Big Head Press Forum

Online Comics => Escape From Terra => Topic started by: paddyfool on April 03, 2011, 08:32:15 am

Title: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 03, 2011, 08:32:15 am
So... in EFT, and in a lot of the rest of the sci-fi here, the concept of rejuvenative medicine keeps coming up. 

How realistic do people here think such tech actually is?  Could it consist of single occasional treatments as seen in EFT, or would it likely necessitate long term treatment etc. to stay young?

Right now, actively altering the ageing process itself, rather than merely treating its symptoms, seems a bit far off, even if we can do it in worms etc. (http://www.nature.com/news/2011/110330/full/news.2011.193.html)  I'm hopeful about better treatments for many of the major diseases of ageing, particularly Alzheimer's and osteoporosis, but actually slowing the ageing process itself is something we haven't begun to do yet.  What are your views on this?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 03, 2011, 10:44:06 am
Right now, actively altering the ageing process itself, rather than merely treating its symptoms, seems a bit far off, even if we can do it in worms etc. (http://www.nature.com/news/2011/110330/full/news.2011.193.html)  I'm hopeful about better treatments for many of the major diseases of ageing, particularly Alzheimer's and osteoporosis, but actually slowing the ageing process itself is something we haven't begun to do yet.  What are your views on this?

From what I read, if you can last 15-20 more years, you will never die of disease or old age. That puts me right on the cusp. I will either be one of the last generation to die of age and disease, or one of the first generation to live indefinitely. For a good overview read Kurzweil's Fantastic Voyage: Live Long Enough to Live Forever.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 03, 2011, 10:52:32 am
Mostly what sickens and kills us now is caused by our own choices. Look at all the biggies in no special order, hell, we all know the list. Don't smoke and a big chunk of them drop away, watch your weight, a bunch more, don't expect to be a drunk with a healthy liver, unlikely in the long term. If the EFT folks avoid all that destructive foolishness or mitigate the bad effects, more work for the same results, they are way ahead.

So if the newlyweds, and I was teasing about the chick flick stuff, really I was. If the newlyweds know enough to not break their innards, fixing age is easier. Then it comes down to normal wear and tear repair.

But treatments for damage teach us how to fix things. If you can regenerate a smoker's lungs a nonsmoker's is way easier. All the smokers out there are in a way subsidizing it for the rest. I wonder how much HIV has taught doctors about the immune system, fixing of. Not one machine or one treatment all at once though but the first steps are all around us.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 03, 2011, 10:57:05 am
Recently 2 of my younger brothers got fat, then hypertensive and diabetic. I'm with Sandy on this one, I got too much to do I can't do dead. And no way I'm getting fat.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 03, 2011, 12:49:43 pm
@Sandy,

Thank you for your speedy reply on this!

From what I read, if you can last 15-20 more years, you will never die of disease or old age. That puts me right on the cusp. I will either be one of the last generation to die of age and disease, or one of the first generation to live indefinitely. For a good overview read Kurzweil's Fantastic Voyage: Live Long Enough to Live Forever.

Thanks for that reference.  Skimming the three free chapters they have online was fairly interesting.  It seems the crux of their book is to put a case for "three bridges":

Quote
This book describes three bridges.
1. The First Bridge—Ray & Terry’s Longevity Program—consists of present-day therapies and guidance that will enable you to remain healthy long enough to take full advantage of the construction of the Second Bridge.

2. The Second Bridge is the biotechnology revolution. As we learn the genetic and protein codes of our biology, we are gaining the means of turning off disease and aging while we turn on our full human potential. This Second Bridge, in turn, will lead to the Third Bridge.

3. The Third Bridge is the nanotechnology-AI (artificial intelligence) revolution. This revolution will enable us to rebuild our bodies and brains at the molecular level.2

Personally, I'm extremely skeptical of any predicted timescale for that "Third Bridge".  We haven't seen any fruits of nanotechnology yet visavis human health.  As for the second bridge... the timescale on dramatic improvements in health from biotech seems to be continually moved back.  We were promised great things from fiddling with telomeres, but their degradation actually seems to fulfil a useful role, so stopping it doesn't altogether help.  We were promised the same from stem cells... but we've learned we have to be very careful indeed with them, since our own stem cells are ultimately at the root of the vast majority of cancer (and the rest are caused by other cells starting to act like stem cells).  Certainly, we can expect to find further treatments and prophylaxis for all sorts of things, and there is more research into the mechanisms of ageing itself than ever before, but I'm very unconvinced of a 10-15 year timescale on a real gamechanger. Finally, on the "first bridge"... the big issue here is that a lot of people simply can't and won't be bothered.  But yes, we are finally getting a handle on what the good advice really is for healthy living (although whether I'd agree with their suggestions is an open question, since the first three chapters don't get into that).  And whether or not you think it'll help you live long enough live forever, we can be pretty sure it can keep you healthier longer, which has to be worth something.

Overall, if I can be forgiven a personal view... I'm 30, and fundamentally pretty healthy, but I really don't expect to live forever, whatever they and Aubrey de Grey (http://www.ted.com/talks/aubrey_de_grey_says_we_can_avoid_aging.html) (whom they reference) might promise. 

@spudit,

Mostly what sickens and kills us now is caused by our own choices. Look at all the biggies in no special order, hell, we all know the list. Don't smoke and a big chunk of them drop away, watch your weight, a bunch more, don't expect to be a drunk with a healthy liver, unlikely in the long term.

I'm with you on all those bits of advice, and would particularly add "exercise regularly" and "try and maintain a happy social life and good long term friends and relationships".

If the EFT folks avoid all that destructive foolishness or mitigate the bad effects, more work for the same results, they are way ahead.

So if the newlyweds, and I was teasing about the chick flick stuff, really I was. If the newlyweds know enough to not break their innards, fixing age is easier. Then it comes down to normal wear and tear repair.

But treatments for damage teach us how to fix things. If you can regenerate a smoker's lungs a nonsmoker's is way easier. All the smokers out there are in a way subsidizing it for the rest. I wonder how much HIV has taught doctors about the immune system, fixing of. Not one machine or one treatment all at once though but the first steps are all around us.

We do indeed learn a fair bit from treatments for such damage.  But we still don't have effective treatments for many of these - to take the example of regenerating smokers' lungs, lung cancer remains a killer, and chronic obstructive pulmonary disease a largely irreversible disabling condition (without a lung transplant, anyway).  HIV, meanwhile, did help drive research into aspects of immunology that were fundamentally hard to reach; but it remains an area where we've made ourselves promises visavis what we might be able to achieve that we haven't been able to reach (cures and vaccines have been promised "within 10 years" for 25 years now; so far, one person in all the world may actually have been cured of HIV, and that's about it).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 03, 2011, 01:49:40 pm
Mostly what sickens and kills us now is caused by our own choices. Look at all the biggies in no special order, hell, we all know the list. Don't smoke and a big chunk of them drop away, watch your weight, a bunch more, don't expect to be a drunk with a healthy liver, unlikely in the long term. If the EFT folks avoid all that destructive foolishness or mitigate the bad effects, more work for the same results, they are way ahead.

Any of those mistakess can take maybe 20 years off your life. But without something new that we don't have much clue about yet, you'll still die by the time you're 120 of a collection of things we might as well call old age.

Talking about life extension beyond the obvious stuff means guessing about future technology. We don't know what we'll find. We won't know until we find out. Maybe there will be some easy way to double lifespan. Maybe there will be a long slog of individual problems that can be solved each separately. If it's the latter, then people who are rich enough can spend their money on life extension, and the rest of us won't have that luxury.

Even if the costs aren't outrageous, wouldn't it be owners and not employees who would get treatment? If you want to hire somebody, would you prefer a young person who doesn't have too many of his own ideas, and can be easily molded? Or an older person with more expensive health needs, who's probably getting set in his ways? If you aren't independently wealthy by the time you're, say, 50 it might be too late for you to get rejuvenation. Unless of course the government makes another boondoggle of it.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 03, 2011, 04:38:14 pm
Maybe there will be a long slog of individual problems that can be solved each separately. If it's the latter, then people who are rich enough can spend their money on life extension, and the rest of us won't have that luxury.

Yes, and also "the rest of us" will never will have computers. Only governments, huge corporations and universities will be able to afford them. And don't get me started about airplanes! Playthings for only the rich. The idea of the "average American" flying from coast to coast or off to Europe is the purest fantasy! Poor people owning portable telephones? Give me a break. If you believe that, you've clearly been reading too much science fiction!
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 03, 2011, 04:57:19 pm
Maybe there will be a long slog of individual problems that can be solved each separately. If it's the latter, then people who are rich enough can spend their money on life extension, and the rest of us won't have that luxury.

Yes, and also "the rest of us" will never will have computers. Only governments, huge corporations and universities will be able to afford them. And don't get me started about airplanes! Playthings for only the rich. The idea of the "average American" flying from coast to coast or off to Europe is the purest fantasy! Poor people owning portable telephones? Give me a break. If you believe that, you've clearly been reading too much science fiction!

If you can find solutions which can be repeated for everybody then it turns cheap. if you're stuck with customized solutions then it stays expensive.

We can mass-produce computers, cellphones, etc. So those turned cheap. When we can mass-produce healthcare then we'll be able to afford it for most people.

We might get just the right breakthroughs that let us have life extension and rejuvenation for everybody. Or we might not. I have no idea how to predict that. We have cellphones for practically everybody and we don't have helicopters or personal jetpacks for everybody. When I was a kid some rich guy visited his poorer relatives across the street. His helicopter landed on the vacant lot and he got out carrying his helmet under his arm. It was impressive. I don't expect to have millions of private helicopters any time soon. Not while they run on fossil fuel. And I could be wrong.

Whether we get working rejuv, and how expensive it will stay, depends on technology which has not yet been developed -- based on science which has not yet been discovered. You can have it your way in your story and I agree it could come out like that.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 03, 2011, 07:04:08 pm
I think what will happen is that we will gradually be able to cure many diseases, cancer being the big one.  But stopping aging, I don't think so, and honestly I do not think it would be a great world to live in if people lived forever.

One small problem of many.  Think of young athletes having to compete with say Michel Jordan forever.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 03, 2011, 08:08:50 pm
Whether we get working rejuv, and how expensive it will stay, depends on technology which has not yet been developed -- based on science which has not yet been discovered. You can have it your way in your story and I agree it could come out like that.

Read Kurzweil and other peoples in the Extropian, Transhuman, Life Extension fields, then come back and argue from knowledge instead of from ignorance. If you don't agree with these folks after that, fine and dandy, but you have no standing to argue anything but uniformed personal opinions otherwise.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: wdg3rd on April 03, 2011, 09:28:33 pm
I think what will happen is that we will gradually be able to cure many diseases, cancer being the big one.  But stopping aging, I don't think so, and honestly I do not think it would be a great world to live in if people lived forever.


If you don't want to live forever, it's your choice.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 03, 2011, 09:52:07 pm
Without doing a full review of his writing, I can, instead, do a quick review of his critical reception - and it seems that he may have been overly optimistic in the past (http://www.scientificamerican.com/article.cfm?id=e-zimmer-can-you-live-forever&page=4) in terms of guessing at future mortality trends.

And in thinking about life expectancy, it's worth noting that while growth in computing power has been exponential, growth in senescent life expectancy in rich countries - ie the lifespan you can expect to have before dying of a disease of old age, ignoring unrelated mortality - has been pretty linear, at a rate of 0.15 years per year (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772142/?tool=pubmed) (considerably less than the >1 year per year you'd need for immortality, and largely attributable to relatively low-tech interventions, such as smoking decline).  The trend in overall life expectancy has been similarly linear; e.g., in the USA, it went from 69.8 in 1960 to 74.6 in 1984 and 78.4 in 2008 (http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le00_in&idim=country:USA&dl=en&hl=en&q=life+expectancy+trends+usa).

On the whole, I'd be willing to make a 15-year gentleman's bet that life expectancy won't dramatically accelerate.  Between 1998 and 2008, life expectancy in the USA increased by 1.8 years, in line with its overall trend over previous decades; I'd be very willing to make the (somewhat morbid) bet that between 2011 and 2026, the growth in life expectancy in the USA will be less than 4.5 years (ie <3 years per decade).  Let's say... the price of a 1/10 Krugerrand on April 4th 2026.  You can promise it to a charity of my choice if I win, and I to a charity of yours.  (I'll pick medicins sans frontieres, since I'm also pretty confident that war and natural disaster won't have stopped in this timeframe).  Anyone want to take this bet?  (I'm open to downwards or currency negotiation on what's at stake).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 03, 2011, 11:21:51 pm
Medically, one size does not fit all. I have never smoked so an insurance company would quote me a different rate than a smoker, and todays overweight kids have a different life expectancy than the skinny ones. Even if a treatment existed to level the field, it absorbs resources better used to enhance what you have.

So I guess the answer is to only have the bad habits needed for sanity and don't paint yourself into any corners, avoid the biggest threats and hope Sandy is right. No matter what, the person with the fewest preexisting conditions is the best candidate for life extension.

Nasty thought, mandnatory rejuvination for prison lifers. That guy who gets 450 years, or 7 life sentences for whacking a whole car load of tourists serves them all.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: dough560 on April 04, 2011, 01:35:52 am
Doc Taylor's books "Warp Speed" and "Quantum Connection"  delve into emerging nano tech.  I expect like any other technology there will be a steady but minor development, until we reach the point a paradigm shift occurs.  Then massive changes will occur.

From government's perspective, people with long healthy lives, the freedom to create and the ability to retain profits from their creativity; will have little use for a government stealing 3/4 of their profits through direct and hidden taxes.  Such people are a direct threat to any suppressive government.  Yes, I'm including the USA.

One thing is guaranteed. Government will move to limit access through regulation.  Regulations designed to drive up costs.  Just look at our current experiences with health care.  Again the government will claim, only Government  can solve the resulting problems.  Again increasing costs through regulations and taxes.  Such as our new Health Care Law.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 04, 2011, 02:25:48 am
Mostly what sickens and kills us now is caused by our own choices.
Really? How come I never see anyone who made the right choices, and lived to be 200?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 04, 2011, 06:26:10 am
Quote
steady but minor development, until we reach the point a paradigm shift occurs.  Then massive changes will occur.

Agreed.  And there's no knowing ahead of time what that shift will look like.

As for projecting life extension from changes in life expectancy:  I do believe that most of the increase in life expectancy comes from improving infant and child health & safety.

Consider a population of two:  one lives 100 years, the other dies before his first birthday.  The "life expectancy" of this population is 50 years (and that does not mean that the oldster was doddering and near death when he was 50! a mistake I was sorry to see Asimov make in The Ugly Little Boy.)

Improve conditions for a second similar population, making infancy perfectly survivable, and both live to be 100.  Now the life expectancy is 100, which is an improvement -- an improvement that says exactly nothing about the maximum possible lifespan of these creatures.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 04, 2011, 07:01:20 am
Quote
If you don't want to live forever, it's your choice.


Its also my choice to look at unintended consequences. 
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 04, 2011, 07:53:05 am
From government's perspective, people with long healthy lives, the freedom to create and the ability to retain profits from their creativity; will have little use for a government stealing 3/4 of their profits through direct and hidden taxes.  Such people are a direct threat to any suppressive government.  Yes, I'm including the USA.

I don't think most UW citizens enjoy rejuve. I'd also have to wonder what the public would do if high ranking officials went away for vacation at apparent age 80 and came back as 25. Maybe the UW elite party members serve a few terms, cash out their funds from a tax shelter, and retire on Mars?

Quote
One thing is guaranteed. Government will move to limit access through regulation.  Regulations designed to drive up costs.  Just look at our current experiences with health care.  Again the government will claim, only Government  can solve the resulting problems.  Again increasing costs through regulations and taxes.  Such as our new Health Care Law.

Yet the rich and famous will always be able to take leave due to "dehydration", fly off to someplace like Switzerland, and have incrimination evidence surgically removed from their penis.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 04, 2011, 08:19:26 am
...
One thing is guaranteed. Government will move to limit access through regulation.  Regulations designed to drive up costs.  Just look at our current experiences with health care.  Again the government will claim, only Government  can solve the resulting problems.  Again increasing costs through regulations and taxes.  Such as our new Health Care Law.

I don't recall if it has come up yet, but the UW severely restricts access to life extension technology to "conserve resources" and "to protect people from unproven medical quackery."

However, you do not need science fiction to find such government interference with life extension. The USG's war against supplements, alternative medicine and its intrusion into food nutrition are only the beginning. People I know who are pushing the envelope on medical treatment and stem cell research are being banned and regulated to death. So far, my attempts to convince them to get the hell out of Dodge have been in vain. They still believe the government is only trying to do the right thing.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 04, 2011, 08:24:50 am
Whether we get working rejuv, and how expensive it will stay, depends on technology which has not yet been developed -- based on science which has not yet been discovered. You can have it your way in your story and I agree it could come out like that.

Read Kurzweil and other peoples in the Extropian, Transhuman, Life Extension fields, then come back and argue from knowledge instead of from ignorance. If you don't agree with these folks after that, fine and dandy, but you have no standing to argue anything but uniformed personal opinions otherwise.

I have read some of that, and in one lifetime I won't get to read it all. I stand by my opinion -- we're talking about future technology and future science. It might come out as they say, or it might not.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 04, 2011, 01:09:07 pm
I don't recall if it has come up yet, but the UW severely restricts access to life extension technology to "conserve resources" and "to protect people from unproven medical quackery."

However, you do not need science fiction to find such government interference with life extension. The USG's war against supplements, alternative medicine and its intrusion into food nutrition are only the beginning. People I know who are pushing the envelope on medical treatment and stem cell research are being banned and regulated to death. So far, my attempts to convince them to get the hell out of Dodge have been in vain. They still believe the government is only trying to do the right thing.

I'd say they have good reason to believe that.  The gains for the USG in preventing access to methods that genuinely kept people healthy longer would be negative, because as soon as people become sufficiently affected by senescence as to no longer be able to work, to require care etc., they generally become a burden on the state.  And to conspire against people being healthier seems unlikely besides; it reminds me of the kind of conspiracy theory that the Mitchell & Webb show like to pull apart (http://www.youtube.com/watch?v=uoZ71sj3Kn0).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 04, 2011, 02:51:45 pm
I have read some of that, and in one lifetime I won't get to read it all.

Try not to move your lips when you read. It will go more quickly.  ;D

> I stand by my opinion -- we're talking about future technology and future science. It might come out as they say, or it might not.
[/quote]

Okay, but your opinion is just that. For a small sample of the research and things being done right now, read:

   https://mail.google.com/mail/#inbox/12f1da903827ef43
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 04, 2011, 03:17:59 pm
[quote ]
Try not to move your lips when you read. It will go more quickly.  ;D
[/quote]

This is the sort of thing that makes me think it might not be a good idea for some people to live forever.  How much grumpier would Sandfort get in a 100 years, a thousand?  If that does not give you pause what will?  From "brave new world" to "get off my lawn."
Title: Re: Rejuvenative medicine - how far off are we?
Post by: wdg3rd on April 04, 2011, 03:40:39 pm
[quote ]
Try not to move your lips when you read. It will go more quickly.  ;D

This is the sort of thing that makes me think it might not be a good idea for some people to live forever.  How much grumpier would Sandfort get in a 100 years, a thousand?  If that does not give you pause what will?  From "brave new world" to "get off my lawn."
[/quote]

Glenn, try not to move your lips when you think.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 04, 2011, 05:35:49 pm
As for projecting life extension from changes in life expectancy:  I do believe that most of the increase in life expectancy comes from improving infant and child health & safety.
Most of the increase in life expectancy that we have experienced comes from that source, yes. A hundred years ago, or a thousand years ago, a person eighty years old was elderly, and that is still true today.

We are very far from having the kind of technology depicted in the comic, where nanotech robots go through a person and rebuild his or her body. Other forms of life extension, such as protecting telomeres from shortening as a result of cell division (and somehow preventing this from causing an increased cancer risk) could come soon - or not. We don't really know.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 04, 2011, 05:42:36 pm
Quote
steady but minor development, until we reach the point a paradigm shift occurs.  Then massive changes will occur.

Agreed.  And there's no knowing ahead of time what that shift will look like.

As for projecting life extension from changes in life expectancy:  I do believe that most of the increase in life expectancy comes from improving infant and child health & safety.

Consider a population of two:  one lives 100 years, the other dies before his first birthday.  The "life expectancy" of this population is 50 years (and that does not mean that the oldster was doddering and near death when he was 50! a mistake I was sorry to see Asimov make in The Ugly Little Boy.)

Improve conditions for a second similar population, making infancy perfectly survivable, and both live to be 100.  Now the life expectancy is 100, which is an improvement -- an improvement that says exactly nothing about the maximum possible lifespan of these creatures.

This was why I led off with the figures on senescent life expectancy first.  Basically, we have been making real advances in terms of living longer... but much more slowly than what's being predicted (about +0.15 years senescent life expectancy per year).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 04, 2011, 06:45:13 pm
Quote
This was why I led off with the figures on senescent life expectancy first.

So you did too.  I wonder if I missed it in the first place through reading too fast, or if I read it and it didn't make it into long(er) term memory to modify the next usage of "life expectancy"?  Hey, Sandy?  Can I get some of that rejuve for my brain?

Although, honestly, I've been paying attention:  once, when I was about 30, I was writing a check in a store and caught myself just before I wrote a date that was completely wrong -- wrong day, month, year.  I paused long enough to think, "You know, if I were 60 right now, I'd be thinking 'early senility'.  That can't be the case now, so when I am 60, I'll remember that I've always had brain farts".

And that bit about being "as young as you feel" isn't so far off:  A researcher sent her control group of elderly men on a week-long retreat to reminisce about being 50 again, and sent her experimental group to a week-long retreat where they were to dress, and speak (amid relevant paraphernalia) as if the time were 20 years earlier.  The experimental group improved measurably in memory, hearing, vision, and physical ability.

Quote
Basically, we have been making real advances in terms of living longer... but much more slowly than what's being predicted (about +0.15 years senescent life expectancy per year).

Is the ~+0.15 years the prediction, or the slower reality?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: sam on April 04, 2011, 08:30:13 pm
Studies of centenarians show that they disproportionately drank, smoked, ate unhealthy foods, and did not get enough exercise - the reason being that their health was not affected by these things one way or another - that they are genetically disposed to not being harmed by things that harm other people.

Thus while healthy living can help us dodge a few bullets, it cannot significantly extend the end of life.

Further, as we learn more and more about genes, we mostly learn that we understand the human body less than we thought we did, that its complexity may well make it incomprehensible.

We could, however, produce people, a next generation, that is very long lived, because there seem to be lots and lots of genes that significantly extend people's lives, which truly slow aging, or which fail to shorten their lives, and any one centenarian only has a small number of such genes.  Someone who had lots of such genes might well live for centuries.

Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 04, 2011, 08:33:29 pm
Quote
Glenn, try not to move your lips when you think.

Hey thats cute.  You insult people just like your daddy.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 04, 2011, 08:33:47 pm
Quote
Try not to move your lips when you read. It will go more quickly.  ;D

This is the sort of thing that makes me think it might not be a good idea for some people to live forever.  How much grumpier would Sandfort get in a 100 years, a thousand? 

Grumpy? Well, like the man said, "The essence of humor is whose ox is being gored."   ;D
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 04, 2011, 08:48:21 pm
Don't you mean "whom's" ox?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 04, 2011, 11:43:50 pm
Don't you mean "whom's" ox?

Nope. I mean "whose," which is the correct possessive form of both who and whom. There is no such thing as "whom's" in standard English. Look it up. Anyway, nice try, but now it's even clearer, you don't teach English (at least I hope not!).

Here's just a little personal observation and a bit of advice. You, GlennWatson/WatsonGlenn/and probably some other handles, have been kicked off numerous lists, presumably for not playing well with others. You have taken numerous swipes at me and others on the Forum. All well and good, but I find it interesting that you are so thin-skinned when you are the subject of  the kidding. Apparently, you can dish it out, but you can't take it. Relax; no one is attacking you. I respect most of your posts.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 05, 2011, 07:28:34 am
....

Thus while healthy living can help us dodge a few bullets, it cannot significantly extend the end of life.

This is probably true. There are cave organisms which live a very long time, probably because they are in an environment where they don't have to adapt much to environmental changes of any sort, and they spend a whole lot of time just waiting for something to happen. So maybe they just plain don't get a lot of wear-and-tear. This is not the way I'd want to live a long life. On the other hand, why put up with a whole lot of bodily stress that you don't need to?

Quote
Further, as we learn more and more about genes, we mostly learn that we understand the human body less than we thought we did, that its complexity may well make it incomprehensible.

It kind of looks like it's heading that way now. But we might get a few great insights which makes sense of a whole lot of it. We can't predict now what we will be capable of after that happens.

Quote
We could, however, produce people, a next generation, that is very long lived, because there seem to be lots and lots of genes that significantly extend people's lives, which truly slow aging, or which fail to shorten their lives, and any one centenarian only has a small number of such genes.  Someone who had lots of such genes might well live for centuries.

May be. I would tend to expect that to be a process of iterative refinement that slowed down over time. You might not find out about the unexpected problems from living past 120 until you get some 120-year-olds to study. So you come up with candidate genes to test which might fix those problems, and it takes say 120 years to find out how well they really work. Then it takes 140 years to find out about the special problems of living to 140, and another 140 years to find out how well your fixes work for those problems. Etc.

But maybe we could find ways to do good testing faster. Or, if we got time travel....
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 05, 2011, 08:17:41 am
I stand by my opinion -- we're talking about future technology and future science. It might come out as they say, or it might not.

Okay, but your opinion is just that. For a small sample of the research and things being done right now, read:

   https://mail.google.com/mail/#inbox/12f1da903827ef43

I was not able to read that. Can others?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: NeitherRuleNorBeRuled on April 05, 2011, 08:20:57 am
Okay, but your opinion is just that. For a small sample of the research and things being done right now, read:

   https://mail.google.com/mail/#inbox/12f1da903827ef43


Sandy,

This is a link, presumably, to (or through) your personal Google mailbox, which is useful only to you, a few Google employees, and the NSA.  Would you mind providing a generally useful link?

Thanks.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 09:49:20 am
Here's a concept which could make medical improvements develop as fast as electronics have. Call it correction box. It knows what should be going on in the body and keeps fixing it second by second. Too many fatigue poisons, fix it, liver cells dividing wrong, fix it, on and on. While we're at it let them interface and accelerate the learning curve.

Yes, the potential for abuse is huge.

I'd breadboard up a whole room, hell a building full of stuff, a box for each of a thousand basic functions. Then I'd get to tweaking. What interferes with what, what can be combined, what should be added. I'd be shrinking the equipment as it is defined from desk top to chip. That part taps into what we know already. Get it down to a fridge sized machine that'll fit in an intensive care unit and keep going. Some day get one small enough to wear or implant.

It is mass produced and easily customized and upgraded. Then load Windows on it, the Human Race crashes and goes extinct.

Hmm. Maybe not that last part though. 
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 11:55:49 am
It's a lot like fusion as a power source. We can sort of take stabs at it but it's one of those things that is always "twenty years away". It's not something that the capitalist industrial approach to science will ever really be able to solve. It'll take one crazy bastard having a sudden moment of genius/insanity. Problem is that if he did do it then no one would ever believe it because it wasn't a big corp or national lab that came up with it.

So all those thinking "twenty years from now we'll all be immortal fuck yeah" don't bother. Not gonna happen. Also if we do end up immortal imagine our world but worse. Imagine the baby boomers immortal and never having to give up their positions in business and government. My generation is already pretty fucked because they're not doing that. Imagine it never changing. We'd end up with massive civil war as the younger generations got sick of it, inevitably resulting in a new government being formed which has mandatory death upon reaching a certain age.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 12:04:51 pm
It seems like the very very old are fragile, all out of backups, the bailing wire and duct tape is about shot, look at them wrong and they break.

It seems like they get that old by luck, attitude and by having spare capacity. So they carry on well above the functional minimum despite having a fraction of what they started with. OK duplicate that, give everyone extra capacity, dunno how though. maybe shoot them up with stem cells set on liver, kidney, immune system, heart muscle. They are fruitful and multiply and the parts get robust as can be, then they don't break as completly as often. Not younger though, just stronger and more able to handle all that slings and arrows crap.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 12:10:00 pm
Good to have you back Holt.

Me, at 52, that old age and treachery tee shirt is looking pretty good about now.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 12:14:53 pm
Meh dunno why I keep coming back. I think I'm a masochist.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 12:43:40 pm
Good, admiting it the first step to a cure.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 12:47:05 pm
Curing it would result in me deciding not to help a friend with his insane plan for changing this country's political system. Sides if I'm a masochist that means I must like it
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 05, 2011, 12:51:46 pm
Also if we do end up immortal imagine our world but worse. Imagine the baby boomers immortal and never having to give up their positions in business and government. My generation is already pretty fracked because they're not doing that. Imagine it never changing. We'd end up with massive civil war as the younger generations got sick of it, inevitably resulting in a new government being formed which has mandatory death upon reaching a certain age.
That depends on the younger generation not wanting immortality for itself.

They certainly will demand better employment opportunities, but the response to that can be an expanding economy instead of compulsory retirement - which would have to be death, given that one can't expect to be supported by others for 99.99999% of one's life.

On a finite Earth, with a finite maximum number of people (which may increase from time to time as we get technological advances, but they can't be relied upon, not coming according to schedule), though, the idea that all the privates become generals, in effect, as they gain seniority, obviously has problems. If you don't have a conveyor belt, as it were, then most people won't get the chance to move up even one layer from the bottom of the pyramid - because it is an economic given that the bottom is wider than the top.

But the obvious solution is to put machines at the bottom and humans at the top. And since lots of people don't have much capital, and can't accumulate much at the bottom of the pyramid, this will pretty much have to be socialistic. Still beats mass slaughter.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 12:52:22 pm
Welcome to the club, Holt.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 12:59:07 pm
You're assuming the older generations will settle for that considering it would deny them their place at the top or bring competition to their dominance in.
Getting offworld might work but again older generations don't have much of a desire for that. They've already got their big houses, vast wealth, hot and cold running women, etc.

Immortality becomes possible and we have to leave the Earth. Or set a legal limit on age.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 05, 2011, 01:32:28 pm
This is a link, presumably, to (or through) your personal Google mailbox, which is useful only to you, a few Google employees, and the NSA.  Would you mind providing a generally useful link?

DOH!

Here is the regular website. It will have different stuff on it on a daily basis.

http://www.fightaging.org/
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Brugle on April 05, 2011, 01:45:40 pm
On a finite Earth, with a finite maximum number of people (which may increase from time to time as we get technological advances, but they can't be relied upon, not coming according to schedule), though, the idea that all the privates become generals, in effect, as they gain seniority, obviously has problems. If you don't have a conveyor belt, as it were, then most people won't get the chance to move up even one layer from the bottom of the pyramid - because it is an economic given that the bottom is wider than the top.

Psychologically revealing.  You see society as a pyramid, with the only possibility of gain being displacing those above you.

Some of us see society as voluntarily associating individuals, where we all gain from cooperation.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 01:49:51 pm
Psychologically revealing.  You see society as a pyramid, with the only possibility of gain being displacing those above you.

Some of us see society as voluntarily associating individuals, where we all gain from cooperation.


True but AnCap focuses on the pyramid model. Corps and their leaders at the top, their minions under them and nearer the bottom you have the independents barely staying above the poor.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Brugle on April 05, 2011, 01:56:47 pm
Psychologically revealing.  You see society as a pyramid, with the only possibility of gain being displacing those above you.

Some of us see society as voluntarily associating individuals, where we all gain from cooperation.


True but AnCap focuses on the pyramid model. Corps and their leaders at the top, their minions under them and nearer the bottom you have the independents barely staying above the poor.

I suggest you learn a little about AnCap.  It would help you avoid such silliness.  Hierarchies are characteristic of statist systems.  Voluntarily cooprating people would form hierarchical organizations for some purposes, but they would be much rarer than is common in (for example) the US today.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 05, 2011, 01:59:40 pm
I suggest you learn a little about AnCap.  It would help you avoid such silliness.  Hierarchies are characteristic of statist systems.  Voluntarily cooprating people would form hierarchical organizations for some purposes, but they would be much rarer than is common in (for example) the US today.


I see...so somehow you utilise magic to organise people in such a manner as to make corporate entities without making corporate entities.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 05, 2011, 02:26:03 pm
Psychologically revealing.  You see society as a pyramid, with the only possibility of gain being displacing those above you.

Some of us see society as voluntarily associating individuals, where we all gain from cooperation.
I see no contradiction between both views.

People work, associate voluntarily, and gain from cooperation. However, there are different levels of demand for different types of products and services. Food and raw materials are in great demand, so there are many farmers and miners. Manufactured goods are in great demand, so many people work in factories.

A smaller group of people manage the factories and so on.

A smaller group of people design the things that are made in the factories.

As people gain experience, they move up from entry-level positions to more senior ones. But that only works if the levels at the bottom are filled - if there is primary production to manage.

The need for large numbers of peasant farmers working at back-breaking labor, however, has been diminished by advances in technology, at least for Americans. Now, India and China just need to discover new continents that are as large relative to them as North America was to Britain.

Industrial robots have diminished the need for workers on assembly lines, but this has not been as liberating as might have been hoped, because the economy failed to properly absorb the workers displaced. Also, there have been inefficiencies in the utilization of developed real estate in Detroit, I have heard, as a result of this.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 05, 2011, 05:22:31 pm
Quote
Here's just a little personal observation and a bit of advice. You, GlennWatson/WatsonGlenn/and probably some other handles, have been kicked off numerous lists, presumably for not playing well with others. You have taken numerous swipes at me and others on the Forum. All well and good, but I find it interesting that you are so thin-skinned when you are the subject of  the kidding. Apparently, you can dish it out, but you can't take it. Relax; no one is attacking you. I respect most of your posts.

Maybe you could point me to the post where I seemed unable to 'take it.'  Anyway thanks for the advice.  Would you like some from me?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 05, 2011, 05:24:14 pm
Quote
Nope. I mean "whose," which is the correct possessive form of both who and whom. There is no such thing as "whom's" in standard English. Look it up. Anyway, nice try, but now it's even clearer, you don't teach English (at least I hope not!).

I thought you might react like that.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 05, 2011, 05:29:20 pm
Quote
Some of us see society as voluntarily associating individuals, where we all gain from cooperation.

Could you point out an example of that sort of society in history?  I am not implying it does not exist or has not existed I just want a frame of reference.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 05, 2011, 10:17:38 pm
Psychologically revealing.  You see society as a pyramid, with the only possibility of gain being displacing those above you.

Some of us see society as voluntarily associating individuals, where we all gain from cooperation.


True but AnCap focuses on the pyramid model. Corps and their leaders at the top, their minions under them and nearer the bottom you have the independents barely staying above the poor.

I suggest you learn a little about AnCap.  It would help you avoid such silliness.  Hierarchies are characteristic of statist systems.  Voluntarily cooprating people would form hierarchical organizations for some purposes, but they would be much rarer than is common in (for example) the US today.


I read some Dolt's post before I realized he had returned from the land of the undead. As soon as I realized who he was, I immediately assigned him to the category of "don't read unless someone else quotes him." Good decision on my part. You might want to give it a shot.

The one thing that just takes my breath away is his willingness to make a complete ass of himself by spouting the aggressively ignorant nonsense such as that which you quoted. Does he really believe that anyone will take this shit he fabricates out of thin air, seriously? What a pitiful little man. You nailed it, by the way.  :)
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 05, 2011, 10:19:58 pm
Anyway thanks for the advice.  Would you like some from me?

De nada. You mean beyond the advice you regularly dish out? Sure, why not? Amuse me.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 05, 2011, 10:29:02 pm
(((( GROUP HUG? ))))
Title: Re: Rejuvenative medicine - how far off are we?
Post by: sams on April 06, 2011, 01:20:55 am
(((( GROUP HUG? ))))
;D

Hey looks like Reggie lost Brain cells in the process, the dude is losing his juice ... Ms Babette is going to get pissed off
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 06, 2011, 02:14:39 am
Back on the original topic, I find I failed to reply to a couple of people two pages back...

Quote
Basically, we have been making real advances in terms of living longer... but much more slowly than what's being predicted (about +0.15 years senescent life expectancy per year).

Is the ~+0.15 years the prediction, or the slower reality?

Sorry about the late reply - it's the slower reality.   For immortality, we'd have to accelerate this to more than a year per year.

Studies of centenarians show that they disproportionately drank, smoked, ate unhealthy foods, and did not get enough exercise - the reason being that their health was not affected by these things one way or another - that they are genetically disposed to not being harmed by things that harm other people.

Not exactly.  Such studies have shown a weaker than expected positive association with "healthy" behaviour among the oldest old, which is quite different from a negative association.  There's definitely a genetic component too, but it's not enough to make lifestyle irrelevant.

The one instance where you may have a point is with regards to the perverse cost/benefit balance of alcohol, which, in moderation, can definitely help your ticker keep going, particularly in older age groups. (http://www.ncbi.nlm.nih.gov/pubmed/20351238)

Quote
Thus while healthy living can help us dodge a few bullets, it cannot significantly extend the end of life.

Further, as we learn more and more about genes, we mostly learn that we understand the human body less than we thought we did, that its complexity may well make it incomprehensible.

We could, however, produce people, a next generation, that is very long lived, because there seem to be lots and lots of genes that significantly extend people's lives, which truly slow aging, or which fail to shorten their lives, and any one centenarian only has a small number of such genes.  Someone who had lots of such genes might well live for centuries.

We could pick and choose genetics for long-life, although I very much doubt that we could easily find a combination that would work well enough of itself for someone to live for centuries (not that either of us will be around long enough to find out).  A more immediately useful alternative might be to use our understanding gained from looking at the genetic differences to find a treatment that mimics the effects of good genes (potentially), enabling lots of people to live longer.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 06, 2011, 06:46:19 am
Quote
Some of us see society as voluntarily associating individuals, where we all gain from cooperation.

As, a network.  Instead of a pyramid. 

I wonder who thinks his brain would work better with one central "leader" neuron.

Quote
Could you point out an example of that sort of society in history?  I am not implying it does not exist or has not existed I just want a frame of reference.

Not a society, but a "corporate entity that isn't a corporate entity":  Semco (http://www.freibergs.com/resources/articles/leadership/semco-insanity-that-works/).

Quakers are fairly anarchic.  In any given local Meeting, there is a "clerk of the Meeting" who serves for two years, and functions as a coordinator.  The clerk is not elected; is more likely a volunteer.  In the case of multiple volunteers, there is discussion until one emerges -- though nothing rules out two (or more) sort of time-sharing the position, cooperatively, you understand.  Local ("monthly") Meetings send representatives to regional ("quarterly") business meetings, and also to Yearly meetings.  There are temporary coordinator-clerks at each level.  Regardless, decisions are made by discussion, among members and from Monthly to Yearly and back, until "the sense of the Meeting" emerges.  There is no vote.

If you're insisting on a pure anarchy, then I will insist on an example of a pure state -- one that does not have, say, a thriving black market operating within it.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 06, 2011, 06:54:20 am
Quote
De nada. You mean beyond the advice you regularly dish out? Sure, why not? Amuse me.

Don't give advice on the Internet unless someone asks you for it.  If I have given unsolicited advice please forgive me.  I try never to do that.  Maybe you could point out the post where I did.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 06, 2011, 09:03:29 am
tl;dr version: Waaaaah he doesn't agree with me and his worldview challenges me to question my own. Must ignore him!

Fixed for you.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 06, 2011, 09:40:55 am
Quote
De nada. You mean beyond the advice you regularly dish out? Sure, why not? Amuse me.

Don't give advice on the Internet unless someone asks you for it.

Hmmm. Why not? Thanks for the advice, but I assume that when someone says something stupid or in error, they don't know that it is stupid or in error. Ergo, they don't know to ask for advice on the subject. If I don't raise the issue, they may go through life not knowing the proper uses of the nominative and objective cases or how and when to use the subjunctive mood. If I got you and others to educate yourselves on the subject, I figure my advice was a good thing. YMMV.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 06, 2011, 10:59:15 am
Quote
I assume that when someone says something stupid or in error, they don't know that it is stupid or in error. Ergo, they don't know to ask for advice on the subject. If I don't raise the issue, they may go through life not knowing the proper uses of the nominative and objective cases or how and when to use the subjunctive mood. If I got you and others to educate yourselves on the subject, I figure my advice was a good thing. YMMV.

See, that's your problem.

The road to Hell Is paved with good intentions.  Especially when the intentions are disingenuous. 

Let me use an analogy.  I see a fat man walking down the street.  I inform him that he is fat.  I am concerned about his health after all.  See the problem? 

Even if it is your life's work to tell people that the word Whom's is not correct there are still times when you should not.

By the way Mr Sandfort I knew  the word "Whom's" was not correct.  I was joking when I used it.  I would have thought this was obvious.  I mean do you really think I think Whom's is correct?  Really?

I have no idea whether this fact will fit into your worldview but it is interesting to me how you reacted with you little English lesson.

Now that I think about it your attitude is the exact reaadon why ANCAP cannot work.  There will always be people like you who want to "help" others with their 'wisdom' and if they have both power and the desire to 'help' they become dangerous. 

None of this should be construed as advice and you are free to grammer/spellcheck to your heart's content.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: macsnafu on April 06, 2011, 01:28:20 pm
Cracked.com actually had a pretty good take on immortality:  http://www.cracked.com/article_18708_5-reasons-immortality-would-be-worse-than-death.html.  But a lot would depend upon how immortality is actually implemented.

I always thought that dying of old age or natural causes was caused by the cellular system breaking down, as in the cells start making an increasing number of mistakes when reproducing, until something vital stops functioning properly.

If so, then longevity can be increased either by fixing cellular reproduction or regeneration, or by figuring out what causes the cells to start breaking down and prevent that. 

Even with DNA mapping, I'm not sure we're all that much closer to solving old age, but who knows?  20 years seems rather optimistic to me, but it could happen.

As for immortality itself, being immortal really just means not dying of old age.  An immortal can still be killed by accidental death or by murder.  To avoid that kind of death, you'd have to be invulnerable as well as immortal, and I don't know any realistic way or approach towards invulnerability.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 06, 2011, 01:32:05 pm
A manga I used to read presented an interesting scenario where everyone became immortal thanks to lol-nanotech.
Some guy stole the research and spread it effectively making everyone immortal. But since they couldn't leave the solar system the powers that came to be made children illegal and removed all rights for minors categorising them as vermin/animals/lunch depending on the region. Children in one region ended up being trained in "youth infantry schools" for use in that areas combat arena where people fought over flags for a bounty. The Jovian Union also engaged in an all out war on an orphanage in the asteroid belt. The only place where children had any rights was Mars which was effectively the solar system equivalent of Africa due to constant war between various factions.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 06, 2011, 02:43:17 pm

I always thought that dying of old age or natural causes was caused by the cellular system breaking down, as in the cells start making an increasing number of mistakes when reproducing, until something vital stops functioning properly.

That makes sense. But consider that different animals senesce at different ages. Many insects die of old age in the fall, but some cicadas live 17 years, and some cave crickets even longer. And there's reason to think those cicadas live that long only to reduce their overlap with the 13-year cicadas.

Mammals have a big variation in lifespan. Could that be somehow programmed into the genes? If so, we might learn how to remove the programmed age limit, and then we'll live until the cellular system breaks down from sheer entropy. It might even turn out to be easy to do that.

On the other hand, we won't know that it's possible until it gets done successfully.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 06, 2011, 04:46:31 pm
Now that I think about it your attitude is the exact reaadon why ANCAP cannot work.  There will always be people like you who want to "help" others with their 'wisdom' and if they have both power and the desire to 'help' they become dangerous. 

Non sequitur. Yes, there will always be people who want to help (and "help") others. However, it does not follow that they will initiate force to do so. I am always free to say, "If I were you [proper use of subjunctive mood] I would try to understand the subjunctive mood." However, you are just a free to tell me to go fly a kite. As long as I don't put a gun to your head and demand that you say, "If it were I," no force has been initiated and AnCap has worked just fine, thank you.

P.S. You were correct about one thing. In your case, my offer of help was disingenuous. In fact, I was just making fun of you. However, I considered it light-hearted, not mean-spirited. Again, YMMV.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 06, 2011, 06:21:14 pm
Quote
Yes, there will always be people who want to help (and "help") others. However, it does not follow that they will initiate force to do so.

Yes it does. it always does.  Every government in history has started with the professed claim of wanting to help.

Quote
I was just making fun of you. However, I considered it light-hearted, not mean-spirited.

Don't we all.  Can I get that same deal Holt has where you ignore his posts?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 06, 2011, 07:11:54 pm
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 06, 2011, 09:13:30 pm
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading

Your bad, or is that you're bad?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 06, 2011, 10:00:27 pm
Quote
Yes, there will always be people who want to help (and "help") others. However, it does not follow that they will initiate force to do so.

Yes it does. it always does.  Every government in history has started with the professed claim of wanting to help.

I doubt it, but in any case, we have a logic problem with your implication. Just because all "A" are "B" does not mean all "B" are "A." Even assuming, arguendo, that every government was started by someone wanting to do good, it does not follow that everyone wanting to do good creates a government. It does not follow.

FYI, I reject your original premise as I see no evidence to support it. Governments are clearly run by people who want power irrespective of what they claim. Sociopaths are heavily over-represented in governments.

Quote
I was just making fun of you. However, I considered it light-hearted, not mean-spirited.

Don't we all.  Can I get that same deal Holt has where you ignore his posts?

"I'm sorry Dave. I can't do that." My view is that while Dolt has brought less than nothing to the table, you have offered valuable viewpoints and insights into the Forum. So I will endeavor to curb my humor in your case, if that helps.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 06, 2011, 10:21:45 pm
Personally, I am impressed with Holt's deep understanding of the Smurfs, profound, uncanny even. It's as if he was one sometimes.

I am curious though Holt, were you lurking and learning here during your recent absence or just elsewhere? I see a new thread has been started about the precieved meaning of words. Maybe your thoughts would be better recieved if everyone shared a conceptual dictionary?

Bit of an up hill battle for some though but best of luck.

That manga sounds interesting, was it online or paper?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: dough560 on April 07, 2011, 02:51:44 am
Like Cold Fusion, or perpetual motion, some dreamer will change the rules.

Government will do anything to take control.  Case in point.  The Food and Drug Administration wants the authority to regulate supplements.  This authority will expanded the agency's political power.  Additionally, the agency acts to protect pharmaceutical companies, preserving the status quo.  The companies do not want to compete with products of  proven effectiveness, fewer or no side effects and lower costs.

There will be periods of social adjustment as technology emerges and matures.  While the world and its resources are finite.  The universe is unlimited.  If nothing else, immortals will get bored and start looking over the next hill.  They will have time to make plans and see them through.

As for practical immortality.  I doubt it happens.  The mature technology may permit a person to live forever, but they won't.  Life will see to it.  People won't die in bed, except in rare circumstances.  If I'm remembering correctly, some genius at an insurance company figured out a actuary table for an "immortal".  I think the average was about 350 years, with a maximum life expectancy about 1000 years.  People will either adapt, die by accident, let nature take its course and die of old age, or suicide.  Whatever the individual decides, we'll have government interference.

I'm 55 years old and have had three careers as an adult.  I'm training for a fourth and would love to have the physicality I had 30 years ago.

As for those who say AnCap can not work.  Have Faith.  Better yet, read some history.  Look at periods of major social change and the forces which brought about the changes.  The political parties prior to the Civil War come to mind.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: terry_freeman on April 07, 2011, 03:21:35 am
Various studies show that, when technologies make cars "safer", people tend to push the envelope further. (example: German taxis and antilock brakes) Might this principle apply if we push the boundaries of human longevity? Would more people engage in skydiving, racing powered vehicles ( including spaceships ), and other risky endeavors?

There are countervailing trends. Even as people adapt to technology by driving a little bit faster, a little closer to the edge, the overall safety rate does improve, when viewed over longer spans of time; the same is true for other accidental death rates for firearms, and other matters; people develop and share practical norms and mores which reduce risks. Governments improve, albeit slowly. For example, after decades, governments finally approved better headlights, and deigned to recognize the safety risks which exploding balloons present to children and small adults; Europeans are also now discovering the advantages of intersections which are uncluttered by signs and signals and other distractions, leaving drivers, cyclists, and pedestrians to focus on the task of emerging unscathed.

These changes tend to swing in cycles. In recent decades, for example, parents have gone all-out to protect their children from any possible harm - a glance at today's skateboarders or cyclists, wearing elbow and knee and head protection, and even back armor, compared to the way we rode in the 50s or 60s, reveals a striking contrast. Some parents now are swinging toward the idea of letting children fail; google "free range kids."

It would not surprise me to see many complex changes as a result of increased longevity. Over long periods of time, I suspect that many people would become fiercely resistant to tyranny. When you have the prospects of hundreds of years ahead of you, do you want your future to be limited by corrupt governments?

Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 07, 2011, 03:39:29 am
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading

Your bad, or is that you're bad?

No I mean Sandy
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 07, 2011, 05:04:59 am
Like Cold Fusion, or perpetual motion, some dreamer will change the rules.

Government will do anything to take control.  Case in point.  The Food and Drug Administration wants the authority to regulate supplements.  This authority will expanded the agency's political power.  Additionally, the agency acts to protect pharmaceutical companies, preserving the status quo.  The companies do not want to compete with products of  proven effectiveness, fewer or no side effects and lower costs.

Personally, I'm extremely sceptical of perpetual motion, highly sceptical of cold fusion, and pretty sceptical of the claims made by the supplements industry (although some supplements are plainly a good idea, there's just too little evidence for most of them, and far too many touted on the basis of reasoning like the "it's natural so it's good" fallacy or anecdote).

As for practical immortality.  I doubt it happens.  The mature technology may permit a person to live forever, but they won't.  Life will see to it.  People won't die in bed, except in rare circumstances.  If I'm remembering correctly, some genius at an insurance company figured out a actuary table for an "immortal".  I think the average was about 350 years, with a maximum life expectancy about 1000 years. 

Now there's a fun appliance of stats.  Even if you take out ageing, we do indeed remain very mortal indeed.

Various studies show that, when technologies make cars "safer", people tend to push the envelope further. (example: German taxis and antilock brakes) Might this principle apply if we push the boundaries of human longevity?

True that.  My favourite example was the effect of making seatbelts in cars mandatory in the UK in the 80s.  Deaths and injuries among drivers went down, even though people started driving a little faster; but deaths and injuries among pedestrians and cyclists went up, because the cars were moving faster.

Would more people engage in skydiving, racing powered vehicles ( including spaceships ), and other risky endeavors?

Tricky one, there.  You aren't taking the risks out of those activities; if anything, you'd have more to lose if, say, you've got a couple hundred years of healthy life ahead of you than a few decades of physical decline.  On the other hand, more people would be physically and mentally capable of various risky physical activities if we could eliminate osteoporosis, arthritis, Alzheimers etc.; so you might well have more 90-year-olds skiing, mountain climbing and so forth than we do today.

It would not surprise me to see many complex changes as a result of increased longevity. Over long periods of time, I suspect that many people would become fiercely resistant to tyranny. When you have the prospects of hundreds of years ahead of you, do you want your future to be limited by corrupt governments?

It'd be interesting to see just what might happen with immortality.  There's a strong association between age and right wing economic views today, but also one between age and "don't rock the boat" political views.  Also, continuing to hold views prevalent among the youth might last longer if physical youth is itself maintained longer, and the old are just that much older. 
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 07, 2011, 06:17:51 am
Quote
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading

. . . says a man who does not have a forum full of people discussing his works, about a man who does.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 07, 2011, 06:39:48 am
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading

Your bad, or is that you're bad?

No I mean Sandy

I know you did.  You are still a bad man.  Shame on you.  Why can't you be more like me.  Always kind and considerate.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 07, 2011, 06:43:33 am
Quote
Governments are clearly run by people who want power irrespective of what they claim.

I agree.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 07, 2011, 07:53:25 am
Quote
and pretty sceptical of the claims made by the supplements industry (although some supplements are plainly a good idea, there's just too little evidence for most of them,

Are you equally skeptical of the claims made by the pharmaceutical industry?  Consider:

http://www.ncbi.nlm.nih.gov/pubmed/9555760?dopt=Abstract  A finding by the JAMA that properly-prescribed and -administered (i.e., not overdoses, not wrong) drugs are around the 5th leading cause of death in the US;

and that there has never been a truly blind test of any drug.  Anyone who gets the side effects knows they received the real thing, which is an opening for the placebo effect to kick in; in a truly blind test, the recipient would not be told what the drug is supposed to do at all.

Quote
far too many touted on the basis of reasoning like the "it's natural so it's good" fallacy or anecdote).

Quite so.  I like pointing out that arsenic is all-natural. . . .

And as far as I can find, "anecdote" is the only evidence for the effectiveness of vaccination.  I have seen no rigorous scientific test of the vaccination theory, and I have some theoretical grounds for doubting its efficacy -- as in, a disease agent naturally encounters multiple bodily systems:  skin, mouth, eyes, nasal & sinus linings, lungs, stomach & intestines; rarely does it go straight to the bloodstream, but vaccinations bypass all those other tissues, and it seems evolutionarily improbable that those normally-involved tissues don't have a role in creating immunity.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 07, 2011, 09:19:08 am
You are seriously debating vaccines? Why is it you fringe folk always descend on vaccines?
The overall principle on widespread vaccination is about herd immunity. You make enough people resistant or immune to the disease to prevent it spreading. Results will always vary per individual on how well the vaccine works. Plus your understanding of the immune system is non-existent or even how vaccines work on the individual. It's about your immune system not the rest of your body. Your immune system is the part of you that fights disease, hence why it is called that. The vaccine is a weakened version of whatever you want to try and vaccinate against or something similar that is safe (enough) to administer in comparison to what you're trying to protect them against. The immune system responds as normal to the infection, fights it, creates antibodies designed to fight it and then deals with it leaving the antibodies with you which means in future your immune system can crank out more of them if a similar disease is detected.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 09:55:48 am

And as far as I can find, "anecdote" is the only evidence for the effectiveness of vaccination.

You disbelieve in statistical trials? I'm real unclear how to respond to this.

Quote
I have seen no rigorous scientific test of the vaccination theory, and I have some theoretical grounds for doubting its efficacy -- as in, a disease agent naturally encounters multiple bodily systems:  skin, mouth, eyes, nasal & sinus linings, lungs, stomach & intestines; rarely does it go straight to the bloodstream, but vaccinations bypass all those other tissues, and it seems evolutionarily improbable that those normally-involved tissues don't have a role in creating immunity.

It seems sensible to me that other tissues could be useful for developing immune system responses, and that tissues which do not receive antigens from blood with immunization might be somehow deficient as a result. Perhaps better vaccines could be devised which get past that potential limitation. But vaccines which provide partial immunity could still be good enough to much reduce the risk of serious disease, or the spread of infection. That's the important thing.

I dislike the tone of Holt's response but he has a point. Some vaccines get testably better results than others, and some are probably not worth using. (We aren't very good at predicting virus epidemics and we can vaccinate a lot of people at big expense and a few of them get serious bad effects, when the disease they are being vaccinated for probably would not have happened anyway. Better to get a series of correct predictions first.)

But I find the idea -- that in general vaccines are not effective -- is hard to grasp.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 07, 2011, 10:16:05 am
You know what all those vaccine naysayers? I have one thing for you.

Smallpox.

Hows that smallpox? You been dying of it lately? Has anyone in the civilised world? Sorry has ANYONE?
It works. Vaccination works. Any who say otherwise are simply spoiled brats who have never experienced the world without it. Are all vaccines flawless? Of course not. Is the general concept and methodology flawless? Most likely not. Is it good enough and been proven to work? Guess what? Reality disagrees with the screams of those who claim it does not.

Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 07, 2011, 10:23:50 am
Quote
and pretty sceptical of the claims made by the supplements industry (although some supplements are plainly a good idea, there's just too little evidence for most of them,

Are you equally skeptical of the claims made by the pharmaceutical industry?  Consider:

http://www.ncbi.nlm.nih.gov/pubmed/9555760?dopt=Abstract  A finding by the JAMA that properly-prescribed and -administered (i.e., not overdoses, not wrong) drugs are around the 5th leading cause of death in the US;

and that there has never been a truly blind test of any drug.  Anyone who gets the side effects knows they received the real thing, which is an opening for the placebo effect to kick in; in a truly blind test, the recipient would not be told what the drug is supposed to do at all.

I am equally sceptical of the motives of the pharmaceutical industry.  Their claims, however, are held up to a higher standard of evidence; they have to demonstrate that their products work in well-designed double-blind randomised controlled trials, or their products won't be licensed.  There are still issues, in this regard; there's continual examples of people trying to cheat the system, sometimes by engaging in one or another form of statistical skullduggery.  But a lot of said issues have been addressed, and being held to account to demonstrate efficacy is all you can do.

Also, have you ever heard of the "nocebo" effect?  (Give people sugar pills, and a certain proportion will still report side effects - to a certain extent, even when you tell them they're receiving a placebo).

Quote
Quote
far too many touted on the basis of reasoning like the "it's natural so it's good" fallacy or anecdote).

Quite so.  I like pointing out that arsenic is all-natural. . . .

And as far as I can find, "anecdote" is the only evidence for the effectiveness of vaccination.  I have seen no rigorous scientific test of the vaccination theory, and I have some theoretical grounds for doubting its efficacy -- as in, a disease agent naturally encounters multiple bodily systems:  skin, mouth, eyes, nasal & sinus linings, lungs, stomach & intestines; rarely does it go straight to the bloodstream, but vaccinations bypass all those other tissues, and it seems evolutionarily improbable that those normally-involved tissues don't have a role in creating immunity.

The crucial test required for any new vaccine is a randomised controlled trial, after the vaccine has been shown to be safe and to induce an effect that's likely to be immunising against the target pathogen in smaller trials.  .  When people get fancy, the trial may be cluster-randomised in such a way that you can see the herd immunity effects within an area as well as the individual effects.  If the people you've vaccinated don't get the disease, or get it much less often, you know it's worked for them and how well.  Furthermore, if you randomise 80% of the people in some randomly selected areas to be vaccinated and the other 20% are less likely to get the disease than people living in unvaccinated areas, you know there's a herd immunity effect.  Here's one recent individually randomised trial (http://www.ncbi.nlm.nih.gov/pubmed/20647284), and another recent cluster-randomised trial. (http://www.ncbi.nlm.nih.gov/pubmed/17955440)
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 10:52:48 am

Are you equally skeptical of the claims made by the pharmaceutical industry?  Consider:

http://www.ncbi.nlm.nih.gov/pubmed/9555760?dopt=Abstract  A finding by the JAMA that properly-prescribed and -administered (i.e., not overdoses, not wrong) drugs are around the 5th leading cause of death in the US;

and that there has never been a truly blind test of any drug.  Anyone who gets the side effects knows they received the real thing, which is an opening for the placebo effect to kick in; in a truly blind test, the recipient would not be told what the drug is supposed to do at all.

I am equally sceptical of the motives of the pharmaceutical industry.  Their claims, however, are held up to a higher standard of evidence; they have to demonstrate that their products work in well-designed double-blind randomised controlled trials, or their products won't be licensed.  There are still issues, in this regard; there's continual examples of people trying to cheat the system, sometimes by engaging in one or another form of statistical skullduggery.  But a lot of said issues have been addressed, and being held to account to demonstrate efficacy is all you can do.

Also, have you ever heard of the "nocebo" effect?  (Give people sugar pills, and a certain proportion will still report side effects - to a certain extent, even when you tell them they're receiving a placebo).

Pharmaceutical testing costs way too much. And it's an excuse for pricing too high also.

I say, elminate the large testing done by pharmaceutical companies and have the FDA do those tests. Do them on random Medicaid patients. You don't have to tell the Medicaid patients that they're part of an experiment.

So when you join Medicaid you agree to take part in medical experiments, and from that you will sometimes get treatment which there is good reason to believe is better than the usual, but sometimes you will get standard treatment. You agree to some minor relaxation on medical privacy to make it easier to discover treatment effects. You perform a service to society by being on Medicaid.

And after a new drug has been tried on, say, 40,000 Medicaid patients and the results compared to other treatments, then it can be released for anybody. The results would be public and as more Medicaid patients are prescribed the drug the results would get routinely updated.

Results: Drug testing becomes considerably cheaper for pharma companies. WIth final testing out of their hands the incentive to cheat becomes much less, and the incentive to cheat at earlier stages is somewhat less -- what good is it to continue work on something that final tests will probably show is no improvement? Testing could be faster for effective drugs -- as early results come out positive the number of Medicaid patients getting it can be increased -- and slower for ineffective drugs. Testing can also be much more thorough, without increasing costs a whole lot. After all, those Medicaid patients would be getting some sort of treatment anyway, so the main increased cost comes from providing the new medication and tracking the results.

This is something that might be approved even by Congressmen who don't like Medicaid. Treating Medicaid patients as lab rats would be a step in the right direction, wouldn't it?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 07, 2011, 11:05:13 am
Just this.

About half a century ago Thalidamide, however you spell the damned thing, caused birth defects in Europe. So the US FDA over reacted, in my opinion, testing things to death. All well and good but how many people have died from delayed drugs since?

Seatbelt anecdote, My brother was trapped in a wrecked car with gasoline leaking and running over his body. So his next car was a diesel and even today, 30 years later, he refuses to wear a seatbelt. Personal choice, personal responsibility, personal safety.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 07, 2011, 11:16:41 am
Problem with your proposed random testing of medicaid patients. Firstly it'll already have to have undergone human trials before its close to ready for clinical testing. Prior to human trials there will have been animal testing and prior to that years of research.
Doesn't solve much and doesn't alleviate much of the cost.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 07, 2011, 11:19:28 am
I don't really want to really join in the piling on of people disagreeing with mellyrn on this - pharmaceutical testing is what pays my princely salary, so my views are probably suspect.

This, however, I felt unable to let pass:
Anyone who gets the side effects knows they received the real thing, which is an opening for the placebo effect to kick in

As it is utterly without basis in fact. "Side effects" (we call them Adverse Events, or AEs, in the trade) do occur in patients in the placebo arms of trials, often at a rate similar to that of the active treatments. So the assumption that "side effect" = "real thing" is simply incorrect.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 07, 2011, 11:21:24 am
@ J Thomas,

Costs are an issue, and yes, big clinical trials are a substantial chunk of the costs.  Your proposed solution, however, would be rejected on ethical grounds.  The principle of autonomy is one of the main ethical foundations of modern medicine; and to make access to medical care contingent on willingness to participate in clinical trials would violate the patient's autonomy.

A further practical objection would be that a voluntary trial participant is more likely to actually take the pills, to be easy to follow-up, and generally to cooperate with the trial than a coerced participant.

@Holt,

See above.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 07, 2011, 11:38:03 am
Additional objections to J Thomas' proposed scheme - even if adopted it only provides access to the US market (which is currently a shrinking proportion of the global pharmaceutical sales).

Unless we're also assuming that such testing would be acceptable to the EMEA, Health Canada, the Chinese SFDA, and Ministries of Health in most other countries. If it isn't acceptable to them, and you want to sell your drugs there, then you're going to have to do those expensive clinical trials anyway.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 11:43:12 am

About half a century ago Thalidimide, however you spell the damned thing, caused birth defects in Europe. So the US FDA over reacted, in my opinion, testing things to death. All well and good but how many people have died from delayed drugs since?

Officially the medical philosophy is "First, do no harm". Killing people with a new drug is considered worse than failing to save them because you depend on proven technology instead of the latest untested thing.

Here's a general testing approach that works well when patients to test a new drug on are rare: Each time a new patient shows up, you givme him the standard treatment until one of them gets an unacceptable result. Then you switch to the first experimental treatment and use that on each new patient until one of them gets an unacceptable result. Then you switch to the second experimental treatment and use that until it fails. Go through the list, and then go back to the standard treatment. When your results reach statistical significance, you will have put the largest number of patients onto the most successful treatment.

Quote
Seatbelt anecdote, My brother was trapped in a wrecked car with gasoline leaking and running over his body. So his next car was a diesel and even today, 30 years later, he refuses to wear a seatbelt. Personal choice, personal responsibility, personal safety.

People can be funny like that. He might have been better off if he was thrown through the windshield onto the pavement. It's possible.

I'm not an EMT so I've only been involved in one serious accident. We were able to cut the jammed seatbelts easily. But one guy had his foot mangled into the crushed part of the car so we couldn't move him. He cut his chin on the steering wheel and his head left a head-shaped break in the windshield where the safety glass stretched.

I think on average seat belts are better, but it isn't 100%. Once I was driving along when somebody pulling out of their driveway suddenly rammed us with his snowplow attachment. It caved in the side of our car and my wife's leg got bruised. She was wearing a seatbelt, and if he had hit us hard enough to go a couple of feet farther that seatbelt would have done her no good whatsoever. But he wasn't going that fast; that kind of collision usually doesn't.

I can't blame people for going by their personal experience rather than the odds, when they didn't themselves inspect the data the odds came from. Your own experience is at least your experience, while statistical data might have subtle systematic bias you have not noticed. On the other hand, people who don't even try to play the odds tend to lose.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 11:44:57 am

Doesn't solve much and doesn't alleviate much of the cost.

It does reduce the cost for the last stages of testing, which are very expensive. And it's a positive good to get that henhouse away from those foxes.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 07, 2011, 11:48:09 am
Yep, that's his choice.

Me, I wear a seatbelt, a bike helmet, sometimes a life jacket and on occasion a pistol, generally not all at once though. Awkward.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 07, 2011, 11:50:57 am
Got some links -- information -- from paddyfool.  Thanks!  Got empty sneering and stereotyping from Holt.  Cheez.

Quote
So the assumption that "side effect" = "real thing" is simply incorrect.

Xavin, I appreciate that you couldn't let that slide.  I infer that I didn't express myself clearly, though.  "Side effect = real thing" may well be factually incorrect.  But the recipient doesn't know that.  If he's participating in a trial of, say, a sleeping pill, and he gets side effects -- or, heck, only what he thinks are side effects -- then "side effect = real thing" in his own mind and he may sleep better, or imagine that he's sleeping better.

Otoh, if he had no idea what result the drug was meant to have, he couldn't imagine himself improving.  That would be a truly "blind" study, is what I was after.  Those administering the drug shouldn't know what is being tested for, either.

And if you're going to "pile on" in an informative way, as you did, then pile on!

Quote
You disbelieve in statistical trials? I'm real unclear how to respond to this.

I said I couldn't find anything beyond anecdote.  I may be using "anecdote" somewhat inappropriately, though.  There are hundreds, perhaps thousands, of examples of communities around the world that showed huge dropoffs in disease X after vaccine X was introduced, which are waved at me as evidence for vaccine efficacy.  "Anecdotes", just sort of larger-scale.

I thought if I said I couldn't "find" stuff (as distinct from claiming it doesn't exist at all), someone would post a link or two.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 11:52:25 am
@ J Thomas,

Costs are an issue, and yes, big clinical trials are a substantial chunk of the costs.  Your proposed solution, however, would be rejected on ethical grounds.  The principle of autonomy is one of the main ethical foundations of modern medicine; and to make access to medical care contingent on willingness to participate in clinical trials would violate the patient's autonomy.

Modern medicine would not have to violate patients' autonomy at all. It's simple -- if patients want their medical costs to be paid by Medicaid they can agree to clinical trials, if and when. If they choose not to be part of Medicaid then modern medicine can give them whatever access modern medicine chooses to, for whatever payments can be arranged. This is an agreement between the US government and Medicaid consumers, not an agreement between modern medicine and its patients.

Quote
A further practical objection would be that a voluntary trial participant is more likely to actually take the pills, to be easy to follow-up, and generally to cooperate with the trial than a coerced participant.

It should be possible to do the testing without telling the patient that he is in an experimental group or a control group, or that he is in an experiment at all. Then if he does not take the pills his results are representative of what we can expect in actual practice, which is the desirable end result.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 11:57:23 am
Additional objections to J Thomas' proposed scheme - even if adopted it only provides access to the US market (which is currently a shrinking proportion of the global pharmaceutical sales).

Unless we're also assuming that such testing would be acceptable to the EMEA, Health Canada, the Chinese SFDA, and Ministries of Health in most other countries.

I would expect that large trials run outside the control of the vendors, with reasonably complete and continuing access to the somewhat-sanitised data, would be preferable than traditional published results. But each nation would have to make its own choice. Other nations which copied the US example might delay sales, but their trials could run in parallel with US trials.

Quote
If it isn't acceptable to them, and you want to sell your drugs there, then you're going to have to do those expensive clinical trials anyway.

Maybe. Not my problem. Not the USA's problem.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 07, 2011, 12:18:35 pm
I have family in the transplant industry.

Parts go from the US elsewhere but not the other way. Corneas at least, by law can't be imported from anywhere. Sure there are plenty of feces-holes you wouldn't want people parts from but plenty of perfectly nice places too. No people parts allowed in from Europe, Japan, Australia. I believe even Canada. The Feds don't like their paper trail.

As a customer, I'd see no reason to prefer a part from here over one from those places. None from Nairobi, sure, but Berlin or Brisbane?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 12:33:19 pm

 I infer that I didn't express myself clearly, though.  "Side effect = real thing" may well be factually incorrect.  But the recipient doesn't know that.  If he's participating in a trial of, say, a sleeping pill, and he gets side effects -- or, heck, only what he thinks are side effects -- then "side effect = real thing" in his own mind and he may sleep better, or imagine that he's sleeping better.

This looks like one of those language things. At any given time, a certain percentage of people get insomnia, some percentage get extra sleepy, some get sinus congestion, some get depressed, etc. So if participants get asked how they slept, some of both experimental and control groups will report insomnia. It doesn't mean much unless the percentage gets way high, in which case you can look into marketing the drug as a sleep aid or caffeine substitute etc.

But what if you are giving people LSD? There's no way that somebody with a dose of LSD will think he's in the control group. If his urine turns purple? If he gets a strong salty lithium taste? If his eyes stream tears all the time? Some of these are not adverse effects at all, but they are clear signs that he is not in the control group, that he is getting a medication which is supposed to do something.

Quote
Otoh, if he had no idea what result the drug was meant to have, he couldn't imagine himself improving.  That would be a truly "blind" study, is what I was after.  Those administering the drug shouldn't know what is being tested for, either.

That does seem like an ideal case. So, say you have a bunch of people who have a particular malady and you have them all institutionalized, and you don't tell them anything. Every morning you give each of them their own personal vitamin pill and you watch while they take it, or possibly forcibly administer it. Their own personal vitamin pills may contain special medications but they don't know that and the person who gives it to them doesn't know. They would have nothing to base a placebo effect on.

I don't think that sort of thing can be done in general, though.

Ideally we would carefully study how to create a placebo effect, and do it as much as possible for experimental and control groups, and look at the improvement over placebo effect.

Quote
Quote
You disbelieve in statistical trials? I'm real unclear how to respond to this.

I said I couldn't find anything beyond anecdote.  I may be using "anecdote" somewhat inappropriately, though.  There are hundreds, perhaps thousands, of examples of communities around the world that showed huge dropoffs in disease X after vaccine X was introduced, which are waved at me as evidence for vaccine efficacy.  "Anecdotes", just sort of larger-scale.

I thought if I said I couldn't "find" stuff (as distinct from claiming it doesn't exist at all), someone would post a link or two.

Did you do anything to look? I chose rabies because that was one of the first. Pasteur started giving his preparation to people who had already been bitten by rabid animals, and some of them lived when hardly anybody had survived rabies before. People were ready to believe. So I googled "rabies vaccine trials" and got a lot of links. Here is the third one:

http://clinicaltrials.gov/ct2/show/NCT01044199

They gave rabies vaccine in different ways to a bunch of people and checked for adverse effects and also checked whether they developed enough of an antibody response to rabies virus. It's pretty clear that their people did not have much antibody response to rabies before the injections, and they did later. They assumed from previous studies that this was enough to much reduce the chance of getting rabies on exposure.

Is this the sort of thing you're looking for? They tend not to inject people with rabies to see whether the immunization actually keeps them from getting symptoms, but I could probably find an animal study like that.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 07, 2011, 12:41:25 pm
Officially the medical philosophy is "First, do no harm". Killing people with a new drug is considered worse than failing to save them because you depend on proven technology instead of the latest untested thing.
And this philosophy made sense 'way back when, before they had anaesthetics, before they had antibiotics, before they had much of anything in the way of useful therapy. if the best you could do was little better than quackery, the rule of primus non nocere at least meant that you were staying away from things that would make things worse.

Today, that rule is not obeyed in its original form; if it was, we wouldn't have cancer chemotherapy or even surgery.

In my opinion, the correct philosophy should be to maximize the expected outcome to the patient, by whatever means are necessary. So interns don't get to perform surgery until they've performed several successful veterinary operations - nobody experiences unneccessary discomfort after an appendectomy just because "there's gotta be a first time" for every doctor.

New and untested medical treatments? After they've undergone extensive animal testing, because it is unethical to perform blind clinical trials on human beings, you instead have people choosing which of the available therapies they feel gives them the best chance. Despite the fact that this is being paid for by a universal medicare system, and not the individual patient. Of course, therapies proven not to work well get withdrawn from the available alternatives, as are those that produce no extra benefit for a large additional cost.

Maybe someday even in the area of health care, the majority of voters would agree to paying for medical care themselves, but given that the cost of medical care seems to be so often far beyond the reach of ordinary people, this seems difficult to imagine. (Except in the United States, where health insurance is a standard employment benefit, so that for most people, the end result is the same as if it were provided socialistically by the government - with some savings, because the unemployed are ignored, and some opportunity for the market to improve the quality of care.)
Title: Re: Rejuvenative medicine - how far off are we?
Post by: macsnafu on April 07, 2011, 02:45:53 pm

I think on average seat belts are better, but it isn't 100%. Once I was driving along when somebody pulling out of their driveway suddenly rammed us with his snowplow attachment. It caved in the side of our car and my wife's leg got bruised. She was wearing a seatbelt, and if he had hit us hard enough to go a couple of feet farther that seatbelt would have done her no good whatsoever. But he wasn't going that fast; that kind of collision usually doesn't.

I can't blame people for going by their personal experience rather than the odds, when they didn't themselves inspect the data the odds came from. Your own experience is at least your experience, while statistical data might have subtle systematic bias you have not noticed. On the other hand, people who don't even try to play the odds tend to lose.


I don't doubt that seat belts can save lives.  What I doubt is that seat belt laws save lives.  There's a difference between the actual action taken and simply being told to do said action.  Especially if enforcement of the law takes away from law enforcement in more important areas.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: macsnafu on April 07, 2011, 02:50:30 pm
Yep, that's his choice.

Me, I wear a seatbelt, a bike helmet, sometimes a life jacket and on occasion a pistol, generally not all at once though. Awkward.

I'm thinking of rigging up a seat belt I can wear, whether I'm in a car or not.  It may not provide much protection, but I can at least tell law enforcement officials that I'm wearing my seat belt!  Which is, after all, what the law technically requires.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: NeitherRuleNorBeRuled on April 07, 2011, 03:51:06 pm
I say, elminate the large testing done by pharmaceutical companies and have the FDA do those tests. Do them on random Medicaid patients.

It would be far better to eliminate the FDA and Medicaid.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 05:30:43 pm
I say, elminate the large testing done by pharmaceutical companies and have the FDA do those tests. Do them on random Medicaid patients.

It would be far better to eliminate the FDA and Medicaid.

Maybe so. But both Medicaid and large-scale drug testing by pharma companies have giant problems, and I don't at the moment begin to see how to eliminate both of them.

Title: Re: Rejuvenative medicine - how far off are we?
Post by: NeitherRuleNorBeRuled on April 07, 2011, 06:55:01 pm
It would be far better to eliminate the FDA and Medicaid.

Maybe so. But both Medicaid and large-scale drug testing by pharma companies have giant problems, and I don't at the moment begin to see how to eliminate both of them.

Trivial; (1) Don't give money to Medicaid administration, and it will go away. (2) Don't give money to the FDA,and it will go away;  both drug testing will become much more efficient, and large pharma companies may go away (being replaced by more efficient small pharma companies).

Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 07, 2011, 08:25:24 pm
You know what all those vaccine naysayers? I have one thing for you.

Smallpox.

How about polio? Recently, finally, the CDC is now recommending a shot of the dead virus vaccine before finishing with the two doses of the oral live vaccine. The reason? Because the number one cause of polio had become the actual polio vaccine (oral live version) itself.

This took decades to happen.  Proof that the government can fuck up vaccines (not to mention healthcare in general).

Any volunteers for the live virus flu vaccine? The government said it was safe, back a few years ago when there was a shortage. 
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 07, 2011, 08:49:16 pm
It would be far better to eliminate the FDA and Medicaid.

Maybe so. But both Medicaid and large-scale drug testing by pharma companies have giant problems, and I don't at the moment begin to see how to eliminate both of them.

Trivial; (1) Don't give money to Medicaid administration, and it will go away.

Yes, that's trivial.

Quote
(2) Don't give money to the FDA,and it will go away;

And that's trivial.

Quote
both drug testing will become much more efficient,

That isn't trivial at all. Not the least little bit.

In the short run, the most efficient way to do drug testing is to fake it. "Let's not do it and say we did." There can be long-term consequences to that, but if I had a dollar for everybody alive to day who has gone with short-run convenience while ignoring long-term consequences, I'd have close to $7 billion.

Quote
and large pharma companies may go away (being replaced by more efficient small pharma companies).

Maybe. If they might be subject to lawsuits that would bankrupt them, then it makes sense to have a lot of little pharma companies rather than a few big ones. Probably spin off a new corporation for each drug they're liable for.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 08, 2011, 12:20:52 am
How about polio? Recently, finally, the CDC is now recommending a shot of the dead virus vaccine before finishing with the two doses of the oral live vaccine. The reason? Because the number one cause of polio had become the actual polio vaccine (oral live version) itself.
You realize, though, why that happened? Because the vaccines against polio - both of them - had been working so well that the chances of contracting polio in other ways had fallen so drastically.

So it's not a bad vaccine, even if the CDC was late in responding to the new reality in which the vaccine is hardly needed.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on April 08, 2011, 01:56:59 am
I don't doubt that seat belts can save lives.  What I doubt is that seat belt laws save lives.  There's a difference between the actual action taken and simply being told to do said action.  Especially if enforcement of the law takes away from law enforcement in more important areas.

Actually, they do (see page 331). (http://www.ncbi.nlm.nih.gov/pubmed/9921384)  Primary law enforcement of seatbelt use means that the risk of fatal injury falls by between 3 and 31%, and the risk of serious non-fatal injury by between 11 and 80%.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 08, 2011, 07:06:09 am
Quote
Quote from: macsnafu on April 07, 2011, 01:45:53 PM
I don't doubt that seat belts can save lives.  What I doubt is that seat belt laws save lives.  There's a difference between the actual action taken and simply being told to do said action.  Especially IF enforcement of the law takes away from law enforcement in more important areas. [emphasis added]

Actually, they do (see page 331).  Primary law enforcement of seatbelt use means that the risk of fatal injury falls by between 3 and 31%, and the risk of serious non-fatal injury by between 11 and 80%.

I think macsnafu meant that there might be no net lives saved per the emphasised clause.  If fatal car injuries fall, but, say, homicides rise even more because the police are on traffic duty instead of walking the beat, kind of thing.  And he did say "if".  It's worth considering.

Otoh, read a very interesting study -- the guy's agenda was that emphasis on seat belts has delayed or deferred interest in better-than-seat-belt devices -- where he noted that at the same time that enforcement of seatbelt use was on the rise, so was the campaign against drunk driving.  He backed out the lives saved by fewer people driving drunk and found a net increase in traffic fatalities and injuries.  I'm sorry I didn't bookmark it.  And I'm not holding it up to claim that you are wrong; only that, again, there are confounding factors that really have to be considered if we're going to get good data.  Your cited study may have done so, but the abstract doesn't mention it.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 08, 2011, 07:28:44 am
I continue to mull vaccinations (oh, J Thomas -- I'm not a good searcher; thanks for helping).  Meantime, I notice that my vaccination heresy was what captured everyone's attention, and the JAMA article finding that correct drugs correctly given are at best the 6th leading cause of death in the US, and more likely at least the 4th, went untouched.

I have at home a hard copy of the full article; contact me privately if you'd like to read it, or check it out via InterLibraryLoan.  Briefly, they're talking about "adverse drug reactions" ("ADRs"), and they assume that one/1 ADR is reported for every ten/10 that actually occur.  You might argue with that assumption; however, an editor of that same issue wrote in an editorial that, given his experience as an MD at a hospital, that assumption is extremely conservative and in his opinion, one/1 report for every twenty/20 occurrences is more likely -- and, if that were the case, correct drugs correctly given would be THE leading cause of death.

So I have to wonder, what the dickens are they doing in drug trials?  How trustworthy are their procedures, when their products are, at minimum, one of the top ten causes of death?

Fool me once, and all that.  If I obviously can't trust the safety trials, can I trust the effectiveness trials?  JThomas, I do think that statistical trials make for good method.  If they were all conducted by Jubal Harshaw's Anne, I would trust the reported results better.

A few years ago I pulled two deer ticks out of my leg.  A few weeks later I took sick.  Hmm.  Correct drugs correctly given are at minimum the 6th leading cause of death.  The Lyme mortality rate is "negligible" -- even given long-term effects allegedly involving brain, heart and/or joint "abnormalities".

Pop quiz:  Did I, or did I not, seek standard medical treatment?

Extra credit:  Was that choice rational?  Why or why not?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: happycrow on April 08, 2011, 08:14:23 am
Pop quiz:  you waited to get a sense of severity, and then sought standard treatment if the symptoms were debilitating, blowing it off otherwise.
Extra Credit:  such a decision was rational.

The 1/6 figure is an agglomerative figure, which does not take into account the specific treatment undergone, nor localized skill of one's physician, etcetera.  In other words, and individual has some scope of control of the quality of one's care.  Lyme's disease has negligable mortality, but extremely high likelihood of incapacitating the sufferer.  At that point, the cascading costs of being incapacitated begin to outweigh the margin of possible fatality likely in this specific scenario.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 08, 2011, 09:39:55 am
I continue to mull vaccinations (oh, J Thomas -- I'm not a good searcher; thanks for helping).  Meantime, I notice that my vaccination heresy was what captured everyone's attention, and the JAMA article finding that correct drugs correctly given are at best the 6th leading cause of death in the US, and more likely at least the 4th, went untouched.

Isn't it funny how that works? CN Parkinson wrote an essay about something kind of similar. He said if you have a committee that's supposed to deal with plans for a building that will cost $100 million, most of the committee will be unable to grasp the size of the money issue and probably there will be only one or two that actually know anything about construction on that scale. They will boggle. But point them at a bicycle shed to be constructed near the building's main entrance and they will be all over it. Everybody has opinions about just where it should be, and what shape and size, and how much it should cost. They can spend hours on a topic like that.

He gave recommendations about how to provide committees with issues like that. Too small and they will consider it a detail beneath them, too large and they will boggle. Give them a problem just the right size and they will happily argue about it and finish up the meeting feeling like they have accomplished a lot.

Similarly when somebody is wrong on the internet. When they say something that's too close to being reasonable a lot of people won't want to argue it. And when it's too absurd, well, people don't want their friends to find out that they are arguing online that Donald Duck could not beat up Superman. But when you say something that everybody knows is wrong but they don't consider too absurd to discuss, then they will likely pile on.

I wanted to suggest that it's like how when a woman loudly says "I fuck horses" every other conversation in the room stops, but on consideration it doesn't seem that similar.

Quote
I have at home a hard copy of the full article; contact me privately if you'd like to read it, or check it out via InterLibraryLoan.  Briefly, they're talking about "adverse drug reactions" ("ADRs"), and they assume that one/1 ADR is reported for every ten/10 that actually occur.  You might argue with that assumption; however, an editor of that same issue wrote in an editorial that, given his experience as an MD at a hospital, that assumption is extremely conservative and in his opinion, one/1 report for every twenty/20 occurrences is more likely -- and, if that were the case, correct drugs correctly given would be THE leading cause of death.

So I have to wonder, what the dickens are they doing in drug trials?  How trustworthy are their procedures, when their products are, at minimum, one of the top ten causes of death?

People die only once in a lifetime, so there's a strong chance that too few people will die in a drug trial due to the drug for it to show up statistically. There are lots and lots of adverse reactions, and typically you have something really bad going on already or you wouldn't be taking a prescription drug. And of course, it's people who are in bad shape already who tend to get the worst adverse reactions. Like, your liver is already failing so you don't metabolise away something that's kind of toxic. and your kidneys are failing so you're slow to excrete it. Etc. Healthy bodies all have a certain similarity, but dying ones may each be unique in their own way, and when attempting to drug dying people it may be particularly easy to kill them quicker instead.

But then there are things like allergies. You never know when somebody will be allergic to some particular drug. It can kill them quick or maybe they just keep taking it instead of calling in to find out they should quit and maybe they should get immediate assistance....

So anyway, I say that expensive drug trials may be a snare and a delusion. We do better to track everybody, and see what patterns we find. So, say you get prescribed some particular drug, and you look it up on the internet and you find out that one person in a thousand who gets prescribed this drug dies within a month. What does that tell you? "Oh gee, I'm really sick." And if you find that 1% of the people who get this drug die within a month? "Oh, I'm real sick." Or maybe you dig deeper and find that it's usually prescribed to old people who are already dying, and the minority of people your age who get it are mostly OK. Why do they prescribe it to people like you? And you can dig deeper still.

Insurance companies are already keeping all this information, and they share it some with credentialed medical researchers. Why not make it available to every MD who thinks he can figure out how to use it? Why not make it available to the public?

Quote
Fool me once, and all that.  If I obviously can't trust the safety trials, can I trust the effectiveness trials?  JThomas, I do think that statistical trials make for good method.  If they were all conducted by Jubal Harshaw's Anne, I would trust the reported results better.

Agreed. It isn't that pharma companies write emails to their researchers telling them to fudge their data. But there can be little things, like the stock options that mature soon after the report comes out. The last time the company had a big success the stock tripled about that time.... And if any little problems were to delay the report, then those options would just have to come due without it.... And of course everybody knows that researchers who work on successful projects go on to bigger and better things, while those who don't ... well of course it isn't their fault, there's nothing they could have done when they were assigned to a dud project, but still it isn't that easy to find work when you have the stink of defeat on you.... And when you aren't the only one doing the studies, when somebody else with more prestige is also doing one, if yours comes out worse than his, people will assume that he's right and you're incompetent. It's only natural when you add new subjects to the study to maybe put the ones you think will do badly into the control group to try to make your results come out like his.

It's always hard to avoid confounding variables etc. But at least we should try to arrange that clinical testing is not done by people who have a lot to gain or lose depending on the outcome. They should have a lot to gain or lose depending on how well they do it, independent of the conclusions.

Quote
A few years ago I pulled two deer ticks out of my leg.  A few weeks later I took sick.  Hmm.  Correct drugs correctly given are at minimum the 6th leading cause of death.  The Lyme mortality rate is "negligible" -- even given long-term effects allegedly involving brain, heart and/or joint "abnormalities".

Pop quiz:  Did I, or did I not, seek standard medical treatment?

I would guess that if you developed the classic bulls-eye inflammation, you did. This is pretty specific and if you get that there's every reason to think you are coming down with Lyme disease and it might get serious. But they say that 20% of Lyme disease patients didn't get a specific rash.

Quote
Extra credit:  Was that choice rational?  Why or why not?

Of course it was. Even if it turns out to be true that prescribed drugs are the #1 cause of death -- even if it were to turn out that the large majority of people die from prescribed drugs --  still most people go a lifetime taking medications before they get the one that kills them. If you already have serious disease symptoms and you have reason to expect them to get worse, and you have reason to think a medication would help (for example, you have a bacterial infection) then the odds are very much on your side to take the medication.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 08, 2011, 10:27:33 am
Quote
you waited to get a sense of severity

Passively?  Not on my life.

With lots of rest, and good hydration, and avoidance of as many additional stressors as I could, while providing my cellular subcontractors, trained by 3 billion years of evolution, with a lavish budget of construction components of top quality -- enough that they could afford to throw away anything not immediately needed so they wouldn't have to skimp in the repair process.

Otherwise, very good, though it would take an awful lot of disability before I'd try standard treatment.  "The prognosis of patients with late Lyme disease after appropriate treatment is a mixed picture." (http://www.lymemd.org/education.html) (emphasis added)  Hey, well, as much can be said for, say, acupuncture, which wouldn't kill me.

Quote
most people go "a lifetime" taking medications before they get the one that kills them. (emphasis added)

Umm, did you intend the morbid irony?  I got a chuckle out of it anyway.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 08, 2011, 10:50:08 am
Damnit! An interesting thread that I actually know stuff about, and I'm so busy actually doing pharma research that I don't have time to meaningfully contribute.

Oh well, if you guys are still discussing it after the weekend, and are interested in an "insider's" views, then I may be able to get involved.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 08, 2011, 10:55:12 am
Please do contribute Xavin, always welcome.

Vaccinations, seat belts, going armed, bike/motorcycle helmets, unplug the saw then replace the blade, like that's gonna happen here.  ;D.

It is all about taking personal responsibility for personal safety.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 08, 2011, 11:43:21 am

Oh well, if you guys are still discussing it after the weekend, and are interested in an "insider's" views, then I may be able to get involved.

Fascinated! If it dwindles away before then I'll try to remember to start it up again.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 08, 2011, 07:48:36 pm
... that assumption is extremely conservative and in his opinion, one/1 report for every twenty/20 occurrences is more likely -- and, if that were the case, correct drugs correctly given would be THE leading cause of death.

Adverse reactions are under reported or adverse reactions that cause death are under reported? For every ten people that die from drugs properly prescribed only one is reported, and the other 9 are blamed on dehydration?

Or is it more likely that the less severe complications, (like a headache, or nausea treated with something off label), is the one more likely to be barely reported?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 09, 2011, 06:41:24 am
Quote
Adverse reactions are under reported or adverse reactions that cause death are under reported?

ADRs causing death are underreported.  The authors assume 1:10 reported deaths:actual deaths and come up with ~100,000 ADR deaths per year, plus or minus some which I forget.  The upper bound of their error bars is less than whatever the third-leading cause of death is (thus still in fourth place), and the lower bound is below whatever the sixth is but more than the seventh, and the centroid, ~100,000, is more-than-fifth-but-less-than-third (i.e., still in fourth place).

Newsweek carried something about it in fall of '06 or '07, around then.  The issue contained a cluster of articles, one of which stuck with medical mistakes (hey, we're all human here).  Between the deaths by mistake and deaths caused by correct treatment, THE leading cause of death in the US is iatrogenic (http://dictionary.reference.com/browse/iatrogenic).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 09, 2011, 08:32:51 am
Quote
most people go "a lifetime" taking medications before they get the one that kills them. (emphasis added)

Umm, did you intend the morbid irony?  I got a chuckle out of it anyway.

I did, but also I meant it seriously. Pneumonia used to be an important cause of death at young or moderate ages. Now when it's bacterial, it usually clears up real fast with medication. The average age of death is rising slowly. What's the chance you die from the medication you need? If you actually need it, likely less than the chance you die without it.

There have been various studies showing that Christian Scientists and others who mostly avoid modern medicine tend to live about as long as people who use it. The last time I did a lit search on that I found several studies that claimed to disprove that about Christian Scientists.

I just did that again, here's one of them.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00015022.htm
They compared graduates of a Christian Science college to graduates of a 7th Day Adventist college. More of the CS graduates had died by the time the study was done. 7th Day Adventists have dietary restrictions that CS members don't, but do accept medical care.
Quote
for male physician graduates of LLU, the age-adjusted death rate was 73% that of graduates of a nonreligiously affiliated medical school and 56% that of all white males in the United States (12).
Between the schools it was 22 versus 40 for men, or 55%. So at a first guess, it would look like Christian Scientists who avoid alcohol and tobacco and the harms of medical care do just about as well as normal Americans who get the benefits of medical care.

This was only a summary of an otherwise unpublished study (at least I didn't find anything more), so I can't look at its methodological problems.

This other guy had compared the same college to a much larger secular college, and for the larger school 13% of the alumni had disappeared. They assumed the unknown ones had the same death rates as the known ones. This is the obvious assumption, but it isn't at all unlikely that the alumni who drop out of sight might have a higher death rate than those who don't. Also, there's the assumption that relatives etc report the same proportion of deaths to both schools.
jama.ama-assn.org/content/262/12/1657.full.pdf

Here's one nibble of data from that study. 96 women graduated from Principia College between 1934 and 1938, and by 1987 15 of them were dead. But in that same time 763 women graduated from University of Kansas, and 105 of them died. 16% versus 14%. So, an *entire lifetime of medical care* resulted in a 2% difference in survival to age 72 or so. The medical care itself killed some of the people who received it, but still, fewer of them died than the ones who didn't get it.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 09, 2011, 01:54:45 pm
Quote
If you actually need it, likely less than the chance you die without it.

Um, that one's pretty much a tautology, isn't it?  If you "need" it and go without it and don't die, in what sense could you be said to have "needed" it?

What's debatable is the need.  Pneumonia used to be a major killer, true.  What else has changed since then, besides the medical practice?  Some things that come to mind include more access to warm dry housing & clothing, and a higher standard of living and its accompanying improvement in diet and hygiene.

I'd have to wonder similarly about your women from Principia and UKansas.  Control for, say, number of pregnancies (I'd expect the religious women to have more -- indeed, rather more than 2% more), and see if anything changes.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 09, 2011, 04:41:46 pm
What's debatable is the need.  Pneumonia used to be a major killer, true.  What else has changed since then, besides the medical practice?  Some things that come to mind include more access to warm dry housing & clothing, and a higher standard of living and its accompanying improvement in diet and hygiene.
Yes. But pneumonia used to kill people in hospitals - to such an extent that it was described as the friend of the old and debilitated, because it killed people relatively painlessly who would otherwise have spent a long time in hospital very sick. Now, we have penicillin, and so it doesn't do that.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on April 10, 2011, 07:15:07 am
Quote
pneumonia used to kill people in hospitals [....] Now, we have penicillin, and so it doesn't do that.

Well, there's an interesting point.  I wonder what it is about hospitals, seeing that we now have "hospital-acquired pneumonia" (even has its own wikipedia entry).  And:

This article (http://www.jstor.org/pss/30141430) says that "crude mortality in patients with hospital-acquired pneumonia (HAP) is high."  The article wonders whether patients die with the pneumonia or of the pneumonia, but its abstract notes, "the number of preventable deaths is likely to be much smaller than the total." (emphasis added)

Could hospital conditions -- apart from germs, I mean -- have anything to do with death by pneumonia?

An interesting thing showed up in orphanages of the late 19th/early 20th century in NYC.  They were understaffed, and the nurses tending the infants had no time to do more than make sure the babies were fed and reasonably clean, no time for just playing with them.  Iirc, two-thirds of the babies died before their second birthday (and those who survived were like Harry Harlow's weird little mother-deprived rhesus monkeys).  And they died of pneumonia.

Why pneumonia?  Why not mumps or measles or diphtheria?  Is there something about institutional conditions that weakens us in this particular way?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 10, 2011, 10:05:41 am
Well, there's an interesting point.  I wonder what it is about hospitals, seeing that we now have "hospital-acquired pneumonia" (even has its own wikipedia entry). 

I've had the vaccine against one way that you can get pneumonia, (there are apparently several things that can cause pneumonia.) Since it's touted for hospital workers, I'd guess that this is still something serious.

Oddly enough, due to a perpetual "shortage", while it is claimed safe, they recommend it only to the elderly, sickly, and those age 65 or older.  (I could go off on a tangent here, putting out my theories that  "shortages" are sometimes used to boost vaccine sales..)
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 10, 2011, 10:28:49 am
Quote
pneumonia used to kill people in hospitals [....] Now, we have penicillin, and so it doesn't do that.

Well, there's an interesting point.  I wonder what it is about hospitals, seeing that we now have "hospital-acquired pneumonia" (even has its own wikipedia entry).  And:

This article (http://www.jstor.org/pss/30141430) says that "crude mortality in patients with hospital-acquired pneumonia (HAP) is high."  The article wonders whether patients die with the pneumonia or of the pneumonia, but its abstract notes, "the number of preventable deaths is likely to be much smaller than the total." (emphasis added)

Could hospital conditions -- apart from germs, I mean -- have anything to do with death by pneumonia?

Why apart from germs? Hospitals have a lot of sick people, and they catch things from each other. Bacteria that cause pneumonia are particularly easy to spread, since you can get them by breathing them. The ones in hospitals tend to be antibiotic-resistant because after all they get exposed to them a lot. They suffer natural selection to do whatever spreads most effectively -- normally what's most effective might be to minimise symptoms for awhile so the host will circulate and expose new hosts, but if hospital patients tend not to be very mobile that would shift the equation a bit....

Quote
An interesting thing showed up in orphanages of the late 19th/early 20th century in NYC.  They were understaffed, and the nurses tending the infants had no time to do more than make sure the babies were fed and reasonably clean, no time for just playing with them.  Iirc, two-thirds of the babies died before their second birthday (and those who survived were like Harry Harlow's weird little mother-deprived rhesus monkeys).  And they died of pneumonia.

Why pneumonia?  Why not mumps or measles or diphtheria?  Is there something about institutional conditions that weakens us in this particular way?

Mumps and measles and diphtheria are all associated with pathogens that have no way to survive except by infecting people. Hospitals tend not to have anybody with mumps or measles, and if by chance they do they do their best to isolate them. But it appears the things that cause bacterial pneumonia are not so uncommon. They can survive and spread without causing pneumonia, but sometimes they do. So it's hard to get rid of them. That's one solid reason for pneumonia and not mumps etc.

The first page of your article talks about ICUs, where the sickest patients get, well, intensive care. But it's easy for them to cross-infect. There is presumably discussion about how to reduce that cross-infection, and definitely recommendations about treatment. The first page said nothing about how often it happens, only that patients who get it often die.

Obviously it would be better for many patients if there were no hospitals but medical personnel came to them instead and they had no contact with other sick people. They would still be exposed to whatever pathogens the medical team and its equipment carried, but that wouldn't be as bad as dying people vomiting in the same room. But for economic reasons we don't do it that way.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 10, 2011, 11:11:12 am
I have worked in a hospital while living with an RN, so here goes.

They really like people to be walking upright because it decreases the chance of blood clots, especially in post op patients. The even have hip replacment types up on their hind legs if they can. Pneumonia too, is discouraged by activity. Imagine having a chest cold, would you breathe better standing or sitting up or laying down. The bedridden are screwed.

Of course that means we have all those big bags of germs wandering the halls, maybe not so good for the rest of us.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 11, 2011, 12:42:13 am
Huh, that's one of mine but huh?

Welcome wzy454545 regardless.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: wdg3rd on April 11, 2011, 11:21:33 am
Huh, that's one of mine but huh?

Welcome wzy454545 regardless.

Don't bother, it's a spammer, probably a bot.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: SandySandfort on April 11, 2011, 02:54:59 pm
Huh, that's one of mine but huh?

Welcome wzy454545 regardless.

Don't bother, it's a spammer, probably a bot.


My guess is someone whose first language is not English.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 11, 2011, 03:01:48 pm
Educate me guys, what's he want. I mean why, it's not like they can send us ads or something.

Who else here is malicious software, funny how a couple come to mind?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 11, 2011, 05:44:22 pm
So children. Have the anarchists finally learnt that vaccines are not the big bad government trying to inject evil robots into your brain so they can control your brain and steal your guns and money?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 11, 2011, 06:07:27 pm
There doesn't seem to be any form of effective vaccination against trolls. Appropriate countermeasures depend on type - fire and acid work on the D&D ones, sunlight and lightning for the traditional Norse ones. The modern internet variety are rarely more than irritants, however, and it's generally best to avoid direct engagement.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 11, 2011, 06:09:45 pm
Same can be said of any form of idealist. Well no they're more like a cancer. The only cure is to cut them out or blast them with radiation.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 11, 2011, 08:02:42 pm
Being called a troll is like being called a racists.  If you deny it thats proof you are a one. 
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 11, 2011, 08:20:18 pm
Well everyones racist to some extent. Me? I just plain don't like Jews. Not individually mind you just as a cultural entity.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 11, 2011, 09:24:15 pm
Holt,
I am impressed with your honesty and guts for saying so.  I don't share that dislike but you are certainly welcome to your opinion.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 11, 2011, 09:27:01 pm
Xavin as I recall you had wisdom to share regarding pharmacuticals, geez, did I even spell it right? Help!
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 11, 2011, 10:30:24 pm
So children. Have the anarchists finally learnt that vaccines are not the big bad government trying to inject evil robots into your brain so they can control your brain and steal your guns and money?

I'm pretty sure they're not mind control nanobots.  I'm still scratching my head over the special H1N1 vaccine though. By all accounts things were going swimmingly, even the fact that a single dose would be all that needed, so since the gov ordered enough for two shots for everyone, there would be plenty to go around.

Then, all of a sudden, there wasn't enough vaccine, there were manufacturing issues, there were all sorts of excuses.  People lined up in soviet-style lines for the few rationed shots. It was almost like someone wanted to show the very worst parts of single-payer rationed healthcare before they decided to deem 0bamacare "passed" so they could see what was in the bill.

Yea, I'm still scratching my head over that one.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 08:08:37 am
You know it was more likely the company who manufactured the shots withholding supply to increase their profits. After all wasn't there only one company who held the patent?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 12, 2011, 08:14:53 am
Xavin as I recall you had wisdom to share regarding pharmacuticals, geez, did I even spell it right? Help!

Close enough that I didn't notice before you asked  :)
And I can offer experience, but I don't guarantee wisdom.

The conversation has drifted a bit from my area of direct experience[1] and whatever train of thought I had on Friday has been thoroughly derailed - but I'll try and pick some of it up (and if anyone has questions they'd like to throw at me then please do - I'll either do my best to answer or explain if I can't).

@mellyrn - I now see what you meant regarding "side effects". The thing is, there are some prety hefty practical obstacle to the level of blinding that you're talking about - unless you start treating people for conditions that they don't have then they know that whatever treatment you provide is intended to treat whatever condition(s) they have (and even then, unless they know that you might be giving them completely irrelevant treatments then the placebo effect will still occur regarding efficacy. And it will occur regarding safety regardless.)
It's also unnecessary, so long as the assumption holds[2] that the placebo effect is the same in both the placebo and active treatment arms - i.e. it doesn't matter if (say) 20% of your placebo patients will get better on their own if 20% of your active treatment patients will also do so. You're not looking for the absolute number (or proportion) of patients who get better, you're looking to see if a (statistically significant) larger proportion of the active treatment patients get better than do the placebo patients.
Note also that quite a lot of trials don't involve a placebo at all - instead they compare the experimental treatment to the current standard treatment instead, especially where it would be (generally regarded as) unethical to leave patients effectively untreated when a treatment is already available.
There are, of course, potential complications with this approach when the standard treatment comes in a different form to the experimental one (say the standard treatment is delivered by IV drip and you're trialling a pill) - the placebo effect differs between forms of treatment[3]. In that case you might give one group the real pill and a saline IV, while another group gets a sugar pill and the real IV.

Anyway, it's well past the point that I should be getting back to work, so I'll leave off for now. I may come back later and witter on about "Informed Consent". And possibly the International Conference on Harmonisation (of Technical Requirements for Registration of Pharmaceuticals for Human Use)

[1] For reference, I'm a "statistical programmer" - I (mostly get the computers to) do the analysis, summary, and reporting of clincal trials data. I'm not a statistician, or medically trained, but I work every day with people who are and you pick up a lot over the years - and the nature of the job means that you also end up with at least some knowledge of trial design, data collection, regulation etc.
It's probably unwise if I say who I work for - suffice to say that I've done this job for a couple of major pharmaceutical companies, and a couple of Contract Research Organisations (both large and small). Feel free to interpret my comments in light of this information.
[2] Although I agree that this is not necessarily true in all cases
[3] Generalising wildly, just getting a consultation with someone in a white coat has a beneficial effect. Getting a sugar pill has a better one. Getting a saline IV has a better one still. Combinations are more effective than each type of "intervention" on its own.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 12, 2011, 08:16:14 am
You know it was more likely the company who manufactured the shots withholding supply to increase their profits. After all wasn't there only one company who held the patent?

There were at least 2. And I'm pretty sure that at least one of them was turning them out as quickly as they could.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 08:18:52 am
Which isn't very quickly when you consider the time they had and the general timescale needed for vaccine manufacture.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 12, 2011, 09:08:55 am

The conversation has drifted a bit from my area of direct experience[1] and whatever train of thought I had on Friday has been thoroughly derailed - but I'll try and pick some of it up (and if anyone has questions they'd like to throw at me then please do - I'll either do my best to answer or explain if I can't).

Thank you! [1]

Quote
@mellyrn - I now see what you meant regarding "side effects". The thing is, there are some prety hefty practical obstacle to the level of blinding that you're talking about - unless you start treating people for conditions that they don't have then they know that whatever treatment you provide is intended to treat whatever condition(s) they have (and even then, unless they know that you might be giving them completely irrelevant treatments then the placebo effect will still occur regarding efficacy. And it will occur regarding safety regardless.)

I think there are some things that could sometimes be done to palliate those problems, but most of them have social side effects. Like, in an institutional setting you could just add new pills to the pills patients are already taking and not mention it. But that sort of violates informed consent.

Quote
It's also unnecessary, so long as the assumption holds[2] that the placebo effect is the same in both the placebo and active treatment arms - i.e. it doesn't matter if (say) 20% of your placebo patients will get better on their own if 20% of your active treatment patients will also do so. You're not looking for the absolute number (or proportion) of patients who get better, you're looking to see if a (statistically significant) larger proportion of the active treatment patients get better than do the placebo patients.

This is where Mellyrn's side effects come in. If they can tell that they are in the experimental group and not the control group, it has a placebo effect. So if the medication has any detectable effect at all, then it isn't a sugar pill, and if it has an effect that they know the standard treatment doesn't, then they know it isn't the standard treatment. People who are hopeful will tend to hope the experimental treatment is better.

Take it a step further and consider the Hawthorne effect. Trying to do controlled studies in an industrial setting, the researchers found that workers behave different when they are being watched. So their control groups were very different from what went on when they weren't doing research. The very fact that an experiment is going on could be enough to produce a strong placebo effect, and that could interact with the drug response!

Quote
Anyway, it's well past the point that I should be getting back to work, so I'll leave off for now. I may come back later and witter on about "Informed Consent". And possibly the International Conference on Harmonisation (of Technical Requirements for Registration of Pharmaceuticals for Human Use)

My view is that informed consent is inconsistent with actual controlled experiments. So we need to get a large group of volunteers who decline informed consent. The collection of everybody who is on Medicaid would be ideal.

[1] For reference, I did the coursework for biostatistics and spent years associating with people who did that work, but did very little of it myself. I have applied those techniques to other problems.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 12, 2011, 11:15:37 am
Placebo effect = voting????

Sorry, had to.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Xavin on April 12, 2011, 11:21:56 am
Which isn't very quickly when you consider the time they had and the general timescale needed for vaccine manufacture.

I'm not sure what you think the timescales for vaccine manufacture are.

In the case of the H1N1 pandemic in 2009/2010 the WHO provided the seed strain for the vaccine to several manufacturers (I can find at least 5) at then end of May 2009.
Turning the seed strain into a working seed bank takes about 2 months.
Getting a standardised vaccine out of that takes another month or so and you can produce enough for clinical trials.
If the regulators are in a hurry you can get regulatory approval in another month and start ramping up production (or you can start doing that a little earlier, if you're prepared to accept the risk of it not getting approved and spending money on producing a big pile of vaccines you can't sell).
The EMEA was approving H1N1 vaccines for general use at the end of September 2009.
The manufacturer that I particularly know about was shipping vaccines in the first week of October 2009.
I am unaware of them having any manufacturing issues (and can't find any mention of them in a brief search). Other manufacturers may be a different story. I don't recall hearing about is, but it doesn't appear that the manufacturer that I am familiar with was one of the major suppliers in the US, so I may not have become aware of it at the time.
Note that by Jan 2010, those governments that had been sensible enough to include break clauses in their contracts were starting to cancel parts of their vaccine orders as it became clear that they weren't going to need such a widespread vaccination programme as they'd thought.

Note also that the US usually gets 90-120million doses of seasonal flu vaccine in a typical year. The predictions from the CDC in mid 2009 look to have been that they would get >100million dose each of both the standard seasonal flu vaccine and of the H1N1 vaccine, by early Nov 2009, despite the fact that producing the H1N1 vaccine slowed down production of the standard seasonal vaccine (even leaving aside the development and testing of the new vaccine, you're using the same production lines for it that you would for the standard vaccine. You don't just throw together a facility for producing vaccine on an industrial scale, you have to use what you already have or spend a lot of time - that you generally don't have - building new capacity. Which will then end up sitting idle once the pandemic is over).
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 12:47:46 pm
Holt,
I am impressed with your honesty and guts for saying so.  I don't share that dislike but you are certainly welcome to your opinion.

Well they're an insular group who think they're better than everyone and often refuse to fully integrate into any society and seem to have an odd historical precedent for being money lenders and usurers.
What's not to hate?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 12, 2011, 12:53:31 pm
They don't beat people up and steal their lunch money at knifepoint!

They have contributed to literature and music and art and science out of all proportion to their numbers!

What's not to like?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 12, 2011, 12:57:40 pm
Gotta love the food, oy vay, what wonderful eats!
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 01:13:30 pm
They don't beat people up and steal their lunch money at knifepoint!

They have contributed to literature and music and art and science out of all proportion to their numbers!

What's not to like?

Tell you what. When they stop using a term for animal to describe anyone who isn't a Jew and stop being a destabilising factor in the middle east. Then I will like them.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 12, 2011, 02:25:57 pm
They don't beat people up and steal their lunch money at knifepoint!

They have contributed to literature and music and art and science out of all proportion to their numbers!

What's not to like?

Tell you what. When they stop using a term for animal to describe anyone who isn't a Jew and stop being a destabilising factor in the middle east. Then I will like them.

Hey, blaming the middle east on Jews is like blaming US racism on WASPs. Or blaming the atrocities of the Union Army on Yankees.

It's like blaming the Mafia on Italians. There could be a little bit of a sort of truth to it, but it's another way to miss the point.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 02:29:24 pm
Hey, blaming the middle east on Jews is like blaming US racism on WASPs. Or blaming the atrocities of the Union Army on Yankees.

It's like blaming the Mafia on Italians. There could be a little bit of a sort of truth to it, but it's another way to miss the point.


They're a part of it these days. Iran would most likely be less interested in nuclear weapons if Israel didn't have a load of them
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 12, 2011, 03:03:39 pm
Well everyones racist to some extent. Me? I just plain don't like Jews. Not individually mind you just as a cultural entity.

Well as long as its not individually thats ok.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 12, 2011, 03:29:37 pm
Hey, blaming the middle east on Jews is like blaming US racism on WASPs. Or blaming the atrocities of the Union Army on Yankees.

It's like blaming the Mafia on Italians. There could be a little bit of a sort of truth to it, but it's another way to miss the point.


They're a part of it these days. Iran would most likely be less interested in nuclear weapons if Israel didn't have a load of them

Sure, Israel is the most important bad actor in the middle east. But blaming Israel on Jews is like blaming National Socialism on Germans.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 04:05:51 pm

Sure, Israel is the most important bad actor in the middle east. But blaming Israel on Jews is like blaming National Socialism on Germans.


Israel is a Jewish nation in case you forgot. That was kind of the point of it being established and something they enforce numerous extremely racist immigration laws to ensure continues.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 12, 2011, 06:38:36 pm

Sure, Israel is the most important bad actor in the middle east. But blaming Israel on Jews is like blaming National Socialism on Germans.

Israel is a Jewish nation in case you forgot. That was kind of the point of it being established and something they enforce numerous extremely racist immigration laws to ensure continues.

Yes, and Nazi Germany was a German nation. But they got over it. Only a minority of the worlds Jewish people have ever been involved with Israel. And many Israelis just live there without actually having much to do with policy or enforcement of policy.

Why blame everybody for the crimes of a small minority?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 07:17:36 pm
Because they can change it?
Inaction can be just as much a crime as action
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 12, 2011, 08:35:08 pm
Because they can change it?
Inaction can be just as much a crime as action

If you want to take responsibility for everything that's wrong with your society that you haven't fixed yet, you won't have a lot of energy left over for blaming others for their society's problems.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Holt on April 12, 2011, 08:51:13 pm
Because they can change it?
Inaction can be just as much a crime as action

If you want to take responsibility for everything that's wrong with your society that you haven't fixed yet, you won't have a lot of energy left over for blaming others for their society's problems.


Do you have any idea how hard it is to catalogue the number of people who need to be killed? Let alone those who need to be punished.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 12, 2011, 10:11:21 pm
Quote

Do you have any idea how hard it is to catalogue the number of people who need to be killed? Let alone those who need to be punished.

Almost as hard as looking into one's own heart.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 12, 2011, 11:52:35 pm
Note also that the US usually gets 90-120million doses of seasonal flu vaccine in a typical year. The predictions from the CDC in mid 2009 look to have been that they would get >100million dose each of both the standard seasonal flu vaccine and of the H1N1 vaccine, by early Nov 2009, despite the fact that producing the H1N1 vaccine slowed down production of the standard seasonal vaccine (even leaving aside the development and testing of the new vaccine, you're using the same production lines for it that you would for the standard vaccine. You don't just throw together a facility for producing vaccine on an industrial scale, you have to use what you already have or spend a lot of time - that you generally don't have - building new capacity. Which will then end up sitting idle once the pandemic is over).

Yea, I remember in some areas the H1N1 vaccine was restricted to pregnant women only, the shortages were so acute.  But the seasonal flu shot was widely available, I noticed no shortage. For months I couldn't get the H1N1 shot, and when I finally could, the pandemic appears to have never shown up and the season was at least half over. I waited until last Oct 2010 to get the seasonal shot that included H1N1 in the three guesses of the dominate strains.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: terry_freeman on April 13, 2011, 12:51:01 am
Gotta love the food, oy vay, what wonderful eats!

Are you kidding me? In all my life, I have yet to meet any Jewish cook worthy of the appellation. The food isn't quite inedible, but it's not far above.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: J Thomas on April 13, 2011, 05:39:23 am
Gotta love the food, oy vay, what wonderful eats!

Are you kidding me? In all my life, I have yet to meet any Jewish cook worthy of the appellation. The food isn't quite inedible, but it's not far above.

I'm kind of indifferent to the english recipes, I usually like the german ones. Some of the russian stuff is very good and some of it I can't eat. I usually like the middle-east food but sometimes not. The Jewish brazilian food I tried was excellent but coconut oil isn't that good for you.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 13, 2011, 06:37:34 am
Gotta love the food, oy vay, what wonderful eats!

Are you kidding me? In all my life, I have yet to meet any Jewish cook worthy of the appellation. The food isn't quite inedible, but it's not far above.

I have to agree, but hey seem to like it.  I went to a Seder once.  Not good.  I know that is not a typical meal but still.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Apollo-Soyuz on April 13, 2011, 07:46:42 am
...but coconut oil isn't that good for you.

Plenty of people would argue with you on this point. What is undeniable though, is that the saturated fat in coconut oil is quite a bit different than the stuff in bacon grease from feedlot pork.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: spudit on April 13, 2011, 09:06:58 am
Mmm bacon grease, Homer Simpson puts butter on his bacon, mmm.

I was refering to kosher deli food, all beef hotdogs for one. That is all I know much about.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on April 13, 2011, 01:22:12 pm
Since things are generally "not illegal" rather than "legal" on AnCap Ceres, one presumes that augmentations that would be illegal on Earth aren't illegal there. Could the Black Mamba be surprised by running into someone faster?
Title: Re: Rejuvenative medicine - how far off are we?
Post by: GlennWatson on April 13, 2011, 03:16:23 pm
Since things are generally "not illegal" rather than "legal" on AnCap Ceres, one presumes that augmentations that would be illegal on Earth aren't illegal there. Could the Black Mamba be surprised by running into someone faster?

Oh that is very good.  I would love to see the look on her face if the professor beat her in a quick draw.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: dough560 on April 22, 2011, 04:51:03 pm
Nutrition, fats, cholesterol etc. What's healthy depends on a persons level of physical activity and exercise program.  My current job requires me to physically move by hand, approximately 20 metric tons five to six days a week. Occasionally I get a "lite" shift where I only move 10 to 15 metric tons.   Additionally I do an aerobic and anaerobic workout in the company gym, each day I work.  During my last physical, my stats were all in the middle of the range.

Enhancement to increase my strength, repair my eyesight and joints, speed up my reaction time, improve my memory and regrow my thinning hair is my favorite fantasy.  Doc Taylor's realized nanotechnology would be ideal.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: Rorschach on April 27, 2011, 05:14:15 am
I admit to having not read this thread, but I'll recap some of the info gained after extensive study.

Aging falls into a few different mechanisms that we are currently aware of:
telomeres shortening (responsible for the Hayflick limit)
accumulated genetic damage
accumulated toxins (including oxidants, mercury, etc)

Using 1997 technology, we could take a retrovirus to activate the telomerase production, lengthening the telomeres. It was believed this may cause cancer, but some 2005 research indicated that it renders cells immune to cancer via microRNA transfers. A single shot will reduce the cellular age of all tissues to around 21 year old or so. Grey hair and wrinkles to normal hair color and tight skin from one shot. This is a permanent change.

Genetic damage from radiation will *eventually* be purged via nanites that search for flawed DNA.

The best way to prevent toxin buildup is to avoid consuming toxins. Unfortunately that means no store bought food, since anti fungal sprays, pesticides, etc are required on all shipped food in the US. Organic food is simply grown organically, THEN sprayed for shipping. There are also 90-92 toxic chemicals that are permitted on "Certified Organic" food at the California and US National levels.

Having telomerase activation treatments will help with the other two forms of aging, through dilution. Some experiments have been done with mice and rabbits, but they are trying to avoid the impact.

Some life lengthening techniques:
hyperbaric chambers for massive oxygen absorption and stem cell production
massively reduced caloric intake to encourage higher efficiency
Miscellaneous things: astragalus, red wine, blueberries, etc
Title: Re: Rejuvenative medicine - how far off are we?
Post by: sams on April 27, 2011, 05:53:45 am
Quote
Truth be told his posts can generally be ignored anyways. He rarely contributes anything worth reading

. . . says a man who does not have a forum full of people discussing his works, about a man who does.

This is called being a Rodent of glory ... like a rodent, but hanging others people's glory.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on June 13, 2011, 06:33:05 am
Using 1997 technology, we could take a retrovirus to activate the telomerase production, lengthening the telomeres. It was believed this may cause cancer, but some 2005 research indicated that it renders cells immune to cancer via microRNA transfers.
One has to be careful before concluding that since "some 2005 research" says something, it is a fact. Work done on the frontiers of science doesn't necessarily tell the whole story.

What I think the general understanding is, or should be, is that individuals differ considerably in their genetic susceptibility to cancer. In some people, the immune system finds nascent cancers and destroys them; in others it doesn't. Where this and other defenses against cancer are in good working order, abolishing cellular aging through telomere shrinking won't cause cancer - but for others, it would eliminate a critical defense.

So what we need to do to make such a technique better than Russian Roulette would be to understand the body's defenses against cancer better, so that the same retrovirus could also repair any missing ones.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: paddyfool on June 16, 2011, 07:14:58 am
So what we need to do to make such a technique better than Russian Roulette would be to understand the body's defenses against cancer better, so that the same retrovirus could also repair any missing ones.

I'm sceptical about somatic gene therapy in general - so far, it's pretty much entirely failed to deliver on its promise.  However, on the subject of defenses against cancer, did you know that the first cancer therapeutic vaccine (i.e. a vaccine designed to direct the body's immune system to attack cancer cells) was licensed last year? (http://www.cancer.gov/cancertopics/factsheet/Therapy/cancer-vaccines)

It rejoices in the unpronouncable name of "Sipuleucel-T", and it seems to extend survival in metastatic prostate cancer by an average of six months. (http://en.wikipedia.org/wiki/Sipuleucel-T)  Not a game-changer yet, but it is promising.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: wdg3rd on June 17, 2011, 03:29:44 pm
Predictions can't be made exactly. but just snapshot therapies available at fifty-year intervals over the past couple of centuries and extrapolate a little.

Title: Re: Rejuvenative medicine - how far off are we?
Post by: quadibloc on July 07, 2011, 07:39:45 am
The best way to prevent toxin buildup is to avoid consuming toxins..
That may be, but these guys who advocate unusual diets as a pathway to youthful health and vigor haven't managed to live to be 200, let alone 500. So advances in conventional medical science, which actually involve going around and re-arranging cellular machinery, not vague notions about going "back to nature", are what is needed for real progress.

As might be expected by the fact that most of the advocates of this or that wonder nature cure diet just invented something out of their own heads based on notions that sounded plausible to them... instead of working from detailed research and experimentation to obtain a solid empirical foundation for what they advocated.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: UncleRice on August 03, 2011, 12:13:20 pm
One bit of rejuve tech not discussed yet are these new 3d printers. They are taking stem cells from a patient, groing new cells of particular varieties and then assembling the new parts cell layer by cell layer for rejection free replacement parts. I understand complex organs are still a problem, but the logical conclusion of the tech is substantial.
You could take a single one of your stem cells, give it a genetic tune-up, regress it's biological age to 16 or so, and then grow enough cells to print out a whole new body ready to have your brain dropped into.
It still leaves brain centric aging issues to be dealt with, but it would all of your other physical issues in one shot.
Title: Re: Rejuvenative medicine - how far off are we?
Post by: mellyrn on September 13, 2011, 09:54:21 am
Quote
working from detailed research and experimentation to obtain a solid empirical foundation for what they advocated.

Which is why I favor the "paleolithic" approach (to a sensible diet, I mean, not to life extension) -- a couple million years' experimentation on the entire species is solid & empirical enough for me.

As for EFT rejuv, I'd expect side effects like drastic personality changes and massive memory loss.  I do think it's quite fantastic -- in the fantasy-genre sense of the word -- to posit a side-effect-free process in the first place.  Not that I mind; side effects would compel a very different story & I'm enjoying this one.