Dr Ford Brewer - PrevMed

Multiple myeloma causes 13,000 deaths each year in the US. It happens due to B cell or plasma cell clone lines. When these grow in the bone marrow, it creates the classic "shotgun" appearance of the skull.

These are classic cancers in terms of development. B cells await in the periphery ( lymph nodes), waiting for stimulation by an antigen/antibody complex to stimulate clone cell line growth.

Incidence peaks in the mid-70s. 5-year survival rates average about 50%. It varies dramatically by age and overall health.

Charite is rated as the best of over 1000 hospitals in Germany, just north of Berlin. It was built in the 1750s by Frederick 1. Over half of Germany's Nobel Prize winners in Medicine work(ed) at Charite. My daughter's graduation from Public Health at Tulane raised several issues about us reliving our past in Public Health and Medicine. We continue to focus on a cure. But it's never been the cures that have changed the course of disease in humans. It's been changed in lifestyle.

We cover the Bubonic plague (black death) as an example of hygiene or lifestyle vs cure. (We also mention Pickwick syndrome as a historical reminder that lifestyle is more important than medicine.)

Jenny Ruhl is the author of the book & web page Blood Sugar 101: What They Don't Tell You About Diabetes. Her patient experience is very interesting.

The USPSTF guidelines on colorectal cancer can be frustrating. They give an extensive literature review. And they cover 7 competing methods for screening. They don't list them in order, and they seem to waffle re: prioritizing or ranking the methods - fOBT, FIT, fDNA, sigmoid, ct colonoscopy, and endoscopic colonoscopy. Why?

Here's the reason: the task force reasons (and rightly so in my opinion) that the biggest variable is actually getting the test done. So, their point is this: Use of four methods are good:

colonoscopy, FIT, sigmoid/FIT(together), CT colonoscopy. FIT-DNA is also good, but not efficient ( read as too expensive). gFOBT ( or the old guaiac test) and sigmoid alone are both better than not screening. But the other listed methods are better.

Don't throw your salmon, halibut, or other omega 3s back in the water yet! After years of bad news for Omega 3 fans, there is a glimmer of hope. How clear is that glimmer? Not very, at least for now. It's basically fueled by stock prices. But I do think there's enough there to keep taking Omega 3s. And be patient. In 6 weeks, we'll get a lot more info.

The ASCEND TRIAL was published in the New England Journal of Medicine on Aug 26, 2018. This trial was about the primary prevention of cardiovascular events in diabetics. However, they included a nested trial of Omega 3s. They looked at over 9,000 patients. There was minimal difference in event rates.

So, Omega 3s are done, right? Not so fast. These studies were done with just 1 gram Omega 3 supplement. These days, the supplement recommendations are for 3 to 4 grams. In addition, there is a question re: whether Omega 3s help with patients who are already on statins and proper blood pressure meds. The original trials done 20 years ago were in populations that did not have proper statin or even blood pressure medication coverage.

The UK Biobank just published a study on coffee drinking and longevity. They found improved longevity with up to 8 cups daily. This study included improvement for all genetic variations of caffeine metabolizers.

At the 2018 American Society of Sports Medicine, there was a presentation by Dr. Chang Woock Lee of the University of Houston-Victoria. Dr. Lee has been researching muscle performance and cholesterol. As his research developed, he became interested in the micronutrients associated with cholesterol. Egg yolks are known as . a source of both cholesterol and choline.

Choline is also an integral part of two other important biochemical pathways: methylation and neurotransmitters.

This research indicated that choline supplementation is very helpful for muscle performance in 50-69-year-olds.

Choline supplementation up to 1 gram/day among 50-69-year-olds improved muscle function improvement did have a large impact. It increased improvement from 12% to 47% on average.

Docs do tend to be slow to diagnose and treat diabetes and insulin resistance. There are reasons. Research has shown risk in cropping the A1c goals. These were the ADVANCE, ACCORD, and UKPD trials.

But these studies relied too much on drugs, and not enough on lifestyle, to manage diabetes. In addition, basics like aspirin, bp lowering, smoking cessation, and statins are also neglected.

This neglect occurs with patients as well as the ADA and doctors.