The Health, Wellness & Beauty Pages

March 12, 2010

The boxed warning for Plavix’s label alerts doctors that genetic tests are available to establish patients’ CYP2C19 status. However, the FDA leaves it up to physicians to decide whether to wait for genetic testing results or put patients on an alternative treatment.

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DNAistheWay.net

President Obama Wants a Health-Care Reform Bill on His Desk by August

President Obama stepped off a plane from Paris Sunday and into his next domestic crisis: health-care reform.

“The status quo is broken. We cannot continue this way,” Mr. Obama said in his weekly address. “If we do nothing, everyone’s health care will be put in jeopardy.”

The president wants a health reform bill that covers all Americans on his desk by August, reaching for a goal that has eluded presidents for decades — in a single summer. He had planned to leave the details of health-care reform to Congress, as long as they met his broad goals for a plan that would “lower costs, improve quality and coverage, and also protect consumer choice.” But now the White House says he’ll play a much stronger role, including demanding an optional government-run health plan.

“The president and many others believe that the availability of a public option alongside private options for people who need health care is, is a positive thing,” presidential adviser David Axelrod told CBS. “He is going to promote that as part of his plan.”

ABC News has learned that Sen. Edward Kennedy, D-Mass., who has vowed to make health care “the cause of my life,” has drafted a plan that would require employers to insure their workers. A Kennedy aide cautioned that was a “draft of a draft” and could be changed.

Health insurers are skeptical of Democratic efforts that could present them with a government rival or restrict their profits. Blue Cross Blue Shield of America is planning advertisements opposing a “government plan,” without mentioning that the new plan would pose a rival to the company’s own. Republicans — left out of the administration’s planning — have already drawn battle lines.

Republican Senate leader Mitch McConnell, R-Ky, has taken to the Senate floor all week, repeatedly lambasting what he calls a “government takeover of health care.”

Republican Sen. Chuck Grassley on Sunday sent this angry message via Twitter: “pres obama you got nerve while u sightseeing in paris to tell us ‘time to deliver’ on health care.”

Obama Enlists Network of Organizers

This weekend the White House enlisted Obama’s old campaign network, now Organizing for America, organizing thousands of health-care reform parties from Boston to Los Angeles.

“As folks talk to their neighbors, they’re going to go out and talk to their congressmen and create this urgent reform this year,” Hari Sevugan, a Democratic National Committee spokesman who also works with Organizing for America, told ABC News.

The health care crisis that drove supporters into Obama’s campaign last year is now driving them by the thousands into health-care parties. What is less clear is whether when they walk out they will be able to make a difference. Hundreds of thousands participated in a similar campaign to boost the president’s budget and stimulus plans, but that remains a far cry from the 13 million Americans on his campaign list.

A few attendees at gatherings in Chevy Chase, Md., and Washington, D.C., expressed skepticism.

“Before we can go out and beat the drums for an Obama health initiative, we have to know what it is,” one meeting attendee said.

Democratic organizers say the movement is growing, and leaders have learned from past efforts to rally supporters for the president’s budget and economic stimulus plans.

“There are tens of thousands of Americans gathered in libraries, in their living rooms — instead of staying outside — talking about reforming the health-care system,” Sevugan said. “I think that is a great success.”

By: Barbara Basler | Source: From the AARP Bulletin print edition | June 1, 2008

In the last year and a half alone, scientists have discovered more than 100 genetic variations associated with many of the medical conditions that affect older people, including type 2 diabetes, Alzheimer’s disease, asthma, osteoporosis, high blood pressure and heart disease.

The human genome is the total genetic information of a human being. It is stored in 23 pairs of chromosomes. These 46 chromosomes that are found in most cells house DNA, which contains the instructions needed to direct the body’s biological activities. DNA looks like a ladder twisted into a coil—the famous double helix. By analyzing strands of DNA, scientists have identified the sections—the genes—with the coded messages that contribute to life processes. Each human being has 21,500 genes. See Also: • Are Genetic Tests a Good Idea? It Depends • Revealing the Secrets of Disease: A Timeline • To learn more, visit the National Human Genome Research Institute

Indeed, genetic science is moving so swiftly that, experts say, people now in their 60s, 70s and even 80s will see medical breakthroughs that will touch their lives.

“What’s happened in just this short period of time is dizzying to contemplate,” says Francis Collins, M.D., the scientist who directed the international Human Genome Project for the National Institutes of Health—and made news around the world.

Just five years ago Collins’ team completed the monumental project—mapping and sequencing all the genetic information encoded in DNA, the “instruction manual” for humans.

Using this astonishing guide, researchers can now compare the genes of groups of people who have a particular condition with groups of people who don’t, surveying the entire genome to find where the genetic differences lie. Such research is vital: Virtually every human ailment, except trauma caused in accidents, has some genetic basis.

The Human Genome Project, experts agree, is a watershed achievement in science.

It was Collins, a guitar-playing, motorcycle-riding geneticist, who brought the project in two years early and under budget. In an interview with the AARP Bulletin, the affable 58-year-old—who will leave his post Aug. 1—talks about the avalanche of information triggered by the genome, particularly in relation to older people.

To see the power and quickness of genomic science, he says, look at age-related macular degeneration, an eye disease that has left nearly 2 million Americans visually impaired.

“We’ve come a huge distance with this disease in the last few years,” Collins says. “Using new genomic tools, we’ve discovered two genes that account for about 60 percent of the risk—the rest is smoking. But we were surprised. These genes are involved in inflammation, and everybody was thinking macular degeneration was caused by aging in the back of the eye.”

Now, doctors are testing for ways to prevent the disease with anti-inflammatory drugs that “have been around for a long time,” Collins says. “Even something as simple as aspirin might have value. This is the best insight into this disease we’ve ever had, and it has completely changed the way we look at it.”

Scientists are optimistic that they’ll find similar breakthroughs for a host of other conditions.

“We knew many common diseases had hereditary links because we knew they tend to run in families,” Collins says. Over the years, scientists have pinpointed some 1,700 genes linked to disease, many of them powerful mutations of single genes. Each variation is responsible for a rare disease, such as Huntington’s, a degenerative brain disease. “But with the genome we are learning the underlying causes at work in complex diseases like diabetes or high blood pressure, which involve many genes, each with a modest effect,” Collins says. “It’s with these more common diseases that we’ve had the recent deluge of discoveries.”

A lanky Virginian, Collins earned a doctorate in chemistry at Yale and his M.D. at the University of North Carolina. He became a dedicated hunter of disease genes as a faculty member at the University of Michigan. Since 1993 he has worked at the epicenter of the genomic revolution, on the leafy NIH campus in Bethesda, Md. The National Human Genome Research Institute is tucked into a suite of beige-colored offices that look more like a dentist’s practice than the headquarters of a world-renowned research center. From here, Collins, who led a team that found the gene for Huntington’s and the gene for cystic fibrosis, oversees 500 scientists on the NIH campus and others at universities.

“Our best hope for curing diseases comes out of genomics,” Collins says, because it points to the problem of disease at the molecular level, rather than at symptoms or secondary effects.

Genomic discoveries are already pointing the way to new drugs that disrupt processes at the molecular level and to tests that predict one’s risk for a disease.

The research is also opening the way for a new “personalized medicine” that allows doctors to test a patient to determine which drugs will work most effectively with the patient’s genetic makeup. Last year the Food and Drug Administration recommended genetic tests for patients taking the blood thinner warfarin (also sold as Coumadin, Jantoven, Marevan and Waran) to help doctors prescribe the right dosages.

Studies show that 40 percent of those who take the drug have genetic variations that make them more sensitive to its effects and so need smaller doses. The genetic test can identify those at risk for bleeding complications from the drug.

“Soon, this kind of testing will be happening for asthma medications, antidepressants and cholesterol-lowering statins,” Collins says. “We should be able to do better with genetic evaluations of these drugs within three to four years.

“And boy, do we need more of this,” says Collins, who in September will be given the Andrus Award, AARP’s highest honor, for his contributions to science.

“Most of the time you go to the doctor, and the drug you’re given is one we arrived at empirically—we tried something and it seemed to work,” he says. “It’s one-size-fits-all medicine, and that’s not ideal. Now, with the genome, we have a whole new paradigm. It’s very exciting.”

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