Healthy Life

How CAR-T works
You’ve read about the FDA’s recent approval of a promising type of immunotherapy called CAR-T cell therapy, that is, a treatment strategy that harnesses the natural ability of the body’s own immune cells to attack and kill tumor cells. Here’s how it works, in (almost) layperson’s terms, according to a blog by National Institutes of Health Director Dr. Francis Collins. CAR-T cells have been called “a living drug” because doctors collect and manipulate a patient’s own immune cells to treat his or her cancer. Specifically, the harvested T cells are genetically engineered to produce new surface proteins (the CARs, or chimeric antigen receptors) that allow them to recognize and attack cancer cells more effectively. After expanding the number of these enhanced T cells, doctors infuse them back into patients to soup up their immune systems.

Grapefruit juice and drugs often don’t mix
Grapefruit juice and the actual grapefruit can be part of a healthy diet, says the FDA. Grapefruit has vitamin C and potassium – nutrients your body needs to work properly. But it isn’t good for you when it affects the way your medicines work, especially if you have high blood pressure or arrhythmia (irregular or abnormal heart beat). This food and drug interaction can be a concern, says Shiew Mei Huang, PhD, of the U.S. Food and Drug Administration. The FDA has required that some prescription and over-the-counter (OTC) drugs taken by mouth include warnings against drinking grapefruit juice or eating grapefruit while taking the drug, Huang says. Here are examples of some types of drugs that grapefruit juice can cause problems with (interact):

  • Some statin drugs to lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin).
  • Some drugs that treat high blood pressure, such as Procardia and Adalat CC (both nifedipine).
  • Some organ-transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine).
  • Some anti-anxiety drugs, such as buspirone.
  • Some corticosteroids that treat Crohn’s disease or ulcerative colitis, such as Entocort EC and Uceris (both budesonide).
  • Some drugs that treat abnormal heart rhythms, such as Pacerone and Nexterone (both amiodarone).
  • Some antihistamines, such as Allegra (fexofenadine).

Grapefruit juice does not affect all the drugs in the categories above. The severity of the interaction can be different depending on the person, the drug, and the amount of grapefruit juice you drink. Talk to your doctor, pharmacist or other health care provider and read any information provided with your prescription or OTC drug.

Time to push it.
The Moov HR Burn is a chest strap that pairs wirelessly with a free app that talks to you, guiding you in real time through four indoor exercise classes, as well as outdoor runs and indoor cycling workouts, according to Bloomberg. The “coach” reads your heart rate to check whether you’re working hard enough. If she decides you aren’t, she’ll scold you – “Time to push it.” Moov HR Burn costs about $60.

VR: Pain-relieving alternative to opioids
In a Los Angeles hospital a short drive from Hollywood, some patients are tapping into virtual reality. But at Cedars-Sinai Medical Center, 3D technology is there not for entertainment, but pain relief. Patients in chronic or acute pain have put on special goggles and traveled virtually through Iceland’s waterfalls and valleys, floated among dolphins or meditated beside an idyllic coastline, according to an article in the Wall Street Journal. Brennan Spiegel, a Cedars-Sinai researcher, says a virtual-reality experience can reduce pain by 24 percent or more, according to clinical trials he conducted in the past two years. VR eased different types of pain, from cancer to orthopedic injuries to abdominal discomfort. An immersive virtual-reality experience can commandeer a patient’s brain so it no longer focuses on pain, says Spiegel, a gastroenterologist and professor of medicine. “It doesn’t work on everybody, but when it works, it really, really works.”

Diabetes and young people
Rates of new diagnosed cases of type 1 and type 2 diabetes are increasing among youth in the United States, according to a report, “Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012,” published in the New England Journal of Medicine. In the United States, 29.1 million people are living with diagnosed or undiagnosed diabetes, and about 208,000 people younger than 20 years are living with diagnosed diabetes. This study is the first ever to estimate trends in new diagnosed cases of type 1 and type 2 diabetes in youth (those under the age of 20). The “SEARCH for Diabetes in Youth” study, funded by the Centers for Disease Control and Prevention and the National Institutes of Health, found that from 2002 to 2012, incidence, or the rate of new diagnosed cases of type 1 diabetes in youth, increased by about 1.8 percent each year. During the same period, the rate of new diagnosed cases of type 2 diabetes increased even more quickly, at 4.8 percent. The study included 11,244 youth ages 0-19 with type 1 diabetes, and 2,846 youth ages 10-19 with type 2. “Because of the early age of onset and longer diabetes duration, youth are at risk for developing diabetes-related complications at a younger age. This profoundly lessens their quality of life, shortens their life expectancy, and increases health care costs,” said Giuseppina Imperatore, M.D., Ph.D., epidemiologist in CDC’s Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion.

Early diagnosis of ALS
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease in which motor neurons – the brain and spinal cord cells that control muscle activity – gradually die off. As motor neurons degenerate or die, they stop sending signals to muscles. Unable to function, the muscles weaken and waste away. This can affect a person’s ability to chew, walk, breathe, and talk. ALS is progressive, meaning the symptoms get worse over time. Currently, there’s no cure and no effective treatment to halt progress of the disease. A protein in motor neurons called p75 is important in early life, but doesn’t appear in adults unless motor neurons are injured, reports the National Institutes of Health. Previous studies in mouse models of ALS found that p75 was re-expressed in motor neurons as the animals became sick. The part of p75 that sticks out from the cells – its extracellular domain – was found in the urine of the mice even before they exhibited muscle weakness. A research team, funded by NIH, analyzed urine samples from 54 patients with ALS and 45 healthy controls, and found correlation between p75 levels and the progression of ALS. The findings “indicate the possibility of assessing whether levels of that protein decrease while patients try future treatments, to tell us whether the therapies are having any beneficial effects,” said Dr. Amelie Gubitz, a program director at NIH.

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