How Young India is fuelling the future of stem cell therapy and signing up to save lives – YourStory

Eighteen-year-old Aisha Choudhary was just like any other adolescent eyes filled with dreams and a heart brimming with energy. The only difference was she was battling a rare genetic disease, Severe Combined Immune Deficiency (SCID). Diagnosed when she was six months old and undergoing medical treatment for years, she was iron-willed in playing the cards she was dealt.

Since one of the most effective cures for SCID is a stem cell transplant (grafting of the parent cells from which all blood cells develop), Aishas parents, Niren and Aditi, decided to opt for that treatment mode. But their cells were not a complete match with their daughters, and they had to look at external donors. However, due to a low number of voluntary, registered stem cell donors, Aisha could not get a compatible donor whose genetic markers were a close enough match to hers. With no other alternative treatment available, Aisha had a bone marrow transplant. But, it came with a side-effect that cost her life Pulmonary Fibrosis, a disease known to damage the lung tissues.

Aishas Choudhary's role has been played by Zaira Wasim in The Sky is Pink.

Aishas journey has been captured in The Sky is Pink, a recent Bollywood movie starring Priyanka Chopra, Farhan Akhtar, Zaira Wasim, and Rohit Saraf.

The 18-year-olds life story is mirrored in the experiences of many who await stem cell donation as treatment for blood-related illnesses likeleukemia, lymphoma, and sickle cell anemia every year. With very few individuals signing up as donors and the probability of finding a match being a dismal 0.0008 percent in India (against a lean 16 percent abroad), fatalities are mounting year on year.

However, in recent times, there has been one small break in the clouds a number of youngsters, non-governmental organisations, and medical professionals have come forward and are working to spread awareness about stem cell donation and motivate a larger number of people to register as donors.

The stem cells in a human body mainly comprise red blood cells, platelets, and white blood cells. These are found in the umbilical cord of newborns and in the peripheral or circulating blood and bone marrow.

A stem cell donation is as simple and painless as a blood donation.

Certain diseases like blood cancer and leukemia tend to destroy the bone marrow or affect its functioning.For these, treatments like chemotherapy and radiotherapy are tried initially. However, in some cases, they do not prove effective for a cure. The only recourse then is replacing the patients stem cells with those of a healthy person.

One of the main criteria for a successful transplant is a good match between the stem cells of the donor and those of the patient. Therefore, a donor registry will administer a cheek swab test (tissue samples extracted from the cheek) on all potential donors to match cell characteristics. This procedure of pairing generic markers is called Human Leukocyte Antigen (HLA) in medical terms.

A cheek swab test in progress.

Each potential donors tissue is entered in the registry and given an identification number after the test is done. If the registry finds a match at any point in time, the donor is contacted to initiate the transplant.

There are many organisations today that are leading the charge in saving the lives of people suffering from serious blood disorders like cancer, thalassemia, and anaemia.

For instance, Datri, an Ahmedabad-based NGO, is working to create a wide and diverse database of potential stem cell donors by organising donation drives. Founded in 2009 by two doctors and an engineer, the organisation focuses on conducting awareness campaigns and helping individuals sign up on its registry as a committed and voluntary benefactor.

The team of the NGO Datri.

The idea for Datri was initially born in the minds of doctors Nezih Cereb and Soo Young Yang, who run a laboratory, Histogenetics, for determining tissue matches between patients and donors. Since pairing tissue types is imperative for any stem cell transplant, and confronting a severe shortage of donors, the doctor duo would run from pillar to post to meet hospitals requirements. Working with a number of the hospitals in India, they realised just how acute the shortfall was in people willing to donate stem cells. They recognised the immediate need to create a donor registry here.

Soon after, Raghu Rajagopal, an engineer from BITS Pilani and Director of ready-to-eat venture Millets and More, connected with them and they decided to start Datri.

Today, the functioning of the registry, its maintenance, and even the substantial costs involved in conducting the HLA matching are taken care of by the lab. In the last 10 years, Datri has gotten over four lakh people to register as donors and has saved around 600 lives through successful transplantation.

Every day, about 40 people are diagnosed with blood disorders in India. Though these can be cured through a stem cell transplant from a genetically matched donor, there is only a 25 percent chance of finding a match from within the family. Others have no option but to rely on unrelated donors. But the chances of getting a match is anywhere between one in 10,000 and one in two million. There is an urgent need to rope in as many potential donors as possible, which is precisely what Datri is trying to do, Raghu explains.

Another organisation that is dedicated to fighting blood disorders with stem cell treatment is DKMS-BMST. It was formed through a joint venture between two renowned NGOs DKMS, which is one of the largest international blood stem cell donor centres globally, and the Bangalore Medical Services Trust (BMST).

The team of DKMS-BMST.

DKMS was founded in Germany in 1991 by businessman Dr Peter Harf, after he lost his wife to leukemia. BMST was born in 1984 from the vision of Dr Latha Jagannathan, a medical director and managing trustee. Since both organisations had a common goal to find a matching donor for every patient with a blood disorder, they decided to come together to achieve it.

A group of youngsters registering to be stem cell donors.

So far, more than 37,000 people in India have registered as potential donors after attending DKMS-BMSTs donor drives.

In highly populous countries like India, thousands of people are in need of stem cell transplants every year to survive. Though donating stem cells is a painless and non-invasive process, it remains a lesser-known medical concept in India, with only 3.6 lakh people willing to play a part in it. Besides, the chances of stem cells of people of the same ethnicity matching are higher than those of individuals from different ethnic backgrounds. But, it is due to sheer lack of awareness that India lags severely in stem cell donations, say experts.

Students taking a cheek swab test at one of the colleges in Bengaluru.

Dr Govind Eriat, a reputed hematologist and bone marrow transplant specialist, says,

With a major hurdle to stem cell donation in India proving to be the myths surrounding the subject, the youth are coming forward to deconstruct common misconceptions.

For instance, 21-year-old Tejaswini Patel, a student of Information Science at New Horizon College of Engineering, Bengaluru, has been busting the false ideas on stem cell donation, starting among her family and friends. She says,

She adds, with a notable sense of pride, In the last two years alone, around 400 students from my college have registered themselves as donors.

(Edited by Athirupa Geetha Manichandar)

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How Young India is fuelling the future of stem cell therapy and signing up to save lives - YourStory

Fit and healthy teacher dies 20 days after discovering he had leukaemia at 33 – The Sun

WHEN teacher Matt Meads started suffering with stomach pains, night sweats and tiredness - he quickly dismissed it as end of school year fatigue.

He was fit and healthy, and avoided drinking and smoking.

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But just three weeks after first falling ill, Matt died - aged just 33 - and after just three chemo sessions.

He and his wife Abi were devastated when they discovered his symptoms were actually a sign ofleukaemia.

Heartbroken Abi, 27, from Nottingham, is now sharing his story to raise awareness and to urge others to be vigilant for signs of acute lymphoblastic leukaemia, a rare and aggressive form of blood cancer.

"I've got so many people around me offering help and support but I still feel really lonely because I've lost my best mate, my husband, my soulmate," Abi said.

It comes as blood cancer charity Bloodwise warns thousands of people are dying of the disease because it's diagnosed too late.

Matt and Abi first suspected something was wrong on July 6, when he began feeling more and more fatigued.

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And when he started vomiting to the point of being unable to keep ice cubes down, Abi urged him to go to the doctor.

At first he was told by his GP he had gastroenteritis or constipation but he soon returned to the hospital for a second time where they did a blood test.

Abi, who works as a teacher too, said: "Obviously I wish it was spotted sooner.

"I don't feel any anger towards to the hospital.

"I genuinely believe they did everything they could for him.

"He would say he was feeling sick."He would send a text saying he wasn't feeling well so was going to bed. I was out with some friends.

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"He said something about feeling hot as well, but we didn't put that down to anything because it was the middle of summer and everyone was feeling hot.

"He was sleeping a lot, particularly at weekends which he would spend mostly asleep.

"But we're both teachers, it was coming up to the end of the school year and we had both got a lot of work on.

"We put it down to the job, and just tried to keep going because we had five weeks off soon.

"We thought it was the usual fatigue that we feel at the end of the year.

"There were sickness bugs going around at both of our schools so it wasn't anything out of the ordinary.

"He was referred to A&E for the second time thinking it was gallstones.

I've got so many people around me offering help and support but I still feel really lonely because I've lost my best mate, my husband, my soulmate

"They did some blood tests on him, sent him for a CT scan. The doctor came back and basically said that it was leukaemia."

Despite the devastating diagnosis, Abi said her brave husband remained positive as he came to terms with what was really happening.

She added: "Matt was a really positive person and was always somebody who believed what would be would be, it is what it is and all that stuff.

"So when the doctor told him he was quite composed.

"He didn't really give anything away about what he was feeling.

"It was obviously a massive shock for him but he didn't really respond in the way I would have done. He was listening to the doctor.

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"The doctor actually stopped at one point because he was explaining what would happen next.

"He actually stopped at one point to ask him if he was okay, it was really big news and is he taking it all in?

"Matt's response was, 'yes, but there's nothing I can do about it. It is what it is'.

"He was definitely really brave."

And Abi says the diagnosis came as even more of a shock given how healthy he was.

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She was forced to watch her husband go from happy and sporty to intensive care within days, before he passed away from a pulmonary embolism after just three chemotherapy sessions.

She said: "We knew he was poorly, but maybe not quite how poorly he was.

"I certainly wasn't expecting a phone call from the hospital.

"I don't know how I am now. It's hard. I don't think I really started to grieve until after the funeral.

"It's hard to think ahead for anything. It's a case of taking everything one day at a time.

"Some days are better than others. Some days are horrific and I don't want to get out of bed.

What is Acute Lymphoblastic Leukaemia?

Acute lymphoblastic leukaemia (ALL) is a type of blood cancer that starts from young white blood cells called lymphocytes in the bone marrow.

Adults and children can get it but it is most often diagnosed in younger people.

It'svery rare, with around 650 people diagnosed with the condition each year in the UK.

Many symptoms of ALL are vague and non specific. It may feel like the flu as symptoms are caused by too many abnormal white blood cells and not enough normal white cells, red cells and platelets.

Symptoms can include:

Recently blood cancer charity Bloodwise warned thousands of patients in England could be unnecessarily dying from blood cancer because they are diagnosed too late.

Experts analysed NHSdata and found 28 per cent of patients are told they have the disease after needing emergency treatment for their symptoms.

Figures show there are around 40,000 cases of blood cancer - a group of diseases including leukaemia, lymphoma and myeloma - each year in the UK.

Around 77 per cent of patients will survive for three years if they are diagnosed after visiting their GP, Bloodwise says.

In contrast, the same survival rate plummets to just 40 per cent for patients who are diagnosed as an emergency.

This is because symptoms develop over a few weeks and become more severe as the number of immature white blood cells increases.

"Matt was a really happy person. He was really positive.

"He was kind, caring, loving, wicked sense of humour. He would make a joke about anything and was very quick-witted.

"As a teacher he would have done anything for his students. He would have done anything for his family.

"He was just a really positive person who would have done anything for anybody.

"He loved his sport. He would go to the gym, he loved being outside and walking. He liked cycling. He was careful about what he ate.

"Everything the doctors warn you about, he didn't do. He didn't drink, he didn't smoke, he had a good diet, he exercised.

If you've got any of the symptoms which are lasting or you can't explain why you've got them, you need to go to the doctor and get checked out and be persistent in asking for a blood test

"He always put sun-cream on because he was paranoid he might catch skin cancer or something.

"He did everything he could to try and prevent anything from happening to him.

"As the doctors said there was nothing he could have done to prevent this."

Abi is now speaking out to urge others to get checked out and insist for a blood test if they have persistent symptoms of blood cancer.

She said: "If you've got any of the symptoms which are lasting or you can't explain why you've got them, you need to go to the doctor and get checked out and be persistent in asking for a blood test.

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"You know your own body. It's as simple as having a blood test.

"If you've got it for days and it's not getting any better, if you're in any doubt, get it checked.

"We didn't know what the symptoms were.

"The only one I knew was bruising, but Matt didn't have any bruises until he was in hospital. So the one thing I knew wasn't relevant.

"I didn't realise about the night sweats, fatigue or heavy breathing.

"We never expected it would be that.

"We had thought worst case scenario it was gallstones or an impacted bowel, so when he came and said leukaemia it was just unexpected.

"When you're poorly you have all these possibilities going through your head but you never think it's going to be that.

Warning

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"I had a really good chat with Matt's consultant where I questioned whether I should have done more, if I had spotted things sooner, whether if I had been more pushy in getting him to hospital.

"But the symptoms are vague and it can come on within days. It doesn't have to be something that has been happening for weeks or months."

You can donate on Abi's fundraising page in memory of Matt here.

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Fit and healthy teacher dies 20 days after discovering he had leukaemia at 33 - The Sun

World Cord Blood Day 2019 to Welcome Leading Transplant Doctors and Pioneering Cellular Therapy Researchers – PRNewswire

TUCSON, Ariz., Oct. 9, 2019 /PRNewswire/ -- World Cord Blood Day (November 15th, 2019) is a free event and open to the public. In addition to events worldwide, World Cord Blood Day will feature a free online conference. Renowned researchers and leading transplant doctors will give introductory presentations for the public as well as academic lectures specifically designed for healthcare professionals.

Attendees will learn about the 40,000+ cord blood transplants performed since 1988 to treat over 80 life-threatening diseases including sickle cell anemia, thalassemia, lymphoma and leukemia. In addition, attendees will learn about exciting advances in the emerging field of regenerative medicine to potentially treat autism, cerebral palsy, spinal cord injury and more.

As the host and organizer of World Cord Blood Day 2019, Save the Cord Foundation is proud to announce the following speakers for this year's program (in order of appearance): Dr. Joanne Kurtzberg (Duke Department of Pediatrics, Duke Center for Autism and Brain Development), Dr. Karen Ballen (University of Virginia), Dave Murphy and Monroe Burgess (Quick Specialized Healthcare Logistics), Dr. Wise Young (Rutgers University), Dr. Elizabeth Shpall (MD Anderson Cancer Center), Dr. Filippo Milano (Fred Hutchinson Cancer Research Center). In addition, attendees will hear from Dr. Alexes Harris who beat cancer thanks to a cord blood transplant from a donor and young Luke Fryer who was treated for cerebral palsy with his own cord blood in a clinical trial.

The morning session will focus on the success of cord blood transplants over the past 30 years and how transplant doctors use cord blood stem cells today, namely, to fight blood cancer. The afternoon session will look at new directions in cord blood research. Attendees will receive updates on several ground-breaking clinical trials using cord blood in regenerative medicine, cellular therapy and more. To view the full agenda, please visit: https://www.worldcordbloodday.org/online-medical-conference-agenda.html

Organized and hosted by Save the Cord Foundation (501c3 non-profit), this year's event is officially sponsored by Quick Specialized Healthcare Logistics. Inspiring Partners include the Cord Blood Association (CBA), Be the Match (NMDP), World Marrow Donor Association (WMDA-Netcord), AABB Center for Cellular Therapy and Foundation for the Accreditation of Cellular Therapy (FACT).

Visit http://www.WorldCordBloodDay.org to learn how you can participate and/or host an event. Join us on social media using the hashtags: #WCBD19 and #WorldCordBloodDay.

About Save the Cord Foundation

Save the Cord Foundation (a 501c3 non-profit) was established to advance cord blood education. The Foundation provides non-commercial information to parents, health professionals and the public regarding methods for saving cord blood, as well as current applications using cord blood and the latest research. Learn more at http://www.SaveTheCordFoundation.org.

About Quick Specialized Healthcare Logistics

Quick is the trusted logistics leader serving the Healthcare and Life Science community for almost 40 years. Quick safely transports human organs and tissue for transplant or research, blood, blood products, cord blood, bone marrow, medical devices and personalized medicine, 24/7/365. Quick's specially trained experts work with hospitals, laboratories, blood banks and medical processing canters, and utilize the safest routes to ensure integrity, temperature control and chain of custody throughout the transportation process. Learn more at http://www.quickhealthcare.aero.

Media contact:Charis Ober225955@email4pr.com520-419-0269

SOURCE Save the Cord Foundation - World Cord Blood Day

http://www.savethecordfoundation.org/

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World Cord Blood Day 2019 to Welcome Leading Transplant Doctors and Pioneering Cellular Therapy Researchers - PRNewswire

Eurecon Verlag GmbH: 20th Pharma Trend Image & Innovation Awards The Winners and Runner-ups – BioSpace

Oct. 10, 2019 10:03 UTC

BOCAhealth with its body fluids manager receives the Pharma Trend 2019 Most Innovative Product award in the startups category. Runner-up is Surge-on Medical with its freedimensional surgical instruments. The third places goes to AiCuris Letermovir, a drug for the prophylactic anti-cytomegalovirus therapy for those who have undergone bone marrow transplantation.

MUNICH--(BUSINESS WIRE)-- An interdisciplinary jury of ten evaluated the applications by medical startups in the categories biotechnology, medical technology and digital health. The products and projects ranked among the top 3 received the Most Innovative Product Award. The discipline-specific awards were presented during the Pharma Trend Image & Innovation Awards, which took place on September 17, 2019, at the German Museum in Munich, this year marking the 20th award ceremony.

The jury assessed the submitted product and project applications based on criteria such as the benefit for the patients, the innovative content, efficiency in application and the transition to standard care. In 2019, the following companies received the Most Innovative Product award:

Digital health: BOCAhealth, the body fluids manager of the future

Body fluids disorders (dehydration or its opposite, chronic fluid retention) are a common and risky issue in many clinical situations, especially in heart failure, chronic kidney disease and elderly patients. It is estimated that every other patient is released from hospital with a hydration problem, and their 1-year mortality is up to 30%. Inside the hospital ward, the patients hydration status is checked through the inaccurate fluid balance (inflow of infusions outflow of urine). At home the patients use weight scales that do not allow an accurate assessment of body water changes either. So far, there is no accurate, easy to use, digital and versatile solution for both hospital and home monitoring.

BOCAhealth is a portable bioimpedance device connected with a smartphone application that easily measures the patients hydration and nutrition status and estimates their cardiac output and systemic vascular resistance. The BOCAhealth software provides doctors with a real-time risk prediction score based on artificial intelligence to guide the infusion and medical therapy.

BOCAhealth is the first body fluid composition analyzer that combines portability, accuracy and a risk predictor score based on artificial intelligence. These benefits convinced the jury to grant BOCAhealth the award for the Most Innovative Product. The award was accepted by the CEO and founder Dr. Allesandro Faragli.

Medical technology: Surge-on Medical, Freedimensional surgical instruments to empower surgeons

Founded in 2015 in the Netherlands, Surge-on Medical has developed the next generation of minimally invasive surgical instruments. Through cable-free technologies, they have created freedimensional instruments that provide better access to surgical areas and replace current pre-bent instrumentation, while complying with current and future FDA and European regulation. Surge-on Medical has been granted four international patents which make minimally invasive instruments steerable, detachable and cleanable. The company is currently active in arthroscopy, laparoscopy and robotic surgery, but it is also preparing to expand to additional surgical fields to keep empowering surgeons. It aims to become the worldwide leader in the development of minimally invasive instruments.

The Most Innovative Product award for the second place was accepted by Dr. Tim Horeman, CTO of Surge-on Medical.

Biotechnology: Letermovir (Prevymis) by AiCuris

AiCuris has developed a new agent against the human cytomegalovirus (HCMV), which occurs around the world. More than half of the global population are chronically infected with the virus, but only patients with a weakened or lacking immune system are at risk of serious illness or even death. The new agent Letermovir inhibits an enzyme within the virus and thus prevents its spread without damaging the host cell. This allows very good tolerability, which for the first time enables prophylactic life-saving therapy.

Letermovir was initially developed, and has already been successfully applied, for HCMV prophylaxis in patients who have undergone stem cell and bone marrow transplantation. Following a successful phase 3, Letermovir was approved in the USA, Canada, Japan and other countries as part of a process of introducing the drug to the global market. In the future, Letermovir will also benefit organ transplant recipients, AIDS patients and new-borns. The drug has been available from German pharmacies since 2018 under the brand MSD brand name Prevymis. It was very well received by the medical community and significantly exceeds revenue expectations in the first months of sales.

AiCuris was founded in 2006 as a spin-off from what was then Bayer research division on infectious diseases. Since then, the company has been researching and developing new drugs to treat virological and bacteriological conditions. In 2012, AiCuris was able to conclude a much-noticed license agreement with MSD concerning HCMV drugs.

Dr. Holger Zimmermann, CEO of AICuris, accepted the third-place award The Most Innovative Product on behalf of his company.

A successful jubilee ceremony

The patron to the jubilee awards ceremony was the Bavarian Permanent Secretary for Health, Melanie Huml. Around 140 invited decision-makers from the pharmaceuticals industry and health care communications agencies attended the event. Keynote speakers were Dr. Peter-Andreas Lschmann, board member of Bio Deutschland (the German biotechnology industry association), and Dr. Thomas Rodenhausen, board member of Harris Interactive AG. The host for the night was Tamara Sedmak, who regularly presents on TV channels including Sat 1, n-tv and N24.

For more information on Pharma Trend, see https://pharma-trend.com/en/pharma-award/ https://youtu.be/ZTnvSoPeZfQ

View source version on businesswire.com: https://www.businesswire.com/news/home/20191010005379/en/

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Eurecon Verlag GmbH: 20th Pharma Trend Image & Innovation Awards The Winners and Runner-ups - BioSpace

A Doctor Plumbs The Depths Of Ivan Doig’s Illness And Asks: ‘Did He Have An Epiphany?’ – Mountain Journal

I grew up in Ohio and met my first real Westerner at age 27. Kate was from Durango, Colorado and lived next door to me for two months during a rural primary care rotation in medical school. They rolled up the sidewalks at night in Twin Falls, Idaho and so we had plenty of time to talk. Books always figured prominently in the conversation and she recommended her favorite book about the West

Reading that first iconic chapter, Time Spent, led to a 25-year Doig odyssey that eventually landed me in a Montana State University archive reading the final draft of that same chapter, marked up with Ivans own red pen.

It begins, That start of memorys gather: June 27, 1945. I have become 6 years old, my mothers life has drained out at 31 years. And in the first grey daylight, dully heading our horses around from that cabin of the past, my father and I rein away toward all that would come next.

The Doig archive at Montana State is a treasure trove for fans. Its extensively indexed and entirely on line and filled with pictures, original manuscripts and the collection of 3 x 5 and 5 x 8 cards on which Doig kept quotes and observations from his extensive research travels in Montana.

Ivan kept box after box of these cards, many of them with only a single type written sentence, sometimes annotated in longhand. He shuffled and reshuffled these bits of memory assembling them into temporary collections as material to flesh out a particular character or story line and then returned them to their boxes only to be reshuffled and reassembled for the next novel.

In summer 2019, Carol Doig met with a group of visitors and discussed her husband's journey in his last years. Joining them was her close friend, Betty Mayfield, who helped assemble Doig's edited manuscripts, diaries, correspondence and other documents that today are part of the MSU Doig collection. Those joining Carol in her living are, left to right, Betty Mayfield, Dr. Rob Patrick, Justin Shanks a post-doctoral fellow working on the Doig material to make it digitally accessible, and writer Todd Wilkinson of Mountain Journal. Photo by Kenning Arlitsch, dean of MSU Libraries

Sometimes this shuffling was frozen into a more permanent form when he collected them into 2-to-3 page novellas with titles like Scotchisms and Curses.Most assumptions arent conscious until they are shattered. Without realizing it, I had cast my favorite writer in his own movie that ran only in my head.

He woke up in the morning, hunted big game, slept with the world's most beautiful women, cavorted at the Algonquin round table, drank his weight in scotch and then, late at night, great work flowed forth from his pen in a tortured and inspired torrent. He threw himself down exhausted, only to arise and repeat the performance with the dawn. The truth that emerged from touching the physical remnants of his process was far different.

Ivan Doig was . . . a nerd . . .just like me. I clipped articles and collected them in folders, wrote down random thoughts and observations on cards, restacked, hoarded and recombined information. My stories were just about thrombocytopenia and clonal proliferation instead of resilient ranchers scraping out an existence under the Big Sky.

The champion of the lariat proletariat was a closet geek. How disappointing.But my biggest disappointment was yet to come.The archive contained an odd and alluring folder title medical journey that was irresistible to me as a physician. I hadnt realized that Ivan suffered from multiple myeloma for the last eight years of his life and had written four books after being diagnosed with a terminal disease.

Myeloma is a strange form of cancer as cancers go, it is both painstakingly slow to progress and inexorably fatal. Patients rack up complications from the treatment, not because treatment is so toxic, but because they live long enough to suffer from the cure as well as the disease.

The core of the pathology is something called a plasma cell which under normal circumstances produces the antibodies that help fight off invading viruses and bacteria. In myeloma, a single plasma cell mutates and grows uncontrollably crowding out everything else in a patients bone marrow and gumming up their organs with immunoglobulin. The mutant cells eventually cant be contained inside the bone marrow and invade the surrounding solid bone causing painful fractures in the spine and long bones of the skeleton.

As if that was not bad enough, the core of chemotherapy is high dose steroids, usually dexamethasone or prednisone. Steroids are the poster child for double edged swords in medicine. They are simultaneously incredibly useful for suppressing the immune system in autoimmune diseases, cancer and anything that involves inflammation, while at the same time having the most broad ranging side effect profile of almost any medication.

It was a love for wildlands in the West that led Rob Patrick, at right, down the trail of Ivan Doig's books and when he had an opportunity to dive deeper into Doig's final years he jumped at the chance. Another thing that brought him to Bozeman and Greater Yellowstone is his close friendship with Kenning Arlitsch, Dean of MSU Libraries. Here they are on an autumn trip into the Yellowstone backcountry.

Probably the most serious side effects for myeloma patients are immunosuppression leading to increased risk for infection, a softening of the bones accelerating the tendency of the disease to cause fractures and emotional lability. The last of these sounds trivial, but isnt.

My first patient who suffered from this particular side effect literally started a sentence laughing and ended it crying. The cognitive effects can be especially debilitating, because at its peak, the drug lulls one into a false sense of security. It can make patients feel super human and I had one multiple sclerosis patient tell me it was the most powerful antidepressant she had ever taken and she almost looked forward to her next flare so she could get it again. However, on the way up and the way down it can cause confusion and a loss of emotional control that is profoundly disturbing, especially to someone who depends on their brain to make a living. Truly a blessing and a curse of modern medicine.

One of my biggest losses of innocence after medical school was realizing that professors had pulled the wool over my eyes concerning one of the fundamental diagnostic tools in medicinethe patient history. During the pre-clinical years you seldom get to talk to an actual patient and instead hone your skills using case presentations which I later came to understand were carefully curated stories masquerading as actual patients in which the non-salient details were conveniently expunged and the salient ones amplified for teaching purposes.

My teachers smugly told me, If you dont know whats wrong by the time you finish taking the history, take the history again." This illusion is perpetuated during third year clerkships when cases are cherry picked for medical students so as not to dispel the myth. The gloves come off during internship when it is too late to turn back and you realize that most patients have a hard time telling you how they feel no matter how many creative ways you come up with to ask the same question. Its not their fault, they usually just have never felt like this before and dont have the words to describe it.

When you add intoxication, mental illness, dementia, etc. to the mix, taking a history often becomes an exercise in communication breakdown and frustration. So imagine my joy at finding a history written by a professional communicator whose livelihood depended on his ability to observe the world and record it. It was like winning the internal medicine lottery.

Doig observed of myeloma: The waiting room of hell, furnished with side effects.

Of those side effects, he observed, The dex makes me longitudinal - - concentrated on a single line of endeavor at a time, no latitude to speak of and I would go to blow my nose and find there was not a handkerchief within 50 of me. Pill bottle caps leapt for the floor. My ordinary thought process resembles a homesteader digging out a stump, when loaded with dex I plodded right past nuances of life in temporary fixations on getting to my desk and writing things down. Which, amazingly, produced pages of a novel faster than when I wasnt taking the stuff. Dex gave me a mental pop, off-the-chart energy upstairs while it played games with the rest of me. Writing proved to be therapy for therapy.

On the topic of mortality, he explained in a written passage, I am now in remission, that terra incognita but better than being off the map(oblivion). He would add, I have not come out of this as any cheerleader for Nietzche: thera are countless preferable ways to strengthen in life without having something trying to kill you.

Facing the reality, he noted, Invariably fatal. Damn. But then, so is life. Its probably not polite to laugh out loud at the writings of a dying man, but I couldnt help myself and I also couldnt help wondering what a pleasure it would have been to take care of him. There was plenty of correspondence in the archive between Ivan and his doctors, but the most striking examples would probably have been overlooked by the uninitiated. The age of electronic medical records and e-mail allow patients unprecedented access to providers.

Like most technology, this chart messaging is both a blessing and a curse. The blessing is that it doesnt take three phone calls to catch a patient at home and tell them about their lab results.

The curse is the dozens of chart messages to return at the end of a busy day. Consequently, as Doig chronicled, brevity is the rule: Everything normal on your labs today, see you in 6 months."

Doig, when in his prime, trying to instill the lessons of history into his work. Here he absorbs the vibe in an abandoned farm house where heart-felt dreams rose, fell part like a heartache and drifted away. Photo by Carol Doig, courtesy MSU Library Doig Archives

The messages from Ivans providers went on for paragraphs, like post cards from your grandmother, and often came close to open displays of affection. All patients are equal, but some are more equal than others.

My day in the Doig archive was followed by an evening at the annual trout lecture hosted by the MSU library and I happened to find the only other Doig nerd who had spent any time with the medical journey files. Todd Wilkinson, the editor of Mountain Journal, shared my fascination with this little known part of Ivan Doigs life and suggested we pursue an event centered around his medical journey.

I couldnt imagine who else would show up to hear about such a niche topic, but didnt want to spoil the glow of our mutual fandom and encouraged him to pursue it. Three months later I found myself sitting in Carol Doigs living room in Seattle.This would be a good time to disclose that I am not a casual Doig fan. Im not a religious person, but I have made two literary pilgrimages in my life. The first was to Arches National Park to find the location of Edward Abbeys trailer from Desert Solitaire and the second was to White Sulfur Springs, Montana to see the place that had figured so prominently in Doig'sThis House of Sky.

Something still haunted me about the archives. Aside from the few pithy quotes above, there wasnt much mention of how Ivan faced his own mortality. How does an author get up every day and write four more novels when he knows hes dying? More importantly, why does he do it?

My practice over the last 20 years was working as a hospitalist. All of my patients were sick enough to be in the hospital and these days you have to be pretty sick to make it through those doors. I had seen hundreds of patients die and typically had end of life conversations with patients and families several times a week. Indeed, I had been on a personal crusade in the last few years to get doctors to talk with their terminally ill patients about their goals for the end of life and had coached other providers about how to do it.

So here was my chance to salvage something of my shattered romantic ideal about writers. Ivan must have had some big epiphany, I thought, that just wasnt there in his writing and my task was to extract it from his widow. I was as if a literary anthropologist on a mission.

It led to having a wonderful day in Seattle, sunny and warm; the Doig living room had a commanding view of Puget Sound. The house was spare and elegant and warm and inviting all at the same time and I got to see Ivans personal desk with his typewriter and his book collection.

Carol was charming and intelligent and well educated and everything you would expect from the spouse of your literary hero. Todd Wilkinson was there and Kenning Arlitsch, Dean of Libraries at MSU, too, and the person responsible for securing the Doig archive. Our conversation flowed easily.

Todd had a flurry of journalistic questions for Carol about Ivan and his writing. I was the final interviewer and my experience told me that it was almost always the wife that was the keeper of the medical history. So I started with some easy logistical questions.

Doig's desk, where he completed five books in eight years, battling through pain, the effects of medicines and a bone marrow transplant. All this and yet critics say these final works contain passages that are among the most incisive and moving of his four-decade long career. Photo by Todd Wilkinson

No, she did not go to all of his medical appointments with him and she didnt even know about the folder where he had kept all of the materials about his illness until after his death. There goes my first assumption.

We walked through the chronology of his illness, his initial diagnosis, the stem cell transplant, chemotherapy, remission, relapse, second line chemotherapy. What was daily life like? How did they deal with telling friends and family since he was not obviously ill until the end? How long was he on hospice? What was it like at the end? I probed, I rephrased, I asked the same question a different way. But there was no profound epiphany.

What she described instead was a guy who got up every day, made breakfast, went to his study and pounded out his words for the day. If he finished a novel on Friday, he started the next on Monday. A literary proletarian if there ever was one.

I have watched plenty of people die in my career, some face it with grace and dignity and resolve and some fight it and raise their fist against the sky until the last breath. What separated those who faced their end well from those who didnt?

Regret. Regret for things they hadnt done or relationships that had soured, but it boiled down to not living life the way they wanted to. My epiphany was that there was no epiphany. Epiphanies are extraneous when you are already living your best life. Ivan Doig was a wonderful writer, husband, friend, and colleague. If it isnt broken, dont fix it.

More:
A Doctor Plumbs The Depths Of Ivan Doig's Illness And Asks: 'Did He Have An Epiphany?' - Mountain Journal

Sarah Ferguson admits shes had Botox, TWO types of facelift and vitamin injections in a bid to stay youthful – The Sun

LESS than a week away from her 60th birthday, Sarah Ferguson has revealed that she has had Botox, two types of facelift and organic fillers to wind back the clock.

Many royal fans marvelled when the Duchess of York stepped out looking surprisingly youthful for her daughter Princess Eugenies high profile royal wedding last year.

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Addressing rumours of cosmetic surgery, Fergie has confessed that her looks arent entirely natural and she has had professional tweaks.

Speaking to the Mail, she said: The happiness was shining out of me because my daughter was getting married. I was so glad. I love Jack. When Im passionate about anything, my eyes shine.

Above all, it was being joyful for Eugenie that made me look good. But Id had some laser treatment on my face which helped, too.

Although she previously had Botox to tackle facial lines, Sarah admitted she now prefers having laser cosmetic procedures, which are pain-free, non-invasive and take just 90 minutes.

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Mum-of-two Sarah goes to Harley Streets Dr Gabriela Mercik, who is the creator of the worlds first 6-Dimension Ultimate Laser Treatment facelift, which Fergie has now tried.

Sarah first met Dr Gabriela in 1992 when the royal was visiting young cancer victims in Upper Silesia, Poland.

At the time, Dr Gabriela was a medical student helping to treat the patients, and she ended up staying in touch with loyal Sarah.

Fergie first became one of her customers after Gabriele opened her own aesthetic clinic in the UK, and the royal felt her fair skin was too exposed to sunshine as a child.

Sarah said: I live on jingly-jangly nerves. Im very focused, earnestly intense, but I live at high speed. I dont sit down for long. Im always saying to Dr Gabriela, Come on, come on! Hurry up! Im the worst patient.

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She opts for the rejuvenating ultimate facelift, which can be done in a lunch hour and involves boosting the skins production of collagen.

Fergie admitted she had Botox a long time ago when alternative treatments werent on the market, but she now prefers having the facelifts.

The royal said shes not a fan of the frozen look as she is so animated, and also hates needles.

Despite her fears of the surgical tool, she opted for a mesotherapy beauty treatment at the clinic in 2013, which is when vitamins, minerals and amino acids are injected under the faces mesodermal layer to plump skin.

Now she has moved on to organic fillers, which are non-invasive injectable used to tackle lines and wrinkles.

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Five years ago, Dr Gabriela suggested Sarah had a thread lift also known as a puppet lift which is when threads are inserted in to the skin to make a mesh which pulls the face upwards.

Although results last for two years, the threads dissolve over six to eight months.

Sarah said: Before I had it done I thought, Oh this is going to be painful, but it wasnt bad. My skin responded well. I think if you look at photos of me after I had it done, I look much better.

She now hopes the 3,750 6-Dimension Ultimate Laser Treatment facelift will help her look her best for her 60th birthday milestone next Tuesday.

The doctor confirmed that Sarah does pay for treatments at her discretion as the pair have become close friends.

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Sarah admitted that the drive to have facial cosmetic surgery comes from skin damage that started from a young age, when her mum incorrectly thought Nivea moisturiser could be used as sunscreen.

The royal was also motivated to take care of her skin after her dad, Major Ronald Ferguson, passed away from skin cancer in 2003, and her best friend Carolyn Cotterell also died of a malignant melanoma when she was 43.

She now admits any tan she has is from a bottle and she hopes to rebuild her collagen by her birthday.

My skin responded well. I think if you look at photos of me after I had it done, I look much better.

In March she revealed she flew to the Bahamas to have a regenerative stem cell therapy on her feet, after feeling her toes were ruined by frequent horse riding when she was young.

Doctors shaved a spot near her big toe and implanted 20 million stem cells from her midriff into the cavity to make new cartilage.

Due to the surgery not yet being proven to be safe, the UK does not widely offer the treatment.

She may be turning 60, but Fergie insisted in July this year, at the launch of a British Heart Foundation campaign, that she feels sexy, sassy and super saucy.

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The proud mum has recently shared how excited she is for her eldest daughter, Princess Beatrice, to get married next year.

Taking to Instagram last month, Fergie shared six photos of the 31-year-old princess with her millionaire husband-to-be Edoardo Mapelli Mozzi.

She later shared a tweet, writing: "I know what a mother feels so I have tears of joy. I am so proud of this sensational news.

Andrew and I are just the luckiest people ever to have two great sons in law."

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Sarah recently confirmed that the "only place" Beatrice can get married is Britain.

Meanwhile its been claimed Beatrice is ready to start a family with multi-millionaire property tycoon Edoardo.

And Fergie recently honoured the family of a teen who died from severe allergy reaction after eating Pret a Manger sandwich.

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Sarah Ferguson admits shes had Botox, TWO types of facelift and vitamin injections in a bid to stay youthful - The Sun

Campaign to save five-year-old cancer sufferer has become one of the fastest online charity appeals EVER – The Sun

A CAMPAIGN to save a five year old cancer sufferer has become one of the fastest online charity appeals after reaching its 500,000 target in just three weeks.

The parents of Oscar Saxelby-Lee are gobsmacked to have reached the huge amount to fund the emergency life saving treatment abroad in under a month.

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Thousands have pledged the cash meaning he will now fly to Singapore to undergo potentially life-saving CAR-T cell therapy and a second bone marrow transplant in a bid to save his life.

Oscars battle has always drawn huge support and in March almost 5,000 people queued in the rain to find a stem cell donor to cure Oscar, from Worcester.

But despite finding a match, doctors discovered the rare T-cell acute lymphoblastic leukaemia had returned so Oscars parents launched the new appeal in September.

Olivia, 26, and Jamie, 23, have now thanked kindhearted givers who organised events from sponsored bike rides to non-uniform days to raise the incredible sum.

In a statement, the pair said: We are absolutely gobsmacked with the amount of humbling support we have received since the word go.

Over the last three weeks, we have watched the people of Worcestershire and beyond work together to raise this seemingly impossible amount of money.

It has been heart-warming to see schools, businesses, individuals and even children giving all they can.

We would like to thank you from the bottom of our hearts - you are truly amazing.

Doctors at Birmingham Childrens Hospital, where Oscar has been treated since last December, say he has only a short window in which he will be strong enough to travel.

But Oscars parents have urged people to carry on supporting them, saying they need help more than ever.

They added: Now we need to make sure that we have contingency funds available should Oscar need more care or have a more complicated recovery whilst there.

As we all know, this journey hasnt gone smoothly so we must be prepared for any additional hurdles.

As you will have seen from Oscars Facebook page, Oscar has needed to receive more treatment and have further tests done whilst we have been fundraising to keep his leukaemia at bay.

Now we have the difficult bit, the waiting.

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The initial funds are ready. Oscars medical team now need to wait for the results of his further tests, which determine the next steps.

When the best treatment plan for Oscar is confirmed by his medical team, having this funding will allow us to move very quickly.

Thank you so much to the people of Worcestershire and beyond for making this possible and once again doing everything in their power to help save our boy.

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Campaign to save five-year-old cancer sufferer has become one of the fastest online charity appeals EVER - The Sun

Six people with links to UCLH listed among most influential people in London – University College London Hospitals

The Progress 1000 is compiled every year. The theme of this years list is the future and technology, and embraces whole new sectors including augmented and virtual reality and cyber security, as well as a wide range of activists challenging inequality and helping the environment.

Dr Prasanna Sooriakumaran, a consultant prostate cancer surgeon at UCLH, was included for his pioneering robotic surgery. He is investigating new techniques to spare men with prostate cancer the potentially debilitating effects of surgery. Early trials show that his new technique has drastically reduced recovery time for up to 94 per cent of patients.

Prasanna said: It is a great honour to top the list of Londons most influential doctors in the Progress 1000 after having also made the list last year. This is a testament to the wonderful staff at UCLH, who provide world class care to men with prostate cancer.

Professor Bryan Williams is director of one of the UKs leading NIHR Biomedical Research Centres at UCLH, director of research at UCLH and Chair of Medicine at UCL. He is a clinician at UCLH and is recognised as one of the worlds leading authorities on high blood pressure.

He said: It is good to see recognition of the influence that staff at UCLH have in driving forward medical research and innovation in London and beyond.

Professor Charles Swanton, UCLs professor of personalised cancer medicine with a lab at UCL Cancer Institute and the Francis Crick Institute in Kings Cross, a consultant at UCLH and chief clinician at Cancer Research UK, is leading pioneering research on lung cancer. Professor Swanton studies how cancers evolve in the body to spread and become resistant to therapy. He is also researching ways to treat tumours more effectively.

Charlie said: This is a great testament to the hospital, university, Crick and CRUK and the team for making TRACERx possible.

Professor Tariq Enver, director at UCL Cancer Institute and professor of stem cell biology at UCL, leads a grand coalition in the war on cancer by encouraging closer working relations between UCL, Kings College London, Queen Mary University of London and the Francis Crick Institute, creating a centre of excellence for biotherapeutics.

Tariq said: It is fantastic that the vital work being done by the team in London - which has the potential to transform cancer treatment in the long run is being recognised and encouraged. Being nominated is a massive boost for all of us who have worked so hard to reach this point.

Professor Ravi Gupta, until recently an infectious diseases clinician at UCLHs Hospital for Tropical Diseases, studies the evolution and spread of HIV drug resistance globally. He, along with colleagues at Imperial College London, recently published a report on how a patient with HIV and lymphoma is now free from both conditions after an allogeneic stem cell transplant using cells from a donor lacking a critical receptor protein for HIV infection, CCR5. This work has rejuvenated the field of HIV gene therapy.

He said: It has been humbling to work at UCLH alongside such dedicated staff, both clinical and academic. I hope that recognition of the London Patient HIV cure in the Progress 1000 list will serve as an inspiration in London and beyond in the fight against HIV/AIDS.

Professor Chris Whitty, the chief medical officer for England and a UCLH physician, was included on the list for his work which focuses on the diagnosis and management of infectious diseases in children and adults.

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Six people with links to UCLH listed among most influential people in London - University College London Hospitals

WWE Hall Of Famer Edge returning to the ring? – Wrestling News

Never say never when you talk about wrestling returns but it seemed like Edge would never step in the ring again due to his neck issues.

However, as reported in the Wrestling Observer Newsletter, Edge got a new deal from WWE by negotiating with both sides (assumed to be AEW) and he ended up with a significant offer to stay with WWE.

Edge did a spear during the SummerSlam Kickoff show, the first thing hes done in the ring in years since he couldnt be cleared to take bumps and he has been training hard and is in great shape. Dave Melzer noted that the idea of Edge wrestling again has been talked about privately but it is not known if he can get cleared by WWE doctors.

Meltzer also noted that people in creative are under the impression that he will never wrestle again. It should be noted that they would not know anything since it would be kept a secret from most people in the company if he were to wrestle again.

Edge recently left the Edge and Christian podcast and Christian hinted that you havent seen the last of Edge and you never know what he will do next.

On his last podcast, Edge said, To be perfectly honest, I think I could do a match tomorrow. I might be blown up but Id be OK. Its just from what I know with the WWE medical staff, they wont allow. It is what it is, right?

He also said that hes been considering getting stem cell therapy. Rey Mysterio credits stem cell therapy for healing his knee issues and Kevin Nash says he feels better than he has in years due to stem cell therapy. Edge also said that a doctor told him that his neck could be relatively healthy within five years.

Edge said the following about wrestling one more match: Just from the stuff Ive experienced in the last eight years and the things Ive done physically, its like I could pull off one. Im not saying I go back and do a years worth.

More here:
WWE Hall Of Famer Edge returning to the ring? - Wrestling News

Digital health, Unicorns and what the smart money is chasing – BizNews

*This content is brought to you byOrbvest

ByHennie Bezuidenhoudt*

The revolutionary advances that technology continues to make in healthcare, have resulted in many medical breakthroughs and innovations. These have been driven by data collection, AI (Artificial Intelligence), machine learning, robotics, 3D printing, stem cell technologies and genome sequencing amongst others.

I would like to take a slightly different tack and pose the question. Amongst all these huge developments in healthcare, what medical innovations will (or already do) win the most investment?

To put it another way What disruptive medical innovations are the smart money chasing?

This article, the first of two around this subject, focuses on two key areas of the massive advancements taking place and the investment in the healthcare sector. So lets look at Digital health and Unicorns in 2019.

I would like to acknowledge and give credit to CB Insights, who devised a detailed report on this subject from which I have derived much of the information in this article. They are, in their own words, a tech market intelligence platform that analyses millions of data points on venture capital, start-ups, etc. most of the information derived from this report, is focussed around the USA, which is the global leader in many of the areas discussed.

Digital innovations have brought so many momentous changes to healthcare systems and these have just escalated through 2019. A good example is the use of software for the easier retrieving, tracking and saving of information regarding various illnesses and their treatment.

A few significant examples of Digital health innovations are:

This is one of the areas where the smart money is seen to be going. Even though in 2019 Digital health at 32% is taking a slightly smaller share of the global overall healthcare pie the funding is still escalating.

CB Insights summed up the phenomenal on-going rise in Digital health funding, as being on the rise for the second straight quarter. Total Digital health funding was $3.5B, up 23% from the first quarter of 2019.

Further to this, there are more deals being done in this sector with 371 in the second quarter, as opposed to 354 in the first. North America still holds dominance for Digital health investments and New York is the hottest metro Digital health investment area.

The last few years, as a result of the need for research and development as well as the implementing of all the medical advancements, the USA in particular has been a good time to be a healthcare or biotech start up business.

In the first half of 2018, healthcare start-ups globally raised $15 billion in funding. According to Forbes, this is the most raised in the first half of the year in the last decade. By July of 2018, a new crop of unicorns (these are start-ups with valuations of over $1 billion) were created, while some existing ones increased their already multi-billion-dollar valuations.

According to the CB Insights report, there are 38 VC-backed Digital health unicorns worth a combined $90.7B! Twenty-one of these are in the USA! Their total valuation in 2019 also continues to grow as a result of continued mega-rounds to existing unicorns, such as Tempus and Doctolib etc.

The value of these companies is immeasurable, as they are the major contributors to research and development. Just one example is Tempus the start-up founded by Groupon founder Eric Lefkofsky whos aim is to use data to come up with better cancer treatments, using both clinical and genetic data from the tumours of cancer patients.

I have just touched the tip of the iceberg here and will continue to show that global disruptors in the world of healthcare are drawing massive funding and inviting solid investment in its future.

Watch this space for my next article, which will give some insights into the roles being played by AI, MIP, Mental health and global healthcare investment trends. Unequivocally, this is what the smart money is chasing.

Continue reading here:
Digital health, Unicorns and what the smart money is chasing - BizNews