Choosing Wisely: With Your Physician The explosion of medical research and new knowledge continues, providing scientific bases to either support interventions recommended by doctors or demonstrate their ineffectiveness. The availability of this data, and the myriad opinions that accompany it, permeate the internet and inform the general public about ways to approach medical problems. So much information can be challenging to navigate for both patients and physicians. The approach to medical decision making has evolved
over the decades. When confronted with medical recommendations and decisions, most individuals have relied on the knowledge and experience of their doctors to determine what course would be best for them to follow. This follows the traditional role of physicians as the final determinant for "what is best" for the person they are treating. Now, the approach to medical decision making is becoming more of a shared process. Decisions that have often involved just the doctor and patient now may involve family members and caregivers – all with varying opinions of how to
approach a medical problem. Goals of medical decisions have traditionally revolved around sustaining life or adding years of life. More nuanced choices have developed around issues of quality of life, not just around "staying alive." Quality-of-life goals are very individualized – and not necessarily the targeted goals of the published medical trials that often form the scientific basis of medical decisions. A set of recommendations have been developed by multiple medical societies to foster the quality-of-life discussion between patients and physicians. The Choosing Wisely campaign
was developed by the American Board of Internal Medicine Foundation to address issues and questions that often arise in patient care and to help provide scientific guidance for physicians making medical recommendations. Its recommendations can be reviewed at choosingwisely.org Additionally, the American Geriatrics Society has provided a set of 10 recommendations for physicians related to the qualityof-life care of older individuals. The list is as follows: ….Read More
For 81-year-old body builder, exercise is the key to staying young Ernestine Shepherd, 81, came to Aurora Saturday to say that exercise should be a key part of everyone’s day, including senior citizens. Shepherd hasn’t let age stop her from being a bodybuilder, she said to a crowd of at least 100 at the African-American Health Coalition’s 13th annual Community Health Fair at Aurora Christian School. Shepherd said she did not embrace serious training until about a decade ago but that she had begun working out in her mid-50s after she and her sister were invited to a church picnic
“and didn’t like the way we looked in our bathing suits.” “This exercising and training started as result of vanity,” Shepherd admitted. “My sister Velvet was 57 at the time, and I was 56. I lost her not long after to a brain aneurysm, and I vowed to keep the promise I made over 25 years ago to continue this journey as long as I have the strength.” Shepherd unveiled a shirt before the crowd with a message that she said epitomizes everything she does. “I have the words, ‘Determined, Dedicated, and
Discipline to be fit’ and that encompasses everything I do,” Shepherd said. “I feel if you use your mind and follow the three Ds, you can’t fail.” Shepherd’s personal trainer and manager, Yohnnie Shambourger, spoke from Washington, D.C., the day before Shepherd’s arrival and said he met his prized pupil when she was 71 and attending a body building show he was promoting. “I remember seeing Ernestine in the audience” Shambourger recalled. “I later saw her again at another event and she told me
she wanted to compete and wanted me to train her. She wasn’t sure she could do it.” When they began working together, Shambourger said, Shepherd was living an hour away in Baltimore and would commute to his fitness center twice a week along with doing online video sessions. After seven months, Shepherd’s “transformation was remarkable,” he said….Read More
New UCSD flu discovery could block illness entirely Scientists led by a UC San Diego chemist reported progress recently in researching a universal flu drug, effective regardless of the strain. Seth Cohen, a UCSD professor and co-founder of San Diego's Forge Therapeutics, said the drug inhibits a critical viral enzyme by jamming molecular machinery common to all strains. It could reduce the flu's severity or perhaps block it completely.
The drug blocks an enzyme containing the metal manganese. Such metalloenzymes form the basis of Forge's technology, which is currently directed toward developing antibiotics, not antivirals. "This enzyme is a component that allows the virus to steal the cellular machinery, so that the virus can reproduce using the human cells," Cohen said. The drug interrupts this process by binding to the manganese ions. While the results were only
observed in lab testing of the viral enzyme, called RNA polymerase, further development in animal testing and eventually humans appears feasible, Cohen said. UCSD retains the rights to the technology, so Forge or another company would need to license it to bring it to the market. The results were presented at the 255th National Meeting & Exposition of the American Chemical Society in New Orleans. The drug is a modified
version of another compound Forge developed. The original compound bound to one of two manganese ions in the enzyme. The new version binds to both, making it much more effective, Cohen said. Next, the effectiveness of the enzyme inhibitor needs to be tested against the entire virus, not just the enzyme. If the virus cannot mutate to bypass the drug, it should be effective therapeutically….Read More
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