Unit 3 Prevention and Treatment of Diseases

1. Unit 3Prevention and Treatment of Diseases College English Center College of Foreign Languages and Literature Fudan University Page 53

2. Issues to be covered • The common and special means of treatment and prevention of diseases • The different roles of genes and environment in causing diseases • The relationship between interpersonal relationship and health • The major steps in designing and developing new drugs Page 53

3. Lead-in • Your experience when you fell ill last time • Time • Visits to doctor • Diagnosis • Treatment Page 53

4. Lead-in • Causes and treatments Page 54

5. Lead-in • Causes and treatments Page 54

6. Text A: The Seventy Percent Solution • Is there a 100% solution for every problem? • Is there a 100% cure for every ailment? Page 54

7. How was Terry’s life before she was diagnosed with (Pre. 1) • loved practicing Tae Kwon Do • loved the surge of adrenaline that came with the controlled combat of tournaments • competed nationally, even winning a bronze medal in the trials for the Pan American Games • attended medical school, practiced as an internal medicine residency, became an academic general internist • married and got a son and a daughter Page 55

8. Language Focuses • sclerosis • scler(o)- • atherosclerosis • scleroderma Page 55

9. Language Focuses • autoimmune • auto- • autocide • automatic • autonomy Page 55

10. Language Focuses • adrenaline • ad- close to • adduction • ren- kidney • reniform • -ine a chemical substance • epinephrine • thyroxine甲状腺素 Page 55

11. Knowledge of the subject matter • the surge of adrenaline • medical school • an internal medicine residency • an academic general internist • to develop a chronic disease Page 55

12. How much do you know about MS and autoimmune disease? (Pre. 2) • Symptoms as mentioned by the author • loss of stamina and strength • problems with balance • bouts of horrific facial pain • dips in visual acuity Page 55

13. How much do you know about MS and autoimmune disease? (Pre. 2) • Cause as mentioned by the author • the assault of immune cells on the brain, with possible origin in genetic make-up or/and combination of environmental factors • Treatment as mentioned by the author • interferon and copolymer-1 Page 55

14. Language Focuses • bouts of horrific facial pain • When I developed the foot drop, the diagnosis was made: multiple sclerosis (MS). • He said that fewer relapses would mean less disability, a greater chance that I’d still be walking, working, and living my life as I once knew it ten years later. Page 55

15. Language Focuses • copolymer • co- • coenzyme • co-inhibitor • poly- • polyuria • -mer • excimer [ek5saimE] • 受激准分子 Page 55

16. Language Focuses • pharmacotherapy • pharmaco- • pharmacology • pharmacy • -therapy • 化疗 • 放疗 • 水疗 Page 55

17. Knowledge of the subject matter • My doctor said that genetics accounted for only 10 to 30% of the risk of MS; the rest (???) was due to some combination of unknown environmental factors. • He never told me what I could do to address those unknown factors, only offering interferon and copolymer-1 to reduce the risk of relapse. • It was increasingly apparent that, with time, becoming bedridden due to my illness was inevitable. Page 26

18. What did Terry do before she self-experimented? (Pre. 3) • Picking up basic science such as cellular physiology, biochemistry and neurophysiology • Reading articles about new MS drugs in animal models and neurodegeneration of all types—dementia, Parkinson’s disease, Huntington’s, and Lou Gehrig’s disease Page 55-56

19. Language Focuses • usage of v-ing • deepening disability • I began my own study of the literature, reading article after article on PubMed, knowing that the seeds for today’s clinical care were laid years, sometimes decades earlier in the basic science literature. • I hoped to find a magic bullet that would halt my worsening disability. • I looked for recent articles testing new MS drugs in animal models. • Eventually, realizing I could not access those drugs unless I was in a clinical trial, I turned to articles concerningneurodegeneration of all types—dementia, Parkinson’s disease, Huntington’s, and Lou Gehrig’s disease. Page 55-56

20. Knowledge of the subject matter • I had only two options: accommodation and acceptance of deepening disability despite optimal treatment, or increased involvement in my own health care. Page 55

21. Knowledge of the subject matter • I began my own study of the literature, reading article after article on PubMed, knowing that the seeds for today’s clinical care were laid years, sometimes decades earlier in the basic science literature. Page 56

22. Knowledge of the subject matter • At first, I looked for recent articles testing new MS drugs in animal models. • …articles concerning neurodegeneration of all types—dementia, Parkinson’s disease, Huntington’s, and Lou Gehrig’s disease. • …gradually relearning much of what I had forgotten in my basic science years: cellular physiology, biochemistry, and neurophysiology. • Make a list of the courses you have taken so far Page 56

23. What approaches did Terry mainly use to deal with neurodegeneration? (Pre. 4) • self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models • self-experimentation with neuromuscular electrical stimulation still based on literature • online search to identify the sources of micronutrients • reduction of food allergy and toxic load Page 56-57

24. Language Focuses • …so I translated mouse-sized doses to human ones … • However, although my decline had slowed, I was still declining. • …there was no guarantee that my brain could talk to these new muscles. Page 56

25. Language Focuses • It did hurt. A lot. • I felt the best I’d felt in years. • My therapist implemented a program of e-stim coupled with daily exercise. • As good as the article was, it did not list all of the building blocks needed for optimal brain health. • The medical literature didn’t have that information, nor did the registered dieticians with whom I consulted, nor did I see it in the food science literature. Page 57

26. Language Focuses • But he did let me have a test session. • I turned eventually to Google, which didhelp me, nutrient by nutrient, to understand where various micronutrients I was taking by pill each day were located in the food supply. Page 57

27. Language Focuses • metamorphosis • morph(o)- • morphocytology • -osis • psychosis • sclerosis Page 56

28. Language Focuses • herbicide • herbi- • herbivorous • -cide • pesticide • suicide • genocide Page 57

29. Knowledge of the subject matter • …so I translated mouse-sized doses to human ones and began my self-experimentation with… • My disease was reclassified as secondary progressive MS, meaning there were no FDA-approved treatments capable of restoring my lost function. • Reviewing a study protocol for the University of Iowa’s Institutional Review Board, I learned about neuromuscular electrical stimulation and wondered if it might help me. Page 56

30. Knowledge of the subject matter • I asked my physical therapist to let me have a test session. • patient autonomy • He told me that e-stim (as he called it) was not an approved treatment for MS… • paternalistic approach Page 57

31. Knowledge of the subject matter • I returned to the literature. • I turned eventually to Google • Which is more helpful and to what extent is Google a reliant source of medical information? Page 57

32. One example to illustrate the correlation between toxic load and disease (Pre. 5) • With 70% to 90% of the risk for diabetes, heart disease, cancer, and autoimmunity being due to environmental factors other than genetics, we can provide the real solution to many health problems and the health care crisis by changing our environment, for example, optimizing our nutrition and reducing our toxic load. Page 57

33. Knowledge of the subject matter • I next looked more deeply at the environmental factors associated with poorly explained neurological and psychological symptoms. • Two stood out: food allergies and toxic load. • Food allergies can cause a myriad of neurological and psychological symptoms, typically without any abdominal complaints, decades before diagnosis and are very difficult to identify. Page 57

34. What does the tile “The Seventy Percent Solution”mean? (Pre. 6) • With 70% to 90% of the risk for diabetes, heart disease, cancer, and autoimmunity being due to environmental factors other than genetics, we can provide the real solution to many health problems and the health care crisis by changing our environment, for example, optimizing our nutrition and reducing our toxic load. Page 58

35. Language Focuses • Physician self-experimentation sometimes does not go as anticipated. • The unthinkable—the unimaginable—happened, stunning me, my family, and my physicians. • As a result, I’ve changed how I practice medicine. • Three years into my healing, I am again experimenting. Page 58

36. Conclusion • 30% vs. 70% Page 26 - 30

37. Assignment for Group Presentation • As an emerging branch of science, Social Neuroscience is unfamiliar and mysterious to many people. Form groups of 4-5 to find relevant information about it and get ready for a presentation in class. The following prompts may be helpful to you: • the definition of Social Neuroscience • the mechanism through which brain-to-brain link works • the application of social neuroscience to treatment of diseases • the prospects of Social Neuroscience Page 44

38. Presentations for Unit 4 1. Give a brief explanation of the concepts: complementary medicine，alternative medicine. (Page 88) 2. To what extent do you agree with the author’s opinion on traditional Chinese medicine as being “affordable, low tech, safe, and effective”? (Page 88) 3. Summarize the clinical uses of acupuncture. (Page 88)

39. Presentations for Unit 4 4. Do you think the author is overoptimistic in predicting a wider future use of acupuncture in the US? (Page 88) 5. Explain how inappropriate uses of herbs may result in complications. (Page 89) 6. Various approaches to herbal study are mentioned in the text. Pick one to discuss the advantages and limitations. (Page 89)

40. Presentations for Unit 4 7. What are the difficulties in investigating herbal therapies? (Page 89) 8. What are the factors to consider when we integrate eastern and western medicine? (Page 89)