Thursday, July 18, 2013

WHAT DO WE LEARN FROM AGING /the future of medical practice!

Our knowledge has been increasing at a rapid pace, and day after day, we are increasingly convinced that medicine practiced today will not be practiced in the future.  Most of our current recommendations leading medical practices will be modified if not abandoned.  There is a lot of ignorance still going around and most likely some of our conclusions are either short sighted or clearly wrong.
Some of the major potential areas of Mistakes:

1.We ignore the fact that our current major tested parameters are related to a corrected physiology:  we check a normal calcium in the blood, sometimes ignoring that this normal in the blood is achieved by an increase in PTH such as in secondary parathyroidism.  We know well that a persistent elevation of PTH means bone stability is impaired.  In this case, the normal Calcium is not a status of health.

2. We tend to ignore some evidences because we do not know what to do about them:  It is known for quite sometime now that aging is related to high levels of growth factors and Cytokines." THE LEVELS OF INFLAMMATORY CYTOKINES INTERLEUKIN-6, IL-1 BETA, C-REACTIVE PROTEIN, TGF-beta ALL INCREASE WITH AGE" (MORTIMER )." Yet we do not intervene despite our current means!  No elderly comes out of his or her Docteur's office with a level of Cytokine or Metalloproteases for that matter.
We have a consensus that obesity is a disease, but no patient comes out yet with IGF levels.  Metformin is good for you, but so far no indications as to what BMI needs to prompt metformin prescription (and at what age: 30 when the decline is reportedly starting?  What level of IGF Receptor desensitization is critical in cancer development, how to measure this?

3. We are at the wee hours of pathway amplification or repression measurements.  Is it the length of exposure, or a critical level of influence on pathways that starts a neoplastic process?  Or is it a sense of cellular polarity? Is it the mere level of cytokines or is it a ratio that is important (ie. IL-6/IL2  or IL12/IL-4) ? This is where the future will be...

4.  What kills post synaptic neurons after a stroke? Cytokines!  Do we do something to stop it? not yet!

5. We know the Wnt and the Notch are critical in the determination of our survival, but how do we know to actually measure this?

6. We know Interferon 1 dysregulates our immune system, insurance will not let measure this but in the future of course, this will be routine!

7. Telomere length...routine

The routine lab test chart will be completely different from the current CBC and CMP.  What is the state of your thymus by the way?  These are the kinds of information that will be routine then!

Add to it the types of virus that have invaded your genome chart and you know the feeling!  Medicine has more room to advance for the benefit of our patients!

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