Imatinib (Gleevec)--Why do cells die?
Peter Ruehlman treated a man with CML (Chronic Myelogenous Leukemia). After years of elevated counts, fatigue, depression and containment with interferon, imatinib was tried. Counts normalized. (The gentleman subsequently has died of a myocardial infarction.)
Dr. Ruehlman describes another CML patient who has been cleared of chromosomal evidence of disease with imatinib. How does a drug that blocks tyrosine kinase eliminate malignant cells? Does it have other effects beyond inhibition of the phosphorylation?
Answer?...Interfering with glucose metabolism may lead to cell death.
4:40:50 PM
Acute diarrhea, Scotland. 'Nae Kentucky or Milwaukee. Scotland faces cryptosporidium (a consideration in our earlier discussion of diarrhea).
4:28:40 PM
Aortic Root Abscess
Back to this unfortunate problem confronted earlier last month. For helpful review, see Brecker SJ, Pepper JR, Eykyn SJ. Aortic root abscess. Heart 1999 Sep;82(3):260-2. [Image Copyright 2002, WebPath]
4:13:25 PM
Soda Pop
Man in the office claimed to drink ten 2-liter bottles of soda per day. (Wife confirmed this. I am still skeptical). He rarely comes to the office, but he drops by this week, a year later. His weight a year ago was 385. Now it is 340 pounds. "You remember our conversation?" he asked. He had stopped drinking sugar drinks...that's all.
Another recent example, same deal, this time a cab driver. Hot days. Lots of sweetened soda. By avoiding soda over six months he had lost 20 pounds. He reminded me of our talk. (In both cases there could, of course, be another cause of weight loss, we will see. I will confirm exact weight loss in each case.)
These are adults. Last year a Lancet article drew attention to the problem in children. Now people and groups with contrary concerns cite personal liberty (right to personal beverage choice) and shoddy evidence. Drink up.
