Guide to planet retirement

Schizophrenia

Schizophrenia occurs in about 1% of the general population. However, it occurs in 10% of people who have a parent, brother or sister with the disorder, indicating that genetics plays a role in its cause. Previous studies have shown that many people with schizophrenia have new genetic mutations. These misspellings in a gene’s DNA sequence occur spontaneously and so aren’t shared by their close relatives. Researchers at the University of Washington in Seattle and colleagues set out to identify spontaneous genetic mutations in people with schizophrenia and to assess where and when in the brain these misspelled genes are turned on, or expressed. The study results were published in the August 1, 2013, issue of Cell, and showed that the likelihood of having a spontaneous mutation was associated with the age of the father in both affected and unaffected siblings. Significantly more mutations were found in people whose fathers were 33-45 years at the time of conception compared to 19-28 years.

Among people with schizophrenia, the scientists identified 54 genes with spontaneous mutations predicted to cause damage to the function of the protein they encode. The researchers used newly available database resources that show where in the brain and when during development genes are expressed. The genes, they found, form an interconnected expression network with many more connections than that of the genes with spontaneous damaging mutations in unaffected siblings. The spontaneously mutated genes in people with schizophrenia were expressed in the prefrontal cortex, a region in the front of the brain. The genes are known to be involved in important pathways in brain development. Fifty of these genes were active mainly during the period of fetal development.

These findings support the concept that schizophrenia may result, in part, from disruptions in development in the prefrontal cortex during fetal development. For more info: Common Genetic Factors Found in 5 Mental Disorders:

A human hair has a diameter of around 100 microns. You can see a single hair with your eyes, and you can even take a picture of one with a smartphone. In comparison, a virus may have a diameter of around 100-300 nanometers (nm). It would take about 300-1,000 viruses lined up side by side to equal the width of a human hair.

Visualizing a virus, or other structures that exist on a nanoscale level, typically requires expensive, sophisticated microscopes. These microscopes have bulky lenses and specialized optical components that are difficult to scale down and implement in a small, portable device. Such a compact device, though, could have enormous health benefits. For instance, it might allow researchers to track viruses and perform other diagnostic tests in the field.

A team of researchers at the University of California, Los Angeles sought to overcome the many challenges involved in building a compact, lightweight, fluorescent microscope that can detect single particles on a nanoscale level. Their work was funded in part by an NIH Director's New Innovator Award. Using a 3-D printer, the researchers constructed a handheld component that could attach to a smartphone. For a light source, they used a compact blue laser diode that was powered by 3 AAA batteries. They positioned the laser to illuminate a sample at a steep, oblique angle. This prevented the background light that could interfere with the detection of signal from the samples. The device also included a specialized filter to further block background noise in the images. The scientists described the construction and testing of the device online on September 9, 2013, in the journal ACS Nano.

Specimens were positioned in a sample holder on a miniature mechanical stage that could be moved to adjust the depth and focus. Both the sample and laser source were housed in a unit that prevented the user from being exposed to laser light and enabled samples to be viewed in the presence of strong ambient light. This “opto-mechanical” attachment weighed less than half a pound. Samples were magnified by the built-in lens of the cell phone camera along with an external lens. The magnified fluorescent images were then recorded by the sensor chip in the cell phone.

The researchers could detect beads as small as about 100 nm. They were also able to view fluorescently labeled human cytomegaloviruses, which range from 150 to 300 nm in diameter. They confirmed the ability of the device to detect nanoscaled objects of varying brightness by viewing the same samples with conventional scanning electron microscopy and confocal microscopy.

I just moved from a house with a grapefruit tree. I never indulged because doctors say that you should not eat grapefruit if you are taking statins to lower your cholesterol -– which I have been doing for years.

Now researchers used nanoparticles derived from grapefruits to deliver targeted drugs to treat cancer in mice. The technique may prove to be a safe and inexpensive way to make customized therapies. Nanoparticles are emerging as an efficient tool for drug delivery. Microscopic pouches made of synthetic lipids can serve as a carrier, or vector, to protect drug molecules within the body and deliver them to specific cells. However, these synthetic nanovectors pose obstacles including potential toxicity, environmental hazards and the cost of large-scale production. Recently, scientists have found that mammalian exosomes—tiny lipid capsules released from cells—can serve as natural nanoparticles. But making therapeutic nanovectors from mammalian cells poses various production and safety challenges.

A research team at the University of Louisville hypothesized that exosome-like nanoparticles from inexpensive, edible plants might be used to make nanovectors to bypass these challenges. The scientists set out to isolate nanoparticles from the juice of grapefruits, grapes and tomatoes. The researchers found that grapefruit juice yielded the most lipid nanoparticles. They then prepared ‘grapefruit-derived nanovectors’ (GNVs) and tested them in different cell types. GNVs were taken up by a variety of cells at body temperature. These nanovectors had no significant effect on cell growth or death rates. They proved to be more stable than a synthetic nanovector and were also taken up by cells more readily. The scientists next tested the GNVs in mice. They proved capable of delivering a broad range of therapeutic agents to targeted cells in culture, including chemotherapy drugs, short interfering RNA (siRNA), a DNA expression vector and antibodies. The researchers next tested GNVs in mouse models of cancer. GNVs carrying a tumor inhibitor reduced tumor growth and prolonged survival when given intranasally to mice with brain tumors. When injected into mouse models of colon cancer, GNVs with targeting molecules collected in tumor tissue to deliver therapies and slow tumor growth.

This is exciting news for people with cancer. These nanoparticles are derived from an edible plant, and are believed to be less toxic for patients, result in less biohazard waste for the environment, and are much cheaper to produce at large scale than nanoparticles made from synthetic materials. They are currently in clinical trials. For more info: www.nih.gov/researchmatters/june2013/06032013grapefruit.htm

MEDICARE UPDATE

The Medicare “Open Enrollment (“Open Season”) is coming up fast: October 15 to December 7, 2013 for coverage starting on January 1, 2014.

Remember that you can do the following during the Open Season:

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  Change from Original Medicare to a Medicare Advantage Plan.
  
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  Change from a Medicare Advantage Plan back to Original Medicare.
  
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  Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
  
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  Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
  
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  Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
  
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  Join a Medicare Prescription Drug Plan.
  
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  Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
  
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  Drop your Medicare prescription drug coverage completely.
  

If you are comfortable reading fine print and not computer savvy, you can get assistance by contacting your local SHINE volunteer (SHIP in Florida, HICAP in California). They will help you to assess the best plan for you, particularly for covering your prescriptions drugs and giving you the most benefits for your monthly premium. Medicare also recently launched Medicare Interactive, an online resource that translates complicated Medicare benefits information into “what-does-this-mean-for-me?” advice for professionals and consumers. The Medicare Rights Center also offers a hotline staffed by expert counselors. People with Medicare can call (800) 333-4114.

Why should you go through this exercise of comparing plans every year? Because the private health plans (Advantage Plans, like HMOs and PPOs, Medigap Plans, Part D drug plans) change their terms and conditions in early October – dropping/adding benefits, dropping coverage for prescriptions drugs that you may be taking or doctors that you are used to seeing, and usually raising co-pays and premiums. Lots of fine print to plow through that you are usually not aware of until you are denied benefits or charged more!

So, don’t make a hasty decision just because a nice Advantage Plan salesman came to your house and showed you the bottom line to sign on or because your “over-50” magazine subscription is sponsoring a healthcare program (which many consider a conflict of interest). And, given the flurry of advertising on TV and in print that are playing on your fears, be sure to notify Medicare if any of the plans you become aware of are breaking any of the following rules:

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  Insurance brokers and agents cannot tell you that you must sign up for a Medicare Advantage plan to get Medicare prescription drug coverage. In fact, upon turning 65 and meeting the eligibility requirements, you can have Original Medicare and sign up for a stand-alone Part D plan to get Medicare prescription drug coverage. Stand-alone Part D plans are usually inexpensive, but you must sign up for them when you become eligible for Medicare (or are still covered by an employer benefits plan) or you will have to pay a monthly penalty for the rest of your life! Most Advantage plans bundle prescription drug coverage into their plans. If you drop out of an Advantage plan and go back to Original Medicare during the enrollment period, be sure to sign up for a Part D plan to cover your prescription drugs.
  

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  Insurance brokers and agents cannot tell you that you can only get information about a plan or sign up for a plan if an agent comes to your home. In reality, you can get information about the plan by either contacting the plan or taking a look at the plan’s website. Keep in mind that while plan agents can come to your home to talk to you about a plan, there are certain rules they must follow before doing so. For example, plan agents cannot come to your home without your consent.
  

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  Insurance brokers and agents cannot tell you that you can always return to Original Medicare coverage if you are dissatisfied with the plan. In reality, people with Medicare can only make changes to their Medicare coverage during certain enrollment periods. The plan agent should also tell you that you can only change your Medicare health and drug coverage during specific times throughout the year.
  

Lastly, keep in mind that you should always double-check everything an insurance broker or agent tells you. For example, if an insurance broker tells you that your doctor is part of a Medicare Advantage plan’s network, call your doctor to verify this.

OTHER HEALTHCARE NEWS FOR WOMEN:

If you are not a member of Medicare or benefiting under the new rules of the Affordable Care Act (“Obamacare”), rejoice!

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  You won’t be charged more for health insurance just because you’re a woman, as was done in the past.
  
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  You can’t be denied coverage or charged more due to pre-existing conditions, like cancer or being pregnant.
  
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  You can choose from any primary care provider, OB-GYN, or pediatrician in your health plan’s network without a referral.
  
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  You’ll get free preventive care like mammograms, well-woman visits, contraception, and more, and will actually receive a reminder when it is time to get them.
  

So, I hope the Government stops the rhetoric and opens enrollment, originally scheduled for October 1, 2013, so that coverage can start for millions of uninsured as soon as January 1, 2014.