The end of diseases by David Agus, interview from Daily Show with Jon Stewart

[nonequilibrium]

"The end of diseases" by David Agus, interview from Daily Show with Jon Stewart

So, I just saw this and I thought it to be rather interesting
http://www.thedailyshow.com/watch/thu-february-2-2012/david-agus
He is being interviewed for a book he wrote about his view on health and its issues and their resolutions in American society. The interview is short, but for example he says that he believes inflammation is the cause of many diseases, and that apparently aspirine prevents this and how he believes it should be mandated. He also gives the view that the discovery of bacteria and viruses as the causes of diseases also had a negative influence: diseases became something with a known one-for-all-people cure, whereas diseases like cancer are totally different and are more body-dependent. He also encourages things like moving more, not really surprising, but he interjects it with interesting data. I thought it was a short, entertaining interview.

Sadly I know close to nothing about it, so I'm not sure what to make out of it. Is he credible? Or a fringe guy? Is it main-stream? Or controversial?

And also: what's your take on the matter?

And is the aspirin thing true?

 

[Moonbear]

You realize that the Daily Show is comedy, right?

 

[nonequilibrium]

Yes, so?

 

[phinds]

You realize that the Daily Show is comedy, right?

Many of the guests on the show do NOT partake in the comedy and are there to seriously promote serious subjects.

That said, I have to say that whether or not this guy is knowledgeable about medicine, he is utterly clueless in terms of political reality. The thought of the government trying to mandate that everyone in America take aspirin is just moronic (politically, I mean ... medically it's probably a good idea).

 

[thorium1010]

So, I just saw this and I thought it to be rather interesting
http://www.thedailyshow.com/watch/thu-february-2-2012/david-agus
. The interview is short, but for example he says that he believes inflammation is the cause of many diseases, and that apparently aspirine prevents this and how he believes it should be mandated.



And also: what's your take on the matter?

And is the aspirin thing true?

Btw its aspirin, How does taking aspirin become a quick fix for all diseases, Can't the same thing be achieved with modifying diet, exercise etc etc. ?

 

[Moonbear]

Many of the guests on the show do NOT partake in the comedy and are there to seriously promote serious subjects.

They all partake in comedy. Some use it as satire to highlight real issues, but everyone on that show is there for comedic value and shouldn't be taken seriously on everything they say, and some shouldn't be taken seriously on anything they say.

 

[Danger]

Btw its aspirin

That depends upon where you are. :tongue:
The drug Aspirin (note the upper case) is a registered trademark of Bayer for the chemical acetylsalicylic acid. It's an infringement to use it unless you are referring to that particular brand, if you are in a country that recognizes patent and copyright treaties.

 

[thorium1010]

That depends upon where you are. :tongue:
The drug Aspirin (note the upper case) is a registered trademark of Bayer for the chemical acetylsalicylic acid. It's an infringement to use it unless you are referring to that particular brand, if you are in a country that recognizes patent and copyright treaties.

ok ok it's the upper case Aspirin, i was simply referring to the spelling

The interview is short, but for example he says that he believes inflammation is the cause of many diseases, and that apparently aspirine prevents this and how he believes it should be mandated

 

[Danger]

 

[Ygggdrasil]

Regarding aspirin, aspirin has been shown to reduce the risk of heart attacks and stroke by helping prevent the formation of blood clots that can cause heart attacks and ischemic stroke (strokes caused by blockage of blood supply to a region of the brain). Taking aspirin, however, comes with side effects, such as increased risks of internal bleeding (e.g. ulcers and hemorrhagic stroke). Therefore, doctors generally recommend against taking aspirin daily if you have an average or below average risk of cardiovascular disease. For those with an increased risk of cardiovascular disease (such as those who have already suffered from a heart attack or ischemic stroke or those who have a family history), daily low-dose aspirin therapy can be helpful.

I should note that you should always consult with your doctor before beginning daily aspirin therapy to determine the proper dosage and formulation. Unfortunately, my grandmother had heard from one of those daytime television doctors that taking an aspirin daily is good for preventing heart disease, so she began taking one of the high-dose painkiller aspirin tablets a day. Soon, she developed a stomach ulcer. It just goes to show you that you should not take medical advice from TV shows (or internet forums for that matter...) without first doing some research on your own and talking with your doctor.

For more information about low-dose aspirin see:
http://www.webmd.com/heart-disease/tc/low-dose-aspirin-therapy-topic-overview
http://www.webmd.com/a-to-z-guides/should-i-take-daily-aspirin-to-prevent-a-heart-attack-or-a-stroke

Regarding David Agus, I did see him on the Daily Show and he immediately began setting off my bull**** meter, especially when he said that everyone should be taking aspirin daily, which is, in my opinion, completely wrong and irresponsible (for the reasons posted above).

 

[Drakkith]

I'm a firm believer that there are zero "Cure-All's", "Quick-Fixes", and the related. Every single medication, chemical, or whatever causes both good and bad things. People simply cannot be in "perfect" health unless everyone was exactly the same. Perfect health for me is unlikely to be perfect health for you.

 

[Ivan Seeking]

It should be noted, from the webmd link:

Who should take aspirin?

By healthy men over age 45 when the benefits of aspirin to prevent a heart attack are greater than the risk of stomach bleeding from taking daily aspirin.

By healthy women over age 55 when the benefits of aspirin to prevent a stroke are greater than the risk of stomach bleeding from taking daily aspirin.

I heard one report recently claiming that anyone over 40 [without other risks] should take a low-dose [safe-coated enteric] aspirin a day.

If you think you are having a heart attack, it is generally recommended that you take an aspirin [chew it] immediately. About a year ago we had a late-night scare and we thought my wife, Tsu, was having a heart attack. I immediatly grabbed her an aspirin and rushed her to the ER [we live too far out for emergency services to respond quickly]. It turned out to be a touch of pneumonia that was causing pain similar to the pain for angina. But I got big kudos from the ER staff for my quick thinking. My wife has been in medicine for 35 years, but in the heat of the moment forgot the aspirin rule.

Moral of the story: If you're having a heart attack, call a physics grad.

I watched the interview which isn't that bad. He is mainly talking about prevention, as opposed to treating disease after the fact.

 

[thorium1010]

It should be noted, from the webmd link:

I watched the interview which isn't that bad. He is mainly talking about prevention, as opposed to treating disease after the fact.

I agree with prevention part, taking aspirin isn't going to prevent a whole lot of diseases including most cancer . The point being no drug is a quick fix to any disease which can be achieved with lifestyle changes, diet etc.

 

[Ivan Seeking]

I agree with prevention part, taking aspirin isn't going to prevent a whole lot of diseases including most cancer . The point being no drug is a quick fix to any disease which can be achieved with lifestyle changes, diet etc.

That is true, however the efficacy of aspirin in preventing heart attacks and some strokes is now well accepted.

He seems to get into a larger discussion of the treatment of inflamation and the role it plays in disease. This may be where he goes over a cliff but he only touched on the concept briefly.

 

[bobze]

It should be noted, from the webmd link:

Who should take aspirin?I heard one report recently claiming that anyone over 40 [without other risks] should take a low-dose [safe-coated enteric] aspirin a day.

The thing with this though Ivan, is aspirin (and other NSAIDs) reduce PG synthesis (that's what gives you the potential bleeding problems--And also makes it great for breaking up clots that can happen in the coronary arteries), but it can also cause other problems like vasoconstriction at the afferent renal arterial arteries leading to hypertensive problems (the kidney "sees" less blood flow so thinks your hypovoluemic and increases anti-diuretic mediators like ATII--bad for business).

Though I agree that NSAIDs (particularly low-dose aspirin) is great for helping prevent some cardiovascular events and should be used in the event of an acute MI (note that is a myocardial ischemic event, aspirin should not be used in acute congestive heart failure--and "laypeople" might not be the best at telling the difference), I also would strongly echo Yggg's advice that anyone thinking about starting an aspirin regimen should first consult their primary health care provider first.

 

[Ivan Seeking]

The thing with this though Ivan, is aspirin (and other NSAIDs) reduce PG synthesis (that's what gives you the potential bleeding problems--And also makes it great for breaking up clots that can happen in the coronary arteries), but it can also cause other problems like vasoconstriction at the afferent renal arterial arteries leading to hypertensive problems (the kidney "sees" less blood flow so thinks your hypovoluemic and increases anti-diuretic mediators like ATII--bad for business).

Though I agree that NSAIDs (particularly low-dose aspirin) is great for helping prevent some cardiovascular events and should be used in the event of an acute MI (note that is a myocardial ischemic event, aspirin should not be used in acute congestive heart failure--and "laypeople" might not be the best at telling the difference), I also would strongly echo Yggg's advice that anyone thinking about starting an aspirin regimen should first consult their primary health care provider first.

I am telling you what is recommended by the medical community. None of this is my opinion.

 

[bobze]

I am telling you what is recommended by the medical community. None of this is my opinion.

I know, and I didn't say anything that contradicted what the medical community recommends--That aspirin regimes can be useful in some types of cardiovascular disease and that you should consult your doctor before starting one :tongue2: No one should start a medical therapy without first consulting a medical professional--Which suffice it to say, is not WebMD

Edit: Funny how topics come up that coincide with my studying, lol. As I sit here and try and find the motivation to start studying cardiac and renal pharmacology :)

 

[Evo]

What really raised my red flag was when the guy said taking aspirin could prevent cancer. He said cancer is caused by inflamation, so if you stop inflamation you prevent cancer.

 

[Ryan_m_b]

What really raised my red flag was when the guy said taking aspirin could prevent cancer. He said cancer is caused by inflamation, so if you stop inflamation you prevent cancer.

What sent alarm bells ringing for me was this:

[H]e says that he believes inflammation is the cause of many diseases

Inflammation does not cause disease, disease causes inflammation! Specifically inflammation is an important part of the wound healing response that results in activation of immune cells, release of pro-healing factors e.g. pro-angiogenic, stem cell recruitment, ECM remodelling etc. To suggest such a simple thing (assuming this wasn't him mis-speaking) reveals a huge ignorance.

 

[Moonbear]

What sent alarm bells ringing for me was this:

Inflammation does not cause disease, disease causes inflammation! Specifically inflammation is an important part of the wound healing response that results in activation of immune cells, release of pro-healing factors e.g. pro-angiogenic, stem cell recruitment, ECM remodelling etc. To suggest such a simple thing (assuming this wasn't him mis-speaking) reveals a huge ignorance.

Exactly! Detection of inflammatory markers when disease is present is consequence, not a cause, of disease. It is also correct that recommendations about taking aspirin to prevent heart disease and stroke are changing in light of recent studies showing that there is a greater risk of bleeding ulcers and other bleeding disorders with chronic aspirin use than there is a risk of heart attack or stroke due to a blood clot.

People with known risks of clotting problems who take anticoagulants should be evaluated for risk of peptic ulcers before starting treatment. http://www.ncbi.nlm.nih.gov/m/pubmed/22283743/?i=11&from=aspirin therapy

 

[Djenko]

Inflammation has been implicated in the pathogenesis of many types of cancer! http://carcin.oxfordjournals.org/content/30/7/1073.long


Also, you are wrong to suggest that inflammation is only ever a marker or end-point of disease. On the contrary, the inflammatory state precedes many diseases and a chronic low-level "systemic" inflammation has long been implicated in the cause of cardiovascular diseases. http://circ.ahajournals.org/content/109/21_suppl_1/II-2.full

The entire process that causes the vast majority of heart attacks, which is the build up of hard fatty tissue in the walls of blood vessels (called "atherosclerosis"), is driven by inflammation and inflammatory cells. (see this new england medical journal article http://www.nejm.org/doi/full/10.1056/NEJMra043430 or search for yourself in a database of medical journals http://www.ncbi.nlm.nih.gov/pubmed/ , the summary abstracts can usually be read for free.

A study called a "meta-analysis" where all of the known relevant studies are assessed for quality and size and then analysed together was published in the Lancet (highly regarded medical journal) last year. A meta-analysis has it's flaws but its basically the best possible picture we can have of a current medical treatment. The studies they looked at looked at the effect of giving large numbers (thousands) of people daily aspirin (for several years mostly) compared to a large number of people taking only a placebo pill. The overall result of all these trials put together found that the people in the aspirin taking group (-on average-) had a reduced death rate from cancer. http://www.ncbi.nlm.nih.gov/pubmed/21144578

However, knowing how to convert data like this into clinical practice is very difficult! Some of those people might have done better without taking aspirin, its only on a very large scale looking at overall averages we get from this. Aspirin has many side-effects though and the use of it on a blanket "everyone, including healthy people over x age" take this is very controversial. On average aspirin will reduce mortality but telling one individual whether taking aspirin will be beneficial to them is simply not possible yet!

I don't know anything of David Agus, his book and I haven't seen his interview but I felt the need to correct some points in this thread!

 

[Ryan_m_b]

I felt the need to correct some points in this thread!

For the record I was never suggesting that inflammation wasn't a bad thing but correcting the statement that inflammation causes disease. Some disease or damage causes inflammation which can in turn cause more damage.

 

[thorium1010]

A study called a "meta-analysis" where all of the known relevant studies are assessed for quality and size and then analysed together was published in the Lancet (highly regarded medical journal) last year. A meta-analysis has it's flaws but its basically the best possible picture we can have of a current medical treatment. The studies they looked at looked at the effect of giving large numbers (thousands) of people daily aspirin (for several years mostly) compared to a large number of people taking only a placebo pill. The overall result of all these trials put together found that the people in the aspirin taking group (-on average-) had a reduced death rate from cancer. http://www.ncbi.nlm.nih.gov/pubmed/21144578

This study , they recruited people who are already diagnosed with cancers be it gastrointestinal or non gastrointestinal and follow up or end point was on mortality. However it does not say anything about prevention.

 

[thorium1010]

This study , they recruited people who are already diagnosed with cancers be it gastrointestinal or non gastrointestinal and follow up or end point was on mortality. However it does not say anything about prevention.

sorry should have mentioned this is a meta analysis not a single study. I am still skeptical of aspirin use for prevention of most cancer (which can be achieved by other means).

 

[Andy Resnick]

I saw the interview (did not read the book), and at first I thought the author was a loon. However, by and large he wasn't saying anything that heretical- basically, he is drawing a distinction between diseases caused by infectious agents (bacteria, virii, parasites, etc) and *pathophysiology*. That is, dysregulation of the normal homeostatic functions and processes present in us. Many diseases are not caused by infection: athlerosclerosis, cystic fibrosis, kidney stones, multiple sclerosis... and of those, many are not (likely) caused by a single defective gene: osteoporosis, arthritis, etc. Finally, it is also true that a chronic inflammatory response is associated with many of those pathophysiological conditions. It's not wrong to call attention to this, nor is it wrong to advocate for treating an underlying inflammatory response- although, to be fair, I am unaware of a causative link between, for example, the pro-growth, pro-inflammatory response present in early athlerosclerotic plaques and the long-term disease progression.

To be sure, he said a few things that were silly: mandated aspirin, for example. OTOH, much of the US has mandated fluoride in the water supply, so...YMMV, I guess. I also agree with his statement that vitamins are overused.