Friday, February 9, 2018

Five major psychiatric diseases have overlapping patterns of genetic activity, new study shows - The Washington Post

Certain patterns of genetic activity appear to be common among five distinct psychiatric disorders — autism, schizophrenia, bipolar disorder, depression and alcoholism — according to a new study. The paper, appearing in the journal Science, was released Thursday.

Scientists analyzed data from 700 human brains, all donated either from patients who suffered one of these major psychiatric disorders or from people who had not been diagnosed with mental illness. The scientists found similar levels of particular molecules in the brains of people with autism, schizophrenia and bipolar disorder; other commonalities between bipolar and major depression; and other matches between major depression and alcoholism.

"We're on the threshold to using genomics and molecular technology to look at [mental illness] in a way we've never been able to do before," said Daniel Geschwind, a neurogeneticist at the University of California at Los Angeles and a leader of the study. "Psychiatric disorders have no obvious pathology in the brain, but now we have the genomic tools to ask what actually goes awry in these brains."

These shared, disease-related "signatures" involve a disruption in how brain cells communicate with one another.

"What we're seeing is giving us a sense of alterations in the way neurons are signaling to each other," Geschwind said. "We think some of it is confused activity. That's the next step, to connect it to the physiology: how do these changes affect neuronal firing and connectivity. We have a clue that it's adding 'noise' to the system. Maybe things are attenuated or jumbled."

More ...

https://www.washingtonpost.com/news/speaking-of-science/wp/2018/02/08/five-major-psychiatric-diseases-have-overlapping-patterns-of-genetic-activity-new-study-shows/?

Thursday, February 8, 2018

How People Die in America

Last week I published a long story about my near-fatal bacterial infection six months ago, and the material benefits that kept me alive. Since the piece ran I have been completely overwhelmed by reader responses.

Everyone, it seems, knows someone who has been financially ruined—or, in a roundabout way, killed—by the opaque mechanizations of our privatized health care system.

I survived, and I have a platform. But as one reader put it, "the people who die from having no insurance are not around to tell their stories."

Our politicians are fond of holding the line that no American dies for lack of access. Doctors and hospitals are bound by oath, the thinking goes, to do everything they can to save a life. But that logic doesn't account for the broader significance of the cycle of debt, or the way generations of families can be ruined by a single medical crisis. It glosses over the insane level of trust we are forced to put in the medical industry—the providers, the doctors, the insurance agents—when we have an accident or suddenly fall ill.

Since I published my own account of illness, I've seen lots of references to the now-deceased self-employed New York carpenter who won the lottery, used his newfound wealth to go to the doctor for the first time in decades, and found he had cancer in his brain and lungs. Someone sent me a link to this story about Susan Moore, a woman in Kentucky who elected to stop the dialysis she needed to stay alive because she couldn't afford to travel to the medical center three times a day.

I tweeted a handful of the comments on my story, but I wanted to post a couple more; these are the kinds of testimonies that can get lost in the glut of statistics about healthcare in this country.

More …

https://splinternews.com/how-people-die-in-america-1822743566?

How to Not Die in America 

On the second Tuesday in June, I start to feel fluish. If this is 2016 and I'm still a freelance writer, I'm losing money immediately on the assignments I can't complete because my vision is blurry and my thoughts are erratic. If this is 2013, I am soon taken off the roster at the cafe where I work.

I am out of my mind with anxiety as I hobble to the clinic, sweating, and pay $60 for cough syrup, $300 for the 10-minute visit (if I even have that in the bank; it's about a week's worth of my earnings slinging coffee). Once I realize I can't keep down the cough syrup and start spitting up bile, maybe I'm so feverish and broke I stay in bed without realizing the bacteria I've inhaled is more lethal than the flu. So perhaps I just up and die right there.

But let's say I somehow make it to the hospital. A friend drives me, because a 15-minute ambulance ride can cost nearly $2,000, which I don't have. I'm struggling financially and I've fallen behind on my ACA payments. My friend realizes in the car I'm not making any sense, and that's because my organs have already begun to shut down. My temperature is well over 100. When the doctors can't figure out what's wrong, they submit me to a credit check before advanced treatment.

More ...

https://splinternews.com/how-to-not-die-in-america-1822555151?

Monday, February 5, 2018

My Father’s Body, at Rest and in Motion | Siddhartha Mukherjee | The New Yorker

The call came at three in the morning. My mother, in New Delhi, was in tears. My father, she said, had fallen again, and he was speaking nonsense. She turned the handset toward him. He was muttering a slow, meaningless string of words in an unrecognizable high-pitched nasal tone. He kept repeating his nickname, Shibu, and the name of his childhood village, Dehergoti. He sounded as if he were reading his own last rites.

"Take him to the hospital," I urged her, from New York. "I'll catch the next flight home."

"No, no, just wait," my mother said. "He might get better on his own." In her day, buying an international ticket on short notice was an unforgivable act of extravagance, reserved for transcontinental gangsters and film stars. No one that she knew had arrived "early" for a parent's death. The frugality of her generation had congealed into frank superstition: if I caught a flight now, I might dare the disaster into being.

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https://www.newyorker.com/magazine/2018/01/08/my-fathers-body-at-rest-and-in-motion

A Doctor’s Painful Struggle With an Opioid-Addicted Patient - Siddhartha Mukherjee - The New York Times

I once found myself entrapped by a patient as much as she felt trapped by me. It was the summer of 2001, and I was running a small internal-medicine clinic, supervised by a preceptor, on the fourth floor of a perpetually chilly Boston building. Most of the work involved routine primary care — the management of diabetes, blood pressure and heart disease. It was soft, gratifying labor; the night before a new patient's visit, I would usually sift through any notes that were sent ahead and jot my remarks in the margins. The patient's name was S., I learned. She had made four visits to the emergency room complaining of headaches. Three of those times she left with small stashes of opioids — Vicodin, Percocet, oxycodone. Finally, the E.R. doctors refused to give her pain medicines unless she had a primary-care physician. There was an open slot in my clinic the next morning, and the computer had randomly assigned her to see me.

We were living, then, in what might be called the opioid pre-epidemic; the barometer had begun to dip, but few suspected the ferocity of the coming storm. Pain, we had been told as medical residents, was being poorly treated (true) — and pharmaceutical companies were trying to convince us daily that a combination of long- and short-acting opioids could cure virtually any form of it with minimal side effects (not true). The cavalier overprescription of addictive drugs was bewildering: After a tooth extraction, I emerged from an oral surgeon's office with a two-week supply of Percocet.

More ...

https://www.nytimes.com/2018/02/01/magazine/a-doctors-painful-struggle-with-an-opioid-addicted-patient.html