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Ketamine and depression.
This has been all over the news media this last week. Too bad the hype didn't occur while JAV was still an ongoing entity, the hype may have made me some money.
Club drug ketamine cures depression instantly: How?
What's the latest recreational drug to make its way to the medical field? Ketamine, also known as "Special K." The club drug, typically used by veterinarians as a cat tranquilizer, is said to provide patients an "instant" relief from depression, according to a new study.
Doctors at Ben Taub General Hospital in Houston are now experimentally using the drug to treat some patients who come to the emergency room with suicidal depression, NPR reported.
Is there an antidepressant shortage we don't know about?
Dr. Anu Matorin, medical director of the Psychiatric Emergency Center at the hospital, told NPR that antidepressants may help suicidal patients eventually, but often take weeks or months to kick in. During the critical few days when very depressed patients have suicidal thoughts, they may be a threat to themselves or to others and are sometimes admitted to inpatient units.
That's why researchers at Ben Taub are among a growing number of scientists trying to transform psychiatric care - with the help of the club drug. Previous research suggests the anesthetic ketamine could help treat depression almost instantly. Dr. Sanjay Matthew, associate professor of psychiatry at Baylor College of Medicine leads the ketamine research program at Ben Taub General Hospital.
"The focus is on really rapidly helping someone get out of a depressive episode," Matthew told NPR.
"We can take care of a migraine in hours," added Dr. Carlos Zarate, a ketamine researcher at the National Institute of Mental Health. "So why do we have to wait weeks or months with depression?"
This isn't the first report of ketamine helping people with depression. A 2006 study of Zarate's found a single intravenous dose of ketamine helped relieve treatment-resistant depression symptoms within 2 hours.
How does ketamine help depressed patients?
Those who take the drug typically say, "'I feel that something's lifted or feel that I've never been depressed in my life. I feel I can work. I feel I can contribute to society.'" Zarate told NPR. "And it was a different experience from feeling high. This was feeling that something has been removed."
Ketamine works differently than other antidepressants. While pills like Prozac boost the levels of the neurotransmitter serotonin to make people feel less depressed over a period of time, an injection of ketamine works on an entirely different neurotransmitter, glutamate. It blocks the receptors critical for receiving glutamate's signals which quickly improves the brain cell's electrical flow. That in turn reduces depression, according to the NIMH.
Dr. Asim Shah, who directs the mood disorder program at Ben Taub General Hospital, told ABC News the researchers hope the effect lasts.
"Will it cure depression for a year or longer? I don't think so," Shah said. "But we're hoping it will work for a few months"
But that doesn't mean people should self-medicate with the illegal drug. Ketamine is popular and "dance clubs and raves," and can be injected, consumed in drinks, or added to smokeable materials, according to the U.S. Drug Enforcement Administration. Some users fall into a dissociative "trip" on the drug, which is called a "K-hole."
Dr. Robert Glatter, emergency medicine physician at Lenox Hill Hospital in New York City, said the drug has similar effects to PCP, and may cause visual hallucinations, vivid dreams, confusion and disorientation, increased salivation, and problems with heart rhythm and breathing. Besides animals, the drug is sometimes administred to people along with a sedative in the hospital for patients undergoing painful procedures.
http://www.cbsnews.com/8301-504763_162-57368946-10391704/club-drug-ketamine-cures-depression-instantly-how/
RE: NGNM and HDVY
I have attempted to find more information regarding the licensing arrangements between HDVY and both DGX and ABT but have not been able to uncover any specifics and have not heard back from IR at HDVY.
The NGNM/HDVY licensing arrangement is as follows:
"NeoGenomics paid $1 million in cash and issued 1,360,000 shares of common stock to HDC in upfront licensing fees. In addition, NeoGenomics will make milestone payments, in cash or stock, based on sublicensing revenue and revenue generated from products and services developed as a result of the Agreement. Milestone payments will be in increments of $500,000 for every $2 million in revenue recognized by NeoGenomics up to a total of $5 million in total milestone payments. After $20 million in cumulative revenue has been recognized, NeoGenomics will pay a royalty of 6.5% on product sales and will share profits from sub-licensing arrangements."
http://finance.yahoo.com/news/NeoGenomics-Enters-Into-prnews-1204970920.html?x=0
If and when I hear back from HDVY, I'll post the specifics.
aj
NGNM…and some interest from both ABT and Quest regarding this test on the side
From the HDVY press release dated 11/14/11
"Quest Diagnostics (NYSE:DGX) has acquired a Non-Exclusive royalty based license for the laboratory developed test (LDT) version of the HDC urine based four gene prostate cancer test. HDC continues to have discussions with other clinical laboratories interested in licensing the LDT version of its urine prostate cancer test.
Abbott (NYSE:ABT) has acquired a worldwide Exclusive royalty based license to develop an in-vitro diagnostic test kit for the HDC urine prostate cancer test."
http://www.healthdiscoverycorp.com/pr/oct14_11.html
aj
OPK and prostrate screen
Looking into this acquisition, I could find no information regarding the reported sensitivity/specificity of the Arctic Partners Ab Oy markers and/or the use of the markers in conjunction with the PSA data. Unless I've missed something, all I hear is the claim that the combined screening criteria will "reduce" the need for biopsy by 50%.
Given that my little baby, NGNM has just entered into a licensing deal with HDVY to commercialize their multidute of genetics screening tests including their urine 4 genetics marker test, with a sensitivity of 90% (and some interest from both ABT and Quest regarding this test on the side), I am looking for the NGNM/HDVY test to perfom well.
http://www.healthdiscoverycorp.com/pr/oct14_11.html
aj
PPHM board post
"Here is what I think will be the next step from just a simple logical (non-scientific gut feeling). "
When one makes investment decisions based upon this cognitive process, there should be no complaints when the investment turns into a turd.
Of course, PPHM has been a turd for more than 10 years. I've followed it for longer than I can even remember (having heard a cardiologist "praise" the co. long ago in a physician lounge before 9/11; so long ago that I cannot even recall the name of the co. prior to the name change)
aj
Biotech walking dead
I suspect wallstarb is just running numbers on the co.'s but don't think that RGDX is anywhere near dead (although I don't know why he would have included it in his analysis as it is sooooo tiny.)
2008 revenues: $7 million
2009 revenues: $9 million
2010 revenues: $21 million
shares outstanding: 19.5 million
They may not have that much cash ($2.5 million) but also don't have much debt ($328,000) and they are not a co. that burns all that much cash, so they have plenty of room to generate some buy offering stock.
JM2C
aj
;]
Didn't want to steal your thunder!
IDIX vs. MNTA: Market caps, earnings and "the rational" market
IDIX:
Current market cap: $1.26 billion
Revenue reprted last quarter: $2.67 million
EPS, 2010: -0.60 cents/share
MNTA:
Current market cap: $959 million
Revenue reported last quarter: $87.9 million
EPS, 2010: $4.38/share
(all data from yahoo)
I just find this laughable, particularly given the relative prospects of both co.'s.
.05 stat sig
Championed by Fischer but also agreed upon via mutual consent. In the social sciences, we were taught that this was a decision that was made via social process (and that most, if not all "decisions" in science are social processes-see Kuhn, "The Structure of Scientific Revolutions") and that that the key issue with the .05 level was to strike a balance between type one and type two errors when analyzing statistical data.
To provide just a little perspective here, I recently had a conversation with an engineering friend who works for a machine tool co. The tools are now manufacturing products to a 0.0001 mm tolerance. Every once in a while, an outlier product measures at 0.001 mm and is rejected, even though the measure error is statistically irrelevant as the measuring tool has an error rate of 0.001.
Clearly, the thing being measured has everything to do with the tolerance in the measurement error.
Dew's quiz was clever and required some "outside of the box" thinking, but really doesn't reflect what would have occurred if humans were hexapedal, (at least imo.) We have 10 fingers, insects have 2 antennae, one could argue that they would be more comfortable using base 2 rather than base 6 (or base 10.)
JM2C
aj
OT: Idit has told me that her friends refer to her as "DT"
I give, I'll be waiting for the answer tomorrow.
aj
OT: LOL!!
Or wise enough to choose a partner who knows how to use his head (and you can use your imagination regarding this statement!), justifying an allowance to keep it.
Life is too short for mindless engagement, n'cest pas?
aj
Quiz:
This is a double dip, but my last answer:
The essential issue that distinguishes human from insect decision making is that, while both human species and the insect species that engage in social behavior (this is an assumption that Dew is not considering what the essentially asocial insects like Mantis Religiosa might do-and as an aside, if DT was an insect, she would be a wise Mantis Religiosa) also engage in decision making processes, once a group decision has been made, insects left in the minority whole heartedly lose any opposition to the decision and become unanimously united behind the decision, unlike humans, who may remain in a minority of detraction to the decision.
The decision making corollary here is that an FDA panel would only need a majority vote, thereby changing the minds of all minority members and the proposed drug would be approved without dissent.
Please see:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827444/
Too bad our politics don't also work this way!!
regards,
aj
DT, I REALLY should stop posting under the influence!
Happy New Year to you!
Insects, it is the species, stupid.
Not to Pick Nits (as in larval Pediculus humanus capitis), but insects are an order, as in:
Kingdom
-Phylum
--Class
---Order
----Family
-----Genus
------Species
Just saying, it's not the species, stupid
aj
Insects in general, particularly social insects, have a much higher degree of "altruism" with regard to individual sacrifice vis a vis the group (think ants or bees who will gladly sacrifice their individual life for the good of the colony/hive). An individual insect's death would be inconsequential in light of group survival.
The corollary here would mean that insects would be much more tolerant of the potential adverse effects of drugs that would cure many at the cost of killing the few. We humans have not been able to negotiate this cost/benefit analysis, skewing our allowance of "acceptable" loss due to drug side effects to the very end of the continuum.
Happy New Year to all,
aj
NGNM: Path to the NASDAQ small market listing
As far as I know, the co. must have an initial share price of $4 (I believe that this must be maintained for 30 business days), have at least 3 market makers and maintain a $1 share price. There are many rules (as you know) regarding continued listing, regarding public reporting and disclosures. They have maintained all but the $4/share price.
The share price has never been greater than $1.85, but has based quite well in the $1.30 range since the last Q's numbers. I would imagine that by Q2 next year, they will approach the $4 range, so long as they continue to grow revenues and drop the increases to their bottom line (5-8 cents per share/quarter) making them a good looking value on a P/E basis. Once listed, they'll get more respect from the market, presumabbly.
All just speculation, but I can dream.
aj
NGNM: Thanks for beating me to the punch on this.
FWIW, my opinion about this upward guidance puts NGNM squarely back into the true "value" category. I have watched mgmt's execution plan including their initial buildout 3 years ago, with its phenomenal growth, through a string of 6 quarters where growth disappointed (down to about 10% YOY) largely due to a series of VP of sales hires who all underwhelmed in their execution, to this announcement, which comes atop of last quarter's upside surprise. I fully expect that growth here will overdeliver for at least the next 3-5 quarters and NGNM will see significant profitability in the second 1/2 of 2012.
The co. is close to being ready for NASDAQ small market listing, which will go a long way towards further recognition as a legitimate and tradable co. One personal sign of this (for me at least) is that my personal contact with Steve Jones, one of the co. principles and IR relations, has stopped communicating with me, suggesting that he has graduated from the need to visit with individual investors and is focused on the bigger picture.
JM2C,
AJ
OT: Small local charities
I am on the board of the Almost Home Ranch in Lincoln, AR. This small operation is a relatively new non-profit that serves active military and veterans in the following manner through the Warrior's Horse Project:
The ranch takes in and boards horses for active military personnel who have been called to duty overseas. These are often non-com's who have horses because of the love for the animals and make economic sacrifices to have the horse to begin with. These warriors do not have the money to board their horses while overseas and without the program would have to face the prospect of selling their horse.
While the horses are at the Almost Home Ranch, they are cared for by Vets with PTSD. The ranch is run by the retired Executive Director of the AR Crisis Ctr, Shelby Rowe, who is well versed in horses, PTSD, and the therapeutic nature of the human/horse relationship.
When the warrior has completed their tour, they are invited to the ranch to spend as much time as it takes to "decompress" and re-adjust to civilian life, get the support from the vets who are staffing the ranch caring for the horses, and can use the time to re-integrate into family and community.
https://www.facebook.com/pages/Almost-Home-Ranch/120366584697633
Shelby will be grateful for any and all donations. She is currently caring for 6 horses in the program and we are starting our first capital campaign after Thanksgiving.
We have plans to expand the program to allow 10 vets to stay in residence at the ranch for a 10-week program (50 vets per year) and a maximum of 10 horses of active personnel at a time. If we can reach some lofty money raising goals, we are looking at bying out a "dude ranch" facility in Hot Springs where we can further expand and start an equine therapy program (Physical therapy based) for veterans with traumatic brain injury (which I will run as a volunteer.)
The address is: 20971 West HWY 62, Lincoln, AR 72744
aj
OT: Ambien
Eminem's story is common for people who abuse ambien during their waking hours.
aj
OT: Green Mountain Coffee
Has anyone here actually had any of the Green Mt. Coffees? I just ran across them on FB and am tempted to buy some beans, just curious if anyone has an opinion regarding the quality of their coffee.
aj
NGNM: Q3 revenues come in at record levels. Coverage initiated by Zach's with an "Outperform" rating and $3 target.
I'm going to violate my own self-imposed rule about posting on NGNM only biannually. The Q3 numbers are the best ever, beat for the second quarter in a row, and the PR contains several items that I have been waiting for, particularly the announcement of a lab expansion to handle the increased volume. This expansion is through internal means (read: no dilution from a purchase of an independent lab). The co. announces that they are ready to launch a record no. of new genetics tests, although details of what they are won't be discussed until today's CC.
http://finance.yahoo.com/news/NeoGenomics-Reports-Third-prnews-486242757.html?x=0&.v=1
Also, Zach's came out yesterday with coverage initiation. My takeaway from them includes their observation that NGNM is currently valued at 1X annual revenue, a steep discount to the industry. Zach's indicates they expect $100+ annual revenue and 17c/share profit by 2015 (I think both of these are low ball estimates and think that they will still announce the purchase of an independent lab sometime in the next year with minimal dilation):
http://finance.yahoo.com/news/NGNM-initiating-coverage-with-zacks-2412925151.html?x=0&.v=1
aj
OT:Welcome to the Pinking of America
For those who do not know about the dark side of the Komen Foundation "monster" the Huffington post article is a good start. There is much more to read, and I have read much as breast cancer has devastated my family (grandmother, maternal aunt) and I am now watching one of my oldest friends, a woman I've known since Kindergarten, survive with stage 4 metastatic breast cancer into her 10th year. That she has lived as long as she has is tribute to her will, and she certainly makes sure that she pulls back the curtain on Komen when she can.
From a recent FB post that she shared, read on:
http://barbarabrenner.net/?p=219
and here's a link to "Think Before You Pink"
http://thinkbeforeyoupink.org/
aj
CXM: There are many small biotech co.'s who claim to have discovered a new way to heal wounds. They range from "pie in the sky" to laughable scams and include (in no particular order): Kane Biotech (TSX-KNE), Cytomedix (CXMI.OB), ULURU (ULU), and Derma Sciences (DSCI), as well as a plethora of private boutique co.s with methods of treating wounds in a variety of ways.
I have followed DSCI and CXMI.OB (primarily because this one is a local co. and I know a couple of the original principals who are no longer with the co.) DSCI actually has pretty good science behind it, but the prospect of using a Manuka Honey-based dressing for wound care is likely to remain offputting to "mainstream" medicine and will likely remain a niche product.
CMXI is mostly scam level biotech pump and dump. I would estimate that most are: they have far too little capital to pursue their claims, and they have far more competition from established medicine than they wish to acknowledge. If you were an established physician, would you rather A) proposed to use a nonreimbursable technique with sketchy, at best, data to treat a patient's wound, or B) send them to a hyperbaric wound treatment Ctr that is medicare approved and reimbursed.
That said, I have several friends who have recently used Platelet Rich Plasma (PRP) therapy to accelerate injury healing. I find this form of therapy is not too far from many of the above co's attempts to use biologs to push the healing process. See the link below:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682411/
CAMH: The co. keeps trying; a sad story of how a valuable diagnostic technique with excellent prognostic value has been squashed by big medicine.
Study Supports Use of Cambridge Heart’s MTWA Test as Predictor of Sudden Cardiac Death
"At a median follow-up time of 36 months, patients with an abnormal MTWA test were 4.4 times more likely to experience a life-threatening arrhythmia or SCD than those with a normal test and were almost eight times more likely to die of cardiac causes. The negative predictive value was 100 percent at one year, 98.6 percent at two years, and 97.0 percent at three years, indicating that patients with a normal or negative MTWA test are at low risk for experiencing sudden death. In the sub-group of patients with non-ischemic cardiomyopathy, the negative predictive value was 100 percent out to three years."
Prognostic utility of T-wave alternans in a real-world population of patients with left ventricular dysfunction: the PREVENT-SCD study
http://www.springerlink.com/content/r243743418357826/fulltext.html
Iwfal, hadn't read this before I posted. You and I are stating exactly the same thing. Must be an important point (or we are both wrong in the same way {;>]
aj
MNTA: So one reading of this law is that Amphastar (or Teva) could freely infringe on MNTA's patent during the development process just so long as they don't infringe during the manufacturing process.
Don't know if anyone will know, but my response to this is that this begs the question of whether or not Amphastar needs to use the potentially protected molecule characterization process as part of their Quality Assurace in their production of aL. If they can get by with the FDA demonstrating that the manufacture does not need regular checks on production, then Peter's find is a broadside to MNTA's patent claims, IMO.
aj
NGNM: Another competitor in this space has been acquired. Please see:
Miraca Holdings to Acquire Caris Life Sciences’ Anatomic Pathology Business
"Tokyo, Japan & Irving, Texas – October 6, 2011 – Miraca Holdings Inc. (“Miraca”), Japan’s largest clinical diagnostics and laboratory testing service provider, and Caris Life Sciences, Inc. (“CLS”), a privately-held company headquartered in Texas and specializing in the development and commercialization of the highest quality anatomic pathology, molecular profiling, and blood-based diagnostic technologies, today announced that the two companies have reached a definitive agreement under which Miraca will acquire the anatomic pathology business operated by Caris Diagnostics, Inc. (“CDx,” a 100% subsidiary of CLS) and its subsidiaries and affiliates. The total purchase price shall be $725 million, including the repayment of the existing debt, subject to customary post-closing price adjustments. The transaction does not include CLS’ Caris Target Now™ molecular profiling service or Carisome™ circulating microvesicle technology, currently under development."
http://www.carislifesciences.com/news/miraca-holdings-to-acquire-caris-life-sciences%E2%80%99-anatomic-pathology-business/
I apologize for not being able to cut and paste the graphics below, but Claris reports 850K patients tested in 2010. We do not know how many patients are subsumed in the business that is being sold. As a comparative metric, NGNM tested approximately 60K patients in 2010 and is on track to test about 75K patients this year. There's no way of knowing what the margins are for Claris's business segment being sold either, but NGNM's stays consistently in the 55% range if memory serves.
http://www.carislifesciences.com/our-history-of-growth
Finally, if you are interested, NGNM will announce Q3 earnings and revenues on 10/19:
http://finance.yahoo.com/news/NeoGenomics-Schedules-its-Q3-prnews-4025585451.html?x=0&.v=1
MNTA: Can you restate your point in a different fashion please? Are you saying that MNTA must prove the "validity" of their own patents to win?
I'll let JBOG provide his own answer, but I understood his response. The current state of affairs with regard to technology patents, with the vagaries of claims, overlap of "coverage", proliferation of applications and patent grants, and the development of "trolls", all have obfuscated the intention(s) of patents. When an individual or company cannot rely on the USPTO to be clear about whether or not a patent truly holds the water intended, there is plenty of room for others to maneuver into a "patent protected" space.
JM2C,
aj
Or they would have to question the validity of the patents. Do not assume they're valid until tested.
I agree, I shouldn't have jumped to the conclusion, particularly where both patents and lawyers are involved!
aj
Could you expand on what you think MNTA will "discover" that will prompt Amphastar (and MNTA, to be sure) to settle out of court?
Here's my WAG,
Amphastar has to have a process for accurately characterizing their molecule. If they use a process that infringes on Momenta's patent(s), Amphastar will have to settle. It doesn't matter that Amphastar may have come up with an accurate process independently, it's a matter of patent protection.
aj
NGNM: Investment Thesis
Lab testing is largely controlled by a duopoly: Quest Diagnostics and Lab Corp (both with market caps of about $8 billion). There are few midtier companies in this business space and my comp, until recently, had been GXDX. At the time of the announced purchase of GXDX, they were at about $150 million/year in revenues and had a market cap of about $600 million, if memory serves. Another similar co. might be BRLI, although they do more basic lab work (high volume, low margin) and less of the complex testing (traditionally higher margin, but this is becoming less of a sure thing.)
The sector of genetics testing is growing at an organic rate of about 25%/year, riding the wave of our aging population. NGNM has grown steadily (see link below) but has overpromised/underperformed in the last year with regard to their growth. About one year ago, they stated at a quarterly CC that they should be ready to open/acquire another CLIA lab by the end of this year, but not a word yet. The good news is that the last quarter was another record (breaking $10 million in revenue) and they had to use a record number of "contract" pathologists to handle the volume. This may be the indication that they are ready for that new lab.
This is a sector that has seen many of these small co.'s acquired, and NGNM will likely be one of those acquired co.'s within the next 2-4 years. ABT owns 10%
Hope this was helpful,
aj
http://finance.yahoo.com/q/is?s=NGNM.OB&annual
Re:Diagnostic Pathology
Hello DT! Didn't know that one could quantify a journal's impact, but it is no surprise to me that you know this.
My take is that the co. had to settle with a low tier journal (after failed submission(s) to more prestigious ones) to get their data published, and the comments thus far (from Peter and JB118) further point out that the test itself is not going to light any fires in terms of revenue.
Thanks for the imput, and hope you are well,
aj
RE: NGNM Publication
The article boils down to the following:
Presented is an analysis of 500 cases, comprised of 157 nevi, 167 dysplastic nevi, and 176 melanoma cases. The four-fluor FISH assay correctly identified 83.8% of melanomas, and 98.1% of all benign nevi.
Senitivity=83.8%
Specificity=98.1%
Given that this test is being marketed to Dermatologists and pathologists for "borderline lesions" these are acceptable numbers.
We'll see if this gives the MelanoSite test any traction.
Re: NGNM publication
Dang, I've been scooped!!! Thanks for the post rkrw. Now the question I have is, "Why hasn't mgmt PR'd this as a relevant step forward in the development of this test?"
I am unfamiliar with Diagnostic Pathology, but see it's only in it's 6 year of publication. Anyone care to comment on the value of the journal and/or how widely it is read?
aj
CAMH: I'm not laughing %(
Still have 15K shares of this ultradog having got out, for the most part, years ago, but held this last little position on the slight chance that science will ultimately validate the technology's use rather than big money.
A fool and his money are so easily parted.
aj
Genoptix (GXDX) has stopped trading as it has aqreed to be acquired by Novartis.
I still hold a large position in Neogenomics (NGNM). I haven't posted anything in a while as they haven't done anything of note except to continue to grow at a healthy pace. Last quarter they broke the $10 million revenue barrier but are still operating at about break even. Still no word from the co. about publication of their MelanoSite melanoma differential diagnostic test and by now, they should have been able to report that these data were in line for publication, so I am skeptical that the data will ever be published. Without publication, the new test will remain a small piece of their overall revenue stream.
aj
RE: Target for PTSD
From the article:, ""Currently, the only medical treatment options for the nearly 8 million American adults with PTSD are anti-depressants and anti-anxiety medications, which show little benefit in improving the mental health of these patients," Neumeister said in a statement.
Spoken like a true drug pusher. There are plenty of effective and high quality treatments for PTSD, and most combine established medications with Exposure Therapy, a type of cogntive-behavioral therapy technique that has repeatedly demonstrated effectiveness for a variety of anxiety and stress related syndromes. Please see:
http://www.apa.org/monitor/jan08/ptsd.aspx
and a short excerpt from this article:
"In perhaps the most important news, in November, the International Society for Traumatic Stress Studies (ISTSS), a professional society that promotes knowledge on severe stress and trauma, issued new PTSD practice guidelines. Using a grading system from "A" to "E," the guidelines label several PTSD treatments as "A" treatments based on their high degree of empirical support, says Keane, one of the volume's editors. The guidelines-the first since 2000-update and generally confirm recommendations of other major practice-related bodies, including the U.S. Department of Veterans Affairs (VA), the Department of Defense, the American Psychiatric Association, and Great Britain's and Australia's national health-care guidelines, he says.
In other PTSD-treatment advances, researchers are adding medications and virtual-reality simulations to proven treatments to beef up their effectiveness. Clinical investigators are also exploring ways to treat PTSD when other psychological and medical conditions are present, and they are studying specific populations such as those affected by the Sept. 11 attacks.
Though exciting, these breakthroughs are somewhat colored by an October Institute of Medicine (IoM) report that concludes there is still not enough evidence to say which PTSD treatments are effective, except for exposure therapies. Many experts, however, disagree with that conclusion, noting that a number of factors specific to the condition, such as high dropout rates, can lead to what may seem like imperfect study designs (see Sidebar).
Lets be realistic about how to treat PTSD,
Regards,
aj
Obesity Surgery Yields Clues to Weight-Loss Mysteries
http://www.livescience.com/14689-weight-loss-surgery-hormones-dieting-obesity.html
Surgery for obesity began with a simple premise: if you make the stomach smaller, people will eat less, so they will lose weight.
But in recent years the results of obesity surgery have been so outstanding, researchers went back to the drawing boards to figure out what was going on.
Their findings are beginning to present a far more complicated picture of weight — and of how much diet and exercise can really do to change it. Turns out, a slew of hormones from the gut, and their communication with the brain, play a role in the way the body maintains and loses weight.
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Chasing down the answer to exactly how obesity surgery works is providing new insights into human weight loss and appetite regulation, researchers say.
"As a result of weight loss surgery, we finally are beginning to understand the physiology of weight loss better than we've ever understood it before," said Dr. Sunil Bhoyrul, a weight-loss surgeon at Olde Del Mar Surgical in La Jolla, Calif.
Their investigations may reveal how to replicate the results of the surgery without requiring patients to go under the knife.
Ghrelin from the gut
There are several different types of weight-loss surgery (also called bariatric surgery), including gastric bypass and gastric banding, but all involve making the stomach smaller. [Infographic: Types of Weight Loss Surgery].
Patients can lose up to 60 to 80 percent of their excess weight in one to four years after surgery, and many have an easier time keeping it off than they did through dieting, Bhoyrul said. However, up to a third can end up back at their pre-surgical weight seven to 10 years later, he noted.
But researchers are realizing that weight loss after surgery is fundamentally different from weight loss achieved by dieting.
A key player in this difference is the hormone ghrelin, which stimulates appetite. When we diet, our ghrelin levels rise, making us hungry. We may lose weight, but our ghrelin levels stay high, and we continue to feel hungry even after eating. Ghrelin levels come down only if we regain the weight, said Dr. Robin Blackstone, a bariatric surgeon at Scottsdale Bariatric Center in Arizona.
"People who are trying to lose weight are being fought tooth and nail by the body to keep that weight on," said Dr. Miguel Burch, associate director of general surgery and minimally invasive surgery at Cedars-Sinai Medical Center in Los Angeles.
But after gastric bypass surgery, ghrelin levels go down significantly, Burch said.
"They're losing more weight than they ever had before and not only are not hungry, they have to force themselves to eat," Burch said. This may be why surgery patients can keep their weight off, he said.
And ghrelin is likely just the tip of the iceberg in terms of hormonal changes that occur. There are likely many more hormones we don't know about that aid in weight loss after surgery, Burch said.
Mind over stomach
Results from the surgery have also highlighted the role of the brain in weight loss and weight gain. Your mind, not just your stomach, manages your waistline.
"We never realized that the brain was so important," Bhoyrul said. "We thought it was just as simple as getting people to eat less. That turns out to be the least of the issues," he said.
The brain is the body's energy thermostat, Bhoyrul said, controlling how quickly you use energy, and when to store and expend it. There is an ongoing conversation between the gut and the brain that takes place via hormones, he said.
Deciphering this conversation could help researchers understand how to best instigate weight loss, Bhoyrul said.
A recent finding underscores how much there is to learn about the stomach-brain connection. Unlike the drop in ghrelin seen after gastric bypass, those who undergo gastric banding experience a drop in their hunger, but not in ghrelin, said Dr. Emma Patterson, a bariatric surgeon in Portland, Ore. This may be because ghrelin communicates with the brain differently after this surgery, Patterson said.
Surgery without the surgery
It might be possible to replicate the results of the surgery using drugs.
"If we can understand how these surgeries work…we can put whatever that thing is in a pill," Patterson said.
One possible target may be an enzyme involved in the production of ghrelin, Burch said.
Indeed, one approach taken by researchers seeking to develop an obesity vaccine has been to block the hormone's production.
However, some have argued that, because many hormones are involved in weight loss, targeting one is unlikely to help people lose weight.
"Most of us are skeptical that 'turning off the ghrelin switch' is the universal answer to all obesity," Bhoyrul said.
yet somehow companies like pfizer generate billions on a drug like this. they are fooling everyone, eh?
Can you say, "Aricept?"
DGX buys Athena Diagnostics unit of TMO for $740M in cash
That is approx. 7X revenue. The GXDX deal was 4X revenue. Looks like some premiums are being paid in this space.
C'mon ABT, give us 7X revenue for NGNM!!!
aj