Saturday, January 26, 2008

Transplant teenage girl changes blood types

A major rethink of what we know about blood types coming up, I suspect

FIFTEEN-year old Demi-Lee Brennan defies belief. Dubbed the "one-in-six-billion miracle girl", the NSW South Coast teenager is the first transplant patient ever to change blood types and take on the immune system of her organ donor. Her body's ability to accept a new liver - and then produce new blood cells on its own - has left doctors mystified. The rare phenomenon now means Demi no longer has to take a cocktail of anti-rejection drugs for the rest of her life. It also gives hope to the 1800 gravely ill Australians awaiting a transplant.

Demi, of Kiama, resembles a healthy teenager who displays no signs of her ordeal - other than the scar on her body. And, in an unexpected medical first, she has experienced a change in blood type from Onegative to Opositive, as a result of her body seeming to perform its own bone marrow transplant.

"It's kind of hard to believe," Demi said. "When I look back, it doesn't feel like it happened." When Demi was nine she became seriously ill and needed a life-saving liver transplant. Doctors at the Children's Hospital at Westmead believe a yet-to-be-identified virus caused her liver to fail. A donor was found but after nine months Demi fell ill again - with doctors unable to identify the problem. During that first nine months, Demi was put on routine anti-rejection drugs after her liver transplant surgery.

Then doctors found that Demi's body had begun to destroy its own blood cells and, at the same time, the donor's blood stem cells took over her immune system. Doctors then halted the anti-rejection drugs, realising her blood type - and immune system - had taken on the characteristics of her organ donor.

Their discovery is now the subject of medical research being pursued around the world. Former head of Westmead's liver transplant unit, Dr Stuart Dorney, said there is no explanation for what occurred. "We now need to go back over everything that happened to Demi and see why, and if, it can be replicated," he said. "It may not be (replicated). We think because we used a young person's liver and Demi had low white blood cells that could have been a reason."

It has been almost four years since Demi received her liver and is hoping to permanently stay off anti-rejection drugs. "I am really thankful (to the donor's family) and I hope that so many people can do this too," she said. "I would say to other transplant patients, 'stay strong and determined'.

In Australia, about 100 liver transplant procedures are carried out each year. Of those, paediatric liver transplantations account for 20 per cent. Recipients have an 85 per cent survival rate one year after successful surgery but the rate reduces to 70 per cent after five years due to possible organ rejection complications.


D'Oh! Correcting nutritional deficiencies is helpful

Perhaps I am being a bit cynical but this sounds a bit like a proof that grass is green to me. It DOES confirm the importance of vitamin D but did anybody doubt that? I suppose we should at least be glad that it was one of the rare double-blind studies and not the usual epidemiological crap. Note that it does NOT show that ALL older women should take vitamin D. Popular summary followed by abstract below

VITAMIN D supplements may help to prevent falls among older women, and should be given to those with a history of falling and low vitamin D levels, concludes an Australian study in the Archives of Internal Medicine this week. Richard Prince and colleagues from the Sir Charles Gairdner Hospital in Perth recruited 302 women aged 70 to 90 years with low blood vitamin D levels and a history of falling in the previous year. They were randomly assigned to take either 1000 international units of vitamin D2 (ergocalciferol) or an inactive placebo, and all received 1000mg of calcium citrate per day. Information about falls was collected from participants every six weeks. During the year-long study, 53 per cent of those in the vitamin D group and 63 per cent in the control group fell at least once. After adjusting for height, which affected the risk of falling, vitamin D therapy reduced the risk of having at least one fall by 19 per cent.


Effects of Ergocalciferol Added to Calcium on the Risk of Falls in Elderly High-Risk Women

By Richard L. Prince et al.

Background: Ergocalciferol (vitamin D2) supplementation plays a role in fall prevention, but the effect in patients living in the community in sunny climates remains uncertain. We evaluated the effect of ergocalciferol and calcium citrate supplementation compared with calcium alone on the risk of falls in older women at high risk of falling.

Methods: A 1-year population-based, double-blind, randomized controlled trial of 302 community-dwelling ambulant older women aged 70 to 90 years living in Perth, Australia (latitude, 32øS), with a serum 25-hydroxyvitamin D concentration of less than 24.0 ng/mL and a history of falling in the previous year. Participants were randomized to receive ergocalciferol, 1000 IU/d, or identical placebo (hereinafter, ergocalciferol and control groups, respectively). Both groups received calcium citrate, 1000 mg/d. Fall data were collected every 6 weeks.

Results: Ergocalciferol therapy reduced the risk of having at least 1 fall over 1 year after adjustment for baseline height, which was significantly different between the 2 groups (ergocalciferol group, 53.0%; control group, 62.9%; odds ratio [OR], 0.61; 95% confidence interval [CI], 0.37-0.99). When those who fell were grouped by the season of first fall or the number of falls they had, ergocalciferol treatment reduced the risk of having the first fall in winter and spring (ergocalciferol group, 25.2%; control group, 35.8%; OR, 0.55; 95% CI, 0.32-0.96) but not in summer and autumn, and reduced the risk of having 1 fall (ergocalciferol group, 21.2%; control group, 33.8%; OR, 0.50; 95% CI, 0.28-0.88) but not multiple falls.

Conclusion: Patients with a history of falling and vitamin D insufficiency living in sunny climates benefit from ergocalciferol supplementation in addition to calcium, which is associated with a 19% reduction in the relative risk of falling, mostly in winter.

Arch Intern Med. 2008;168(1):103-108.


Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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