perceived sense of responsibility’.

I think that last point is the decisive one and the reason for the beetroot-faced fury that greets any critic of ‘dyslexia’ (and will probably greet this book and article). If it’s really a disease, it’s nobody’s fault. But it is somebody’s fault. For the book also describes the furious resistance, among teachers,  to proven methods of teaching children to read. Such methods have been advocated by  experts since Rudolf Flesch wrote his devastating book Why Johnny Can’t Read almost 60 years ago.

It was not so long ago that James Davies addressed the ills of Psychiatry in his book “Cracked: Why Psychiatry is Doing More Harm Than Good” and Richard Saul published his book “ADHD Does Not Exist” criticising the over-diagnosis of ADHD. Richard Saul writes in the New Republic:

The stimulants most often prescribed for ADHD represent several different types of agents that help control attention and behavior. These include methylphenidate (like Ritalin and Concerta) and mixed salt amphetamines (like Adderall and Vyvanse). Each of these has a specific effect on the body’s neurotransmitters, or the chemical compounds that help transmit signals within the nervous system. The exact mechanisms by which these chemicals interact are very complex, but essentially, if levels of these chemicals are too low or their activity is blocked, the transmission of messages within the nervous system decreases, corresponding to a state of inattention or impulsivity. Specific medications aimed at targeting attention-deficit and hyperactivity symptoms help increase levels of neurotransmitters and their activity. For example, methylphenidate-based medications like Ritalin increase the activity of the neurotransmitters dopamine and noradrenaline in the parts of the brain that help to control attention and behavior. Adderall also increases dopamine’s effects, but in a more gradual way than Ritalin and similar agents do.

So let’s back up a moment. If stimulants can increase one’s attention span and reduce impulsivity, why shouldn’t we use them? Furthermore, even if we’re masking another underlying condition, aren’t we at least solving the problems of inattention and impulsivity in the patient? The answer to both of these questions is a resounding NO. While stimulants can help people with a variety of symptoms in the short term, they have multiple damaging effects in the short- and long-term. The most common short-term side effects associated with stimulants involve overstimulation, such as loss of appetite and sleep disturbance, but perhaps more troubling are the longer-term effects of stimulant use, which include unhealthy weight loss, poor concentration and memory, and even reduced life expectancy in some cases. Long-term, patients also face the development of tolerance, which exacerbates these side-effects. After a while, the body adjusts its natural production of these same chemicals in the brain, and the temporary improvements in attention and behavior begin to disappear. This is why we see doctors prescribing higher and higher doses of the stimulant to achieve the same effect in the patient as time wears on—a dangerous pattern.

Medicalising behavioural issues or blaming genetic causes for behavioural lapses is a cop-out. Both for the offending individual and for those who ought to be helping the individual to modify his behaviour.

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Older Dads have sicker children

February 27, 2014

There is – it seems – an optimal child bearing age for fathers as well as mothers. Older fathers may be richer and more able to support a child but there is an increased risk to the health of their children.

A study by Indiana University, in the US, and Sweden’s Karolinska Institute is the largest and one of the best designed studies on the issue and suggests that mutated sperm with older fathers are the cause.

Seems very plausible.

Brian M. D’Onofrio, Martin E. Rickert, Emma Frans, Ralf Kuja-Halkola, Catarina Almqvist, Arvid Sjölander, Henrik Larsson and Paul Lichtenstein Paternal Age at Childbearing and Offspring Psychiatric and Academic Morbidity, JAMA Psychiatry, doi:10.1001/jamapsychiatry.2013.4525

BBC reports: 

A wide range of disorders and problems in school-age children have been linked to delayed fatherhood in a major study involving millions of people.

Increased rates of autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, suicide attempts and substance abuse problems were all reported. …….

…. The researchers looked at 2.6 million people and at the difference between siblings born to the same father as it accounts for differences in upbringing between families.

Comparing children of a 45-year-old dad to those of a 24-year-old father it indicated:

  • autism was more than three times as likely
  • a 13-fold increased risk of ADHD
  • double the risk of a psychotic disorder
  • 25 times more likely to have bipolar disorder
  • 2.5 times more likely to have suicidal behaviour or problems with drugs
  • lower scores at school

There was no starting point after which the risk started to increase, rather any increase in age had an associated increase in risk.

….. One of the researchers, Dr Brian D’Onofrio, said he was shocked by the findings, which suggested a higher risk than previously estimated. He told the BBC: “The implications of the study is that delaying childbearing is also associated with increased risk for psychiatric and academic problems in the offspring. The study adds to a growing body of research, that suggests families, doctors, and society as a whole must consider both the pros and cons of delaying childbearing.”

The social trend for both parents to have children later in life thus seems to have repercussions for the children. Though the risk may be small it could be said that this a social trend which weakens the health and reduces the well-being of succeeding generations. The demographic effect is that the incidence of psychoses will increase. While having children later may allow a maximisation of the economic contributions of the parents to society, it could also lead to increased medical costs for the affected children in the following generations. Genetic screening and abortion could of course mitigate some of the long term consequences for the evolution of humans.

It could be that we are moving towards greater promiscuity during the “best” child-bearing years but without the production of children due to the availability of contraception. Child bearing itself is then postponed to a more economically suitable time of life for the parents, but a less than optimal time for the health of the children so conceived. Apart from genetic screening of foetuses and abortion of some there does not seem to be a “natural” self-correcting mechanism for this social trend.

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Posted in Aging, Behaviour, Demographics, Evolution, Medicine | Comments Off on Older Dads have sicker children

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