Richard G. Petty, MD

Healing Everything

I get a huge number of requests for more information about my philosophy of health and healing; where it came from, and why people believe that my approach is the medicine of the future: hence the amusing title of “The Future Doc.”

My belief in an “integrated” approach to health and healing, that engages the physical, psychological, social, subtle and spiritual aspects of life is not confined to the treatment and personal growth of individuals. It also encompasses ecology, sociology and business practices. In many respects I have followed a similar path to Ken Wilber, but while he has been the theorist par excellence, whose ideas are now being test-driven in a multitude of different applications, I started from personal perception and clinical practice. I talk about some of the origins of my work in Healing, Meaning and Purpose.

It is well-known that I had the privilege of working with the Prince’s Foundation for Integrated Medicine, which is now the Foundation for Integrated Health, and I recently came across this statement by His Royal Highness The Prince of Wales in the magazine Temenos that beautifully summarizes the philosophy that underlies the entire approach.

“As I have grown older I have gradually come to realize that my entire life so far has been motivated by a desire to heal - to heal the dismembered landscape and the poisoned soil; the cruelly shattered townscape, where harmony has been replaced by cacophony; to heal the divisions between intuitive and rational thought, between mind, body and soul, so that the temple of our humanity can once again be lit by a sacred flame; to level the monstrous artificial barrier erected between Tradition and Modernity and, above all, to heal the mortally wounded soul that, alone, can give us warning of the folly of playing God and of believing that knowledge on its own is a substitute for wisdom.”

Most of us realize that the world has become terribly unbalanced, with an extraordinary over-emphasis on the intellect and a tacit assumption that the world is an object to be plundered. In the halls of academia, “heart,” “intuition” and “soul” have often become dirty words, even though it is difficult to see how we can repair our imbalanced world without acknowledging the importance of all of them. This is not to decry the importance of reasoning, but it is an appeal to acknowledge the existence of the soul, to heal our connection with and to listen to her intuitive urgings.

Prince Charles has also said that,

“In medicine, as in architecture, the doctrine of man as a machine has held sway. God was declared dead - I remember it happening. The soul was declared moribund and redundant. Ancient well-tried therapies and diagnostic techniques were simply abandoned and thrown away. The balance of the rational and the intuitive was destroyed.”

I totally agree, and it is this balance that we have to restore.

Our lives depend on it.

An Extraordinary New Book

Regular readers will know that I sometimes review books at Amazon.

I only review around 10% of the books that I read, and they are ones that I think are consistent with my aims of improving the quality and quantity of our lives. I belong to the "If you cannot say something nice, say nothing" school, so I don't review a book unless it is special and brings something new to the table. Unless somebody has written something that is just plain wrong!

A few months ago I was at a meeting in New York and met a man named Kurek Ashley. I have met more than my fair share of people from every continent, and it is not often than someone impresses me: Kurek did. Not because he was a larger than life person, but because of his heart and soul. I asked to have a look at his book, which at that stage was not published. It really surprised me, and I read it twice in once weekend while shuffling to and from the West Coast.

The book is published today as How Would Love Respond?: Imagine If You Were Given a Gift So Powerful That You Knew You Had to Share It with the World, and I was so impressed that I helped with the launch.

Here is what I had to say in my review,

"When I was first asked to examine this book several months ago, I was not sure what to expect.

I had been told that Kurek Ashley was a kind of antipodean Tony Robbins. Nothing wrong with that: I have a great deal of respect for Tony's work. I then heard that Kurek had been in movies, held a record for fire walking and had helped a volleyball team to an Olympic gold medal, as well as propelling forward the lives of countless other people in all walks of life.

So I thought that I knew what I was getting: some sort of high-energy motivator. Then I met the author and discovered something very different. Certainly he is passionate, highly energetic and always positive. But there was another quality to him as well: he had a completely unexpected humility and clarity about what he wants to do for other people. I don't often meet someone with such evident integrity. He told an amazing story of being involved in the most terrible tragedy in which his best friend was killed. But then the dead friend reappeared to him and asked for his help. I had wondered whether he might have had some kind of breakdown. Instead I found a man who is remarkably level headed, and who has absolutely no reason to tell a story that could have damaged his reputation. Far from having had a breakdown, he had experienced a breakthrough. So for all these reasons I was eager to read this book and discover more of the story and Kurek's message.

I only review a small number of the books that I read, and I am not given to hyperbole, but Kurek's book is magnificent! The fact that I read it twice is unusual enough in itself. The book begins with an amazingly candid story of hardship and tragedy, and of the incredible series of experiences that ultimately transformed Kurek into someone very different. He becomes a shining example of what can happen to someone who opens his or her heart and mind. Though he became known as a motivator, as you read the book it becomes clear that he now inspires people to transform themselves in the most extraordinary way. This is a not just another feel good book. It presents a precise map for creating a different kind of life, and one that is in the reach of most of us. I really do believe that it will change many lives."

I would also suggest that you have a look here.

As part of the celebration of the launch, experts from all over the world who have read and been moved by the book have contributed gifts and bonuses. They are all interesting, and many will likely to of value to anyone reading this. I have offered two eBooks and a set of audios.

This is a bit of blurb that was written about my piece:

A Cutting-edge Course in Integrated Health

First there was “folk” medicine. Then there was “alternative”, then “complementary” and finally “integrative” medicine. What comes next? The answer is Integrated Health.

Robert Stuberg - the well-known expert in personal development – had this to say about Integrated Health, “It’s not every day that a new program comes along that covers new and uncharted territory. If you have enjoyed any of Deepak Chopra’s material, you are going to love this. It’s the next step.”

Richard G. Petty, MD is a world-renowned physician who has spent more than 35 years working with thousands of experts throughout the world who are creating a scientifically credible blend of the best of modern medicine with traditional and natural methods of healing to create a new science of health and well-being.

Professor Richard Petty is a biochemist, endocrinologist, neurologist, psychiatrist and advisor to the Prince of Wales’ Foundation for Integrated Health. He is also a recognized expert on nutrition, acupuncture, homeopathy and herbal medicine who has taught at many major universities on five continents.

During the thirty years that he was in full time clinical practice, people in all walks of life, including royalty, politicians, captains of industry and many famous musicians, dancers and artists - as well as other healthcare professionals - sought his opinion. After watching a popular show on television, a grateful patient recently described Dr. Petty as “The real Dr. House!”

For this launch Dr. Petty is – for the first and only time - making available a very special Course in Integrated Health. It contains a completely revised special deluxe version of his latest sixty thousand-word masterpiece, Healing, Meaning and Purpose. It also includes a full study guide with session summaries, questions and answers. In addition, the Course contains a set of full color illustrations; over eight hundred references, scores of carefully selected websites and over an hour of specially recorded audio files that have been described as “incredibly powerful” and “mind blowing.” The Course is complemented by a collection of five hundred extraordinarily profound and inspirational messages to illustrate and amplify the core material. Dr. Petty has carefully selected them from his personal collection of over 48,000.

Until today, this entire Course has only been available to Professor Petty’s private students. This will be the only time that this whole package will be offered to members of the public. It is hard to calculate its value, but if sold separately it would be priced at $297.

In addition, the first 100 people who take advantage of this very special offer will also be given free access to participate in one of his group coaching sessions. These last for one and a half to two hours. Though most sessions are accompanied by a set of handouts, this time together is a great deal more than an information download: many people describe them as unique  and even life-changing experiences. Students normally pay $97 for each session, and many people have waited for more than a year to study with Dr. Petty.

Feel free to have a look and see what you think.

A New Approach to the Diagnosis and Treatment of Depression

Although textbooks and pharmaceutical company literature often claim that the biological component of depression has been clearly defined, the fact is that we still have no certain knowledge about the molecular and biochemical disturbances in depressive disorders. Furthermore, our theories of how antidepressants are constantly being revised, and it is now thought likely that these drugs have several mechanisms of action.

There is an interesting study from the University of Illinois at Chicago College of Medicine and Maryland Psychiatric Research Center in Baltimore in today’s issue of the Journal of Neuroscience.

They have discovered that a change in the location of a protein in the brain could serve as a biomarker for depression. This is exceptionally important, since it may give us a simple and rapid laboratory test to identify patients with depression and, more importantly, to predict clinical response to specific antidepressants.

Over the last few years this same team of researchers, and others around the globe, have been examining a protein named Gs alpha that activates adenylyl cyclase. Adenylyl cyclase is a link in signal transduction that is in part responsible for the action of neurotransmitters including serotonin. Instead of just looking at the biochemical properties of the protein, they have also been looking at the way that it moves in the cell membrane, which in turn impacts the way in which neurotransmitters act on cells.

In both rats and cultured brain cells, Gs alpha changes its location in response to antidepressants, moving out of lipid “rafts” in the cell membrane, to areas of the membrane that allow more efficient communication among membrane components responsible for the action of neurotransmitters. Both antidepressant and antipsychotic drugs have been shown to concentrate in these lipid rafts.

In this new study, brain samples from depressed people who had committed suicide were compared with controls who had no history of psychiatric disorders. Although the total amount of Gs alpha was the same in the depressed and non-depressed, in people with depression, Gs alpha was stuck in these lipid “rafts.” Therefore the protein is unable to do its job of mediating the action of neurotransmitters. Antidepressants have the opposite effect, moving it to regions of the membrane where it can do its work. The localization of other G proteins was not different.

This is such a robust finding, that identifying the location of Gs alpha in the cell membrane may provide an objective diagnosis of depression and second, whether someone is responding to the chosen antidepressant therapy.

The senior author in this research is Mark Rasenick, who is distinguished university professor of physiology and biophysics and psychiatry at the University of Illinois. He described the lipid “rafts” and the importance of the findings like this:

"These “rafts” are thick, viscous, almost gluey areas, that either facilitate or impede communication between membrane molecules… When Gs alpha is caught in these lipid raft domains, its ability to couple with and activate adenylyl cyclase is markedly reduced. Antidepressants help to move the Gs alpha out of these rafts and facilitate the action of certain neurotransmitters."

He goes on to say,

"This test could serve to predict the efficacy of antidepressant therapy quickly, within four to five days, sparing patients the agony of waiting a month or more to find out if they are on the correct therapeutic regimen."

The findings may also help explain two old puzzles:

• Why do antidepressants take so long to work?
• Why do such chemically different compounds produce similar clinical effects?

Further studies to confirm and expand these findings, and to examine the clinical utility of the test.

The Price of a Placebo

Placebos can be powerful things, whether they come wrapped in a nicely colored box, or take the form of an enthusiastic clinician.

Dan Ariely, a behavioral economist at Duke University, and author of the excellent new book Predictably Irrational has written a letter in this week’s issue of the Journal of the American Medical Association in which he suggests that pill costing ten cents is not as effective at preventing pain as a $2.50 pill, even when they are identical placebos.

Ariely and a team of collaborators at the Massachusetts Institute of Technology recruited 82 people to participate in a study in which light electric shocks were administered to participants' wrists to measure their subjective rating of pain. The 82 study subjects were tested before getting the placebo and after. Half the participants were given a brochure describing the pill as a newly approved painkiller that cost $2.50 per dose. The other half was given a brochure describing it as marked down to 10 cents, without saying why.

• In the full-price group, 85 percent of subjects experienced a reduction in pain after taking the placebo.
• In the low-price group, 61 percent said the pain was less.

Although simple and small, the experiment raises some large questions.

As Dr. Ariely says,

"Physicians want to think it's the medicine and not their enthusiasm about a particular drug that makes a drug more therapeutically effective, but now we really have to worry about the nuances of interaction between patients and physicians.”

The results are consistent with previous data about how people perceive quality and how they anticipate therapeutic effects. What is interesting here is the combination of the price-sensitive consumer expectation with the placebo effect of being told that a pill works.

Would it help if prescription medications offer cues from packaging, rather than coming in indistinguishable brown bottles?

Is there a way of giving people cheaper or generic medications without them thinking they will not work?

As Dr Ariely says,

“At the very least, doctors should be able to use their enthusiasm for a medication as part of the therapy. They have a huge potential to use these quality cues to be more effective."

Wise words!

“It requires a great deal of faith for a man to be cured by his own placebos.”
--John L. McClenahan (American Physician and Writer, 1935-)

“Your thoughts are like the seeds you plant in your garden. Your beliefs are like the soil in which you plant these seeds.”
--Louise Hay (American Spiritual Teacher, 1927-)

“Change your beliefs and you change your destiny.”
--Sterling Welling Sill (Elder of the Church of Jesus Christ of Latter Day Saints, 1903-1994)

Testing for Diabetes in Children

Diabetes mellitus can be a devastating illness, especially when it comes on suddenly in a child or adolescent. In young people it is usually so-called Type 1, or insulin-dependent diabetes, an autoimmune disease in which the immune system attacks the insulin-producing beta cells in the pancreas. The disease can have a major impact on the whole family, and sometimes people forget the way in which it can affect siblings whose needs often need to be subordinated to the needs of the newly diagnosed young person.

And here is an important point: even when it appears suddenly, the disease process may have been going on for some time before the clinical symptoms appear. By the time that blood glucose levels begin to rise, it usually implies that the damage to the insulin-producing cells in the pancreas has reached a critical point, and the chance of recovery is low. Anything that we can do to prevent the disease from progressing to the point of producing symptoms would be immensely helpful, and that starts with early recognition before the pancreatic damage has reached critical.

Although we now understand a great deal about the interplay of genetic, environmental and immunological factors that may lead to the illness, this knowledge has so far not helped us very much. There has been a tremendous need to try and identify the early stages of the disease, but that goal has been elusive.

In a study published in the Journal of Immunology researchers from the University of Queensland's Diamantina Institute for Cancer, Immunology and Metabolic Medicine, are developing a simple test that may predict whether a child will develop Type 1 diabetes. They have identified a cellular pathway known as NF-kappa B that is activated in certain blood cells – monocytes and dendritic cells - of people with Type 1 diabetes.

In healthy people monocytes remain quiescent unless they are activated by an infection or other stressor. Then the NF-kappa B pathway gets activated.

In people with Type 1 diabetes things work the other way round: monocyte NF-kappa B was already activated in the blood, and when exposed to infection the pathway shut down. This tells us that there is a problem of immune control that may cause diabetes to develop in children. It is this monocyte abnormality that will hopefully form the basis of a diagnostic test.

This work is assuming more urgency since there are several trials of diabetes vaccines underway, and if successful, it may become possible to identify and intervene in children at risk of Type 1 diabetes before it occurs.

In addition, understanding why the immune system loses control before the disease starts should open up a number of new options for prevention and treatment.

A New Treatment for Toxoplasmosis

I have talked at some length about the possible link between toxoplasmosis and some forms of mental illness, but there is also another side to toxoplasmosis: the Toxoplasma gondii parasite infects nearly one-third of all humans: more than two billion people worldwide. In the United States alone, congenital toxoplasmosis occurs in an estimated 1 per 5,000 births a year and can cause severe vision loss, brain damage and even death. The human cost is incalculable, and in dollars and cents, it has been estimated that the annual cost of caring for these children may exceed $1 billion.

Toxoplasma gondii is carried by some cats and it is said that an infected cat can excrete up to 20 million oocysts over a period of two weeks, and every single oocyst is infectious. They are tenacious and can remain infectious in water for up to six months and in warm moist soil for a year of more.

Toxoplasma infects humans through three main routes:

• Consumption of undercooked, infected meat
• Ingestion of T. gondii oocysts in food, through accidental contamination from cat litter
• Finally, a newly infected pregnant woman may pass the infection to her fetus, hence the warning that pregnant women should not clean the cat box

Not only is toxoplasmosis the most common parasitic infection in the world, but also it can cause particular problems in people with compromised immune systems, for instance people with cancer, autoimmune disease, AIDS or transplant recipients.

It is even possible for people with normal immune systems to suffer major organ damage from chronic infections. Eye disease leading to loss of sight can be caused both a primary infection and as a result of infection transmitted from mother to child. Damage to other organs has recently caused deaths among otherwise healthy young people during epidemics in Surinam and French Guiana.

The parasites that cause malaria are related to Toxoplasma gondii, and a new drug that will soon enter clinical trials for the treatment of malaria also appears to be 10 times more effective than the current gold-standard treatment of toxoplasmosis, a combination of the drugs pyrimethamine and sulfadiazine.

In the March issue of PLoS Neglected Tropical Diseases, a research team based at the University of Chicago Medical Center reports that the drug, known as JPC-2056, is extremely effective against Toxoplasma gondii, both in cell culture and in mice, and apparently without the toxicity associated with the current standard treatment.

The drug works inhibiting the action of the from of the enzyme dihydrofolate reductase (DHFR) that is produced by the family of parasites that includes those that cause toxoplasmosis and malaria, and in cell culture studies, the drug appears actually to kill the parasite, rather than simply preventing its replication. This is very important: not only do most of the current medications have a good many side effects, they have little effect on Toxoplasma during certain phases of its life cycle. It can hunker down in the quiescent cystic phase and wait until the antibiotics are gone.

Rima McLeod, professor of ophthalmology and specialist in infectious diseases at the University of Chicago said,

"JPC-2056 has the potential to replace the standard treatment of pyrimethamine and sulfadiazine. Taken by mouth, is easily absorbed, bioavailable, and relatively nontoxic. In tissue culture and in mice, it was rapidly effective, markedly reducing numbers of parasites within just a few days."

JPC-2056 is not a new drug. It was developed in the late 1980s by teams led by Wilbur Milhous and Dennis Kyle of the Walter Reed Army Institute for Research and David Jacobus of Jacobus Pharmaceutical Company. The original version was quite toxic, but the researchers found ways to reduce the toxicity and developed an oral version of the drug. Clinical trials using JPC-2056 to treat malaria are scheduled to begin later this year.

Career Contentment

I am very happy to report that my friend Jeff Garton's new book - Career Contentment: Don't Settle for Anything Less - has just come out.

As you will see from my review, I just love the book, and it is amazing how Jeff's work and mine fit together.

We are going to be having a panel discussion about the book on www.Business.VoiceAmerica.com on Thursday March 6th at 3PM Eastern, which is noon Pacific time. The discussion is also going to be archived for people in other time zones. I plan to put up a link as soon as it is available.

There is a nice press release here.

I hope that you can listen in: I think that you will get a lot of food for thought!



“Contentment is natural wealth, luxury is artificial poverty.”
-Socrates (Greek Philosopher, 469-388 B.C.E.)

Men, Women and Forgiveness

We recently discussed the importance of forgiveness on health. Over the years studies have shown that men tend to be more vengeful than women, presumably because they have been taught from childhood to empathize with others and build relationships. Though there could yet be a biological basis for this difference.

New data from Case Western Reserve University, Florida State University, Arizona State and Hope College published in the Journal of Personality and Social Psychology suggests that forgiveness does not come naturally for both sexes. Psychologist Julie Juola Exline’s research indicates that men have a harder time forgiving than women do. However that can change if men develop empathy toward an offender by seeing they may also be capable of similar actions. That empathy closes the gender gap and men become less vengeful.

The authors conducted seven forgiveness-related studies (1,2,3,4,5,6,7) between 1998 and 2005 that involved more than1,400 college students: Gender differences have been a robust finding.

The studies used hypothetical situations, actual recalled offenses, individual and group situations and surveys to study the ability to forgive. When men were asked to recall offenses they had committed themselves, they became less vengeful toward people who had offended them. Women started at a lower baseline for vengeance, but thinking about their own transgressions had no effect on levels of unforgiving. When women were asked to recall a similar offense in relation to the other's offense, women felt guilty and tended to magnify the other's offense.

The researchers found that people of both genders are more forgiving when they see themselves as capable of committing a similar action; it tends to make the offense seem smaller and increases empathic understanding of the offense. Therefore people similar to the offenders and therefore more forgiving attitudes.

The ability to identify with the offender and forgive also happens in intergroup conflicts. In a study on forgiveness of the 9/11 terrorists Exline comments that,

"When people could envision their own government committing acts similar to those of the terrorists, they were less vengeful. For example, they were less likely to believe that perpetrators should be killed on the spot or given the death penalty, and they were more supportive of negotiations and economic aid."

It is not difficult to see that prosecution and defense attorneys are going to study this data carefully. It will likely come into play during jury selection processes.

And I am going to think about it the next time that I am called upon to serve on a medical school interview board.


“An eye for an eye will only serve to make the whole world blind.”
--Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)

“And be ye kind one to another, tenderhearted, forgiving one another, even as God, for Christ’s sake, hath forgiven you.”
--The Bible (Ephesians 4:32)

“Everyone and everything I see will lean toward me and bless me. I will recognize in everyone my dearest friend. What could there be to fear in a world that I have forgiven, that has forgiven me?”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

A Stunning Video

For anyone interested in publishing and promoting book, the John Kremer website and blog are essential reading.

John has just published this extraordinary video, and I thought that I would pass it on.

Heart Pressure Medicine for Cocaine Addiction?

Cocaine addiction can be frightfully hard to treat since cocaine affects two key neurotransmitters in the brain: dopamine and glutamate.  So investigators have been looking for ways to interfere with the action of the chemicals in key regions of the brain.

Researchers from Boston University School of Medicine and Harvard Medical School have published new data from a rat study in which they examined the impact of a calcium-channel antagonist called diltiazem, a drug used in the treatment of high blood pressure.

Diltiazem reduced cocaine cravings and the research indicates that calcium channels provide critical links between dopamine and glutamate that drives the intense craving associated with cocaine addiction in a region of the brain known as the nucleus accumbens.

This makes sense: we have known for some time that calcium plays an important role in learning, memory and motivation in this part of the brain. In effect cocaine trains the brain using a dysfunctional form of learning that drives the desire to use the drug.

Though it is still early, this is important research that may give us a whole new approach to treatment. It is unlikely that diltiazem itself with be useful in treating humans, since the amount needed to produce the effect in the brain would likely cause a major drop in blood pressure, but any new approach like this should speed up the search for other effective treatments.

Disturbances in Working Memory in Children

There is news from England about some research that indicates that many children who were thought to have low intelligence actually have a problem with working memory, the ability to hold information in your head and manipulate it mentally. It is largely genetic and if it fails to function normally it can affect long-term academic success into adulthood and prevent children from achieving their potential.

The researchers from Durham University surveyed over three thousand children in 35 schools across the UK using the first tool to enabled them to assess memory capacity in the classroom. They found that ten per cent of school children across all age ranges suffer from poor working memory seriously affecting their learning. Poor working memory is rarely identified by teachers, who often describe children with this problem as inattentive or as having lower levels of intelligence.

The new tool is a combination of a checklist and computer program created after many years of research into poor working memory in children, and it should enable psychologists and teachers to identify and assess children's memory capacity as early as four years old.

The hope is that early assessment of children will enable teachers to adopt new approaches to teaching.

The checklist, called the Working Memory Rating Scale (WMRS), will enable teachers to identify children who they think may have a problem with working memory without immediately subjecting them to a test. A high score on this checklist shows that a child is likely to have working memory problems that will affect his or her academic progress.

Children can be evaluated using the computerized Automated Working Memory Assessment (AWMA). The tools also suggest ways for teachers to manage the children's working memory loads that will minimize the chances of children failing to complete tasks. Recommendations include repetition of instructions, talking in simple short sentences and breaking down tasks into smaller chunks of information.

Pearson Assessment publishes the tools.

This is interesting work, but we still need more research to answer another question: disturbances in working memory have been identified in attention deficit/hyperactivity disorder (ADHD). So the question is whether many of the children found to have defects in working memory may actually have had ADHD.

 

Qi, Prana and Pneuma

I often hear people expressing concern over words like qi (chi), believing that it has something to do with primitive or pagan cultures. In actual fact qi is based upon observations by a culture that looked at the world very differently from that developed in the Western world. It is often mistranslated as “energy” which is not quite accurate.

Some experts now refer to the “subtle systems” of the body, and they appear to be of many types. In China these systems were thought to be the highways of the animating force of the body. In Japan it s known as ki, in India it is prana, the Greeks called it “Pneuma” or in the West were called the etheric or the fifth element, after earth, fire, air and water. There are at least 97 cultures around the world that have claimed the existence of some form of “energy.” We use the term subtle “systems”, to be a little more precise than saying “energies”, for these subtle systems are composed of the inseparable twins: 
1. Subtle energies and
2. The subtle fields that carry them.
Without energy, the fields could not actualize, and without the fields, there would be nothing to carry the energy.

Let’s look at something else.

I have been interested to see whether these different concepts map onto each other. I just found an interesting discussion here, that adds some interesting material, all of which I have been able to confirm.

According to my dictionary the word prana does indeed come from the root "Ãpraa" that expresses the idea of "breathing" or "blowing of the wind." Prana means "breath" and also "life" and "living being". In Genesis God formed us out of dust from the soil, He blew into his nostrils the breath of life and the human became a living being.

Jung is one of the people who said that the Indian prana corresponds to the Greek pneuma. Pneuma means "air in motion" as in breath and wind, and it is connected with the idea of life. There is a further correlation: prana is related to the mind and rendered as "spirit," and pneuma has the same meaning.

The trouble with qi has arisen because the Chinese have never had any interest in discussing the meaning of a concept. So they do not speculate on the nature of qi, but instead perceive it functionally: by what it does. Qi, chi, ki has a similar meaning to prana and pneuma: it is translated as breath, vapor, and energy.

This is different from the New Age idea that everything "has" prana or qi. Only living beings do.

"Jesus answered and said unto him,
Verily, verily I say unto thee, except a man born be born again,
He cannot see the Kingdom of God.
Nicodemus saith unto him,
How can a man be born again when he is old?
Can he enter the second time into his mother's womb, and be born?
Jesus answered: Verily, verily, I say unto thee,
Except a man born of water and the Spirit,
He cannot enter into the Kingdom of God.
That which is born of flesh is flesh and that which is born of Spirit is spirit,
Marvel not that I said unto thee: Ye must be born again.
The wind bloweth where it listeth, and thou hearest the sound thereof,
But cannot tell whence it comes and where it goeth:
So is every one that is born of the Spirit.”
The Bible John 3:3-8


"The term "Spirit" translates the Hebrew word ruah (Rûach), which, in its primary sense, means breath, air, wind. Jesus indeed uses the sensory image of the wind to suggest to Nicodemus the transcendent newness of him who is personally God's breath, the divine Spirit."

J. Cardinal Ratzinger, Catechism of the Catholic Church 1994

Jazz and the Brain

It is remarkable how good the brain is at coordinating multiple regions at once. A new study published in today's issue of the journal Public Library of Science (PLoS) One has used functional magnetic resonance scanning (fMRI) to examine musicians engaged in highly creative and spontaneous jazz improvisation. They found that a large region of the brain involved in monitoring one's performance is shut down, while a small region involved in organizing self-initiated thoughts and behaviors is highly activated. The researchers propose that this and several related patterns are likely to be key indicators of a brain that is engaged in highly creative thought.

During the study, six highly trained jazz musicians played keyboard under two conditions. In the first scenario, called the Scale paradigm, the music was based on a simple C major scale. Using only their right hand, the volunteers first played the scale up and down in quarter notes. Next, they were asked to improvise, though they were limited to playing quarter notes within the C major scale.

The second scenario, called the Jazz paradigm, examined higher-level musical improvisation. This paradigm was based on a novel blues melody that the volunteers had memorized beforehand, and had been written by one of the researchers. Again, using only their right hand, the musicians played the tune exactly as they had memorized it, only this time accompanied through headphones by a pre-recorded jazz quartet. When they were asked to improvise, the musicians listened to the same audio background, but they were free to spontaneously play whatever notes they wished.

The brain scans were nearly identical for the low-level and high-level forms of improvisation, supporting the idea that the change in neural activity was due to creativity and not the complexity of the task.

Much of the change between improvisation and memorization occurred in the prefrontal cortex, the region of the frontal lobe of the brain that helps us think and problem-solve. It is also involved in generating the sense of self. The dorsolateral prefrontal cortex is responsible for monitoring our own performance and it shuts down completely during improvisation, while the much smaller, centrally located region at the foremost part of the brain – the medial prefrontal cortex - increases in activity. The medial prefrontal cortex is believed to be involved in self-initiated thoughts and behaviors, and it becomes very active when a person describes an event that has happened to him or makes up a story.

The suppression of inhibitory, self-monitoring brain mechanisms helps to promote the free flow of novel ideas and impulses. This is an unusual pattern of brain activity that closely resembles the pattern seen in people when they are dreaming.

Another unusual finding was that there was increased neural activity in each of the sensory areas during improvisation, including those responsible for touch, hearing and vision, despite the fact that there were no significant differences in what individuals were hearing, touching and seeing during both memorized and improvised conditions. This suggests that when the brain wants to be creative, a whole range of sensorimotor processing is increased. At the same time systems that regulate emotion were also engaged during improvisation.

As someone who has done a lot of brain imaging, and has spent many hours inside scanners, this whole piece of work is dazzling from a technical point of view. The hardy musicians had to lie on their backs with their heads and torsos inside the scanner and their knees bent upward. They had to use a plastic keyboard, which was shortened to fit inside the scanner and which rested on their knees. A mirror placed over the volunteers' eyes, together with the headphones, helped the musicians see and hear what they were playing.

Just thinking about it makes me queasy.

“Words are the children of reason and, therefore, can't explain it. They really can't translate feeling because they're not part of it. That's why it bugs me when people try to analyze jazz as an intellectual theorem. It's not. It's feeling.”
--Bill Evans (American Jazz Pianist, 1929-1980)

“Jazz tickles your muscles, symphonies stretch your soul.”
--Paul Whiteman (American Musician and Bandleader, called the King of Jazz for popularizing a musical style that helped to introduce jazz to mainstream audiences during the 1920s and 1930s, 1890-1967)

“Jazz music is an intensified feeling of nonchalance.”
--Françoise Sagan (French Novelist and Dramatist, 1935-2004)

Human Taste Perception

It is remarkable that we still know so little about one of our most important senses: taste. Despite the significance of taste to survival and gratification much of what is written in basic books is outdated and we have only a rudimentary understanding of how our taste buds operate and how their sensations are translated into comprehensible sensations.

Taste provides both us with pleasure and protection: we use taste to evaluate everything that we put in our mouths. Taste mediates recognition of a substance and the final decision process before it is either swallowed and taken into the body, or rejected.

A new primer written by scientists at the Monell Center in Philadelphia and Florida State University is published in today’s issue of Current Biology. It provides a clear and accessible overview of recent advances in understanding human taste perception and its underlying biology.

Within the past few years, identification of receptors for sweet, bitter and umami (savory) taste has led to new insights regarding how taste functions. The Current Biology primer reviews the current state of knowledge regarding how taste stimuli are detected and ultimately translated by the nervous system into the perceptual experiences of sweet, sour, salty, bitter, and umami.

These perceptual evaluations are related to the function and the consequences of taste evaluation. These can range from pleasurable emotional reactions to the critical life-dependent response that causes a person to spit out a bitter potential toxin.

Paul Breslin, a sensory scientist at the Monell Center, had this to say,

“For all mammals, the collective influence of taste over a lifetime has a huge impact on pleasure, health, well being, and disease. Taste's importance to our daily lives is self-evident in its metaphors - for example: the 'sweetness' of welcoming a newborn child, the 'bitterness' of defeat, the 'souring' of a relationship, and describing a truly good human as the 'salt' of the earth."

Are Antidepressants Effective?

An important story has been flashed around the world, but unfortunately some of the interpretations of the story have been intemperate. In a study published in PLOS Medicine a  team of researchers from the University of Hull team concluded the drugs actively help only a small group of the most severely depressed. They based this on a meta-analysis of all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available.

The researchers reviewed data on 47 clinical trials, both published clinical trial data, and unpublished data secured under Freedom of Information legislation.

They focused on four antidepressants: fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone) and paroxetine (Paxil).

Many of the reports in the media have taken this research to mean that antidepressants are no better than placebo. That is not the case. The medications can be very effective and even life saving in people with severe depression. However, the effect in people with mild depression is no greater than placebo.

What this tells us is that the over-prescription of antidepressants for normal variations in mood is probably not justified. We are all allowed to be miserable from time to time, but that does not mean that we need to take medications.

Not surprisingly, some of the manufacturers have strongly disputed the findings.

The biggest worry after reading some of the news reports is that some people might stop their medications abruptly, and that can cause many problems. And some folk really do need to be on the medications and stopping them without clear guidance can be very risky.

Fast Foods, Exercise and Your Liver

We have known for many years that insulin resistance can cause non-alcoholic fatty liver disease (NAFLD). Now a new study published in the journal Gut reports that too much fast food and too little exercise can harm the liver in a matter of weeks.

In an experiment looking a lot like Morgan Spurlock’s Super Size Me, Swedish researchers selected 18 thin, healthy volunteers - 12 men and 6 women - to attempt a 5 to 15% body weight increase by eating at least two fast-food-based meals per day for four weeks. The participants in this intervention group also restricted their level of physical activity to no more than 5000 steps a day. A comparison group, matched for age and sex, ate a normal diet and maintained normal exercise levels.

The plan was to see if doubling calorific intake and increasing total body weight had any impact on participant's liver health.

Changes in major liver enzymes, such as alanine aminotransferase (ALT), and in hepatic triglyceride content (HTGC) were used to indicate liver damage. Abnormally high ALT levels are frequently seen in people who consume a lot of alcohol or who have been infected with the hepatitis C virus. HTGC measures fatty acid levels in the liver; too much fat in the liver leads to a condition called fatty liver disease.

At the end of the four weeks, the researchers found that:

• Fast-food consumers had put on an average of 6.5 kg (14.3 lbs.)
• Five participants increased their weight by 15%
• One person gained 12 kg (26.4 lbs.) in two weeks
• Sharp increases in ALT occurred after just one week on the fast food diet
• The average ALT level increased four-fold from 22 U/l to of 97 U/l over the 4 weeks
• ALT rose to liver damage levels in 11 participants
• No changes were seen in levels in the comparison group
• The increases in ALT levels were linked to weight gain and increased sugar and carbohydrate intake. One subject developed fatty liver disease, and there was a large rise in liver cell fat content in the other participants

Although nobody should be surprised that gorging on junk food and becoming a couch potato is bad for the body, the speed and extent of the liver damage is alarming.

“Don't dig your grave with your own knife and fork.”
--English Proverb

“I saw few die of hunger; of eating, a hundred thousand.”
--Benjamin Franklin (American Author, Inventor and Diplomat, 1706-1790)

RP On The Radio... Again... and Again

I am pleased be able to let you know that starting this week I am going to be doing a regular slot on Donna Seebo's show on www.bbsradio.com.

We are going to be doing regular updates on Integrated Medicine and the science that underpins it.

I shall let you know when the shows are on, and I shall be attaching the broadcasts to my website.

Here is a little piece that I just recorded for the station.

Download seebo_advert2.mp3

Acupuncture for Hay Fever

A study from Melbourne, Australia has found that acupuncture can significantly reduce the symptoms of persistent allergic rhinitis (PAR), a.k.a. hay fever. This was a randomized, single-blind, sham-controlled trial included 80 patients with PAR aged 16-70 years, who were randomly assigned to real or sham acupuncture. Three key acupuncture points, Yingxiang L.I.-20, Yintang M-HN-3 and Fengchi GB-20, plus one supplementary point (determined individually on the basis of traditional Chinese Medicine pattern differentiation) were used for each participant. After a one-week baseline period, participants were treated twice weekly for eight weeks and followed up for another 12 weeks. Nasal obstruction, sneezing, rhinorrhea and nasal itch were each self-assessed daily on a 5-point scale, and individual symptom scores were added to give a sum of the symptom scores: total nasal symptom score (TNSS). A secondary outcome was use of PAR relief medication. At the end of eight weeks' treatment, the weekly mean difference in TNSS from baseline was significantly greater with real (-17.2) than with sham acupuncture (-4.2) and these benefits persisted three months after the end of treatment. Comparisons of relief medication scores revealed a significant decline in the use of medication in the real acupuncture group between baseline and Week 8 of treatment, the reduction being still apparent at the end of follow-up.

This research is convincing. The effect size is not enormous, and we do not know how long the effect will last, but it does suggest another approach for people who have chronic symptoms and for whom medications are ineffective, or who do not want to take medications, or have side effects from them.

It may be relevant that some years ago it was shown that needling the Fengchi point - which lies at the base of the skull at the back of the head - increases some components of cerebral blood flow. That may give us a mechanism of action of the acupuncture in this trial.

“I am pretty sure that, if you will be quite honest, you will admit that a good rousing sneeze, one that tears open your collar and throws your hair into your eyes, is really one of life's sensational pleasures.”
--Robert Charles Benchley (American Humorist, Critic and Parodist, 1889-1945)

“The nose is for breathing, the mouth is for eating.”
--English Proverb

“Warmth, moisture, food-these are the causes that activate latent germs and arouse them to activity. They exist, all except the food, in the mouth, nose and throat at all times. The food is thrown out into these, as excretions, in disease. The germs feed on the excretions. They are scavengers. They were never anything else and will never be anything else. They break up and consume the discharge from the tissues. This is the function ascribed to germs everywhere in nature outside the body and is their real and only function in disease. They are purifying and beneficial agents. The medical profession has worked itself into hysteria over the germ theory and is using it to exploit an all too credulous public. Germs are ubiquitous. They are in the air we breathe, the food we eat, the water we drink. We cannot escape them. We can destroy them only to a limited extent. It is folly to attempt to escape disease by attempting to destroy or escape germs. Once they are in the body, the physician has no means of destroying them that will not, at the same time, destroy the patient. We cannot avoid germs. We must be proof against them. We have to accept them as one of the joys of life.”
--Herbert Shelton (English Evolutionary Philosopher, 1820-1903)

Fatalism and Ethics

We are constantly inundated by reports of the consequences of bad decision-making, and that leads us to consider two issues: genetic determinism - the notion that our behavior is totally the result of our genes - and whether or not we have free will. This is a hugely important issue, not only for each of us personally, but also for our views about morality and the justice system. And what happens when everyone becomes convinced that they have no free will and that “they’re genes made them do it?”

We know from our own experience as well as empirical studies that changing a person’s sense of responsibility can change his or her behavior.

Interestingly, the link between fatalistic beliefs and unethical behavior seems never to been examined scientifically.

In two recent experiments published in the journal Psychological Science psychologists Kathleen Vohs of the University of Minnesota and Jonathan Schooler of the University of British Columbia decided to see if otherwise honest people would cheat and lie if their beliefs in free will were manipulated.

They gave college students a mathematics exam. The math problems appeared on a computer screen, and the subjects were told that a computer glitch would cause the answers to appear on the screen as well. They were told that to prevent the answers from appearing, the students had to hit the space bar as soon as the problems appeared.

This was a ruse: the researchers were observing to see if the participants surreptitiously used the answers instead of solving the problems honestly on their own. Before the test they used a well-established method to prime the subjects' beliefs regarding free will. Some of the students were told that science has disproven the notion of free will and that the illusion of free will was an artifact of brain activity. The other group where told nothing about free will.

The results were clear: those with weaker convictions about their power to control their own destiny were more likely to cheat when given the opportunity compared with those whose beliefs about controlling their own lives were left untouched.

The researchers then went a step further to see if they could get people to cheat with unmistakable intention and effort. The experimenters set up a different deception. This time they had the subjects take a very difficult cognitive test. Then they were asked to solve a series of problems without supervision and to score themselves. They also "rewarded" themselves $1 for each correct answer. To collect the cash they had to walk across the room and help themselves to money in a manila envelope.

The psychologists had previously primed the participants to have their beliefs in free will bolstered or reduced by having them read statements supporting a deterministic view of human behavior.

This study shows that those with a stronger belief in their own free will were less likely to steal money than were those with a weakened belief.

The results of this study indicate a significant value in believing that free will exists. The work also raises some significant questions about personal beliefs and personal behavior.

“The flame of Christian ethics is still our highest guide.”
--Sir Winston Churchill (English Statesman, British Prime Minister, 1940-1945 and 1951-1955, and, in 1953, Winner of the Nobel Prize in Literature, 1874-1965)

"You’re born with intelligence, but not with ethics.”
--Masad Ayoob (American Firearms and Self-defense Instructor and the Director of the Lethal Force Institute in Concord, New Hampshire, 1948-)

“Fatalism, whose solving word in all crises of behavior is "All striving is vain," will never reign supreme, for the impulse to take life strivingly is indestructible in the race. Moral creeds which speak to that impulse will be widely successful in spite of inconsistency, vagueness, and shadowy determination of expectancy. Man needs a rule for his will, and will invent one if one be not given him.”
--William James (American Psychologist and Philosopher, 1842-1910)

“To live lightheartedly but not recklessly; to be gay without being boisterous; to be courageous without being bold; to show trust and cheerful resignation without fatalism -this is the art of living.”
Jean de La Fontaine

“Custom has furnished the only basis which ethics have ever had.”
--Joseph Wood Krutch (American Naturalist, Writer and Critic, 1893-1970)

Violence and Diet

We have talked before about the link between nutrition and violence.

The evidence has continued to mount and I was pleased to see that the Wellcome Trust is funding trials in three British prisons to investigate the link between nutrition and behavior. This is a placebo study that will examine which nutrients are most important and at what dosage.

Volunteers from three young offenders institutions housing male prisoners aged 16 to 21 will take nutritional supplements in addition to their normal choice of food to ensure they receive the necessary vitamins, minerals and essential fatty acids to meet daily guidelines. The investigators will monitor how levels of nutrients affect a range of behaviors including violence, drug-related offences and incidents of self-harm.

The new trials build on previous research published in the British Journal of Psychiatry that was conducted at the then maximum security Young Offenders Institution in Aylesbury, Buckinghamshire. That study was funded by Natural Justice, a research charity that investigates the social and physical causes of offending behavior. Nutritional supplements  - 2 grams per day of the omega-3 fatty acids EPA and DHA for three months - were given to ensure that inmates' diets reached recommended UK dietary standards. The researchers found that the prisoners who consumed the active nutrient capsule committed on average 26% fewer disciplinary offenses overall than those taking the placebo and 37% fewer violent offenses.

The most likely reason why supplements can have such a large effect is because the proper functioning of nerve cell membranes and signaling molecules depends upon adequate amounts of minerals, vitamins and essential fatty acids in the diet.

This is extremely important work. Clearly nutrition is not the only driver of violence but it has been wondered for a long time whether the industrialization of our diets has contributed to the enormous rise in violent crime between the 1950s and 1970s.

“Violence is the last resort of the incompetent.”
Isaac Asimov (Russian-born American Biochemist and Writer, 1920-1992)

“Blessings crown the head of the righteous, but violence overwhelms the mouth of the wicked.”
--The Bible (Proverbs 10:6)

“Peace cannot be achieved through violence, it can only be attained through understanding.”
--Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

Antioxidants May Raise Cancer Risk?

Regular readers will know that I have for some years now been raising a red flag the wholesale promotion of antioxidants.

The trouble is this: antioxidants are supposed to help rid us of some of the free radicals that have been implicated in a small number of diseases, and may also play a role in some of the physical aspects of aging. However, free radicals are also some of the major cancer killers in the body, so eradicating them – even if it were possible – hardly seems like a good idea.

According to an analysis of a dozen studies including more than 100,000 patients in the Mayo Clinic Proceedings taking antioxidant supplements do not reduce cancer risk.

In fact smokers who take beta carotene supplements could be increasing their risk of smoking-related cancer and death.

Different antioxidants have different effects, and their effects may also vary depending on the part of the body involved.

The researchers looked at 12 trials that compared antioxidant supplements with placebo on cancer incidence and mortality. Antioxidant supplements did not reduce the risk of cancer. When they looked separately at beta carotene, they found the nutrient actually increased cancer risk by 10 percent among smokers. There was also a trend toward a greater risk of dying from cancer with beta carotene supplementation.

Selenium supplements reduced cancer risk by 23 percent among men, the researchers found, but had no effect on women. While vitamin E had no anti-cancer effect overall, supplementation with the nutrient was tied to a 13 percent lower prostate cancer risk.

A large study looking at vitamin E supplementation for prostate cancer is currently underway. While future studies of beta carotene and vitamin E for cancer prevention are very unlikely to show effectiveness, it would be worth doing further studies on selenium.

The moral of the story: we should be going for a balanced diet and a balanced life in general rather than putting our hopes in an over-simplified nutritional message.

A Shrine to Bobby

For people interested in the late Bobby Fischer, an enthusiast has put together every public video featuring or about Fischer.

A real labor of love, and there are many fascinating items there.

Bonnie D. Graham on WGBB Tonite

I have the privilege of being on Bonnie D. Graham on WGBB Tonite:

LISTEN LIVE TODAY 6PM-EST: www.am1240wgbb,com
Up Close & Personal with Bonnie D. Graham on WGBB Tonite – Featured guests:
6 PM: Richard Petty, MD, "Healing, Meaning and Purpose–The Magical Power of the Emerging Laws of Life" on journaling, integrated medicine, healthy aging & more. www.RichardGPettyMD.com

The second guest is:
6:30 PM: Masha Malka, "The One Minute Coach– Change Your Life One Minute At A Time" believes we are all potential geniuses capable of achieving success in all areas of life. www.MashaMalka.com

I have just reviewed Masha's most recent book on the Amazon website.

LISTEN to PODCASTS Anytime: www.BonnieRadioPodcasts.com
Digital media services: www.QBProductions.com
See you on the radio!.../bonnie

I shall let everyone know once we have the Podcasts prepared.

Bobby Fischer R.I.P.

News services round the world have been reporting the untimely death of Bobby Fischer, a.k.a. Robert James Fischer, the American-born chess genius.

Fischer’s match with Boris Spassky in 1972 had a huge influence on me, tempting me back to competitive chess, and over the years I studied most of his games in great detail. So I was definitely a fan.

But sadly much of the coverage has focused on some of the foul things that he said in his later years. It is particularly unfortunate because most of the reports failed to mention a number of other things about him.

I never met or examined Fischer and it is dangerous to diagnose people at long range. But there were multiple reports that made it very clear that he long ago crossed the line into mental illness.

He was always single-minded and cantankerous, and some of his allegations about cheating turned out to be correct. But when he began to believe that people could pick up or manipulate his thoughts through the fillings in his teeth, it was clear that something else was going wrong with him.

Some people have tried to link genius in chess and mental illness, but the link is at best tenuous, even though more than one very strong player has succumbed to mental illness. As we have discussed, there may be a link between creativity and schizotypal personality disorder, but the thing about chess is that high-level play requires enormous sustained concentration and motivation, to say nothing of the ability to withstand intensive mental stress. Thos are all things that become difficult as mental illness progresses.

One of the best ways of evaluating a culture is the way in which it treats its weakest members. So let us remember and celebrate Fischer’s genius and recognize that his later and ever darker life was driven by a terrible mental deterioration.

“The chessboard is the world, the pieces are the phenomena of the Universe, the rules of the game are what we call the laws of Nature. The player on the other side is hidden from us.”
--Thomas Henry Huxley (English Biologist and Educator, 1825-1895)

“Chess is the touchstone of intellect.”
--Johann Wolfgang von Goethe (German Poet, Playwright and Philosopher, 1749-1832)

Judah Folkman R.I.P.

I just heard that Judah Folkman just passed away at the age of 74. That is a name that is not widely known outside the scientific world, although a couple of years ago an excellent book –Dr. Folkman’s War - was written about him and his work.

His major work and his enduring legacy was in the field of angiogenesis: the production of new blood vessels. In the 1960s he came up with the idea that a way to kill tumors was to starve them of the blood supply that they need to survive. He was initially ridiculed, but history is now proving him correct. I got to know him twenty years ago after publishing a paper in which I described the discovery of a growth factor that is involved in the production of new blood vessels at the back of the eye in people with diabetes. Judah was very supportive and we had many good discussions about the potential role of angiogenesis not only in tumors and diabetic retinopathy, but also in diseases like rheumatoid arthritis and psoriasis.

Last November, at the 12th Annual Society for Neuro-Oncology Meeting in Dallas, researchers from the University of Virginia and several other leading brain tumor centers in the United States presented data on the successful use of an inhibitor of angiogenesis in the treatment of glioblastoma multiforme (GBM), the most common form of primary brain cancer. It is hard to treat, and if it recurred after surgery, radiation and/or chemotherapy there was often not much to be done.

Building on Judah’s work, they wanted to see if they could inhibit vascular endothelial growth factor (VEGF) that has an important role in the disease. VEGF fosters the growth of a tumor by stimulating the growth of new blood vessels to feed it. According to earlier studies, bevacizumab (BV) (Avastatin), a humanized monoclonal antibody that specifically targets VEGF, in combination with irinotecan (also called CPT-11) could have a role in recurrent glioblastoma multiforme. The researcher was an attempt to establish the clinical benefit of BV, both alone and in combination with CPT-11, in a multicenter, randomized phase II trial.

The results were very promising, substantially exceeded the pre-specified thresholds set for this work.

They looked at 6-month progression-free survival (PFS) defined as no clinical or MRI tumor growth and the objective response rate (ORR), which measures tumor shrinkage. Secondary endpoints included safety and survival. Response assessments were conducted by an independent radiographic facility that did not know which patients had been treated. All patients were followed for 24 weeks to determine efficacy and safety.

When taking BV, 35.6 percent of patients on average had a 6-month survival with no progression of their cancer, and an objective response rate of 21.2 percent on average.

The combination of BV and CPT was even more effective, with results of 51 percent and 34.1 percent, respectively.

The investigator group found similar results when they evaluated the patients. Those results showed that 44.7 percent of patients on average had a 6-month survival with no progression of their cancer, and an objective response rate of 38.8 percent on average. The combination therapy yielded results of 60.9 percent and 46.3 percent, respectively.

The surviving patients have remained in the study and are still being treated and followed, so we shall be seeing some longer-term results in the future.

In the United States bevacizumab has already been approved for the treatment of metastatic colon cancer and most forms of metastatic non-small cell lung cancer.

This is very encouraging research and a fitting tribute to a genuine medical pioneer.

Grapefruits, Medicines and Medical Correspondents

Mark Twain once said:
“Be careful of reading health books, you might die of a misprint.”

I was thinking about that as I was watching a TV show earlier.

I have spoken before about the frustration of many of us about the quality and accuracy of some media medical correspondents. Though every show has a disclaimer about the importance of discussing any issue with a health care provider, it is really unfortunate to present inaccurate data that could needlessly alarm people.

I will immediately put my hand up and say that I have done more than my share of media work, not just in the United States and Great Britain, but also in countries from Finland to Australia and twenty or thirty more in between. And I may well have misspoken at some time or other. Even the most well intentioned people sometimes make slips, and it is especially easy when you are in a studio and you know that the clock is counting down.

But that stress makes it all the more important to have accurate material prepared in advance so that slip-ups don’t happen.

Today’s piece was about a story that pink grapefruit may not interact with some medications. The correspondent rightly said that any type of grapefruit may interact with some medications, but then said that there was an interaction in the stomach. This is not correct and could be very confusing.

The issue is that grapefruit juice may induce the enzyme complex cytochrome P450 3A4 in the liver and intestine. So if you or a medication that is metabolized by the enzyme, grapefruit juice may lower the plasma level of the drug, making it less effective. This is another example of the importance of telling your health care provider about ANYTHING that you eat or drink, in addition to listing any herbs and supplements that you take.

Here is a list of some of the more common medicines metabolized by cytochrome P450 CYP3A4:

Alprazolam
Amiodarone
Amlodipine
Aripiprazole
Astemizole
Atorvastatin
Buspirone
Cafergot
Chlorpheniramine
Cimetidine
Cisapride
Clarithromycin
Cocaine
Codeine
Cyclosporine
Dapsone
Dexamethasone
Dextromethorphan
Diazepam
Diltiazem
Domperidone
Erythromycin
Estradiol
Felodipine
Fentanyl
Finasteride
Fluconazole
Fluvoxamine
Grapefruit juice
Faloperidol
Hydrocortisone
Iindinavir
Itraconazole
Ketoconazole
Lidocaine
Lovastatin
Methadone
Midazolam
Mifepristone
Nefazodone
Nifedipine
Nitrendipine
Norfluoxetine
Ondansetron
Pimozide
Progesterone
Propranolol
Quetiapine
Quinidine
Quinine
Risperidone
Ritonavir
Sildenafil
Simvastatin
Tacrolimus
Tamoxifen
Taxol
Telithromycin
Terfenadine
Testosterone
Trazodone
Triazolam
Verapamil
Vincristine
Ziprasidone
Zolpidem