Jewish World Review Jan. 25, 2002 / 12 Shevat, 5762
By Robert A. Wascher, M.D., F.A.C.S.
http://www.NewsAndOpinion.com --
FROM this week's Proceedings of the National Academy of Sciences is an
intriguing study of life extension through the use of a drug. The drug,
4-phenyl butyrate (PBA), binds to the genetic material in the nucleus of
cells, and is known to activate some genes that are normally inactive in
adult cells, while shutting down other genes that are normally active. In
this study, fruit flies were fed a diet consisting of "fly chow" and PBA
throughout their lifetime, and average and maximal life spans were then
calculated for these flies.
Compared with control flies not fed PBA, the PBA-fed flies exhibited
significant increases in average lifespan. Moreover, the PBA-fed flies
appeared as healthy and vigorous as their fly buddies that not receiving
PBA. This life-extending effect was also observed after even limited periods
of PBA feeding. The authors then assessed a panel of 7,500 fly genes, and
found that flies exposed to PBA had about 100 genes activated and 48 genes
inactivated when compared to flies not receiving PBA.
Although it was not possible to identify precisely which
activated and/or inactivated genes played a role in the life-extending
effects of PBA, these results suggest that a particular balance between
activation and inactivation of certain genes can actually extend the
lifespan of, at least, flies. Since the metabolism of fly cells is not
terribly different from human cells, this study has important implications
for human health.
Not only does this study provide important clues
regarding the genetic determinants of lifespan, but it also suggests that
one can intervene to alter the genetic milieu in such a way as to extend the
duration of an organism's natural life. One can easily predict that further
elucidation of the specific genetic underpinnings of longevity will,
inevitably, lead to such interventions in humans.
WORKPLACE ATTITUDES AND SMOKING CESSATION
Compared with so-called white-collar workers, blue-collar
workers who smoked reported significantly less social pressure to quit
smoking--as well as greater acceptance of smoking--by their peers at work.
At the same time, smokers who strongly expressed an intention to quit
smoking reported higher levels of social pressure against smoking at work as
compared to smokers not planning to quit. The authors summarize that social
attitudes towards smoking at work may play an important role in the
decisions that smokers make to either continue smoking or to quit.
EFFECTS OF INADEQUATE SLEEP ON SURGEONS
The sleep-deprived residents were required to
perform standardized laparoscopic surgery tasks in a laparoscopic surgery
simulator. The findings, not surprisingly, included an increase in time
necessary to complete the tasks (as compared to the same residents'
performance of these tasks when well-rested), and the commission of
significantly more technical errors. The number of unnecessary movements
also increased after a busy night in the hospital.
This is yet another study that demonstrates, contrary to traditional
surgical training tenets, that sleep deprivation reduces the surgeon's
accuracy and speed in the operating room.
Unfortunately, and more than most
of the other clinical specialties, surgical training programs continue to
submit their residents to a punishing schedule of hospital duty. Reports of
surgical and non-surgical residents being involved in one-car automobile
accidents at an alarmingly high rate, as well as other signs of exhaustion,
are relatively common. Errors in patient treatment, by both surgeons and
non-surgeon physicians, have been well documented to be associated with long
periods of sleeplessness.
Despite the efforts of some states (New York,
most notably) to limit the hours of resident physicians, little progress has
been made in trimming the 80-100 hour work-weeks of most
physicians-in-training. Despite the bravado and machismo of young
surgeons-in-training, a chronic lack of sleep combined with a high-stress
environment can lead to poor judgment, mistakes in the operating room, and
sometimes even worse
JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at
the John Wayne Cancer Institute in Santa Monica, CA.
Comment by clicking here.
Drug increases lifespan (if you're a fly...)
A Harvard University study of the role of workplace attitudes towards
smoking is reported in the American Journal of Health Promotion this month.
The authors surveyed 11,456 employees, including 2,626 smokers, at 44
different worksites. The study assessed workplace social support for
quitting tobacco.
From Denmark comes a study, reported in the British Medical Journal, that I
can certainly relate to: the effects of inadequate sleep on surgeons'
performance in the operating room. Fourteen surgery residents were assessed
in a simulated operating room following a night of on-call activities in the
hospital, with each resident reporting less than three hours of sleep during
the preceding 24 hours (a very common occurrence among
surgeons-in-training).
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