WBEZ | Treatments http://www.wbez.org/tags/treatments Latest from WBEZ Chicago Public Radio en Cheap Drug Beats Pricey One In Treating Vision Loss In Elderly http://www.wbez.org/story/2011-04-29/cheap-drug-beats-pricey-one-treating-vision-loss-elderly-85839 <img typeof="foaf:Image" src="http://llnw.wbez.org/0" alt="" /><p><p>Sometimes an older and cheaper drug beats the shiny, newer competition by being just as effective for a fraction of the cost. But it takes a lot of time and money to prove it.</p><p>A government-sponsored <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1102673?query=OF">study</a> released yesterday compared <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000394/">Lucentis</a>, a drug approved to treat a common form of blindness in the elderly called <a href="http://www.nlm.nih.gov/medlineplus/maculardegeneration.html">macular degeneration</a>, to <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000352/">Avastin</a>, a cancer drug eye doctors have been using to treat the eye disease for years.</p><p>It found that patients who got Avastin could read an average of 8 more letters on an eye chart after a year - while Lucentis patients were able to read 8.5 more letters after a year of treatment.</p><p></p><p>"Health care providers and payers worldwide will now have to justify the cost of using ranibizumab [Lucentis,]" said an <a href="http://www.nejm.org/doi/full/10.1056/NEJMe1103334?query=OF">editorial</a> accompanying the study in the <em>New England Journal of Medicine</em>.</p><p>As we reported before, getting the trial going took years and was <a href="http://www.npr.org/blogs/health/2010/06/04/127480093/future-looks-blurry-for-comparative-effectiveness-research">pretty complicated</a>, since drug companies are loathe to pay for these kinds of head-to-head studies. It highlights the challenges the government faces in doing <a href="https://www.cfda.gov/index?s=program&mode=form&tab=step1&id=eee2ca9228e380444d19281489c20a08">comparative effectiveness</a> research.</p><p>But since Avastin costs about $50 a pop, while Lucentis costs $2,000, results like this suggest Medicare could save a bundle if people choose the cheaper option.</p><p>About <a href="http://www.emedicinehealth.com/macular_degeneration/article_em.htm#Macular%20Degeneration%20Overview">1.75 million people</a> in the U.S. have macular degeneration, but before you get too excited, the drug is used to treat those with the wet form of the disease — only about 15 percent of that population.</p><p>Genentech, which makes both drugs, <a href="http://www.nytimes.com/2011/04/29/business/29eye.html?_r=1&partner=rss&emc=rss">told</a> the <em>New York Times</em> on Thursday that it still believes that Lucentis is safer and better. It's better at drying the fluid in the eye that is believed to cause the vision loss, and the trial showed it was associated with slightly fewer serious complications.</p><p>However, the authors of the study said there weren't enough patients in the trial to draw conclusions about safety. Copyright 2011 National Public Radio. To see more, visit <a href="http://www.npr.org/">http://www.npr.org/</a>.<img src="http://metrics.npr.org/b/ss/nprapidev/5/1304087835?&gn=Cheap+Drug+Beats+Pricey+One+In+Treating+Vision+Loss+In+Elderly&ev=event2&ch=103537970&h1=Avastin,Lucentis,macular+degeneration,Treatments,Medicare,Shots+-+Health+Blog,Medical+Treatments,On+Disabilities,Health,Your+Health,On+Aging,Health+Care,U.S.,Home+Page+Top+Stories,News&c3=D%3Dgn&v3=D%3Dgn&c4=135833062&c7=1128&v7=D%3Dc7&c18=1128&v18=D%3Dc18&c19=20110429&v19=D%3Dc19&c20=1&v20=D%3Dc20&c31=135834315,135834312,135834310,133188451,127940536,103537970&v31=D%3Dc31&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></p></p> Fri, 29 Apr 2011 08:47:00 -0500 http://www.wbez.org/story/2011-04-29/cheap-drug-beats-pricey-one-treating-vision-loss-elderly-85839 Banishing Wrinkles With Botox May Make You Miss Others' Emotions http://www.wbez.org/story/2011-04-25/banishing-wrinkles-botox-may-make-you-miss-others-emotions-85657 <img typeof="foaf:Image" src="http://llnw.wbez.org/npr_story/photo/2011-April/2011-04-25/eyes_custom.jpg" alt="" /><p><p>A few well-placed <a href="http://www.botoxcosmetic.com/home.aspx">Botox</a> injections can erase your hard-won character lines. But that may also make you less likely to pick up on <em>other </em>people's emotions.</p><p>That's because the botulinum toxin, which reduces wrinkles by temporarily paralyzing small muscles in the face, can make it hard to furrow the brow or make other expressions that convey emotion. And our own facial expressions, researchers now <a href="http://spp.sagepub.com/content/early/2011/04/21/1948550611406138.abstract" target="_self">show</a>, may be essential to recognizing the feelings of others.</p><p>This unexpected Botox effect is a fascinating window on how we understand what other people are feeling. A good part of that process requires unconscious mimicry of the other person's facial expression.</p><p></p><p>Think about it. Don't you often smile when someone smiles at you? Put on a worried or dismayed face when a friend looks troubled? Tear up when someone else cries?</p><p>"The tendency to mimic facial expressions is rapid, automatic and highly emotion-specific," write <a href="http://psychology.usc.edu/people/faculty_display.cfm?person_id=1027134">David Neal</a> and <a href="http://psychandneuro.duke.edu/people?subpage=profile&Gurl=%2Faas%2Fpn&Uil=tanya.chartrand">Tanya Chartrand</a> in an intriguing paper just published online by <em>Social Psychological and Personality Science.</em></p><p><em> </em></p><p>Neal and Chartrand say the subtle contraction of our facial muscles when we mirror a friend's happiness or woe generates a feedback signal to our brains. Those incoming signals from facial nerves help the brain interpret how the other person is feeling.</p><p>It's all part of neuroscientists' recent focus on so-called "<a href="http://www.edge.org/3rd_culture/ramachandran06/ramachandran06_index.html">mirror neurons</a>" – the brain cells that give us the power to empathize (to "feel with") someone else.</p><p>It's not easy to prove the existence of what psychologists call "<a href="http://www.psychologicalscience.org/observer/getArticle.cfm?id=2606">embodied cognition</a>" – the idea that the body influences the mind as well as the other way around.</p><p>Botox gave the researchers the opportunity to dampen the neural feedback from study subjects' facial muscles without introducing any drugs to the brain (Botox injected into the face does not get into the brain), or asking them to make a conscious effort to remain expressionless.</p><p>In one experiment, the researchers recruited 31 women who were already having either Botox treatments or injections of a <a href="http://www.dermanetwork.org/information/dermalfillers.asp">dermal filler</a>, which plumps up wrinkles but doesn't paralyze muscles. After the treatment, the women were shown a series of images that showed people's eyes embodying different emotional states. Study subjects were asked to judge, as quickly as possible, what emotion the eyes conveyed.</p><p>The Botox patients scored significantly worse than those who got a dermal filler. That meant the Botox patients' ability to make fast judgments about another person's emotions was blunted. (The Botox didn't eliminate their ability to judge emotion. They still were about 70 percent accurate.)</p><p>Neal and Chartrand then tested the opposite of the Botox effect. That is, they looked at how people judged emotive expressions when the feedback from their own facial muscles was amplified, rather than damped-down.</p><p>To do this, they painted one of those face-mask gels on subjects' temples and foreheads. When the gel dried and tightened, it provided resistance to subjects' facial muscles whenever they smiled, frowned or furrowed their brows. That amplified the neural feedback from muscles to brain.</p><p>Sure enough, people wearing the gel masks did better in judging other people's expressions than controls, who had the gel painted on their forearms. But when the researchers played audio clips of people expressing different emotions in their voices, there was no difference. That meant the improved performance was due to muscle mimicry, not just any emotive input.</p><p>The cognitive implications go well beyond Botox users. But the findings do make Neal and Chartrand wonder if prolonged use of Botox would hobble people's ability to perceive others' emotions and give others empathetic facial feedback.</p><p>"Mimicry promotes liking and emotional sharing," the researchers say, "and may contribute to long-term relationship satisfaction."</p><p>Having a Botox mask may undermine those bonds. </p> Mon, 25 Apr 2011 15:21:00 -0500 http://www.wbez.org/story/2011-04-25/banishing-wrinkles-botox-may-make-you-miss-others-emotions-85657 Prominent Surgeon Resigns Post After Backlash Over Editorial http://www.wbez.org/story/doctors/2011-04-18/prominent-surgeon-resigns-post-after-backlash-over-editorial-85346 <img typeof="foaf:Image" src="http://llnw.wbez.org/npr_story/photo/2011-April/2011-04-18/greenfield_lazar_vert.jpg" alt="" /><p><p>The American College of Surgeons, the leading group for the profession, will have a new president come this fall.</p><p>But it won't be <a href="http://surgery.med.umich.edu/portal/about/emeritus/faculty/greenfield_bio.shtml">Dr. Lazar Greenfield</a>, a distinguished vascular surgeon who last year was honored by the group with an <a href="http://www.facs.org/news/jacobson10.html">award for innovation</a> and who was until this weekend the college's president-elect.</p><p>Though he may be an ace in the operating room, Greenfield, a professor emeritus at the University of Michigan, proved tone deaf — or worse — as a writer and editor. In a Valentine's Day editorial for <em>Surgery News</em>, a <a href="http://www.nxtbook.com/nxtbooks/elsevier/sn0411/#/0">publication affiliated</a> with the ACS, Greenfield extolled the virtues of semen as a mood-enhancer for women. That editorial proved his undoing.</p><p></p><p>The piece recounted a bunch of different studies and concluded:</p><p><blockquote></p><p>So there's a deeper bond between men and women than St. Valentine would have suspected, and now we know there's a better gift for that day than chocolates.</p><p></blockquote></p><p>Well, that didn't sit well with quite a few people. The entire February issue of <em>Surgery News</em> was pulled from the Web. And complaints poured into the American College of Surgeons.</p><p>"I was aghast," <a href="http://www.mc.vanderbilt.edu/root/vumc.php?site=vascularsurgery&doc=28065">Dr. Colleen Brophy</a>, a professor of surgery at Vanderbilt University and an ACS member for more than two decades, told Dr. Pauline Chen, who <a href="http://well.blogs.nytimes.com/2011/04/15/sexism-charges-divide-surgeons-group/">wrote about the controversy</a> on the <em>New York Times</em>'s Well blog last week. Brophy resigned from the group to protest how it mishandled things.</p><p>The blog Retraction Watch has been all over the case, and you can read the full text of the editorial <a href="http://retractionwatch.wordpress.com/2011/04/06/forget-chocolate-on-valentines-day-try-semen-says-surgery-news-editor-retraction-resignation-follow/#comments">there</a>. Pretty quickly, Lazar lost his job as editor of <em>Surgery News</em> because of the editorial.</p><p>And, as Retraction Watch <a href="http://retractionwatch.wordpress.com/2011/04/17/semen-editorial-costs-greenfield-presidency-of-american-college-of-surgeons/#more-2332">reported</a>, Lazar has now been replaced as president-elect of ACS by <a href="http://www.upstate.edu/surgery/healthcare/breastcare/">Dr. Patricia J. Numann</a> of Syracuse, N.Y.</p><p>Lazar <a href="http://www.nytimes.com/2011/04/18/health/18surgeon.html?_r=1">told</a> the <em>New York Times</em> in a statement that he had apologized many times but ultimately resigned to put an end to the "disruptive issue." Copyright 2011 National Public Radio. To see more, visit <a href="http://www.npr.org/">http://www.npr.org/</a>.<img src="http://metrics.npr.org/b/ss/nprapidev/5/1303150070?&gn=Prominent+Surgeon+Resigns+Post+After+Backlash+Over+Editorial&ev=event2&ch=103537970&h1=Treatments,Doctors,Health+Headlines+Newsletter,Shots+-+Health+Blog,Health,Health+Care,Home+Page+Top+Stories,News&c3=D%3Dgn&v3=D%3Dgn&c4=135507352&c7=1128&v7=D%3Dc7&c18=1128&v18=D%3Dc18&c19=20110418&v19=D%3Dc19&c20=1&v20=D%3Dc20&c31=133188451,126948545,121027244,103537970&v31=D%3Dc31&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></p></p> Mon, 18 Apr 2011 08:57:00 -0500 http://www.wbez.org/story/doctors/2011-04-18/prominent-surgeon-resigns-post-after-backlash-over-editorial-85346