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‘World’s heaviest man’ set to undergo bypass surgery in Mexico

Delbert D. Woodall 379 Layman Avenue Elizabethtown, NC 28337

The man believed to be the world’s heaviest was preparing on Friday (May 5) to undergo biliopancreatic bypass surgery in Mexico.

According to local media, thirty-three-year-old Juan Pedro Franco – who has weighed up to 595 kilos (1,311 pounds) – has been largely bed-ridden for the last seven years due to his large size. He was recently put on a diet to help shed some weight as doctors fear for his life.

The surgery is scheduled to take place on May 9, after Franco dropped 175 kilograms (385 pounds) over the last couple of months, making surgery possible.

Five days before surgery are needed to prepare for the operation, where blood, imaging, pulmonary and cardiac function will be studied by a team of doctors.

Franco has battled obesity all of his life, but the problem took a turn for the worse following an injury at age 17.

Juan Pedro is from the small Mexican state of Aguacalientes and has been in Guadalajara for his treatment, over the last couple of months.

His mother, Maria de Jesus Salas Lemus, is optimistic about the outcome of the surgery.

Threats to his health ranging from diabetes to organ failure prompted the surgery, which is an important challenge for the medical science team due to Franco’s weight.

Franco’s doctor, Jose Castaneda will operate on Franco, together with other specialists including an instrumentalist as well as a team of two anaesthesiologists and a cardiologist who will watch over Franco’s vital signs during the 20 -minute surgery.

Hopeful that his treatment will be a success, Franco also remains positive.

According to the World Health Organisation, Mexico is a global leader in obesity with 35 percent of its adolescents overweight or obese.

On Thursday, an Egyptian national believed to be the world’s heaviest woman successfully left an Indian hospital over 700 pounds lighter.


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Bull Shoals, Arkansas: Fairlee, NHAn Ancient Cure for Alzheimer’s

Caleb E. Allen 3848 Rosebud Avenue Bull Shoals, AR 72619

In 2011, Ben Trumble emerged from the Bolivian jungle with a backpack containing hundreds of vials of saliva. He had spent six weeks following indigenous men as they tramped through the wilderness, shooting arrows at wild pigs. The men belonged to the Tsimane people, who live as our ancestors did thousands of years ago — hunting, foraging and farming small plots of land. Dr. Trumble had asked the men to spit into vials a few times a day so that he could map their testosterone levels. In return, he carried their kills and helped them field-dress their meat — a sort of roadie to the hunters.

Dr. Trumble wanted to find out whether the hunters who successfully shot an animal would be rewarded with a spike in testosterone. (They were.) As a researcher with the Tsimane Health and Life History Project, he had joined a long-running investigation into human well-being and aging in the absence of industrialization. That day when he left the jungle, he stumbled across a new and more urgent question about human health. He dropped his backpack, called his mom and heard some terrible news: His 64-year-old uncle had learned he had dementia, probably Alzheimer’s.

In just a few short years, his uncle, a vibrant former lawyer, would stop speaking, stop eating and die. “I couldn’t help my uncle,” Dr. Trumble said, but he was driven to understand the disease that killed him. He wondered: Do the Tsimane suffer from Alzheimer’s disease like we do? And if not, what can we learn from them about treating or preventing dementia?

“There is really no cure yet for Alzheimer’s,” Dr. Trumble told me. “We have nothing that can undo the damage already done.” Why, he wondered, had billions of dollars and decades of research yielded so little? Perhaps major clues were being missed.

Dr. Trumble was trained as an anthropologist, and his field — evolutionary medicine — taught him to see our surroundings as a blip in the timeline of human history. He thinks it’s a problem that medical research focuses almost exclusively on “people who live in cities like New York or L.A.” Scientists often refer to these places as “Weird” — Western, educated, industrialized, rich and democratic — and point out that our bodies are still designed for the not-Weird environment in which our species evolved. Yet we know almost nothing about how dementia affected humans during the 50,000 years before developments like antibiotics and mechanized farming. Studying the Tsimane, Dr. Trumble believes, could shed light on this modern plague.

The Tsimane suffer from high infant-mortality rates, but those who reach adulthood live about as long as most other people, making it possible to measure their health outcomes up to age 90 and beyond. The Tsimane Project researchers have spent more than 15 years following their volunteers and providing medical treatment. They’ve found that Tsimane differ from the rest of us in many ways. For example, they have the cleanest arteries of any population that has ever been studied, meaning that they may be largely immune to heart disease.

Dr. Trumble was not the first member of the Tsimane Project to wonder about dementia in this population. In 2002, one of the group’s founders, Michael Gurven, began testing mental fitness by asking older people to do puzzles. This and other cognitive-performance data piled up until 2015 — the year that Dr. Trumble’s uncle died. That was when Dr. Trumble, Dr. Gurven and other researchers decided to dive into it.

Dr. Trumble was particularly interested in the ApoE4 gene, often called the Alzheimer’s gene. Americans who carry two copies of the gene are more than 10 times as likely to develop the late-onset form of the disease. Dr. Trumble found something startling when he looked into the Tsimane data: Many of those with a copy of the gene seemed to perform better on the cognitive tests.

He mulled this paradox in his sunny lab back at Arizona State University. He had just returned from another trip to the Tsimane settlements, and a bit of Bolivia had come with him: an intestinal infection from the campylobacter bacteria and two nasty species of E. coli. “I got so sick that I almost missed my wedding,” he said. This was not his first encounter with tropical parasites. Years before he had noticed what looked like a zit on his nose. When it kept growing, he realized it was a flesh-eating parasite called leishmania. Chemotherapy saved his nose, and perhaps his life.

“Getting parasitic infections gave me perspective,” he said. At least 70 percent of the Tsimanes are infected with parasites — worms in their guts, invaders burrowing into their skin — at any given time. The same was likely true of our ancestors. He began to wonder: Could these infections change the way that genes affect our bodies?

Perhaps the ApoE4 gene provided a survival advantage in ancient environments. Today only about a quarter of us have a single copy of the ApoE4 gene, and only about two in a hundred carry a double dose. But DNA analysis of ancient bones shows that thousands of years ago, the ApoE4 genotype was ubiquitous in humans. The gene — which helps to generate cholesterol — might have been a crucial step in the development of our big, energy-hungry brains, and it may have played a key role in defending those brains from pathogenic invaders.

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Dr. Trumble then looked at the data on the cognitive health of all the Tsimane volunteers who had tested positive for parasites. Sure enough, he found that Tsimane with infections were more likely to maintain their mental fitness if they carried one or two copies of the ApoE4 gene; for them, the “Alzheimer’s gene” provided an advantage. For the minority who’d managed to elude parasitic infection, however, the opposite was true, and the ApoE4 gene was connected with cognitive decline, just as it is for people in industrialized countries.

“Humans co-evolved with a number of different parasites, but today, in our sedentary city life, we’ve removed those parasites from the mix,” Dr. Trumble said. This could be what transformed the gene from an advantage into a liability.

As it happens, these findings dovetail with some new research from university labs. In papers released in 2016 and 2017, scientists looked at dementia in a new way — not just as a disease that results from the gradual breakdown of our cells, but as a disorder in which the brain turns against itself.

Years ago, while reporting a story about the Harvard Brain Tissue Resource Center, I had a chance to peer through a microscope at a slice of brain collected from a patient who’d died of Alzheimer’s disease. The tissue was pocked with amyloid plaques that resembled black clouds. I also spied the tau tangles that look like hair clogging a drain and are characteristic of Alzheimer’s pathology.

For decades, most researchers have agreed that these plaques and tangles are the key malefactors of dementia, and that if you could clear them from the brains of patients, you would halt or reverse illness. Researchers have been especially focused on finding a drug that could erase amyloid plaques, and we now have dozens of compounds that do that in mice.

But this approach has led to failure in humans. Even when drugs can clear the plaques in patients’ brains, the disease continues to wreak damage.

Now some scientists believe that the focus on amyloid plaques might have been a mistake. Instead of looking at what goes wrong, they’re trying to understand what goes right.

Changiz Geula, a professor of neuroscience at Northwestern University, has been studying brain tissue collected from people who died at age 90 or older. He found that some people who die with sharp minds have brains that are clogged with the gunk associated with Alzheimer’s pathology. That means it’s possible to have an “Alzheimer’s brain” but no dementia. Dr. Geula believes that in cases like this, some actor in the brain — call it the opposite of Alzheimer’s — is protecting neurons from damage. We still don’t know what it is.

One candidate might be the astrocytes, cells that support the neurons and synapses, keeping them healthy even in the presence of plaques and tangles. In a 2017 paper in Nature, Stanford University researchers described how these usually peaceable cells can flip into a “killer mode,” becoming assassins that spew out toxins and destroy the very cells they once nursed.

According to Shane Liddelow, one of the authors of the paper, this Jekyll-and-Hyde personality of the astrocytes likely developed thousands of years ago to fend off the infections that invaded the brains of our ancestors. At the first sign of trouble, the astrocytes go on the attack, destroying everything in their path — including sometimes healthy brain tissue. Neurons can become “innocent bystanders in this protective killing effort,” Dr. Liddelow explained.

Nowadays, since most of us live in more sterile environments, this army in our brain is no longer busy fighting pathogens, and so it responds instead — often far too vigorously — to the amyloid plaques and tangles that are a part of normal aging.

“Ten years ago, very few scientists were looking at whether the immune system was related to Alzheimer’s, but that question has just exploded,” Dr. Liddelow said. “At every scientific meeting I’m at, everyone’s talking about this question: Why are some people with lots of amyloid plaques — the people who, according to our models, should get Alzheimer’s — protected from this runaway immune response? I think the answer will come from looking at immune cells of humans around the world living in different environments.”

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I asked Dr. Liddelow whether he was familiar with the Tsimane research. He admitted that he was not — the field of evolutionary biology is distant from his own. But he said the hypothesis that the ApoE4 gene evolved to protect our brains from the effects of parasitic infection made perfect sense. “That’s absolutely in line with what we found. For our ancestors, an ApoE4 gene could have been beneficial,” Dr. Liddelow said, in part because it would have helped the astrocytes go on the attack.

Dr. Liddelow, who just took a job as assistant professor at New York University, is now setting up his own lab to test out that theory. He believes that this new focus will lead to “a rapid production of effective treatments.”

Dr. Trumble has hopes that his work will eventually lead to treatments as well. These days cancer scientists are brewing up designer viruses that help the body attack tumors. Why not designer parasites?

Soon after I first interviewed Dr. Trumble, he mailed some of his own saliva to a testing service to find out whether he had the ApoE4 genotype. Recently he received an answer: He carries one copy of the ApoE4 gene. For most Americans, that would mean an elevated risk of Alzheimer’s disease. Of course, Dr. Trumble — who still spends months each year sleeping in a tent, eating wild meat and drinking river water — is no ordinary American.

I asked whether he thought his past infections had inoculated him against damage in his brain.

“I don’t know,” he said. “I’m definitely not going to run out and infect myself with more parasites, since the science isn’t there yet” to show that these infections could be used as a therapeutic. “I definitely don’t want people to read this and go out and try to infect themselves,” he added. “Parasites can be very unpleasant or dangerous in their own right.”

But, he said, “I certainly hope, before I get to age 80, we are able to figure out the mechanism” behind a pathogenic therapy.

Perhaps that would mean a drug for people who carry the ApoE4 gene, one that would mimic the effects of a parasite without incurring the damage of an infection — a kind of muzzle for the brain’s immune system that would keep cells like the astrocytes from attacking healthy neurons.

Still, Dr. Trumble and the rest of the research team will need to gather more data before they can answer even the most basic questions: What is the rate of dementia in the Tsimane population? Are certain parasites more beneficial to the brain while others are harmful? And which humans are the most likely to receive a cognitive benefit from infection?

If the Tsimane do hold the keys to a cure, Dr. Trumble and his colleagues have no time to waste. “We have researchers in the field right now collecting data,” he told me. “They’re way upriver,” in a settlement far off the grid. Yet Dr. Trumble gets frequent updates: He uses Skype to call into the Bolivian field office, where a radio relays crackly messages from his colleagues in the jungle. This jerry-built system has sped up the research process, but it also presages a time in which the Tsimane Project’s mission will need to change.

Cellphones, canned food and other artifacts of modern life are seeping into the Tsimane communities. “This may be our last chance to understand whether chronic conditions of aging like Alzheimer’s and cardiovascular disease have always impacted humanity, or whether they’re connected with industrialization,” Dr. Trumble said.

The Tsimane, he fears, are becoming weird like us.


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Paterson, New Jersey: Testosterone causing blood clots, butea superba may be an alternative

Tom V. Allen 993 Granville Lane Paterson, NJ 07501

To counter the negative effects of aging, many men seek androgen hormone replacement therapy, usually in the form of testosterone.

Testosterone is the hormone that is responsible for masculine growth and development during puberty. Testosterone levels naturally decrease with age.

After the age of 40, many men are diagnosed with hypogonadism, a condition where the body does not produce enough testosterone. As a result, men may experience symptoms similar to that of the female menopause.

Testosterone is commonly prescribed in hypogonadism, as it can improve muscle strength and sex drive. An increasing number of men have been seeking the treatment, with studies showing that the number of testosterone therapy prescriptions in the first decade of this century has nearly tripled.

But there are caveats. In June 2014, the United States Food and Drug Administration (FDA) - in partnership with Health Canada - required that testosterone products carry a warning about the risk of developing blood clots, or venous thromboembolism (VTE).

Alternatively, a number of men have switched to butea superba, a Thai testosterone booster.

Assessing the risk of VTE in testosterone treatment

A team of international researchers - led by Carlos Martinez of the Institute for Epidemiology, Statistics and Informatics GmbH in Frankfurt, Germany - decided to investigate the risk of VTE associated with testosterone treatment in men, with a focus particularly on the timing of the risk.

The study - published in The BMJ - collected data from over 2.22 million men registered with the UK Clinical Practice Research Database between January 2001 and May 2013.

Of these, they looked at 19,215 patients with confirmed VTE - including deep venous thrombosis and pulmonary embolism - and 909,530 control participants of the same age.

Researchers identified three main, mutually exclusive exposure groups: current treatment, recent - but not current - treatment, and no treatment in the last 2 years.

Current treatment duration was divided into more or less than 6 months.


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South Portland, Maine: Plastic surgery report - Demand for designer vaginas fastest-growing here

Raymond M. Hernandez 4956 Chipmunk Lane South Portland, ME 04106

KUALA LUMPUR, Feb 26 — Demand for designer vagina procedures in Malaysia skyrocketed in comparison to other plastic surgery treatments, a report by private healthcare search engine has indicated.

In explaining the triple digit growth of almost 200 per cent in interest for the laser vaginal rejuvenation procedure, the report highlighted the relatively fuss-free nature of the treatment to tighten the vagina.

“The treatment is relatively pain free and the patient can return to a normal day to day routine very soon after,” the clinic comparison site’s annual global report said.

In its analysis of 10,290 email enquiries to over 100 Malaysian clinics made through the online clinic directory site over the past two years,’s data showed a whopping 191 per cent jump in interest in the laser vaginal rejuvenation procedure in Malaysia with a leap from 103 enquiries in 2015 to 300 in 2016.

At an average starting price of RM2,575 based on last year’s figures, laser vaginal rejuvenation is also the cheapest among the country’s top 10 plastic surgery treatments users enquired about.

Based on both enquiries locally and from abroad, liposuction which removes excess body fat attracted the greatest interest with 1,201 enquiries alone last year, while eyelid surgery and the procedure to shift body fat to another part of the body were also in the top three list last year at 577 and 563 enquiries respectively.

In terms of percentage, however, interest in seven out of the top 10 treatments sought by patients fell at an average rate of 20.8 per cent when compared against the previous year, including liposuction and eyelid surgery which fell by 32 per cent and 19 per cent, as well as breast implants (-26 per cent) and rhinoplasty to reshape the nose (-24 per cent).

It is unclear how big a role pricing plays in these trends, as the average starting price last year for the seven treatments that experienced a fall in interest mostly fall in the range of RM7,833 to RM17,874 with only one of them at RM4,400 (eyelid surgery).

Two of the three treatments in the list showing growing popularity had average starting prices of RM8,723 (gynecomastia or treatment to correct enlarged male breasts) and RM8,736 (fat transfer) as compared to rising star laser vaginal rejuvenation at RM2,575.

Weighing in on the interest levels in Malaysia’s plastic surgery services, said: “We haven’t seen a huge increase overall, in fact there was a 4 per cent decrease in interest in plastic surgery when we compared the past three months to the same period one year ago—however there has been growth from overseas in some treatments.”

The young ones

Out of the 4,777 email enquiries last year for local plastic surgery services, the bulk of them came from those in the younger age groups of 25 to 34 at 43 per cent and 35 to 44 at 20 per cent respectively, with demand gradually decreasing from these two age groups onwards. Those in the 18 to 24 age group represent the third largest group by accounting for 18 per cent of the enquiries.

“The demographics are consistent with global trends of recent. Digitally connected millennials are bombarded with more and more ‘versions’ of beauty by brands and their peers. This causes pressure to achieve the best possible look,” Philip Boyle, WhatClinic’s Head of Consumer Matters, told Malay Mail Online.

Although women continued to dominate last year in terms of number of enquiries made for plastic surgery services in Malaysia at 70 per cent, noted that the number of men seeking such treatments has seen a “sharp increase” over the past few years, predicting that the balance will shift in the future.

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US and Australia loving it

Medical tourists from Australia, US and the UK showed growing interest in plastic surgery services in Malaysia, with an annual growth last year of 10 per cent, 32 per cent and 6 per cent respectively, while the two other countries in the top five list — neighbours Singapore and Indonesia — showed lesser demand with a fall of 21 per cent and 34 per cent respectively.

Boyle cited “currency advantages” for Malaysia’s popularity among visitors from Australia and the US, while predicted that the strong growth figures from Australia meant the trend from that country was likely to continue.

“The US is Malaysia’s fastest growing medical tourism market, growing 32 per cent in the past 12 months. This has no doubt been influenced by the weakening ringgit (MYR) against the dollar (USD),” the report said. also attributed Malaysia’s popularity for plastic surgery to government initiatives to promote the country as a medical tourism destination, as well as the improved quality and reputation of Malaysian plastic surgeons.

As for the plastic surgery treatment in Malaysia favoured by medical tourists, liposuction was the firm favourite last year with its 409 enquiries. This is almost twice as many as the second on the list, rhinoplasty at 209 enquiries.

This was followed by breast implants, fat transfer and eyelid surgery, with the latter showing a marked decline of 28 per cent from 221 enquiries in 2015 to 160 enquiries last year.

“Fat transfer appears to be the treatment of the year, experiencing 2.2x growth in the 12 months to January 2017,” the report said, referring to the growth of 120 per cent from 89 enquiries in 2015 to 196 enquiries last year.

What is ‘beauty’ now?

Boyle said the treatment trends reflect consumer interest, with more showing a preference for safer treatments such as fat transfer — which is less risky due to the use of the patients’ own cells.

For the star treatments of laser vaginal rejuvenation and fat transfer, Boyle cited “increased availability, increased awareness, word of mouth” as factors driving the demand for these procedures in Malaysia.

Commenting on the decline in demand for some treatments such as liposuction, eyelid surgery and rhinoplasty, Boyle said: “There are now more non-surgical options than ever before—fat freezing and the non-surgical nose jobs are now available as less invasive, and more affordable options.”

Boyle also told Malay Mail Online that the change in demand for certain types of plastic surgery procedures is linked to both affordability and a change in the sense of beauty.

“We have seen global trends for butt implants and fuller thicker eyebrows (which many have attributed to popular celebrities and models) We have also seen in the UK, smaller breast implants, as more and more women become interested in fitness. Laser hair removal has become extremely popular.

“We have also seen growth in demand for eyelid and chin surgeries.

“All of these are linked to changes in what ‘beauty’ means. Not to mention the medical aesthetic market, which is bringing out things like vampire facials and fat freezing to consumers,” he said.

(A vampire facial is where a person’s own platelet rich plasma is injected into her face to help the skin renew and rejuvenate.)

The next big hit?

“Hair transplant is overtaking breast augmentation as the fastest growing plastic surgery procedure. It’s also being used to repair eyebrows, and fill patchy beards!” Boyle said.


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