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Mutations In Father’s Sperm Can Predict Children’s Autism

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There’s no question that autism can be traced to a combination of genetic and environmental factors. One genetic contributor in particular has in recent years intrigued scientists studying autism: DNA mutations originating in fathers’ sperm.

Studies have linked autism risk to de novo mutations, or changes in DNA that arise spontaneously in sperm as the germline cell develops, or in the embryo after fertilization. Researchers estimate that such mutations might be involved in anywhere from 10% to 30% of autism cases, and that the older a father is at the time of conception, the higher the chance his sperm will result in de novo mutations that can contribute to autism spectrum disorder. In fact, with every decade of life, the number of de novo mutations in sperm doubles.

In a new study published in Nature Medicine, researchers led by a team at the University of California, San Diego (UCSD) set out to determine if they could match specific disease-causing genetic mutations in the DNA of children with autism to the same mutations in their fathers’ sperm.

The team analyzed DNA from eight sets of fathers and children. In the children, they looked for a phenomenon called mosaicism, which are genetic differences even among cells from the same person. Each time a cell divides, the process can generate mutations, or genetic mistakes—some can be harmful (for example, some can lead to cancer), but most are not because they occur outside of important genes in what are known as “DNA deserts.”

The researchers then matched these changes found in the children to those found in their fathers’ sperm. That confirmed that the de novo mutations were indeed playing some role in contributing to autism.

The researchers also determined what percentage of sperm produced by the father contained these de novo mutations. This knowledge, say the study authors, could potentially lead to a test that can help fathers of children with autism to know how likely they are to have another child affected by the condition.

Eventually, the genetic test could also tell parents-to-be if they are at increased risk of having a child with autism. The DNA sequencing technology used is basically the same as used for whole genome sequencing, and the price for that continues to drop, so this wouldn’t be an especially expensive tool.

Inhibitor CocktailsCurrently around 165 genetic mutations have been linked to autism, and conducting a deep analysis of a potential father’s sperm for some of these aberrations could let him know if he is at higher or lower risk of fathering a child who might be affected by autism. (The list of implicated genes continues to grow at a rapid pace, and at the time of the study, the scientists worked with a smaller number of culprit genetic variants).

In some of the eight fathers in the study, up to 10% of their sperm carried mutations; if these men decided to have more children, they would have the option of choosing whether they wanted to take measures to reduce the risk their children would be affected. Some, for example, might use IVF so they could screen their embryos for the mutations.

By Alice Park December 23, 2019

you wouldn't settle for one star products. why settle for a 1 star bank?

Source: Mutations In Father’s Sperm Can Predict Children’s Autism

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Part of the joy and challenge of being a parent is making sacrifices so your children can hit traditional milestones: a high school graduation, going off to college, starting a life of their own. But for some parents – like Barbara Rivera, a mother of three with two autistic children – the sacrifices are far greater and the milestones far different than what she expected. (Caregiving; Season 2, Episode 8. Original Air Date: Saturday, December 20, 2014.)

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Robotic Prostatectomy Surgery

Also known as robotic prostatectomy, this minimally invasive procedure is performed with the assistance of advanced surgical technology and an experienced laparoscopic surgery team.

Robotic-assisted radical laparoscopic prostatectomy is accomplished using the da Vinci® Surgical System, a sophisticated robotic surgery system that allows surgeons to operate on the prostate with enhanced vision, control and precision.

Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patient’s abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is much less invasive than a conventional radical retropubic prostatectomy, which involves an abdominal incision that extends from the belly button to the pubic bone.

During robotic-assisted radical prostatectomy, a three-dimensional endoscope and image processing equipment are used to provide a magnified view of delicate structures surrounding the prostate gland (e.g., nerves, blood vessels and muscles), allowing optimal preservation of these vital structures. The prostate is eventually removed through one of the keyhole incisions.

For most of the surgery, the surgeon is seated at a computer console and manipulates tiny wristed instruments that offer a range of motion far greater than the human wrist. The surgery is performed without the surgeon’s hands entering the patient’s body cavity.

Benefits of Robotic Surgery

Compared with traditional open surgery, patients who undergo robotic-assisted radical prostatectomy experience:

  • Less blood loss
  • Less pain
  • Shorter hospital stays
  • Faster recovery times (although catheter needs to remain in bladder for same amount of time after robotic or open procedure).

Risks of Robotic-Assisted Laparoscopic Radical Prostatectomy

The potential risks of robotic-assisted laparoscopic radical prostatectomy include the following:

  • Bleeding
  • Infection at the surgical site
  • Adjacent tissue/organ damage

Side Effects of Robotic-Assisted Laparoscopic Radical Prostatectomy

The rates of major side effects from robotic-assisted laparoscopic radical prostatectomy are about the same as open surgical approaches. The most common side effects include the following:

  • Urinary incontinence (inability to control urine): Similar to open surgery, urinary incontinence can occur following a robotic prostatectomy. However, this side effect often improves over time.
  • Erectile dysfunction (impotence): The return of erectile function following prostatectomy is based on the patient’s age, degree of preoperative sexual function and whether the nerves were spared during surgery. Unless cancer is suspected in the nerve tissue, surgeons will use nerve-sparing techniques during robotic prostatectomy to minimize the surgical impact on sexual function.

Prostate Cancer: When to Treat Versus When to Watch

Because certain prostate cancers grow very slowly, your doctor might determine that it’s not likely to present a significant threat to you. This is particularly true if a prostate cancer is localized, meaning it hasn’t spread beyond the prostate.

If that’s the case, you and your doctor can discuss getting regularly tested instead of undergoing treatment right away. Doctors call this approach active surveillance. By not rushing into treatment for a cancer that may not cause you any harm, this approach helps many men avoid treatment-related side effects.

Active surveillance , or active monitoring, means your doctor will monitor you closely, watching to see how the cancer progresses, if at all. This is primarily for cancers that doctors classify as:

  • Slow-growing
  • Very low risk for causing symptoms

To monitor a low-risk prostate cancer, someone on active surveillance could undergo:

  • Rectal exam : Every six months
  • PSA test : Twice a year. This blood test, commonly used to screen for prostate cancer, measures how much prostate-specific antigen (PSA) is in your blood.
  • Biopsy : Once a year (until and unless your doctor determines a less frequent biopsy is warranted)
  • MRI scan : Necessary in some cases to show more details of a cancer if your doctor has any questions or concerns from your test results

Prostate Cancer Treatment: When Watching May Be Enough

Your doctor will consider many factors before deciding whether this approach is right for you. This includes:

  • Gleason score : This scoring system grades how aggressive a prostate cancer is. It also gives doctors hints as to how likely a cancer is to spread. Gleason scores less than 7 are considered lower risk and might be appropriate for active surveillance.
  • Biopsy results : A prostate biopsy (removing tissue samples from the prostate) is the only definitive way to diagnose prostate cancer today. After a prostate biopsy, your doctor will count how many of the samples contain cancer. For biopsies that show three or fewer samples (or cores) with cancer, your doctor might recommend watching you before starting treatment.
  • PSA results : A PSA test is the standard way doctors assess prostate cancer risk. Doctors use PSA test results along with information about your prostate size to measure your PSA density. If PSA density is less than 0.15, you might not need treatment right away.
  • Physical characteristics : Another way your doctor will assess prostate cancer is through a rectal exam. If he or she can’t feel a cancer (via a hard nodule, for example), that’s another sign that could point to active surveillance as a possible treatment approach.

Source: Robotic Prostatectomy | Johns Hopkins Medicine

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This 3d medical animation provides an overview about the anatomy of the male urogenital system, with the main focus on the prostate. Prostate cancer is shown developing in the tubular ducts of the prostate. All of the general steps are then demonstrated in the animation to show how the cancerous prostate will be robotically removed during a minimally invasive procedure.

What Causes Vertigo and How You Can Treat It

Woman with vertigo

Lauren Gerlach was in the middle of a workout video, doing leg lifts that required bending over and steadying herself on the back of a chair, when it began: “This wave of nausea hit, and the room began whirling around me,” she recalls. The sensation lasted for about 10 seconds, and because Gerlach, 45, had been prone to bouts of motion sickness in the past, she dismissed the episode. But in the days following her workout, she felt a little dizzy and unsteady on her feet.

Then one night Gerlach awakened from a sound sleep and shot straight up in bed. “I looked across at the TV, which I always leave on when I sleep,” she says. “It was literally spinning in a circle — at least, that’s how I saw it.” She raced to the bathroom and was sick.

That’s vertigo. Almost 40 percent of adults in the U.S. will experience this unsettling sensation at some point in their lives, according to the University of California San Francisco. Defined as “an illusion of motion,” vertigo is a very specific type of dizziness. “If you have an illusion that you’re moving and you’re not, or have an illusion that the world is moving about you when it’s not, you are having vertigo,” says Steven Rauch, a Boston-based ENT-otolaryngologist affiliated with Massachusetts Eye and Ear Hospital and Massachusetts General Hospital.

A lot of people assume that vertigo has to be a spinning sensation, says Rauch, but it could be rocking, swaying, tumbling, or a feeling of bouncing up, as if you were on a pogo stick.

Causes

Many things can bring on a bout of vertigo, including inner ear infections, migraines and even some medications, including those used to treat high blood pressure or anxiety. But one of the most common causes, as Gerlach discovered after a doctor visit, is an inner-ear condition with a tongue twister of a name: benign paroxysmal positional vertigo (BPPV). About half of all people over age 65 will suffer an episode of BPPV, according to the Cleveland Clinic, and the Mayo Clinic says women are particularly prone. Along with the “Whoa, what the heck …?” sensation, people may also experience lightheadedness and a wonky sense of balance. Queasiness and vomiting may also be part of the package.

BPPV occurs when tiny calcium carbonate crystals, which normally reside in an inner-ear organ called the utricle and help you keep your balance, break loose and travel into the semicircular canals of the inner ear. This may simply be part of the normal aging process. “BPPV is a degenerative change in the inner ear,” says Rauch. “A degenerative utricle will shed crystals from time to time, like shingles falling off the side of an old house.”


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Sometimes it’s a bump on the head that dislodges the crystals.

“BPPV is positionally triggered,” says Kim Bell, a San Diego-based doctor of physical therapy who specializes in vestibular rehabilitation. That means when you move your head in certain ways — dropping it forward to pick something up off the floor or attempting a Downward-Facing Dog yoga pose, for instance — you can cause these crystals to move and bring about an attack of vertigo.

It’s often triggered when you’re lying down: You go to bed feeling perfectly fine, then roll over toward your bad ear to get out of bed in the morning, and wham!

The shifting of the crystals sends a faulty signal from your inner ear to your brain about how you’re moving, which leads to that “world is spinning” sensation.

Those dizzy spells typically last for less than a minute but can return anytime you pitch your head and trigger another brief, brisk spin. Some attacks can be merely annoying, says Brian McKinnon, an ENT-otolaryngologist in Philadelphia: “Others can be debilitating and dangerous, making you feel off-balance and putting you at risk for falls.”

Treatment

BPPV usually goes away on its own within weeks of the first episode, though it can last for months or even years. If you want immediate relief from those bouts of spinning, you might consider something called the Epley maneuver. The treatment — typically performed by a vestibular rehabilitation therapist (a specially trained physical therapist), occupational therapist, audiologist or ENT — involves moving the head in a series of precise positions, allowing the crystals to migrate out of the semicircular canals back to the original vestibular organ they came from — the utricle. “It’s kind of like playing one of those small, handheld pinball games,” says Bell, “tipping it right and left, trying to get the silver ball through the maze.”

Typically, BPPV can be eliminated in about 85 to 90 percent of patients with just one or two treatment sessions, though it can recur periodically. “A few of those little crystals get loose and the whole thing starts all over again,” says Rauch. If this happens, your doctor or therapist can teach you how to perform the Epley maneuver on your own at home.

Even after BPPV has been treated, some people have residual symptoms of imbalance or unsteadiness. These can be resolved by working with a vestibular rehabilitation therapist — basically, using specific exercises to help patients regain their stability. It might include walking on different types of surfaces, stepping over thresholds, or maintaining one’s balance in a stationary position.

Unsettling symptoms aside, BPPV isn’t life-threatening. “If your symptoms are centered exclusively around the ear, and you want to wait it out, there’s probably no big danger in doing that,” says Rauch. However, he notes, there are times when dizziness can point to more serious disorders, such as heart disease, stroke, diabetes, brain tumors or multiple sclerosis. If you have symptoms in any other part of your body — say, your vision has changed, or you have numbness, weakness, confusion or slurred speech — it’s worth taking a trip to the ER and getting it checked out by a doctor.

Source: What Causes Vertigo and How You Can Treat It

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Vertigo can make you feel as though you’re moving when you’re not. In this video, expert otolaryngologist Mr Richard Irving outlines the different conditions that can cause vertigo and what treatment for each condition looks like. Book a consultation wth Mr Irving: https://www.topdoctors.co.uk/doctor/r…

CBD Oil for Parkinson’s Disease

Every year in the United States, approximately 60,000 individuals are newly diagnosed with Parkinson’s disease according to the Parkinson’s Foundation (PF).[1]

The PF adds that, by the year 2020, the number of people living with this medical condition is expected to near one million in total, making it more prevalent than multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease combined.

What is Parkinson’s disease?

The American Parkinson Disease Association (APDA) defines Parkinson’s as “a type of movement disorder that can affect the ability to perform common, daily activities.”[2]

Unlike other movement disorders, Parkinson’s disease is characterized by a loss of brain cells, specifically those in the substantia nigra region. This lowers dopamine levels which causes issues related to movement regulation, thus impacting the patients’ quality of life.

Parkinson’s disease is both chronic and progressive, making this movement disorder one that is long-lasting, while also worsening as time progresses.

Also, though it typically appears after the age of 50, roughly one in ten Parkinson’s disease patients are diagnosed at a younger age. This is called Early Onset Parkinson’s.

Symptoms of Parkinson’s tend to vary from person to person and fall into one of two categories: motor symptoms and non-motor symptoms.

The APDA shares that it is the motor symptoms of Parkinson’s that typically make these typical daily movements more difficult, some of which include experiencing tremors, having stiff or rigid muscles, walking difficulties, slowness of movement (also known as bradykinesia), and postural instability.

Another motor symptom Parkinson’s disease patients tend to notice is a change in their voice. Changes in volume are common in the early stages, whereas speaking fast, crowding words, and stuttering are more prevalent in advanced stages of this disease.

Parkinson’s symptoms that don’t involve movement and are therefore sometimes missed, include:

  • Reduced sensitivity to smells
  • Trouble staying asleep
  • Increased depression and anxiety
  • Psychotic symptoms such as hallucinations and delusions
  • Fatigue
  • Weight loss
  • Excessive sweating
  • Difficulty multi-tasking
  • Harder time with organization
  • Constipation
  • Increase in urinary frequency and urgency
  • Lightheadedness
  • Reduced libido
  • Slower blinking and dry eyes

Currently, there is no cure for Parkinson’s. However, patients do have a few treatment options that can help manage this particular medical condition.

One is taking a medication to help better manage motor function. Two well-known options include Levodopa and Carbidopa, both of which can be prescribed in varying strengths and formulations.

Another common Parkinson’s treatment is therapy. For instance, physical therapy may be pursued to aid in walking and occupational therapy can help enhance fine motor skills. Speech therapy may also be required to assist with vocal issues.

Deep brain stimulation is an option as well. Approved by the U.S. Food and Drug Administration (FDA) several years ago, this treatment method is a form of surgical therapy in which an electrode is implanted in the brain, then stimulated via a device that is placed in the chest area under the skin.

The APDA further indicates that complementary medicine such as yoga and massage can also provide relief from symptoms of PD as well. Research is also finding that CBD oil can potentially help too.

CBD is short for cannabidiol, a chemical compound found within the cannabis plant that binds to cannabinoid receptors located in the body’s endocannabinoid system.[3]

CBD is different than other cannabinoids found in the marijuana plant that are known for producing the high commonly associated with medical marijuana use. This includes tetrahydrocannabinol (THC) and a similar cannabinoid, tetrahydrocannabivarin (THCV). Both THC and THCV can produce this high effect, whereas CBD does not.[4]

Additionally, our bodies do produce some cannabinoids on its own. These are called endogenous cannabinoids because they are so similar to cannabis plant compounds. CBD works by mimicking and augmenting these natural cannabinoids, providing a more therapeutic effect.

Admittedly, information in this field is still emerging, primarily because the endocannabinoid system is a relatively new finding due to the first endocannabinoid not being discovered until 1992.[5]

After the second one was identified three years later, researchers began to realize that the human body has an entire endocannabinoid system that offers positive effects related to bone density and diabetes prevention.

Since that time, research has also connected CBD with providing benefits for Parkinson’s disease.

For instance, one 2018 study published by Frontiers in Pharmacology shares that CBD helps by increasing levels of the endocannabinoid anandamide, an agonist of cannabinoid receptors.[6] It is also thought to aid in other processes found helpful for Parkinson’s patients, such as those related to serotonin receptors like 5-HT1A, peroxisome proliferator-activated receptors, and more.

Other studies shared by the National Institute of Health (NIH) have found similar results. Specifically, they indicate that the study of CBD in relation to Parkinson’s disease is especially interesting because of the direct relationship between endocannabinoids, cannabinoid receptors, and the neurons associated with this neurodegenerative disease that impacts the central nervous system.[7]

Another piece of research, this one published in the journal Cannabis and Cannabinoid Research, indicates that many clinical trials have been conducted in this area. [8] Though some have been inconclusive or controversial, others have found that CBD has positive effects on some of Parkinson’s motor symptoms.

One such study looked at 22 patients who engaged in the medical use of cannabis, which contains CBD.[9] In this case, improvements were noted in regard to tremor, rigidity, and bradykinesia 30 minutes after using medical marijuana.

Other pieces of Parkinson’s research have found that CBD can also help relieve non-motor symptoms. For instance, an open-label study—meaning that there is no placebo group, so the subjects know that they’re receiving active treatment—found that, after being taken for four weeks, CBD helped reduce psychotic symptoms.[10]

Another double-blind trial involved 119 Parkinson’s patients who were treated with either 75 mg of CBD per day, 300 mg CBD daily, or a placebo. Although researchers could not establish a statistically significant difference in motor and general symptoms scores, there were significantly different means in relation to their well-being and quality of life.[11]

The Michael J. Fox Foundation for Parkinson’s Research adds that research in this area is somewhat limited due to governmental regulations, with interpretation of results also impacted due to no standardization of CBD doses or use of products containing CBD and THC combined.[12] Therefore, it can be difficult to determine the specific effect CBD can provide to Parkinson’s patients.

Healthline reports that CBD oil has a number of scientifically-proven benefits that extend beyond those related to Parkinson’s.[13] Among them are:

One of the major concerns patients have with the use of CBD oil is whether or not it is legal. Psychology Today stresses that, while many people think that the passing of the 2018 Farm Bill legalized CBD federally, this isn’t exactly the case.[14]

Instead, the Farm Bill only legalized hemp, which is the fibrous stalk of the marijuana plant. Technically, all other parts of the plant are still illegal under the Controlled Substances Act.

What confuses the issue even more is that each state has set its own statutes regarding hemp, medical marijuana, and CBD. For instance, in New York, patients can smoke cannabis, but they aren’t banned from accessing it as a dried flower. However, if you live in Colorado, not only can individuals use medical cannabis, but children can even legally possess it on school campuses if they have status as a medical cannabis patient.[15]

Because of these variations, it is always recommended that Parkinson’s patients check the legality of cannabis use or CBD oil in their individual states before utilizing this option for treatment purposes.

[1] “Statistics.” Parkinson’s Foundation. https://parkinson.org/Understanding-Parkinsons/Statistics

[2] “What is Parkinson’s Disease?” American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/

[3] “What is CBD?” Project CBD. https://www.projectcbd.org/about/what-is-cbd

[4] Rahn, B. “What is THCV and What Are the Benefits of This Cannabinoid?” Leafly. Feb 03, 2015. https://www.leafly.com/news/cannabis-101/what-is-thcv-and-what-are-the-benefits-of-this-cannabinoid

[5] “A History of Endocannabinoids and Cannabis.” UTT BioPharma. https://www.uttbio.com/a-history-of-endocannabinoids-and-cannabis/

[6] Peres, F.F. et al. “Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?” Frontiers in Pharmacology. May 2018; 9:482. Doi:10.3389/fphar.2018.00482. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958190/

[7] Fernandez-Ruiz, J et al. “Endocannabinoids and Basal Ganglia Functionality.” Prostaglandins, Leukotrienes and Essential Fatty Acids. Feb-Mar 2002; 66(2-3):257-67. https://www.ncbi.nlm.nih.gov/pubmed/12052041

[8] Stampanoni Bassi, M et al. “Cannabinoids in Parkinson’s Disease.” Cannabis and Cannabinoid Research. Feb 2017; 2(1):21-29. Doi: 10.1089/can.2017.0002. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436333/

[9] Lotan, I et al. “Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.” Clinical Neuropharmacology. Mar-Apr 2014; 37(2):41-4. Doi: 10.1097.WNF.0000000000000016. https://www.ncbi.nlm.nih.gov/pubmed/24614667

[10] Zuardi A.W. et al. “Cannabidiol for the Treatment of Psychosis in Parkinson’s Disease.” Journal of Psychopharmacology. Nov 2009; 23(8):979-83. Doi: 10.1177/0269881108096519. https://www.ncbi.nlm.nih.gov/pubmed/18801821

[11] Chagas M.H. et al. “Effects of Cannabidiol in the Treatment of Patients with Parkinson’s Disease: An Exploratory Double-Blind Trial.” Journal of Psychopharmacology. Nov 2014; 28(11):1088-98. Doi: 10.1177/0269881114550355. https://www.ncbi.nlm.nih.gov/pubmed/25237116

[12] Dolhun, R. “Ask the MD: Medical Marijuana and Parkinson’s Disease.” The Michael J. Fox Foundation for Parkinson’s Research. May 02, 2018. https://www.michaeljfox.org/foundation/news-detail.php?ask-the-md-medical-marijuana-and-parkinson-disease-a

[13] Kubala, J. “7 Benefits and Uses of CBD Oil (Plus Side Effects).” Healthline. Feb 26, 2018. https://www.healthline.com/nutrition/cbd-oil-benefits

[14] Pierre, J. “Now that Hemp is Legal, Is Cannabidiol (CBD) Legal Too?” Psychology Today. Jan 02, 2019. https://www.psychologytoday.com/us/blog/psych-unseen/201901/now-hemp-is-legal-is-cannabidiol-cbd-legal-too

[15] “Legal Information By State & Federal Law.” Americans for Safe Access. https://www.safeaccessnow.org/state_and_federal_law

Dr. Andrew Colucci

By: Dr. Andrew Colucci

Doctor of Medicine (M.D. cum laude) from Boston University School of Medicine in 2012 – Dr. Colucci is currently a radiologist in MA

Source: CBD Oil for Parkinson’s Disease

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Does medical marijuana help Parkinson’s symptoms? Rachel Dolhun, MD, movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, answers this and other common questions about medical marijuana and Parkinson’s disease. The “Ask the MD” series is intended as an educational resource for people with Parkinson’s and their loved ones. Please consult with your personal healthcare provider to address individual medical questions. The Michael J. Fox Foundation for Parkinson’s Research is dedicated to finding a cure for Parkinson’s disease through an aggressively funded research agenda and to ensuring the development of improved therapies for those living with Parkinson’s today. https://www.michaeljfox.org We gratefully acknowledge the Steering Committee members of our Patient Disease Education Consortium in conjunction with The Albert B. Glickman Parkinson’s Disease Education Program and Charles B. Moss Jr. and family, whose sponsorship allows us to create and distribute materials, while preserving our track record of efficiency in stewarding donor-raised contributions for maximum impact on Parkinson’s drug development. Sponsorship support does not influence MJFF’s content perspective or panelist selection. Note: Tap cc in the lower right corner of the player to enable auto-generated captions for the video.

Study: Women With Dense Breast Tissue May Benefit From Regular MRIs

Breast cancer. Coloured sagittal magnetic resonance imaging (MRI) scans of a breast of a 39- year-old woman with breast cancer. The cancer (orange) has been highlighted by the injection of a gadolinium contrast medium, a contrast medium suitable for use in MRI scans. The front of the breast is at left in each scan, in these views from the side. The cancer is a ductal carcinoma, a carcinoma of the ducts that channel milk to the nipple. Ductal carcinoma is a common form of breast cancer. Breast cancer, the most common cancer in women, can be treated by surgical removal of the affected breast, often combined with radiotherapy and chemotherapy.

While there has been some controversy over when women should start getting mammograms, all experts agree that screening is an important first step in detecting breast cancers and treating them early. But for some women, that’s not enough. For the approximately 40% of women with dense breast tissue, and especially the 10% with extremely dense tissue, cancer cells are harder to detect, since the denser tissue can mask small growths. In addition, dense breast tissue itself is also a risk factor for developing cancer.

There’s been debate among experts over whether these women should have additional screening, on top of mammograms. A new study published in the New England Journal of Medicine provides the strongest data yet to support adding MRI screening to mammograms for women with extremely dense breast tissue.

Previous studies have compared rates of breast cancer in women getting mammograms alone to rates in those getting mammograms and MRI, but it hasn’t been clear that the “cancers” identified in these data sets were actually cancer. That’s because some breast cancers are what experts consider a pre-cancerous stage, known as ductal carcinoma in situ, meaning they may not grow or progress into disease.

That’s led some doctors to worry over potential over-diagnosis of breast cancer, which can lead to over-treatment of lesions that may never develop into tumors. The U.S. Preventive Services Task Force, which attempts to find answers to controversial health questions, has concluded that there is not enough evidence to advise women about the benefits or harms of adding other breast-cancer testing on top of mammograms.

In the new study, Carla van Gils, professor of clinical epidemiology of cancer at the University Medical Center Utrecht, attempted to address this concern by focusing on how many actual cancers the combination of mammogram and MRI can help to detect in women with dense breast tissue. Taking advantage of the fact that the Netherlands has a national cancer registry that includes about 99% of all diagnoses in the country, she and her team studied more than 40,000 women with extremely dense breast tissue, who were randomly assigned to screening with mammography alone or both mammography and MRI.

Each woman in the study was screened once in the two year study period (following the Netherlands’ screening guidelines that call for mammograms every other year for women over 50). Van Gils and her team analyzed how many invasive cancers were detected in between screenings, which serves as a measure for how effective the MRI was in detecting what the researchers call interval cancers—those diagnosed after a negative mammogram, and before the next mammogram was scheduled.

“If we can prevent those, we know at least we are preventing clinically relevant tumors,” says van Gils, “and not just over diagnosing.” They found that the rate of such cancers in women getting both types of imaging was 2.5 per 1,000 screenings, compared to 5 in 1,000 for women just getting mammograms.

The idea is that supplementing mammograms with MRI in the initial screening led to earlier detection of tumors that the mammograms missed which in turn contributed to lower cancer rates during a second screening, because presumably the women are seeing their doctors when suspicious growths are found and getting them treated.

The data do not confirm that combining mammograms and MRIs can lead to fewer deaths from breast cancer; that’s something van Gils will study in coming years. But documenting the reduction in cancer detected in between screenings is an important first step in showing the value of supplemental MRI for women with extremely dense breast tissue.

It also supports the reasoning behind a law passed earlier this year in the U.S. requiring that mammogram reports include an assessment of the density of women’s breast tissue, along with an explanation for why that might make mammogram results more difficult to interpret.

Van Gils notes that the results of her study aren’t robust enough yet to recommend that all women with dense breast tissue (even those with extremely dense breast tissue) should get MRIs on top of their regular mammogram screenings. For one, lowering the rates of false positives for MRIs is still a challenge; training radiologists to become more adept are reading images of dense breast tissue could help, as could applying machine learning technology to pick up subtle changes that even the best-trained human eyes cannot.

That said, if longer-term studies—enabling doctors to compare MRI readings over time to track the growth of lesions—also confirm that supplementing mammograms with MRI can lower death rates from breast cancer, it could push experts to change guidelines and give women firmer advice on how best to manage their cancer risk.

By Alice Park

November 27, 2019

Source: Study: Women With Dense Breast Tissue May Benefit From Regular MRIs | Time

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Dr. Amy Degnim, surgeon at Mayo Clinic, explains what dense breast tissue is and different types of imaging that may be recommended for breast cancer screening. To learn more about breast cancer screening, visit: https://mayocl.in/31AZAoC To request an appointment at Mayo Clinic, visit: https://mayocl.in/2QwVBoc Dense breast tissue makes breast cancer screening more difficult due to its appearance on a mammogram. Other imaging used for screening includes 3D mammogram, breast MRI, breast ultrasound and molecular breast imaging (MBI). More health and medical news on the Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/

The Technologies Driving Tomorrow’s Healthcare Solutions

Robots performing surgeries? New hip joints “printed” on command? “House calls” made from hundreds, even thousands of miles away? What seemed like science fiction just a few years ago has become an everyday reality as technology is revolutionizing the way healthcare is delivered.

Innovation changes health care for the better

Back in 2010, a video of a surgical robot sewing a split grape back together seemed so improbable, it went viral, garnering more than 5 million views [“Suturing a Grape,” YouTube clips (various uploads).] Fast forward to today, and robot-assisted surgery is firmly in the mainstream, used for gallbladder, prostate, gynecologic and kidney surgeries. The benefits of this minimally invasive technique are significant, including faster recovery times, shorter hospital stays, and less patient down time.

3D printing, still in its relative infancy, is already making massive contributions in healthcare. 3D-printed joint components have been used in more than 100,000 hip replacement surgeries over the past decade, according to a GE Report from March of 2018. The next evolution for 3D printing will be even more spectacular, promising the ability to print artificial organs, blood vessels, and even synthetic ovaries.

At a time when there is a shortage of doctors, especially in rural areas, telehealth is becoming a viable alternative to an in-office visit.

Virtual medical providers enable doctors to treat millions of Americans each year through internet and telephone consultations. That’s based on estimates from a recent J.D. Power study from July 2019, which found 9.6% of the adult population has used telemedicine in the past year. More than 75 percent of hospitals use telehealth services, too, as noted by the American Hospital Association Fact Sheet dated February 2019. Patients can consult with a doctor via phone or video, and receive diagnoses and prescriptions. Some employers use telehealth to provide virtual health clinics for employees.

Managing the cost

While such health innovations are exciting, they come at a cost. That’s where supplemental insurance can play a key role, enabling employers to offer a benefits option that provides added financial security over and above traditional health insurance. Beyond financial security, supplemental insurance also offers employees peace of mind.

“Employees are increasingly shouldering the high cost of medical care, especially when it comes to new medical solutions,” says Teresa White, president of Aflac U.S. In fact, 85 percent of employees see the need for supplemental insurance benefits to cover such costs, according to the Aflac WorkForces Report.

Adding to the challenge is the complexity of what’s covered and what isn’t under traditional health insurance.

“Health care today isn’t simple,” says Virgil Miller, Aflac EVP and chief operating officer. “Some consumers are confused by their benefit options and what their health care plans cost and cover. Our annual Aflac WorkForces Report found that just 39 percent of employees have a full understanding of their health insurance policies.

“And with medical debt being the most common reason people fall behind on bills, supplemental benefits such as Aflac’s should be a priority on every smart preparation checklist. Aflac helps cover the expenses health insurance doesn’t.”

Innovations improve insurance, too

Customer concerns like these led Aflac to create online tools like its easy-to-use critical illness calculator. “The calculator makes it easier for consumers to understand typical out-of-pocket heath care expenses and how Aflac’s critical illness coverage can help cover the costs health insurance doesn’t cover,” Miller says.

Aflac sees technological innovation as essential in serving its policyholders. To provide good customer service, Aflac worked with several industry experts on a technique called journey mapping to understand the various touch points and pain points customers have. “Through journey mapping, our customer experience teams created reliable road maps of where we needed to take our technology in the future,” adds Keith Farley, vice president of innovation for Aflac.

One byproduct of this research is an advanced mobile app called MyAflac. With the MyAflac mobile app, policyholders can handle myriad healthcare-related tasks, ranging from filing a claim to signing up for direct deposit of their insurance payments, right from their phones. Combined with Aflac’s One Day PaySM initiative, it helps get payments into the hands of policyholders faster than ever. “Our goal is to help policyholders worry less about finances and focus more on recovery, which can lead to better health outcomes,” adds Miller.

Innovation is woven into every level of Aflac’s culture. Farley points to My Special Aflac Duck as a perfect example of this. “This isn’t just a toy, it is a high-tech robot that interacts with children, helping provide them with comfort as they move through their cancer treatment. As a company, we have been blown away by the response,” Farley says.

The company has invested millions of dollars into this program including donating to cancer research, developing the duck and giving away more than 5,000 of them to pediatric cancer patients at more than 220 hospitals in 47 states.

Innovation is also at the heart of how Aflac designs its benefits policies. Aflac’s cancer policy, for example, helps policyholders take greater advantage of cutting-edge medical techniques. “Genetic testing helps identify potential health risks and help people understand and prepare for potential risks. Screenings can also save lives. Aflac’s cancer policy is designed to reflect the evolution of patient needs and challenges, and it helps cover modern approaches to prevention, early detection and diagnosis, treatment, and ongoing care,” White says.

At Aflac, innovation is more than saving money and improving efficiencies. It is part of its mission to help employers support their employees to lead healthier and happier lives. At the end of the day, it’s about growing consumer trust and satisfaction, Miller says.

One Day PaySM is available for certain individual claims submitted online through the Aflac SmartClaim process. Claims may be eligible for One Day Pay processing if submitted online through Aflac SmartClaim, including all required documentation, by 3 p.m. ET. Documentation requirements vary by type of claim; please review requirements for your claim(s) carefully. Aflac SmartClaim is available for claims on most individual Accident, Cancer, Hospital, Specified Health, and Intensive Care policies. Processing time is based on business days after all required documentation needed to render a decision is received and no further validation and/or research is required. Individual Company Statistic, 2019.

Aflac herein means American Family Life Assurance Company of Columbus and American Family Life Assurance Company of New York. WWHQ | 1932 Wynnton Road | Columbus, GA 31999

By Anita CampbellCEO, Small Business Trends

Source: The Technologies Driving Tomorrow’s Healthcare Solutions

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https://www.job-applications.com/afla… An Aflac benefits consultant talks about the interview process, interview questions, how to get a job and what its like to work for Aflac.

How Exercise Lowers Alzheimer’s Risk by Changing Your Brain

Senior woman on bicycle by beach

More and more studies are showing how regular exercise benefits the brain, and in particular, the aging brain. What’s less clear is how exactly exercise counters the cognitive decline that comes with aging and diseases like Alzheimer’s.

To find out, for nearly a decade, Ozioma Okonkwo, assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health and his colleagues have studied a unique group of middle-aged people at higher risk of developing Alzheimer’s. Through a series of studies, the team has been building knowledge about which biological processes seem to change with exercise.

Okonkwo’s latest findings show that improvements in aerobic fitness mitigated one of the physiological brain changes associated with Alzheimer’s: the slowing down of how neurons breakdown glucose. The research, which has not been published yet, was presented at the annual meeting of the American Psychological Association on Aug. 9.

Okonkwo works with the 1,500 people on the Wisconsin Registry for Alzheimer’s Prevention (WRAP)—all of whom are cognitively normal, but have genes that put them at higher risk of developing Alzheimer’s, or have one or two parents who have been diagnosed with the disease, or both. In the latest study, Okonkwo recruited 23 people from the WRAP population who were not physically active. Eleven were asked to participate in an exercise regimen to improve their aerobic fitness for six months, and 12 served as the control.

All had their brains scanned to track Alzheimer’s-related brain changes including differences in how neurons metabolized glucose, since in people with Alzheimer’s glucose breakdown slows. At the end of the study period, the group that exercised more showed higher levels of glucose metabolism and performed better on cognitive-function tests compared to the controls.

“We are carrying our research full circle and beginning to demonstrate some causality,” says Okonkwo about the significance of his findings.

In their previous work, he and his team identified a series of Alzheimer’s-related biological changes that seemed to be affected by exercise by comparing, retrospectively, people who were more physically active to those who were not.

In this study, they showed that intervening with an exercise regimen could actually affect these processes. Taken together, his body of research is establishing exactly how physical activity contributes to significant changes in the biological processes that drive Alzheimer’s, and may even reduce the effect of strong risk factors such as age and genes linked to higher risk of neurodegenerative disease.

For example, in their earlier work his group confirmed that as people age, the presence of Alzheimer’s-related brain changes increases—including the buildup of amyloid, slower breakdown of glucose by brain cells, shrinking of the volume of the hippocampus (central to memory), and declines in cognitive function measured in standard recall and recognition tests.

But they found that in people who reported exercising at moderate intensity at least 150 minutes a week, as public health experts recommend, brain scans showed that these changes were significantly reduced and in some cases non-existent compared to people who were not active. “The association between age and Alzheimer’s brain changes was blunted,” says Okonkwo, “Even if [Alzheimer’s] got worse, it didn’t get worse at the same speed or rate among those who are physically active as in those who are inactive.”

In another previous study, they found the benefits of exercise in controlling Alzheimer’s processes even among those with genetic predisposition for the disease. When they divided the participants by fitness levels, based on a treadmill test and their ability to efficiently take in oxygen, they found that being fit nearly negated the effect of the deleterious gene ApoE4. “It’s a remarkable finding because it’s not something that was predicted,” says Okonkwo.

In yet another previous study, Okonkwo and his team also found that people with higher aerobic fitness showed lower amounts of white matter hyperintensities, brain changes that are signs of neuron degeneration and show up as brighter spots on MRI images (hence the name). White matter hyperintensities tend to increase in the brain with age, and are more common in people with dementia or cognitive impairment.

They form as neurons degrade and the myelin that surrounds their long-reaching arms—which helps nerves communicate with each other effectively—starts to deteriorate. In people with dementia, that process happens faster than normal, leading to an increase in white matter hyperintensities. Okonwko found that people who were more aerobically fit showed lower amounts of these hyperintensities than people who were less fit.

Given the encouraging results from his latest study of 23 people that showed intervening with exercise can change some of the Alzheimer’s-related brain changes of the disease, he plans to expand his small study to confirm the positive effect that exercise and better fitness can have in slowing the signs of Alzheimer’s. Already, his work has inspired a study launched earlier this year and funded by the National Institutes of Health that includes brain scans to track how physical activity affects biological factors like amyloid and glucose in people at higher risk of developing Alzheimer’s.

The cumulative results show that “there may be certain things we are born with, and certain things that we can’t change ]when it comes to Alzheimer’s risk], but a behavior like physical exercise might help us to modify that,” says Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

By Alice Park

Source: How Exercise Lowers Alzheimer’s Risk by Changing Your Brain | Time

Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

Image result for Cardiac Arrest

If you were walking down the street and a man fell to the pavement clutching his chest, would you know what to do? According to a recent study, of 19,331 out-of-hospital cardiac arrests, there’s a 45 percent chance that someone would rush forward to give the man the CPR he needs.

Important follow-up question: if you were walking down the street and a woman fell to the pavement clutching her chest, would you know what to do? The same study showed that a woman is 27 percent less likely than a man to get CPR from a bystander in public. While there isn’t enough research on the intersecting factors of gender and race, studies looking at race and gender separately suggest that women of color are even less likely to receive bystander CPR.

As half a million Americans will die from cardiac arrest annually, timely CPR is an incredibly important matter. Even as major health organizations train tens of millions of people in resuscitation techniques each year, women still lack equal access to the lifesaving compressions of CPR.

It’s important to look at why bystanders are so much less likely to intervene to save a woman in cardiac arrest. The first barrier is a wildly inaccurate myth that women don’t even experience cardiac arrest. Though many people think heart issues are a “men’s problem,” heart disease actually affects more women than men, killing roughly one woman every minute. Even when bystanders accurately identify that a woman needs CPR, they may be afraid to touch her breasts, confused about where to put their hands, or apprehensive about pushing down hard and fast on a woman’s body.

So, how do we address this laundry list of misconceptions that are literally killing women? The same way we popularized the resuscitation techniques that remarkably double or triple cardiac arrest victims’ chances of survival: through education.

Imagine a CPR manikin (the medical term for the dummies used in training courses), that expressionless, universal human form meant to represent everybody and anybody who could suffer cardiac arrest. See something missing from the manikin’s body? Or rather, two things?

Noticing this shocking oversight, an equal parts pissed-off and inspired team at JOAN Creative had an idea—the WoManikin. The WoManikin is a universal attachment that can easily be slipped over the common flat-chested manikin to add breasts. The WoManikin teaches people how to perform CPR on a torso with breasts during training, so they’ll know what to do when they see a woman or person with breasts in cardiac arrest.

By putting the sleeve design on WoManikin.org as an open source pattern and starting a fund to create more attachments, JOAN hopes to get a WoManikin in every CPR training program in the country by 2020. JOAN developed the WoManikin in collaboration with CPR experts, cardiologists, and organizations that care about closing the gender gap in CPR. So, in that way, the WoManikin doesn’t just provide a way to challenge biased CPR training—it shows what happens when women collaborate and apply creativity to tackle the inequities around them.

To learn more and join the fight to end gender disparities in CPR, visit WoManikin.org.

Hannah Lewman Hannah Lewman Brand Contributor

Hannah Lewman is a Strategist for JOAN Creative.

Source: Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We’re Going To Do About It

3 Things Coca-Cola, AWS And Smartsheet Taught Me About Innovation

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In today’s market, companies that are not constantly evolving or changing go extinct very quickly. Back in 1950, the average age of a company on the S&P 500 was 60 years old; today, it’s 20. With so many companies failing, disappearing, or getting consolidated, transformation is critical for businesses seeking to survive, let alone compete and win.

To be successful in product innovation, start with the customer and work backwards to determine the products you need to design and build.Smartsheet

Some companies are really good at transformation and continuous innovation; disruption is built into their DNA. Others struggle with their legacies of success, becoming overly focused on self preservation, which leads to slow decision making and aversion to risk.

But it’s not impossible for large companies to reinvent their business; indeed, it’s essential for their survival. During the course of my career, I’ve been fortunate to work at three amazing companies — all very different — each of which has been integral in transforming their industry.

Through these experiences, I learned important lessons about innovation and business transformation that can be applied to almost any company. Here are three critical keys to success:

1. Start with the customer

To be successful in product innovation, start with the customer and work backwards to determine the products you need to design and build. Only by truly understanding your customers can you deliver products that they will love.

When I worked on Coca-Cola Freestyle, we knew we had to start with the consumer and figure out what they wanted, so we did a ton of research. We started with focus groups in five different cities, five groups per city, all different age groups and demographics. The insights we gathered in these sessions informed our quantitative research, in which we ultimately talked to more than 7,000 consumers.

By truly understanding consumer preferences, we were able to build the Coca-Cola Freestyle in a way that appealed to consumers, with striking results: Installing a Freestyle machine led to increased beverage sales for restaurants by 17- 20 percent, and increased Coca-Cola sales volume by 30-40 percent in those locations. What’s more, about 25 percent of consumers who knew about Freestyle told us that they chose which restaurant they went to based on whether it had a Freestyle machine!

To innovate at Smartsheet, we set out to understand what problems our customers are trying to solve and then build solutions that help them do that. Smartsheet is a cloud-based work-execution platform that makes it easy for anyone to get work done without having to wire together a bunch of other tools. Today, most of the companies chasing this market overestimate the technical bar that most business users can clear, which results in overly complex products that are not easy for most business users to adopt. At Smartsheet, we really focus on how we can meet the needs of the average business user.

Every time we build a new product, we start by writing a document called a “PR/FAQ” (Press Release/Frequently Asked Questions”), which outlines what we’re going to build — and why — before we actually go to code (an exercise I brought with me from Amazon.) This means we create the story that we want to tell customers on the day the product launches — before we actually build anything. Then, we iterate on the press release until we like what it says about the product and how it solves a problem for the customer. We validate it with existing customers. Only when we’re satisfied that what we have is the right product definition do we begin work on building the proposed product.

2. Small independent teams move faster

Once you determine what to build based on research and customer feedback, assign a small team to the project and empower them to make decisions and innovate. Keeping the team small and focused helps prevent scope creep and eliminates the management overhead required to coordinate work across a large group. It is important to establish mechanisms for the team to escalate when they need help, but try to limit the amount of energy the team has to expend reporting up. This will speed innovation.

To develop Coca-Cola Freestyle, I built a small dedicated team that was completely isolated from the rest of the organization. We reported to a board of advisors on a quarterly basis but were empowered to make decisions without having to ask for permission.This was pretty game-changing, as it allowed us to move fast, experiment and learn, and be singularly focused on capturing the opportunity we saw in the market.

Coke’s idea of isolating a small, scrappy team to work on product innovation is the Amazon model as well. In fact, Amazon has a name for it: a “two-pizza team.” Almost every new service that starts at Amazon starts with a two-pizza team — a team small enough to feed with two pizzas.

Small, scrappy teams can help you make better decisions by forcing you to make trade-offs based on the constraints faced by the team. They’re better able to innovate quickly and course correct as needed to keep the project on track.

3. Take a long view

Another key to supporting innovation is to take a long view of the business. Rather than expecting an immediate return on an innovative new idea, focus on how you’ll develop the product to best serve your target market.

At Amazon, they take a very long view of the business. When we launched a service at Amazon, no one was pushing us with the question: How fast can you get to profitability? Instead, the discussion was framed around:

●    What’s the market you’re going after?

●    How much of the market do you think you can serve with the MVP (Minimum Viable Product — the first, solid foray to market)?

●    Where do you think you’d go after that?

Rather than worry about getting a very quick return on investment, the idea is that if we build meaningful, compelling products, we’ll figure out how to make money over the long term.

At Smartsheet, we not only take a long view of our business, but also encourage our customers to do the same. For example, when customers come to us for a solution, we try to understand the problem they are trying to solve or the pain point they want our help to address. This deep understanding enables us to build solutions that are both opinionated and flexible. We bring best practices to the table, along with a real point of view on ways that our customers can change how they work, and how we can help their businesses innovate faster as they navigate a constantly changing market — now, and into the future.

Gene Farrell Gene Farrell Brand Contributor

Source: 3 Things Coca-Cola, AWS And Smartsheet Taught Me About Innovation

How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

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Photographer: Scott Eisen/Bloomberg

© 2016 Bloomberg Finance LP

The landscape of experimental Alzheimer’s disease (AD) drugs is strewn with failures, so much so that it has been referred to as “an unrelenting disaster zone”. Recognizing the greatly increasing number of patients with this disease, many biopharma companies have invested a lot of resources in attacking this problem, only to be turned away in late stage studies as happened to Merck with its BACE inhibitor, verubecestat, and Lilly with its beta-amyloid antibody, solanezumab.

Now add Biogen to the list of companies that have failed in this arena. Its drug, aducanumab, partnered with Eisai, was believed to be better in removing beta-amyloid from the brain than any agent previously tested. Many have hypothesized that beta-amyloid causes the formation of damaging clumps of debris in the brain leading to AD. Unfortunately, Biogen halted a major clinical trial with aducanumab due to a futility analysis showing that the drug doesn’t work.

This is a terrible result for Alzheimer’s patients who had hoped that this was the drug that would finally succeed in treating AD. But the demise of aducanumab is also disastrous for Biogen which had expended an enormous amount of resources into this program, likely at the expense of other opportunities. It was a risky bet and one for which Wall Street has delivered a punishing blow. Biogen’s stock dropped by nearly 30% shortly after announcing the disappointing aducanumab results.

How is Biogen going to respond? As John Carroll has reported, many industry analysts believe that there aren’t many gems in the Biogen pipeline that can make up for the loss of this potential blockbuster. In predicting Biogen’s next steps, perhaps there are some learnings from another such pipeline failure – that of Pfizer’s torcetrapib.

Torcetrapib was the first of a class of compounds known as CETP inhibitors, drugs that both raised HDL-cholesterol and lowered LDL-cholesterol. A CETP inhibitor had the potential to remodel a heart patient’s lipid profile thereby greatly reducing his risk of a heart attack or stroke. There was tremendous excitement generated in this potential breakthrough treatment, not just in Pfizer but also among cardiologists and heart patients. In fact, internal commercial analyses predicted annual sales in excess of $15 billion. However, as happened with aducanumab, on December 4th, 2006, Pfizer announced that torcetrapib failed its long-term clinical study. The drug was dead. The Wall Street reaction was swift, albeit not as dramatic as Biogen’s experience. Pfizer stock dropped 10% as a result of this news.

Internally, the Pfizer reaction was intense. Torcetrapib was supposed to be the blockbuster that would drive growth into the next decade. Its loss created an enormous hole. Pfizer CEO Jeff Kindler responded in a couple of ways. First, he decided to “right size” R&D in relation to lower expected future revenues. In effect, hundreds of millions of dollars needed to be cut from R&D. Pfizer’s R&D budget had already undergone major portfolio adjustments and reorganizations over the previous five years due to the acquisition of Warner-Lambert Parke-Davis in 2000 followed by the acquisition of Pharmacia in 2004. Meeting the new R&D budget targets weren’t going to be achieved by simple cuts; rather, major research sites had to be closed and jobs had to be eliminated. Gone were R&D sites around the world including those in France, Japan and, most significantly, the iconic laboratory in Ann Arbor, Michigan.

But budget cuts weren’t going to be enough for Pfizer to meet its desired goals. The company began assessing major M&A opportunities and in 2009 it acquired Wyeth for $68 billion leading to yet another round of reorganizations and portfolio reshuffling. The ripple effect of the torcetrapib demise was felt by the entire company and lasted for a number of years.

So, how will Biogen respond? Undoubtedly, there will be budget cuts. In addition, perhaps Biogen will look at its R&D portfolio and give a higher priority to those programs that have the potential to deliver revenues in the short term. There might also be a push to drop programs deemed to be very risky or where the proof-of-concept requires long, expensive clinical trials. Finally, it wouldn’t be surprising to see Biogen become aggressive in their M&A activities. But make no mistake. The death of an important drug like aducanumab will have both a short and a long term effect on Biogen as a company and especially on R&D.

I was the president of Pfizer Global Research and Development in 2007 where I managed more than 13,000 scientists and professionals in the United States, Europe, and Asi…

Source: How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

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