GENERAL MEDICAL LITERATURE
We in this section offer commentaries on a broad survey of recent articles in the English literature. Articles are mostly chosen for two reasons: their potential translational value for immediate clinical practice or to help in determining where clinical practice might evolve to. Today’s subjects are of general medical interest.
Shared theocentric perspectives between orthodox Jewish and Muslim patients
A group of authors from the Division of Medical Ethics at Weil Cornell Medicine in NYC recently addressed this rather unusual - but, certainly interesting - subject in a paper (1). Practicing in NYC or in any other city where both of these two religious groups are very prominently represented, this paper offers interesting and useful insights.
Incidental cancer diagnosis through non-invasive prenatal cell-free DNA screening
It has been known for quite some time that cell-free DNA (cfDNA) used in early prenatal testing for fetal aneuploidy (NIPT) can incidentally detect maternal cancers. Now the group that initially made this observation reported on 107 pregnant women with unusual clinical cfDNA sequencing results on NIPT but no hint at cancer and had them undergo detailed cancer screening. Occult cancer was detected in 52 (48,6%), with lymphoma being the most frequent diagnosis (31 out of 52) (2). Interestingly, neither the paper nor an accompanying editorial (3) commented on the fact that cfDNA may, therefore, also be used for diagnostic purposes in non-pregnant states and in men to detect occult cancers. Certainly worth a trial!
David Andrew Sinclair, A.O., PhD – aging guru - again on the frontpage
David Andrew Sinclair, A.O., PhD
So, who is this guy from Australia, David Andrew Sinclair (D.A.S), who is now a Professor at Harvard you may ask, - especially if you are not familiar with the anti-aging world of medicine. In that world, everybody knows D.A.S. because he, unquestionably, is considered one of the field’s “gurus,” as The Wall Street Journal recently described him in a front-page article with the not too friendly title, “A reverse aging” guru’s trail of failed businesses (4). A tenured geneticist and full professor at Harvard, he has become known for his highly controversial believe that aging is a disease that can be reversed.
And like many other geneticists (we fully acknowledge an inherent bias against geneticists offered commercial testing), he may be a better salesman than scientist since none of the many companies he has founded over the years – though having raised for them over $1 billion according to the Wall Street Journal article - ever succeeded in developing a worthwhile product. Four companies have gone bankrupt or halted operations, among those – yes there is a link to reproductive medicine – in 2011 a company called OvaScience, which became infamous in the field of infertility for an absurd hypothesis about how older ovaries could be rejuvenated. Based on D.A.S.’ and an (at the time prominent) biologist’s representations, the company in March of 2015 reached a market cap of $1.3 billion. By March 2018 the stock traded below $1, and the company was acquired in a reverse merger for basically nothing.
Another four of his companies have not yet tested any drugs or gene therapies in humans or have, according to the article in the Wall Street Journal, initiated only small-scale trials that are unpredictive of their potential effectiveness. We recently had also the opportunity to see and hear D.A.S. debate Rockefeller University’s Ali Brivanlou, PhD on the question whether aging is a disease in a sold-out venue in Brooklyn Harbor and he was, indeed, a great salesman; but Brivanlou clearly won the scientific debate (In full disclosure, - we may be biased because we have maintained a close relation with Brivanlou for years).
Everybody is suddenly talking about ultra-processed foods
And Eric Topol, MD, in his Ground Truth blog, is no exception, when in another recent posting interviewing Kevin Dennis Hall, PhD (5), a Senior Investigator and Section Chief at the Integrative Physiology Section in the Laboratory of Biological Modeling in the Intramural Research Program at the National Institutes of Health (NIH). The interviewee is widely recognized for his rigorous randomized human trails as well as animal model studies in advancing the understanding of nutrition and metabolism.
Here are a few key points from the conversation we found interesting: (i) The link between ultra-processed foods and higher risk of cancer, cardiovascular disease, type 2 diabetes and neurodegenerative disease are “pretty darn strong.” (ii) Vegan as well as ketogenic diets have a positive effect on the immune system, - indeed, both, on innate and adaptive immune functions which, of course, has special relevance in autoimmune diseases (and in reproductive medicine, likely, in endometriosis/adenomyosis). (iii) Adiposity is somewhere between 40% to 70% polygenetic heritable. (iv) GLP-agonists are associated with loss of muscle mass and patients on these medications, therefore, should be encouraged to use resistance exercises.
Is bird flu (H5N1) another pandemic threat for the country and the world?
Zeynep Tufekci, PhD thinks so, a professor of sociology and public affairs at Princeton University and columnist of The New York Times in a recent Op-Ed, urging Biden in his final weeks in office “to get serious“ about the bird flu and avoid a foreseeable catastrophe (6). She may be right according to comments by former Coronavirus Response Coordinator under President Donald Trump, Deborah L. Birx, MD, who feels that “we [again] have our heads in the sand” (7). What is also worrisome is the finding that the H5N1 sample from a very ill patients – according to the CDC – demonstrated concerning mutations, which make the virus more contagious (8).
References
1. Hossain et al., Cambridge Quarterly of Healthcare Ethics 2024.:1-17. Doi:10.1017/SO963180124000379
2. Turriff et al., N Engl J Med 2024;391(22):2123-2132
3. Vora NL. N Engl J Med 2024;391(22):2168-2169
4. Marcus et al. The Wall Street Journal. December 5, 2024. https://www.wsj.com/health/wellness/david-sinclair-reverse-aging-failed-business-8bc4a43d
5. Eric Topol. Ground Truth. November 30, 2024.https://erictopol.substack.com/p/kevin-hall-what-should-we-eat
6. Tufekci Z. The New York Times. November 29, 2024. https://www.nytimes.com/2024/11/29/opinion/bird-flu-pandemic.html
7. Tirrelll M. CNN. December 27, 2024.
8. Mueller B. The New York Times. December 27, 2024. https://www.nytimes.com/2024/12/27/health/bird-flu-mutations-louisiana.html