A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.
Caffeine in Food and Dietary Supplements is the summary of a workshop convened by the Institute of Medicine in August 2013 to review the available science on safe levels of caffeine consumption in foods, beverages, and dietary supplements and to identify data gaps. Scientists with expertise in food safety, nutrition, pharmacology, psychology, toxicology, and related disciplines; medical professionals with pediatric and adult patient experience in cardiology, neurology, and psychiatry; public health professionals; food industry representatives; regulatory experts; and consumer advocates discussed the safety of caffeine in food and dietary supplements, including, but not limited to, caffeinated beverage products, and identified data gaps. Caffeine, a central nervous stimulant, is arguably the most frequently ingested pharmacologically active substance in the world. Occurring naturally in more than 60 plants, including coffee beans, tea leaves, cola nuts and cocoa pods, caffeine has been part of innumerable cultures for centuries. But the caffeine-in-food landscape is changing. There are an array of new caffeine-containing energy products, from waffles to sunflower seeds, jelly beans to syrup, even bottled water, entering the marketplace. Years of scientific research have shown that moderate consumption by healthy adults of products containing naturally-occurring caffeine is not associated with adverse health effects. The changing caffeine landscape raises concerns about safety and whether any of these new products might be targeting populations not normally associated with caffeine consumption, namely children and adolescents, and whether caffeine poses a greater health risk to those populations than it does for healthy adults. This report delineates vulnerable populations who may be at risk from caffeine exposure; describes caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to pre-existing conditions; explores safe caffeine exposure levels for general and vulnerable populations; and identifies data gaps on caffeine stimulant effects.
The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
"[This book] deserves to be in everyone’s library. . . . It’s loaded with great information, and it can save your life or the life of someone you love."—Dr. Joseph Mercola "This book is life-changing for those trying to understand their own bodies, or those of loved ones, and it’s truly transformative in the hands of medical professionals, especially young doctors."—Foreword Reviews Thomas Cowan was a 20-year-old Duke grad—bright, skeptical, and already disillusioned with industrial capitalism—when he joined the Peace Corps in the mid-1970s for a two-year tour in Swaziland. There, he encountered the work of Rudolf Steiner and Weston A. Price—two men whose ideas would fascinate and challenge him for decades to come. Both drawn to the art of healing and repelled by the way medicine was—and continues to be—practiced in the United States, Cowan returned from Swaziland, went to medical school, and established a practice in New Hampshire and, later, San Francisco. For years, as he raised his three children, suffered the setback of divorce, and struggled with a heart condition, he remained intrigued by the work of Price and Steiner and, in particular, with Steiner’s provocative claim that the heart is not a pump. Determined to practice medicine in a way that promoted healing rather than compounded ailments, Cowan dedicated himself to understanding whether Steiner’s claim could possibly be true. And if Steiner was correct, what, then, is the heart? What is its true role in the human body? In this deeply personal, rigorous, and riveting account, Dr. Cowan offers up a daring claim: Not only was Steiner correct that the heart is not a pump, but our understanding of heart disease—with its origins in the blood vessels—is completely wrong. And this gross misunderstanding, with its attendant medications and risky surgeries, is the reason heart disease remains the most common cause of death worldwide. In Human Heart, Cosmic Heart, Dr. Thomas Cowan presents a new way of understanding the body’s most central organ. He offers a new look at what it means to be human and how we can best care for ourselves—and one another.
Recognizing the potential design complexities and ethical issues associated with clinical trials for gene therapies, the Forum on Regenerative Medicine of the National Academies of Sciences, Engineering, and Medicine held a 1-day workshop in Washington, DC, on November 13, 2019. Speakers at the workshop discussed patient recruitment and selection for gene-based clinical trials, explored how the safety of new therapies is assessed, reviewed the challenges involving dose escalation, and spoke about ethical issues such as informed consent and the role of clinicians in recommending trials as options to their patients. The workshop also included discussions of topics related to gene therapies in the context of other available and potentially curative treatments, such as bone marrow transplantation for hemoglobinopathies. This publication summarizes the presentation and discussion of the workshop.
Can horses really teach us to be better human beings? In this groundbreaking work, you will discover that the answer is a resounding "Yes". While working with severely disturbed youths, therapists Adele and Deborah McCormick discovered the best healers were their herd of Peruvian Paso horses. Through their work with horses, the McCormicks' patients were initiated into the hidden world of animal energy and instinct, and found a safe and natural way to learn about their own dualistic natures. Patients learned to tap into their primal "animal" mind and energies and apply them toward more creative and responsible living. What took days or months to uncover in an office setting took onyl minutes when patients were on a horse. You will read case after fascinating case of people discarded by society and the psychiatric community whose lives were turned around by the intuitive guidance and friendship of their equine therapists. What People are saying... "This book got me. It is about personal growth and the cultivation of wisdom, and is one of the wisest contributions I have come across in years...Its implications for healing are utterly profound. Horse Sense and the Human Heartis a breakthrough work." --Larry Dossey, M.D. author Prayer is Good Medicine and Healing Words "Horse Sense and the Human Heart is an eye-opening and heartwarming adventure. In sharing their pioneering therapeutic discoveries, Adele and Deborag McCormick take us on a shamantic interspecies odyssey. They reveal a secret world governed by wise equine masters, availalbe to help heal our psyches, and guide the human spirit on its journey toward wholeness." --David Jay Brown, author, Brainchild and Mavericks of the Mind
The secret history of our most vital organ: the human heart. The Man Who Touched His Own Heart tells the raucous, gory, mesmerizing story of the heart, from the first "explorers" who dug up cadavers and plumbed their hearts' chambers, through the first heart surgeries -- which had to be completed in three minutes before death arrived -- to heart transplants and the latest medical efforts to prolong our hearts' lives, almost defying nature in the process. Thought of as the seat of our soul, then as a mysteriously animated object, the heart is still more a mystery than it is understood. Why do most animals only get one billion beats? (And how did modern humans get to over two billion, effectively letting us live out two lives?) Why are sufferers of gingivitis more likely to have heart attacks? Why do we often undergo expensive procedures when cheaper ones are just as effective? What do Da Vinci, Mary Shelley, and contemporary Egyptian archaeologists have in common? And what does it really feel like to touch your own heart, or to have someone else's beating inside your chest? Rob Dunn's fascinating history of our hearts brings us deep inside the science, history, and stories of the four chambers we depend on most.
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
