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A Medical Mystery of the Best Kind: Major Diseases Are in Decline

307 点作者 suprgeek将近 9 年前

21 条评论

magila将近 9 年前
On the other hand, autoimmune diseases have been increasing in prevalence over the last century. While these diseases are rarely immediately fatal, in severe cases they can have a major impact on quality of life. Onset often occurs in early adulthood so the cost of treatment over a lifetime can be extremely high. The usual treatment, immunosuppressive therapy, also has serious risks of its own.<p>While there has been much progress on finding new treatments, their scope has been limited to new and creative ways of suppressing the immune system. There are a multitude of theories which attempt to explain the causes of autoimmune diseases, but we seem to be quite far from truly understanding them.
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mrfusion将近 9 年前
I always wondered if the removal of lead in gasoline could account for a lot of this. Especially the dementia drop.
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lordnacho将近 9 年前
Speculation:<p>- People have become more aware of the risk factors, and behave accordingly. Awareness would be connected to prevalence but have a lagged effect.<p>- Deadly diseases cause evolutionary responses. Perhaps a disproportionate number of people with predisposition to these illnesses passed away before having offspring.<p>- Reporting bias? While an illness looms large in the minds of the medical community, doctors are more likely to either wrongly attribute to the illness (false positive), or do false negatives less often.<p>- Highly speculative: combined effects are non-linear. I don&#x27;t know what they use to do these studies, but typically you hear something along the lines of &quot;for every x, there&#x27;s m*x effect&quot;, which makes things sounds nice and linear. Maybe better prevention and better treatment does better than either on its own summed up, and so you won&#x27;t be able to find the &quot;reason&quot; by splitting into each feature.
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sgt101将近 9 年前
wow - I have no clue (obviously) but possible reasons :<p>- better home heating (less open fires, more heated bedrooms)<p>- increased time from atmospheric nuclear bomb testing (and the various dispersals of plutonium in the 60&#x27;s and 70&#x27;s)<p>- better nutrition in general<p>- higher genetic diversity in breeding populations; not many peoples grandparents all come from the same village in the developed world now<p>- less pollution in the west; import of finished goods rather than local manufacturing
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ktRolster将近 9 年前
This is weird:<p><pre><code> &gt;Until the late 1930s, stomach cancer was &gt;the No. 1 cause of cancer deaths in the &gt;United States.</code></pre>
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sjclemmy将近 9 年前
What about widespread use of painkillers? Aspirin, paracetamol and ibuprofen have become common place over this period. Calming the body&#x27;s immune response might have a beneficial effect on overall health.
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codecamper将近 9 年前
I wonder if all the benefits may be coming from people having kids later in life. You&#x27;d think this would lead to more disease, but maybe we are actually evolving to be longer living and the kids later in life is what is causing it.
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mrfusion将近 9 年前
It mentions statins as something obviously good but is there any evidence they&#x27;re actually beneficial? I thought cholesterol was good now?
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raverbashing将近 9 年前
The question I guess is not what diseases are in decline, but which ones are going up
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robbles将近 9 年前
Is it possible that medical advances in the last couple of decades have simply delayed the deaths of many sufferers? Heart disease and cancer survival rates are usually qualified with a number of years, given that they are difficult to fully cure. With a larger aging population just barely hanging on, perhaps an upswing is just around the corner but hard to see now. i.e. the rate of death has not actually dropped, the average survival time is longer.
lastres0rt将近 9 年前
Put bluntly: All of these &#x27;little increases&quot; are starting to add up in big ways. I&#x27;m not that surprised that a decline in one disease is leading to declines in others. As we all live a little longer, we make each other healthier as well, being better able to cope with the expanded safety net.<p>As someone who&#x27;s seen her grandparents suffer with a cacophony of diseases right before death? Sometimes, one thing really DOES lead to another.
throwwit将近 9 年前
The largest extrinsic factor (causally effective), should be the environment&#x27;s physiological interaction with cells that have accumulative exposure: the alimentary system. Lower incidences of alimentary cancers should be the hallmark result of bans on various carcinogenic additives. The question should be how low the rates can inherently go based on diet alone, and to then proceed to narrow down the scope of any further factors.
known将近 9 年前
Check <a href="https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;WHO_Model_List_of_Essential_Medicines" rel="nofollow">https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;WHO_Model_List_of_Essential_...</a> and <a href="https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;List_of_bestselling_drugs" rel="nofollow">https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;List_of_bestselling_drugs</a>
JoeAltmaier将近 9 年前
Is it simply, that fewer people can afford insurance&#x2F;visit a doctor? So they die of &#x27;natural causes&#x27; and never get diagnosed?
nxzero将近 9 年前
Curious, if the cause is the decline in cigarette consumption; here&#x27;s a graph showing roughly 100 years of data for the topic:<p><a href="http:&#x2F;&#x2F;4.bp.blogspot.com&#x2F;-p4ECPyex_cY&#x2F;TzSalazW2XI&#x2F;AAAAAAAAA2o&#x2F;Wrgj5mSyGHA&#x2F;s1600&#x2F;Smoking+1900-2006.JPG" rel="nofollow">http:&#x2F;&#x2F;4.bp.blogspot.com&#x2F;-p4ECPyex_cY&#x2F;TzSalazW2XI&#x2F;AAAAAAAAA2...</a>
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alphaoverlord将近 9 年前
One explanation can be expanding criteria and&#x2F;or earlier diagnosis. Earlier diagnosis, even with the same treatment efficacy, will lead to records of improved survival, and expanding criteria of particular diagnoses will often identify borderline cases that likely don&#x27;t have the same morbidity and mortality.
triadicmonad将近 9 年前
Of course hundreds of probable individual causes can be attributed to this phenomenon. The Galileo of medicine will be the one who can unify and make the data sensible without pretending one or two factors caused it all.
dmix将近 9 年前
Better home food (popularity of brown bread vs white bread), better take out food (not just McDonald&#x27;s and diners anymore), and more indoor working conditions (less exposure to pollution) likely play a big part.
artagnon将近 9 年前
Our genes are somehow improving in quality (survival longevity, quality of life, IQ), and this effect is cascading over generations. I don&#x27;t know if it can be explained using pure epigenetics, and natural evolution is certainly too slow to explain this, so there might be mutagens in our everyday environment that directly modify the DNA sequence. We recognize cigarette smoke, heavy metals as mutagens, but are there more subtle mutagens that lead to better DNA?
dm03514将近 9 年前
Coffee?
mrfusion将近 9 年前
Interesting about the stomach cancer. Makes me wonder if we should be careful about limiting antibiotic usage too far? Perhaps everyone should take a course every five years or so?
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