TEACHABLE MEDICAL NEWS

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Can you strengthen the immune system of cancer patients in chemotherapy treatment?

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On December 21, 2019

In cardiovascular system, cellular basis of life, lymphatic and immune system

TeachableMedicalNews article 12202019

Teachable moment in classrooms:

  1. cellular basis of life chapter – formation of cancer cells
  2. cellular basis of life chapter – DNA and mitosis
  3. blood chapter – formation of white blood cells in red bone marrow
  4. immune system chapter – immune protection by white blood cells 

The news item:  The pharmaceutical Neulasta was in the news recently:

Mylan CEO promises Neulasta biosimilar will offer “significant savings” for patients

It’s been nearly two years since the pharmaceutical giant took tremendous heat for the rising cost of EpiPens

The article mentions that a new company will be making a similar and cheaper drug to Neulasta, and that Neulasta is used to reduce infections in patients during cancer treatment.

So, Why Do I Care??  Cancer patients are frequently treated with drugs to kills the cancer cells. Such chemotherapy drugs are used to treat most of the 1.7 million new cancer cases each year in the USA.  Chemotherapy treatments have many damaging side effects on the patients.  Minimizing of those side effects improves patient comfort, survival, and the success of the chemotherapy treatment.

Plain English, Please!!! First, let’s; talk about chemotherapy.  Cancers grow by cells dividing faster than normal cells of the body, and the chemotherapy drugs are used to stop or slow the division of cancer cells.  One side effect of chemotherapy treatment is that normal cells are also stopped from dividing. One of those normally quickly dividing group of cells is located in the red bone marrow.

Second, let’s talk about red bone marrow.  This red, toothpaste-like mush of cells is trapped inside our spongy bones, like breastbone, pelvic bone, and others.  Millions of new red and white blood cells are created by cell division in the red bone marrow every day.  Picture cell division as a car driving at normal speed; you have to keep your foot on the gas pedal.  Chemotherapy drugs are like a foot on the brake pedal; as they slow down cell division, they slow down red and white blood cell production in the bone marrow.

Third, let’s talk about white blood cells.  The white blood cells defend our bodies against bacteria, viruses and fungi. Every day we lose thousands of white blood cells during that defense, so we need constant replacement.  When the cell division in the red bone marrow is slowed by chemotherapy drugs, the replacement of white blood cells slows down, and bacteria and virus infections can get a foothold in the body.  Neulasta (and similar drugs) speeds up white blood cell creation; they step on the gas pedal of cell division in the bone marrow even during chemotherapy treatment.  That provides enough white blood cells to defend the body better against invaders during chemotherapy treatment.

 

Can genetic information guide personalized timing of radiation therapy?

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On December 15, 2019

In cellular basis of life, integumentary system, nervous system

TeachableMedicalNews article 12152019

Teachable moment in classrooms:

  1. cellular basis of life chapter – cancer cell formation
  2. cellular basis of life chapter – DNA and membrane damage from radiation
  3. nervous system chapter – circadian rhythm directed by reticular formation and the hypothalamus
  4. integumentary system chapter – stem cells of epidermis in stratum basale

The news item:  This article describes promising research into minimizing radiation toxicity in cancer patients:

Use genetic data to predict the best time of day to give radiotherapy to breast cancer patients, say researchers

A new clinical study led by the University of Leicester and conducted in the HOPE clinical trials facility at Leicester’s Hospitals has revealed the pivotal role that changing the time of day that a patient receives radiotherapy could play in altering radiotherapy toxicity.

The article mentions PER3 and NOCT genes of circadian rhythm, and how they change skin biology, and the adverse response of skin to radiation therapy.

So, Why Do I Care??  Many types of cancers are treated with radiation therapy, bringing the total to over 3 million patients every year in the USA.  While radiation therapy is successful in reducing cancer growth, the treatment has several side effects, called radiation toxicity.  One of those side effects is the thickening and reddening of the skin.  Any approach that reduces the side effects of the treatment will increase the comfort and quality of life of millions of cancer patients.

Plain English, Please!!!

First, let’s talk about radiation therapy. The eradication of the cancer cells in cancer patients can be achieved by surgery, chemotherapy, and by radiation therapy.  The radiation is nothing else but invisible rays that are aimed at the body part that has the cancer; those rays kill the cancer cells by damaging their DNA and the cell membrane. As the radiation comes from a machine, those killer rays must pass through the skin in order to reach cancer inside the body.

Second, let’s talk about skin reaction to radiation.  No surprise that the very rays that destroy cancer cells also damage the skin as the rays are passing through it.  Think about how the rays from the Sun pass through the skin, and cause sunburn.  Cells in the actively growing layer of the skin are damaged most, and that layer has to regenerate to keep the skin functioning.  That regeneration is making the skin red, and thick, painful, cracked, and even bleeding.  This is worse than the dry and cracked skin you get in the winter time.

Third, let’s talk about circadian rhythm.  We feel sleepy at night, and wake up in the morning, because of the daily rhythm directed by our nervous system.  That daily rhythm is called the circadian rhythm.  As it turns out our skin regenerates better at certain times of the day, so the skin regeneration is also moving along a circadian rhythm.  People with specific version of the genes called Per3 and Noct have skin rhythms with better regeneration in the afternoon.  This means that for those patients, identified by genetic analysis, the radiation treatment scheduled for the afternoon will speed up the regeneration, and minimize skin damage.

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Can an injectable treatment reduce cluster headaches?

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On November 30, 2019

In cellular basis of life, lymphatic and immune system, nervous system

TeachableMedicalNews article 11302019

Teachable moment in classrooms:

  1. Cellular basis of life chapter – receptors on cell membranes bind ligands
  2. general senses chapter – unconventional types of pain
  3. general senses chapter – pharmaceuticals of pain control
  4. immune system chapter – antibodies as pharmaceuticals

The news item:  A new injectable treatment for cluster headaches has recently been in the news:

Emgality Receives First FDA Approval for Treating Cluster Headache

US News is a recognized leader in college, grad school, hospital, mutual fund, and car rankings. Track elected officials, research health conditions, and find news you can use in politics, business, health, and education.

The article mentions the similarity of the pain of cluster headaches to that of migraines, and the approval of the drug Emgality (galcanazumab).

So, Why Do I Care??

About 1 million people suffer from a debilitating disorder, cluster headaches, in the USA.  While there are several therapeutic approaches to cluster headaches, but their effectiveness varies, and many of those treatments have unpleasant side effects.

Plain English, Please!!!  First, let’s talk about cluster headache.  Cluster headache a quick onset and intensely painful type of headache.  That pain makes patients disfunctional, and many cases the pain wakes them up at night, and, so, that is why this disorder is so debilitating.  The headaches happen during a particular time of the day, because these headaches are linked to the body’s own internal clock.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain

Third, let’s talk about this new treatment for cluster headache.  Because cluster headache is not the result of tissue damage, common pain killers don’t work well on cluster headache pain.  Many years of research identified a chemical that trigger cluster headache pain; that chemical is called calcitonin gene related peptide (CGRP).  Cluster headaches happen when CGRP reaches receptors on neurons in the brain.   So, how can you block the action of that peptide?  Imagine a football game where the defensive tackle wraps his arms around the running back to keep him out of the end zone.  The drug mentioned in the article, galcanezumab, acts like a defensive tackle wrapping arms around the running back CGRP, and keeping it away from receptors on neurons in the brain.  The defensive tackle, galcanezumab, can target CGRP only, because galcanezumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

Can electrical stimulation to your throat cure sleep apnea?

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On November 27, 2019

In muscular system, nervous system, respiratory system

TeachableMedicalNews article 11272019

Teachable moment in classrooms:

  1. respiratory system chapter – anatomy of upper airways
  2. nervous system chapter – organs innervated by cranial nerve XII (hypoglossal)
  3. skeletal muscle chapter – electric excitation of skeletal muscles lead to contraction (excitation-contraction coupling)

 The news item: Recently, several articles appeared about an electrical device called Inspire:

Sleep apnea patient finds rest with implant device: “It saved my life”

An estimated 22 million Americans suffer from sleep apnea, putting them at greater risk for diabetes, heart disease, stroke and memory loss

The articles mention that the device treats sleep apnea, and that the device sends electrical impulses to the throat muscles.

So, Why Do I Care??  Sleep apnea, or more precisely, obstructive sleep apnea, is a sleep disorder that affects about 22 million people in the US.  Those people are not just losing sleep, but are at higher risk for several cardiovascular diseases, and for daytime sleepiness.  While not every patient is a good candidate for the Inspire device, the patients with the device show significant improvement in sleep quality and time.

Plain English, Please!!!     So, let’s talk about sleep apnea first.  Apnea is a brief closure of the airways where the closure stops air from getting into the lungs.  The lower portion of our airways have solid cartilage framework (trachea, bronchi), so narrowing rarely occurs; it is always open, like a steel pipe.  However, in the upper airways (mouth, soft palate) we have muscles that surround those airways, and the inappropriate relaxation of the muscles can lead to closure of the upper airway; imagine putting on a sock: it’s easy when we open it up with our fingers, but it’s harder to put our toes through it when the sock is collapsed on the floor.

Second, let’s talk about throat muscles.  While we do have muscles in the throat (anatomically called pharynx), in the soft palate, and in the tongue, surprisingly, the muscles in the tongue are the culprit in narrowing of the airways during sleep. The task of the Inspire device is to contract the muscles inside our tongue.

Third, let’s talk about muscle contraction.  How come those muscles of the upper airways stop working when we’re asleep?  That happens, because muscles need an instruction, a nerve signal, to work, to contract.  When we’re asleep, our brain is no longer sending nerve signals to the tongue muscles, so the muscles relax, and may obstruct the upper airways.  It follows then that during our sleep we could reopen the closed airways by sending a signal to the muscles of the tongue.  Because most of the tongue muscles get their nerve signal through a nerve called cranial nerve XII, it makes sense that the wire of the Inspire device sends electrical impulses to cranial nerve XII.  In turn, those nerve impulses will make the tongue muscles to contract, and keep the airways open.

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Is putting a filter into our large blood vessels a good idea?

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On November 15, 2019

In cardiovascular system, nervous system, respiratory system

TeachableMedicalNews article 11152019

Teachable moment in classrooms:

  1. blood chapter – blood clot formation
  2. blood vessel chapter – direction of blood flow in veins
  3. heart chapter – pulmonary circulation
  4. respiratory system chapter – blood flow to alveoli for gas exchange

The news item: The medical device called “IVC filter” was in the consumer safety news recently:

IVC Filter Lawsuit | 2020 Updates and Settlements

If you experienced side effects from an IVC filter, you may be eligible for compensation. Get a free case review today at ConsumerSafety.org.

The article provided updates regarding lawsuits targeting the IVC filter. The article mentioned the purpose of the device which is to remove unwanted blood clots, and that the device as placed in the inferior vena cava.

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Can peeing out blood sugar possibly save us from kidney disease?

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On October 14, 2019

In endocrine system, urinary system

TeachableMedicalNews article 10132019

Teachable moment in classrooms:

  1. urinary system chapter – glucose reabsorption from filtrate
  2. urinary system chapter – filtration by small blood vessels in glomerulus
  3. endocrine system chapter – insulin and insulin receptor in type 2 diabetes

 

Can peeing out blood sugar possibly save us from kidney failure?

The news item:  Recent news reports wrote about the unexpected health benefit of the type 2 diabetes drug, Invokana.

https://www.seattletimes.com/business/study-finds-diabetes-drug-may-prevent-slow-kidney-disease/

The article mentions that deaths from kidney failure, the need for dialysis, the need of kidney transplant were reduced by 30% in treated patients.

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Can you fight influenza by using used tissue papers?

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On October 2, 2019

In lymphatic and immune system

TeachableMedicalNews article 10012019

Teachable moment in classrooms:

  1. immune system chapter – concept of antigen-based recognition of specific invaders
  2. immune system chapter – antigen-specific activation of the T-cell and B-cells

The news item:  Recently there was a report on a commercially available tissue paper from the company Vaev.

A Mysterious Company Claims to Sell Sneeze-Filled Tissues for $80. Is It Real?

Vaev Tissue sells a used tissue that a sick person has sneezed into, claiming that it boosts your immune system. Health experts disagree.

The tissue paper has a special property: it is used by another person who has the “cold”. The company claims that “a human sneeze is safer than needles or pills” and when flu season comes around you should be able to get sick on your own terms”. 

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How gene editing may cure kidney disease?

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On September 12, 2019

In cellular basis of life, urinary system

TeachableMedicalNews article 09112019

Teachable moment in classrooms:

  1. cellular basis of life chapter – concept of exons within a gene
  2. cellular basis of life chapter – concept of gene mutation leading to protein malfunction
  1. urinary system chapter – damage to nephrons causes kidney disease

 

 Can gene editing cure kidney disease?

 The news item:  Recent news hinted at a possible genetic treatment to halt kidney diseases.   The article mentioned Joubert syndrome, and gene editing technology.

Gene editing possible for kidney disease

For the first time scientists have identified how to halt kidney disease in a life-limiting genetic condition, which may pave the way for personalised treatment in the future.

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Can an injectable treatment work for migraines?

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On July 31, 2019

In lymphatic and immune system, nervous system

TeachableMedicalNews article 07312019

Teachable moment in classrooms:

  1. general senses chapter – unconventional types of pain
  2. general senses chapter – pharmaceuticals in of pain control
  3. immune system chapter – antibodies as pharmaceuticals

 

Can an injectable treatment work for migraines?

 The news item:  New injectable preventions and treatments for migraine were in the news recently. One of them is Aimovig (erenumab):

FDA approves new drug that stops chronic migraines

The FDA approves, Erenumab, a new migraine treatment, that blocks chronic and disabling headaches, without causing many side effects.

The article mentions migraine statistics, the calcitonin gene related peptide (CGRP) as the culprit in migraines, and that the new drug is an antibody.

 

So, Why Do I Care??  There are about 39 million migraine sufferers in the USA.  Among them about 4 million who suffers from chronic migraine lasting for 10-14 days.  The impact of migraine is more than the personal suffering; the US economy loses $36 billion yearly because of lost productivity linked to migraine.  While occasional migraine can be successfully treated with common medications, the chronic migraine sufferers don’t have a reliable treatment.

 

Plain English, Please!!!  First, let’s talk about migraine.  Migraine is a disorder of the central nervous system, and during a migraine attack the malfunctioning nervous system creates pain in the head area, visual disturbances (auras), and sometimes dizziness and nausea.   So, that’s why this disorder is so debilitating.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain.  Everyday pain killer drugs either block the action of chemical released during tissue damage, or they block the movement of the nerve impulse to the brain.

Third, let’s talk about this new treatment for migraine. Because migraine is not the result of tissue damage, common pain killers don’t work on chronic migraine pain.  Many years of research identified a chemical that trigger migraine pain; that chemical is called calcitonin gene related peptide (CGRP).  Migraine happens when CGRP reaches receptors on the neurons in the brain.   The receptor is like a wide receiver in football; the peptide has to be caught by the receptor to start migraine pain, like the wide receiver has to catch the football for a touchdown.  So, how can you block the action of that migraine-triggering peptide?  Imagine a football game where the arms of the wide receiver are duct taped to his body.  The drug erenumab does that to the receptor, so the CGRP peptide can not be caught by the receptor, so there is no more triggering of pain.  The duct tape, erenumab, can target CGRP receptors only, because erenumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

Can a practical artificial heart fit in a backpack?

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On July 28, 2019

In cardiovascular system

TeachableMedicalNews article 07282019

Teachable moment in classrooms:

  1. cardiovascular system chapter – importance of the heart’s functioning
  2. cardiovascular system chapter – importance of heart valves, myocardium, conduction system for proper heart function
  3. cardiovascular system chapter – devices that replace faulty parts of the heart, or the entire heart in patients

 

This article is the work of Mallory Riggs.

 

Can a practical artificial heart fit in a backpack?

The news item:

The use of an artificial heart in a backpack was reported by Express website:

Mother carries heart in rucksack following severe heart failure

THANKS to her amazing rucksack Selwa Hussain is celebrating the New Year her family feared she would never see.

 

 

The article reports on Selwa, a law school graduate, a wife and a mother, who has a portable artificial heart.  The article describes her symptoms that lead to the diagnosis of heart failure.  The article states that a heart transplant wasn’t an option for her, so she was connected to an artificial heart, and eventually she received a portable version of it.

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